December 8, 2017
Since the introduction of direct oral anticoagulants (DOACs) less than a decade ago, use of this class has expanded beyond the prevention and treatment of venous thromboembolism and stroke prevention in the setting of atrial fibrillation. The potential role of DOACs in the secondary prevention of coronary artery disease (CAD) has been of considerable interest. In the setting of CAD, warfarin has resulted in significant more major bleeding when given either alone or in combination with antiplatelet agents when compared to aspirin alone. Therefore, clinicians have been reluctant to embrace the combination of an anticoagulant plus an antiplatelet agent. However, could DOACs have a role in stable CAD? The COMPASS trial aimed to find an answer.
Guest Authors: Candyce Bryant, Pharm.D., Joy Hoffman, Pharm.D., and M. Shawn McFarland, Pharm.D.
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June 10, 2017
For the acute treatment of venous thromboembolism, the direct oral anticoagulants (DOACs) have increasingly replaced injectable anticoagulant therapy followed by warfarin. For patients with an unprovoked deep vein thrombosis or pulmonary embolism who may benefit from long-term extended prophylaxis for the secondary prevention of VTE, the choice is less clear. Should a DOAC be used? If so, which one and what's the best dose? What about low-dose aspirin? Is extended therapy needed at all? The EINSTEIN CHOICE study adds important new insights to the growing body of literature.
Guest Author: Sarah Anderson, PharmD, BCPS
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April 14, 2017
More than 15 million Americans have coronary heart disease and most should be taking aspirin daily. Given aspirin’s ubiquity in cardiovascular medicine and patients’ pill boxes, it is shocking that there are still so many unanswered questions about aspirin use. Which dose and dosage forms should be prescribed? How common is aspirin resistance? What is the relationship between platelet inhibition and clinical outcomes?
Guest Author: Daniela Valencia, Pharm.D.
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March 24, 2017
Many patients with atrial fibrillation (AF) received triple antithrombotic therapy after undergoing a percutaneous coronary intervention (PCI) and receiving cardiac stent. Triple therapy consists of warfarin plus dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor and low-dose aspirin. But is triple therapy the best approach? This practice, while widely employed, is not entirely evidence-based. Moreover, the effectiveness and safety of the direct oral anticoagulants (DOACs) in this patient population is unknown.
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December 22, 2015
Several studies have evaluated the correlation
between low-dose aspirin and NSAID use and the development of colorectal
cancer. In 2007, the U.S. Preventive Services Task Force (USPSTF) recommended against the use aspirin for the
prevention of colorectal cancer in most adults. However, there is
mounting evidence that daily, long-term aspirin use may prevent colorectal
cancer in patients aged 50-69. Could something as simple as an
aspirin a day prevent colon CA?
October 30, 2015
The CHANCE (Clopidogrel
in High risk patients with Acute Non-disabling Cerebrovascular
Events) trial investigators examine whether patients who have a TIA or mini-stroke should receive aspirin AND clopidogrel to reduce the risk of recurrent stroke.
June 21, 2015
Our guests - Dr. Cortney Mospan and Dr. Augustus (Rob) Hough - critically examine the results of the DAPT and PEGASUS-TIMI 54 studies and explain how the results should be applied in practice.