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During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
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Long-term potent antithrombotic therapy reduces atherothrombotic events after PCI

19 Mar 2020

Long-term treatment with more potent antithrombotic therapy lowers spontaneous atherothrombotic events and prevents complications related to stenting of the culprit lesion following acute coronary syndrome (ACS), suggests a recent study.

“In patients undergoing percutaneous coronary intervention [PCI] for ACS, spontaneous events predominate after 30 days, with the later-phase cardiovascular benefit of potent dual antiplatelet therapy driven largely by reducing de novo atherothrombotic ischaemic events,” the researchers said.

Of the patients included in the TRITON-TMI 38* study, which randomized participants to prasugrel or clopidogrel, 12,844 with ACS received at least one stent. Myocardial infarction (MI) and cardiovascular death were categorized as follows: procedural (related to revascularization); definite or probable stent thrombosis (ST); or spontaneous (non-ST or nonprocedural-related). Median follow-up was 14.5 months.

Of the first events that occurred within 30 days, 584 (69.0 percent) were procedural, 126 (14.9 percent) ST-related and 136 (16.1 percent) spontaneous. After 30 days, 22 (4.7 percent) events were procedural, 63 (13.5 percent) ST-related and 383 (81.8 percent) spontaneous.

Treatment with prasugrel significantly reduced the incidence of MI or cardiovascular death for ST-related (1.0 percent vs 2.1 percent; p<0.001) and spontaneous events (3.9 percent vs 4.8 percent; p=0.012), with a directionally consistent numerical reduction in procedural events (4.4 percent vs 5.1 percent; p=0.078). However, prasugrel led to more spontaneous, but not procedural, major bleeding.

“Recent emphasis on reduced duration and/or intensity of antiplatelet therapy following PCI irrespective of indication for PCI may fail to account for the substantial risk of subsequent nontarget lesion events in ACS patients,” the researchers said.

*Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel–Thrombolysis In Myocardial Infarction 38

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Most Read Articles
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
11 Aug 2020
During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
Rachel Soon, 28 Aug 2020
MOH Director-General Tan Sri Dato' Seri Dr Noor Hisham Abdullah speaks about NHMS 2019 and pharmacists' roles in combating NCDs among Malaysians.
Audrey Abella, 07 Sep 2020
Mavacamten, a first-in-class myosin inhibitor, may be the first targeted therapy to address the underlying cause of obstructive hypertrophic cardiomyopathy (OHCM), the EXPLORER-HCM trial has shown.