keyword
MENU ▼
Read by QxMD icon Read
search

clopidogrel in stroke

keyword
https://www.readbyqxmd.com/read/28931362/dual-antiplatelet-therapy-is-associated-with-coagulopathy-detectable-by-thrombelastography-in-acute-stroke
#1
Mark M McDonald, Tareq S Almaghrabi, Daniel M Saenz, Chunyan Cai, Mohammad H Rahbar, H Alex Choi, Kiwon Lee, James C Grotta, Tiffany R Chang
BACKGROUND: Thrombelastography (TEG) provides a global, dynamic measure of coagulation. We examined the effect of antiplatelet (AP) medications on coagulation in patients with acute stroke as measured by TEG. METHODS: We reviewed prospectively collected data on patients presenting with acute ischemic stroke (AIS) and spontaneous intracerebral hemorrhage (ICH) between 2009 and 2014. Patient demographics and baseline TEG values were compared among 4 different drug use groups: aspirin only, clopidogrel only, both aspirin and clopidogrel, and no AP...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28921447/structure-pharmacology-and-roles-in-physiology-of-the-p2y12-receptor
#2
Ivar von Kügelgen
P2Y receptors are G-protein-coupled receptors (GPCRs) for extracellular nucleotides. The platelet ADP-receptor which has been denominated P2Y12 receptor is an important target in pharmacotherapy. The receptor couples to Gαi2 mediating an inhibition of cyclic AMP accumulation and additional downstream events including the activation of phosphatidylinositol-3-kinase and Rap1b proteins. The nucleoside analogue ticagrelor and active metabolites of the thienopyridine compounds ticlopidine, clopidogrel and prasugrel block P2Y12 receptors and, thereby, inhibit ADP-induced platelet aggregation...
September 12, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28906384/the-safety-and-efficacy-of-oral-anticoagulants-with-dual-versus-single-antiplatelet-therapy-in-patients-after-percutaneous-coronary-intervention-a-meta-analysis
#3
Jie Chen, Li-Yu Wang, Chao Deng, Xing-Hua Jiang, Tu-Gang Chen
BACKGROUND: A growing number of patients require oral anticoagulant (OAC) after undergoing percutaneous coronary intervention (PCI) with stent implantation due to the development of atrial fibrillation, but the optimal antithrombotic regimen remains controversial in these patients. METHODS: We systematically searched PUBMED, EMBASE, and CENTRAL from inception until September 2016 for randomized controlled trials or cohort studies that evaluated the comparative effects of TT versus DT...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28902590/long-term-outcomes-of-patent-foramen-ovale-closure-or-medical-therapy-after-stroke
#4
RANDOMIZED CONTROLLED TRIAL
Jeffrey L Saver, John D Carroll, David E Thaler, Richard W Smalling, Lee A MacDonald, David S Marks, David L Tirschwell
BACKGROUND: Whether closure of a patent foramen ovale reduces the risk of recurrence of ischemic stroke in patients who have had a cryptogenic ischemic stroke is unknown. METHODS: In a multicenter, randomized, open-label trial, with blinded adjudication of end-point events, we randomly assigned patients 18 to 60 years of age who had a patent foramen ovale (PFO) and had had a cryptogenic ischemic stroke to undergo closure of the PFO (PFO closure group) or to receive medical therapy alone (aspirin, warfarin, clopidogrel, or aspirin combined with extended-release dipyridamole; medical-therapy group)...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28893489/review-of-aspirin-and-clopidogrel-resistance-in-peripheral-arterial-disease
#5
REVIEW
Mina Guirgis, Peter Thompson, Shirley Jansen
OBJECTIVE: Aspirin resistance (AR) and clopidogrel resistance (CR) are terms used to describe a reduction in the medication's efficacy in inhibiting platelet aggregation despite regular dosing. This review gives context to the clinical role and implications of antiplatelet resistance in peripheral arterial disease (PAD). METHODS: A review of English-language literature on AR and CR in PAD involving human subjects using PubMed and MEDLINE databases was performed in April 2017...
September 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28877643/a-case-series-of-18-patients-receiving-ticagrelor-after-carotid-stenting
#6
Elizabeth M Olafson, Jodi R DeGrote, Alexander Drofa, Evgueni Kouznetsov, Michael Manchak, Nathan D Leedahl, David D Leedahl
PURPOSE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor antagonist is often used to prevent thrombotic complications after endovascular stent placement. Most of the published experience surrounding DAPT after carotid stenting is with clopidogrel. Ticagrelor may be a promising alternative, especially in patients who may be considered nonresponders to clopidogrel. However, clinical outcomes utilizing DAPT with ticagrelor in a cohort with carotid stenting is lacking. In this case series, we describe our experience with systematic prescribing of ticagrelor after carotid stent placement in 18 patients...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28875481/proteinuria-predicts-resistance-to-antiplatelet-therapy-in-ischemic-stroke
#7
Gemlyn George, Nikul Patel, Cecilia Jang, David Wheeler, Sridhara S Yaddanapudi, Jonathan Dissin, Ramani Balu, Janani Rangaswami
The occurrence of a stroke while on antiplatelet agents presents a therapeutic dilemma. One of the main causes for recurrent strokes is antiplatelet resistance more commonly known as high on treatment platelet reactivity (HTPR). Prior studies have established that proteinuria is associated with HTPR following myocardial infarction. Here, we investigated whether dipstick proteinuria correlates with HTPR in patients presenting with stroke. We performed a retrospective cohort analysis of 102 patients admitted for a recurrent ischemic stroke that had either a VerifyNow aspirin or VerifyNow clopidogrel laboratory test performed to assess platelet reactivity...
September 5, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28865942/left-atrial-appendage-closure-in-patients-with-intracranial-haemorrhage-and-atrial-fibrillation
#8
F Fayos-Vidal, D Arzamendi-Aizpurua, X Millán-Álvarez, D Guisado-Alonso, P Camps-Renom, L Prats-Sánchez, A Martínez-Domeño, R Delgado-Mederos, J Martí-Fàbregas
INTRODUCTION: The use of oral anticoagulants in patients with a history of atrial fibrillation (AF) and intracranial haemorrhage (ICH) is controversial on account of the risk of haemorrhagic stroke recurrence. This study presents our experience regarding the safety and efficacy of percutaneous left atrial appendage closure (LAAC), an alternative to anticoagulation in these patients. METHODS: We conducted a retrospective, single-centre, observational study. LAAC was performed in patients with a history of ICH and non-valvular AF...
August 30, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28855078/guided-de-escalation-of-antiplatelet-treatment-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-tropical-acs-a-randomised-open-label-multicentre-trial
#9
Dirk Sibbing, Dániel Aradi, Claudius Jacobshagen, Lisa Gross, Dietmar Trenk, Tobias Geisler, Martin Orban, Martin Hadamitzky, Béla Merkely, Róbert Gábor Kiss, András Komócsi, Csaba A Dézsi, Lesca Holdt, Stephan B Felix, Radoslaw Parma, Mariusz Klopotowski, Robert H G Schwinger, Johannes Rieber, Kurt Huber, Franz-Josef Neumann, Lukasz Koltowski, Julinda Mehilli, Zenon Huczek, Steffen Massberg
BACKGROUND: Current guidelines recommend potent platelet inhibition with prasugrel or ticagrelor for 12 months after an acute coronary syndrome managed with percutaneous coronary intervention (PCI). However, the greatest anti-ischaemic benefit of potent antiplatelet drugs over the less potent clopidogrel occurs early, while most excess bleeding events arise during chronic treatment. Hence, a stage-adapted treatment with potent platelet inhibition in the acute phase and de-escalation to clopidogrel in the maintenance phase could be an alternative approach...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28844193/dual-antithrombotic-therapy-with-dabigatran-after-pci-in-atrial-fibrillation
#10
Christopher P Cannon, Deepak L Bhatt, Jonas Oldgren, Gregory Y H Lip, Stephen G Ellis, Takeshi Kimura, Michael Maeng, Bela Merkely, Uwe Zeymer, Savion Gropper, Matias Nordaby, Eva Kleine, Ruth Harper, Jenny Manassie, James L Januzzi, Jurrien M Ten Berg, P Gabriel Steg, Stefan H Hohnloser
Background Triple antithrombotic therapy with warfarin plus two antiplatelet agents is the standard of care after percutaneous coronary intervention (PCI) for patients with atrial fibrillation, but this therapy is associated with a high risk of bleeding. Methods In this multicenter trial, we randomly assigned 2725 patients with atrial fibrillation who had undergone PCI to triple therapy with warfarin plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and aspirin (for 1 to 3 months) (triple-therapy group) or dual therapy with dabigatran (110 mg or 150 mg twice daily) plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and no aspirin (110-mg and 150-mg dual-therapy groups)...
August 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28838471/risk-of-early-adverse-events-after-clopidogrel-discontinuation-in-patients-undergoing-short-term-dual%C3%A2-antiplatelet%C3%A2-therapy-an-individual-participant-data-analysis
#11
Raffaele Piccolo, Fausto Feres, Alexandre Abizaid, Martine Gilard, Marie-Claude Morice, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Deepak L Bhatt, Tullio Palmerini, Gregg W Stone, Stephan Windecker, Marco Valgimigli
OBJECTIVES: The study sought to evaluate the presence of a clinically relevant rebound phenomenon after dual antiplatelet therapy (DAPT) discontinuation in randomized trials. BACKGROUND: It is currently unknown whether clopidogrel discontinuation after short-term DAPT is associated with an early hazard of ischemic events. METHODS: The authors performed an individual participant data analysis and aggregate meta-analysis. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of cardiac death, myocardial infarction (MI), or stroke...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28834792/antiplatelet-treatment-in-diabetic-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-a-greek-antiplatelet-registry-substudy
#12
Michalis Hamilos, Stylianos Petousis, Ioanna Xanthopoulou, John Goudevenos, John Kanakakis, George Sitafidis, Manolis Vavouranakis, Emmanuel Skalidis, George Kochiadakis, John Lekakis, Panos E Vardas, Dimitrios Alexopoulos
BACKGROUND AND AIMS: We compared the clinical outcome of diabetic versus nondiabetic patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) in the GReek AntiPlatElet (GRAPE) registry. PATIENTS AND METHODS: GRAPE is a prospective observational study, focusing on contemporary antiplatelet use in moderate-risk to high-risk ACS patients receiving PCI. Major adverse cardiovascular events (MACE), (composite of death, nonfatal myocardial infarction, urgent revascularization, and stroke) and bleeding events (Bleeding Academic Research Consortium definition) at 1 year of follow-up were analyzed using propensity score adjustment...
August 23, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28830290/emergent-loading-dose-of-antiplatelets-for-stenting-after-iv-rt-pa-in-acute-ischemic-stroke-a-feasibility-study
#13
Yun-Fei Han, Qi-Liang Dai, Xiang-Liang Chen, Yun-Yun Xiong, Qin-Yin, Ge-Lin Xu, Wu-Sheng Zhu, Ren-Liang Zhang, Min-Min Ma, Wen-Hua Liu, Xin-Feng Liu
BACKGROUND: A loading dose of antiplatelets reduces in-stent thrombosis after stent implantation. However, whether it is safe in patients undergoing acute stenting after intravenous recombinant tissue plasminogen activator (rt-PA) is unclear. METHODS: A case series of acute ischemic stroke patients treated with intravenous rt-PA followed by emergent stenting were prospectively included in Jinling Hospital Stroke Unit. An emergent loading dose of antiplatelets (aspirin 300mg and clopidogrel 300mg) were administered to all patients through a nasogastric tube immediately before stenting...
August 23, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28826995/effects-with-and-without-clopidogrel-loading-treatment-for-acute-ischemic-cerebrovascular-disease-patients-a-retrospective-cohort-study
#14
Yasuko Ikeda-Sakai, Masahiro Sasaki, Taizen Nakase
OBJECTIVES: We investigated the effectiveness of clopidogrel loading (CL) treatment compared with usual clopidogrel non-loading (NL) treatment for acute ischemic cerebrovascular disease. METHODS: We screened consecutive 1072 patients with ischemic cerebrovascular disease within 48 hours of symptom onset admitted to our hospital. Eligible patients were divided into the CL group (300 mg on day 1, followed by 50-75 mg once daily) and NL group (50-75 mg once daily)...
August 18, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#15
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28818261/contemporary-medical-therapies-of-atherosclerotic-carotid-artery-disease
#16
REVIEW
Suk F Cheng, Martin M Brown
Contemporary medical therapy consists of identification and treatment of all patient-modifiable vascular risk factors. Specific atherosclerotic disease therapies are designed to reduce the risk of thrombosis, and the disease progression in order to reduce the risk of future cardiovascular events. Contemporary medical management emphasizes the need to support the patient in achieving lifestyle modifications and to adjust medication to achieve individualized target values for specific quantifiable risk factors...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818254/medical-treatment-strategies-to-reduce-perioperative-morbidity-and-mortality-after-carotid-surgery
#17
REVIEW
A Ross Naylor
There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. There is emerging evidence that early implementation of dual antiplatelet therapy in recently symptomatic patients (aspirin 75 mg plus clopidogrel 75 mg) can reduce recurrent cerebral events before CEA and that dual antiplatelet therapy will significantly reduce stroke due to early postoperative carotid thrombosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#18
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28809046/platelet-transfusion-to-reverse-antiplatelet-therapy-before-decompressive-surgery-in-patients-with-intracranial-haemorrhage
#19
M Baschin, S Selleng, J-P Zeden, A Westphal, T Kohlmann, H W Schroeder, A Greinacher, T Thiele
BACKGROUND: Platelet concentrates (PC) are transfused to improve primary haemostasis before urgent neurosurgery in patients with intracranial haemorrhage (ICH) receiving antiplatelet therapy (APT). It is unresolved, whether PCs increase the risk for major cardio- and cerebrovascular adverse events. We evaluated a standardized transfusion regimen to reverse APT in patients with ICH who required decompressive neurosurgery. METHODS: Analysed were consecutive patients between 2012 and 2014...
August 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28783201/validation-of-the-dapt-score-in-patients-randomized-to-6-or-12-months-clopidogrel-after-predominantly-second-generation-drug-eluting-stents
#20
Yukinori Harada, Jonathan Michel, Raphaela Lohaus, Katharina Mayer, Roberto Emmer, Anna Lena Lahmann, Roisin Colleran, Daniele Giacoppo, Annabelle Wolk, Jurrien M Ten Berg, Franz-Josef Neumann, Yaling Han, Tom Adriaenssens, Ralph Tölg, Melchior Seyfarth, Michael Maeng, Bernhard Zrenner, Claudius Jacobshagen, Jochen Wöhrle, Sebastian Kufner, Tanja Morath, Tareq Ibrahim, Isabell Bernlochner, Marcus Fischer, Heribert Schunkert, Karl-Ludwig Laugwitz, Julinda Mehilli, Robert A Byrne, Adnan Kastrati, Stefanie Schulz-Schüpke
The DAPT score is a recently-proposed decision tool for guiding optimal duration of dual antiplatelet therapy (DAPT). It showed modest accuracy in prior derivation and validation cohorts of patients with ≥12 months DAPT. This study was aimed to evaluate the validity of the DAPT score in a cohort of patients with 6 or 12 months DAPT after implantation of predominantly second-generation drug-eluting stents. We analyzed data of patients enrolled in the ISAR-SAFE trial. Patients were classified into low (<2) or high (≥2) DAPT score groups...
July 27, 2017: Thrombosis and Haemostasis
keyword
keyword
105981
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"