Vorapaxar Has Greater Net Benefit in Patients with Diabetes

Bleeding risks and ischemic benefits were similar in diabetes and nondiabetes groups, but the drug had greater effects overall in diabetes patients because of their elevated cardiovascular risks.

Vorapaxar is a new type of antiplatelet agent that blocks thrombin-induced activation at the protease activated receptor 1. In patients with myocardial infarction (MI), stroke, or peripheral arterial disease (PAD), it reduces subsequent risks for cardiovascular death, MI, and stroke. However, because vorapaxar increases risks for major bleeding, including intracranial hemorrhage (NEJM JW Cardiology May 2012 and N Engl J Med 2012; 366:1404), it is approved in the U.S. only for patients without history of stroke or transient ischemic attack (TIA). To examine vorapaxar's risk and benefit in diabetes mellitus (DM) patients, researchers reanalyzed these earlier, manufacturer-supported study results, focusing on 16,896 patients with an MI history…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)