Wilfried Dinh: Top 10 Thrombosis And Antithrombotic Therapy Papers Of 2024
Wilfried Dinh, Senior Clinical Program Leader at Boehringer Ingelheim, posted on LinkedIn:
”Top 10 Thrombosis and Antithrombotic Therapy Papers of 2024
A new European Heart Journal review summarizes the most impactful studies of 2024, shaping atrial fibrillation (AF), acute coronary syndromes (ACS), TAVI, pulmonary embolism (PE), and novel anticoagulants.
Key Takeaways by Category
Atrial Fibrillation (AF) and Anticoagulation
– EPIC-CAD Trial → Edoxaban monotherapy (vs. edoxaban + antiplatelet) reduced bleeding in AF + chronic coronary syndrome (CCS)
– FRAIL-AF Trial → Switching elderly frail AF patients from VKA to DOAC increased bleeding – suggests stable patients should stay on VKA
– OPTIMAS Trial → Early DOAC initiation (≤96h) after mild-moderate stroke was safe & effective in AF-related stroke
Acute Coronary Syndrome (ACS) and DAPT
– ULTIMATE-DAPT → Ticagrelor monotherapy from day 30 post-PCI matched ticagrelor + aspirin for efficacy but halved bleeding
– STOPDAPT-3 → 1-month DAPT better than immediate prasugrel monotherapy for ACS or high bleeding risk (HBR) PCI
Transcatheter Aortic Valve Implantation (TAVI)
– PAUSE TAVI Trial → Peri-TAVI oral anticoagulant (OAC) discontinuation reduced bleeding risk without increasing thrombotic events
– ACE-PROTAVI Trial → Routine protamine use post-TAVI reduced bleeding & vascular complications
Pulmonary Embolism (PE) Management
– PEERLESS Trial → Mechanical thrombectomy not superior to catheter-based thrombolysis for intermediate-risk PE
– Meta-Analysis on Home PE Management → Low-risk PE patients had 0.3% mortality with home treatment, reinforcing early discharge strategies
Factor XI Inhibitors: The Future of Anticoagulation?
– AZALEA-TIMI 71 → Abelacimab (FXI inhibitor) reduced bleeding vs. rivaroxaban in AF
– OCEANIC-AF → Asundexian (FXI inhibitor) had excessive stroke risk vs. apixaban, casting doubt on dose selection
Clinical Implications
- DOACs should be started early post-AF stroke
- Shorter DAPT strategies are gaining traction
- Routine anticoagulation may not be needed post-TAVI
- FXI inhibitors show promise but need better dose selection
Which study do you think will have the biggest impact on your practice?
The views and opinions expressed in my posts are solely my own, made in my capacity as a private individual, medical doctor, and researcher. They do not represent or reflect the views, policies, or positions of my employer, colleagues, or any affiliated organizations. My posts are intended for informational and discussion purposes only.”
Read more here.
Title: The year in cardiovascular medicine 2024: the top 10 papers in thrombosis and antithrombotic treatment
Authors: Felicita Andreotti, Jurriën M Ten Berg, Michelle L O’Donoghue
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