New DES studies add new understanding about clopidogrel duration, LAD usage, and ISR

Clopidogrel duration:  In a study of nearly 3,000 DES patients, stopping clopidogrel at 30 days or 6 months, but not 12 months,  was associated with stent thrombosis, “thus suggesting,” according to Waksman’s group at the Washington Hospital Center in an article in press in the American Journal of Cardiology, “the optimal duration of therapy for the prevention of ST to be 6 to 12 months.”

DES versus BMS for proximal LAD: One-year clinical outcome in 136 BMS and 350 DES patients were the same, according to another study by Waksman’s group in the February 15 issue of  the American Journal of Cardiology.

DES for the treatment of BMS vs DES ISR: The advent of DES has not eliminated the problem of in-stent restenosis. According to yet another study from Waksman’s group in the February 15 issue of the American Journal of Cardiology, “DES ISR continues to be a therapeutic challenge because patients with DES ISR treated using DESs experience higher rates of recurrence compared with patients with BMS ISR treated using DESs. The optimal treatment of patients with DES restenosis remains to be defined.”

DSCT to detect in-stent restenosis: Dual source computed tomography may help in thenoninvasive detection of ISR, according to a German study published online in the American Journal of Cardiology.

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