The AVERROES (Apixaban Versus Acetylsalicylic Acid (ASA) to Prevent Strokes) trial randomized 5600 AF patients who were unable to take warfarin to receive either aspirin or apixaban, a factor Xa inhibitor. (Another trial still underway, ARISTOTLE, is a direct comparison of warfarin and apixaban in AF.) AVERROES was stopped early after the Data Monitoring Committee…

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The EINSTEIN-DVT study tested the effect of the new oral anticoagulant rivaroxaban in the setting of DVT. The open-label, non-inferiority study randomized more than 3,400 patients with acute, symptomatic DVT to either oral rivaroxaban or conventional therapy with enoxaparin followed by warfarin or acenocoumarol for 3, 6, or 12 months, based on the attending physician’s…

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FUTURA (Fondaparinux Trial With Unfractionated Heparin During Revascularization in Acute Coronary Syndromes)/OASIS-8 is the first trial to compare low-dose unfractionated heparin with conventional heparin dosing in PCI patients receiving fondaparinux. Sanjit Jolly and colleagues randomized 2026 non-STEMI high-risk patients undergoing PCI within 72 hours to either low-dose unfractionated heparin or a standard dose of heparin…

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African-Americans are nearly three times more likely than other races to develop stent thrombosis after receiving a drug-eluting stent, according to a new study appearing in Circulation. Ron Waksman and colleagues analyzed data from a large, single-center registry of 7,236 patients who received a DES and found that African-American race was the single strongest predictor…

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“Not all atherothrombosis is equal.” That’s the message from the latest findings of the international REACH (Reduction of Atherothrombosis for Continued Health) registry of more than 45,000 patients with “various manifestations” of atherothrombosis. According to the REACH investigators, “easily demarcated subgroups of atherothrombotic patients had widely varying risks [for future ischemic events], ranging from 7%…

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Genetic substudies across a broad range of large clinical trials that used clopidogrel raise questions about the clinical utility of clopidogrel genotyping. The substudies come from large and important trials like PLATO, TRITON-TIMI 38, CURE, and ACTIVE A. A genetic substudy of PLATO finds that ticagrelor is superior to clopidogrel irrespective of genetic subtype. Therefore,…

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At last year’s ESC meeting, the RE-LY trial heightened interest in the prospect of dabigatran as a potential replacement for warfarin. Now the RE-LY investigators have analyzed the trial data in an attempt to see whether the local standard of care has an impact on the beneficial effects of switching to dabigatran. In a presentation…

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In the SHIFT trial, Karl Swedberg and colleagues tested the effects of ivabradine, a selective sinus-node inhibitor, in 6558 patients with heart failure who had a heart rate ≥70 bpm. After a median 23 months of follow-up, the rate of cardiovascular death or hospital admission for worsening heart failure was 24% in the ivabradine group…

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To test the effect of omega-3 fatty acids in cardiovascular disease, Kromhaut and colleagues with the Alpha Omega Trial Group randomized 4837 patients with a history of MI to treatment with one of four margarine preparations: one containing EPA and DHA; one with ALA; one with EPA, DHA, and ALA; or placebo. After 40 months,…

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The annual meeting of the European Society of Cardiology starts this weekend in Stockholm, and CardioExchange will be there. Associate Editor Anju Nohria will be blogging from the meeting, and I’ll be covering the most important news stories. Here are a few of the most-anticipated, late-breaking clinical trials.