Antiplatelet and Anticoagulation Therapies
This channel includes news and new technology innovations for cardiovascular pharmaceutics. This includes antiplatelet agents, anticoagulation drugs, international normalized ratio (INR) testing, oral anticoagulants, IV administered drugs such as Heprin, and dual antiplatelet therapy (DAPT). The most commonly used anticoagulant is warfarin, which available in generic form at a low cost. However, it has a narrow therapeutic window and its effectiveness is altered by food containing vitamin K. To regulate warfarin, regular INR testing is needed. The newer anticoagulation drugs are referred to as novel oral anticoagulant (NOAC). However, since some of these drugs are now more than six years old, they are commonly referred to as non-vitamin K oral anticoagulant (NOAC), and the newest term, direct oral anticoagulant (DOAC). NOAC or DOAC agents have much larger therapeutic windows, do not require INR testing. Aspirin and clopidogrel (Plavix) are the most commonly used antiplatelet agents for the prevention of heart attacks and stroke. They are often prescribed together as DAPT.
The Boston Scientific Synergy stent uses a unique abluminal, bioresorbable drug-carrier polymer that dissolves after the vessel wall has healed months after the stent is implanted. Stent polymers have been implicated in cases of late-stent thrombosis, which required patients with DES to stay on dual antiplatelet therapy (DAPT). This study looked at using the device as a way to shorten DAPT duration.
The VOYAGER PAD trial showed patients with symptomatic peripheral artery disease (PAD) who took the blood thinner rivaroxaban with aspirin after undergoing a procedure to treat blocked arteries in the leg had a 15 percent reduction in the risk of major adverse limb and cardiovascular events when compared with those receiving aspirin alone.
EchoPixel showed technology at TCT 2019 that creates live holograms in the cath lab from 3-D TEE imaging. It projects the holograms on a special display screen that does not require the user to wear 3-D glasses. The interventional cardiologist can use hand movements and a foot switch to move the image around without breaking the sterile field. It offers a new way to visualize catheters, device positioning and deployment in structural heart procedures. (Photos by Dave Fornell)