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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EThe results of the multicenter TAXUS Libert\u00e9 Post Approval Study [TL-PAS] are discussed in this article. Patients randomized in this prospective open-label study were also participants in the Dual Antiplatelet Therapy Study. While the TL-PAS was not powered to show a difference in the end point analyses, the results from this specific trial were presented.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Einterventional techniques \u0026amp; devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ethrombotic disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EThe results of the multicenter TAXUS Libert\u00e9 Post Approval Study [TL-PAS; Garratt KN et al. \u003Cem\u003ECirculation.\u003C\/em\u003E 2014] were presented by Kirk Garratt, MD, Lenox Hill Hospital, New York, New York, USA. Patients randomized in this prospective open-label study were also participants in the Dual Antiplatelet Therapy Study [Mauri L et al. \u003Cem\u003ENew Eng J Med.\u003C\/em\u003E 2014]. While the TL-PAS was not powered to show a difference in the end point analyses, the results from this specific trial were presented.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EEligible patients had a TAXUS Libert\u00e9 paclitaxel-eluting stent placed and then took open-label aspirin plus prasugrel for 12 months after the index procedure [Garratt KN et al. \u003Cem\u003ECirculation.\u003C\/em\u003E 2014]. At the end of 12 months, patients were randomized to blinded prasugrel (30-month group) or placebo (12-month group) plus open-label aspirin for another 18 months. Thirty months after the index event, blinded study medication was stopped, and the patients took aspirin for \u2265 3 months.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe co-primary efficacy end points were the occurrence of major adverse cardiac and cerebrovascular events (defined as the composite of death, myocardial infarction [MI], or stroke) and stent thrombosis (ST) occurring between 12 and 30 months after the index procedure. The primary safety end point was major bleeding occurring between 12 and 30 months after the index procedure (defined as \u003Cem\u003Emoderate\u003C\/em\u003E or \u003Cem\u003Esevere\u003C\/em\u003E by GUSTO criteria).\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOf the 2191 randomized patients, about 75% were men, and the mean age was approximately 59 years; \u0026gt;96% were aged \u0026lt; 75 years and weighed \u0026gt; 60 kg.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAt 540 days after randomization, patients in the 30-month prasugrel group had a significantly lower rate in the co-primary composite end point of death, MI, or stroke when compared with the 12-month group (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). This difference was also significant at the 90-day postrandomization time point (\u003Cem\u003EP\u003C\/em\u003E = .002). The co-primary end point of ST was also lower in patients taking prasugrel for 30 months versus the 12-month group.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/52\/10\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Co\u0026#x2014;Primary End Point: Major Adverse Cardiac and Cerebrovascular Events at 540 Days\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1950495423\u0022 data-figure-caption=\u0022Co\u0026#x2014;Primary End Point: Major Adverse Cardiac and Cerebrovascular Events at 540 Days\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/52\/10\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/52\/10\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/52\/10\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15193\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003ECo\u2014Primary End Point: Major Adverse Cardiac and Cerebrovascular Events at 540 Days\u003C\/p\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EASA, acetylsalicylic acid (aspirin); MACCE, major adverse cardiac and cerebrovascular event.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003E\n               \u003Csup\u003Ea\u003C\/sup\u003E\u00b11.5 SE.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-3\u0022\u003E\n               \u003Csup\u003Eb\u003C\/sup\u003EHR, 0.303; 95% CI, 0.137 to 0.670; \u003Cem\u003EP\u003C\/em\u003E =.002.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-4\u0022\u003E\n               \u003Csup\u003Ec\u003C\/sup\u003EHR, 0.407; 95% CI, 0.281 to 0.589; \u003Cem\u003EP\u003C\/em\u003E \u0026lt;.001.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-5\u0022\u003E\n               \u003Csup\u003Ed\u003C\/sup\u003EHR, 0.591; 95% CI, 0.431 to 0.811; \u003Cem\u003EP\u003C\/em\u003E \u0026lt;.001.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-6\u0022\u003EAdapted from Garratt KN et al. Prasugrel plus aspirin beyond 12 months is associated with improved outcomes after Taxus Libert\u00e9 paclitaxel-eluting coronary stent placement. \u003Cem\u003ECirculation.\u003C\/em\u003E 2015. E-pub ahead of print. DOI: 10.1161\/CIRCULATIONAHA.114.013570. Accessed December 10, 2014. With permission from American Heart Association, Inc.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EThere were no significant differences in the rates of stroke or death, but patients in the 30-month group had significantly fewer MIs (\u003Cem\u003EP\u003C\/em\u003E \u0026lt;.001). An increase in major bleeds was observed with prolonged prasugrel therapy, but the increase was not statistically significant, and the rate of severe bleeds was not higher in the 30-month treatment group. An important finding was that stopping prasugrel appeared to result in a loss of protection, as an increase in ischemic events was seen within 90 days of discontinuation in both arms. Key effectiveness and safety study results are presented in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15194\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15194\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15194\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EKey TL-PAS Results at 540 Days Postrandomization\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-12\u0022\u003EDr Garratt noted that the trial has several limitations. Patients with a history of prior cerebrovascular or active bleeding events were excluded, and those patients who were randomized had demonstrated tolerance to prasugrel for 12 months. In addition, elderly patients or those with a lower body mass may have been under-represented. However, these data demonstrate that long-term prasugrel reduces ischemic events while increasing the risk of bleeding. Furthermore, these data provide additional evidence that cessation of antiplatelet agents increases the short-term risk of ischemic events during the period immediately following cessation of therapy.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/52\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzocb1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzocb1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzocb1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}