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clopidogrel in stroke

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https://www.readbyqxmd.com/read/28202699/association-of-multiple-infarctions-and-icas-with-outcomes-of-minor-stroke-and-tia
#1
Yuesong Pan, Xia Meng, Jing Jing, Hao Li, Xingquan Zhao, Liping Liu, David Wang, S Claiborne Johnston, Yilong Wang, Yongjun Wang
OBJECTIVE: To estimate the association of different patterns of infarction and intracranial arterial stenosis (ICAS) with the prognosis of acute minor ischemic stroke and TIA. METHODS: We derived data from the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 1,089 patients from 45 of 114 participating sites of the trial undergoing baseline MRI/angiography were included in this subgroup analysis. Patterns of infarction and ICAS were recorded for each individual...
February 15, 2017: Neurology
https://www.readbyqxmd.com/read/28161565/dual-antiplatelet-therapy-does-not-increase-the-risk-of-bleeding-after-carotid-endarterectomy-results-of-a-prospective-study
#2
Giulio Illuminati, Fabrice Schneider, Giulia Pizzardi, Federica Masci, Francesco G Calio, Jean-Baptiste Ricco
BACKGROUND: The purpose of this study was to evaluate the risk of bleeding and other postoperative complications of carotid endarterectomy (CEA) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From January 2005 to December 2015, 188 consecutive patients undergoing CEA and receiving DAPT (aspirin 100 mg + clopidogrel 75 mg) were enrolled in a prospective study. All of them underwent coronary artery stenting with drug-eluting stents during the 6 months preceding CEA...
February 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28141599/gastrointestinal-hemorrhage-related-to-fluoxetine-in-a-patient-with-stroke
#3
Tze Chao Wee
We report on a patient who developed massive gastrointestinal hemorrhage related to the use of fluoxetine in combination with aspirin and clopidogrel. A 58-year-old man was admitted with a posterior circulation infarct with significant weakness in all four limbs and dysarthria. Aspirin and clopidogrel were started. Fluoxetine was started for pharmacological neurostimulation to promote motor recovery and for low mood. He developed gastrointestinal hemorrhage a week after fluoxetine was started. Fluoxetine was suspended and investigations failed to reveal the source of the bleeding...
January 30, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28135786/the-effect-of-correcting-verifynow-p2y12-assay-results-for-hematocrit-in-patients-undergoing-percutaneous-coronary-interventions
#4
P W A Janssen, T O Bergmeijer, T C Godschalk, T T D Le, N J Breet, J C Kelder, C M Hackeng, J M Ten Berg
BACKGROUND: High on-treatment platelet reactivity is predictive for the occurrence of atherothrombotic events following percutaneous coronary interventions (PCI). A low hematocrit (HCT) value is associated with higher platelet reactivity values expressed in P2Y12 reaction units (PRU) as measured with the VerifyNow P2Y12 assay. However, it is suggested that this is only an in vitro phenomenon. OBJECTIVE: To determine whether adjusting PRU for HCT improves the predictive value for thrombotic events following PCI...
January 30, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28131222/clopidogrel-and-ischemic-stroke-outcomes-by-smoking-status-smoker-s-paradox
#5
Qian Zhang, Yuan Wang, Haiqing Song, Chengbei Hou, Qingyu Cao, Kai Dong, Xiaoqin Huang, Wuwei Feng, Bruce Ovbiagele, Moli Wang, Xunming Ji
BACKGROUND AND PURPOSE: Active smokers with myocardial infarction were shown to have enhanced benefit with clopidogrel compared with aspirin. Whether this "paradox" exists in ischemic stroke patients is unknown. We aimed to investigate whether smoking status has a differential impact on the efficacy of clopidogrel vs. aspirin in patients with non-cardioembolic strokes. METHODS: This single-center study retrospectively assessed 1792 non-cardioembolic ischemic stroke patients discharged from January 2013 to October 2014, and followed for 12months...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28103324/use-of-proton-pump-inhibitors-predicts-heart-failure-and-death-in-patients-with-coronary-artery-disease
#6
Ana María Pello Lázaro, Carmen Cristóbal, Juan Antonio Franco-Peláez, Nieves Tarín, Álvaro Aceña, Rocío Carda, Ana Huelmos, María Luisa Martín-Mariscal, Jesús Fuentes-Antras, Juan Martínez-Millá, Joaquín Alonso, Óscar Lorenzo, Jesús Egido, Lorenzo López-Bescós, José Tuñón
OBJECTIVES: Proton-pump inhibitors (PPIs) seem to increase the incidence of cardiovascular events in patients with coronary artery disease (CAD), mainly in those using clopidogrel. We analysed the impact of PPIs on the prognosis of patients with stable CAD. METHODS: We followed 706 patients with CAD. Primary outcome was the combination of secondary outcomes. Secondary outcomes were 1) acute ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and 2) heart failure (HF) or death...
2017: PloS One
https://www.readbyqxmd.com/read/28091702/platelet-receptor-gene-p2y12-p2y1-and-platelet-glycoprotein-gene-gpiiia-polymorphisms-are-associated-with-antiplatelet-drug-responsiveness-and-clinical-outcomes-after-acute-minor-ischemic-stroke
#7
Xingyang Yi, Qiang Zhou, Chun Wang, Jing Lin, Ping Liu, Cheng Fu
PURPOSE: Patients with minor ischemic stroke (MIS) are at high risk of recurrent ischemic stroke (RIS). The aim of this study was to evaluate the effects of platelet receptor gene (P2Y12, P2Y1) and glycoprotein gene (GPIIIa) polymorphisms, as well as their interactions, on antiplatelet drug responsiveness and clinical outcomes in patients with acute MIS. METHODS: We prospectively enrolled 426 patients with acute MIS who had been receiving combined aspirin and clopidogrel treatment for at least 3 months...
January 13, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#8
RANDOMIZED CONTROLLED TRIAL
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28065908/ticagrelor-but-not-clopidogrel-active-metabolite-displays-antithrombotic-properties-in-the-left-atrial-endocardium
#9
Martin F Reiner, Alexander Breitenstein, Erik W Holy, Martina Glanzmann, Heidi Amstalden, Simon F Stämpfli, Nicole R Bonetti, Volkmar Falk, Stephan Keller, Gianluigi Savarese, Stefano Benussi, Francesco Maisano, Thomas F Lüscher, Jürg H Beer, Jan Steffel, Giovanni G Camici
AIMS: Oral anticoagulation is considered standard therapy for stroke prevention in atrial fibrillation (AF). Endocardial activation triggers expression of pro-thrombotic mediators including tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1), and contributes to thrombus formation in the left atrial appendage (LAA) of AF patients. Recently, pleiotropic effects of specific P2Y12 receptor antagonists were demonstrated; however, whether these drugs possess antithrombotic effects on LAA endocardial cells currently remains unknown...
January 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28064328/pharmacogenetics-of-cyp2c19-genetic-polymorphism-on-clopidogrel-response-in-patients-with-ischemic-stroke-from-saudi-arabia
#10
Adel A Alhazzani, Murali Munisamy, Gauthaman Karunakaran
OBJECTIVE: To elucidate the degree of genetic polymorphisms CYP2C19 (CYP2C19*2, CYP2C19*3) of key drug metabolizing enzymes on the antiplatelet effect of clopidogrel response in patients with acute ischemic stroke from Saudi Arabia. METHODS: A case-control study carried out at Neurology Clinics at Asser Central Hospital, Abha, Kingdom of Saudi Arabia from October 2015 to January 2016 and included 25 stroke patients responding to clopidogrel therapy and 25 stroke patients non responding to clopidogrel monotherapy...
January 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28039577/antiplatelet-strategies-and-outcomes-in-patients-with-noncardioembolic-ischemic-stroke-from-a-real-world-study-with-a-five-year-follow-up
#11
Huimin Xu, Yanting Ping, Haoran Lin, Ping He, Wenlu Li, Haibin Dai
Aspirin and clopidogrel are both acceptable antiplatelet options for the secondary prevention of noncardioembolic ischemic stroke. Associations between Essen Stroke Risk Score (ESRS) and antiplatelet treatment in Chinese patients with noncardioembolic ischemic stroke were assessed. This retrospective study was taken in a tertiary care hospital located in eastern China. Patients with noncardioembolic ischemic stroke hospitalized during January 1, 2009, to December 31, 2011, were classified according to ESRS during index stroke hospitalization...
December 31, 2016: Translational Stroke Research
https://www.readbyqxmd.com/read/28028061/clinical-impact-of-pharmacogenomics-of-clopidogrel-in-stroke
#12
EDITORIAL
Tabassome Simon, Nicolas Danchin
No abstract text is available yet for this article.
January 3, 2017: Circulation
https://www.readbyqxmd.com/read/28024656/validation-of-bleeding-classifications-in-coronary-artery-bypass-grafting
#13
Debora Brascia, Daniel Reichart, Francesco Onorati, Andrea Perrotti, Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Ciro Bancone, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Giuseppe Faggian, Tuomas Tauriainen, Eeva-Maija Kinnunen, Francesco Nicolini, Tiziano Gherli, Stefano Rosato, Fausto Biancari
Perioperative bleeding is a determinant of poor outcome in patients undergoing coronary artery bypass grafting (CABG), but there is a lack of adequate stratification of its severity. The ability of the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Study of Platelet Inhibition and Patient Outcomes (PLATO), Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Syndromes (CURRENT-OASIS 7), Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events (ESSENCE), and SafeTy and Efficacy of Enoxaparin in Percutaneous coronary intervention patients, an internationaL randomized Evaluation (STEEPLE) bleeding classifications to predict early mortality, stroke, acute kidney injury (AKI) stage 3, and deep sternal wound infection/mediastinitis was investigated in 3,730 patients from the prospective, multicentre E-CABG registry...
December 3, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28003013/oral-antiplatelet-and-anticoagulant-agents-in-the-prevention-and-management-of-ischemic-stroke
#14
Shreya Shrestha, Shannon Coy, Kimon Bekelis
Despite numerous advances over the last 50 years, stroke continues to be a leading cause of death and disability worldwide. The treatment and prevention of stroke has undergone extensive study, and significant advances in medical management have occurred within the past decade principally with the development of new classes of orally active anticoagulant drugs. Here we review these recent breakthroughs and the varying roles of anticoagulants and antiplatelet agents in the prevention and management of different ischemic stroke subtypes, as well as describe the benefits and ongoing challenges to incorporating the novel oral anticoagulants (NOACs) into clinical management guidelines...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28002996/oral-antiplatelet-and-anticoagulant-agents-in-the-prevention-and-management-of-ischemic-stroke
#15
Shreya Shrestha, Shannon Coy, Kimon Bekelis
Despite numerous advances over the last 50 years, stroke continues to be a leading cause of death and disability worldwide. The treatment and prevention of stroke has undergone extensive study, and significant advances in medical management have occurred within the past decade principally with the development of new classes of orally active anticoagulant drugs. Here we review these recent breakthroughs and the varying roles of anticoagulants and antiplatelet agents in the prevention and management of different ischemic stroke subtypes, as well as describe the benefits and ongoing challenges to incorporating the novel oral anticoagulants (NOACs) into clinical management guidelines...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27973009/assessment-of-secondary-recurrence-of-stroke-in-aspirin-clopidogrel-combination-therapy-and-aspirin-monotherapy-in-transient-ischemic-attack-patients-in-south-india-a-comparative-study
#16
M Pal, O Prasad, A Fatima, C Bakki, M Ahmed
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27960183/antithrombotic-therapy
#17
Sun U Kwon, Jong S Kim
Symptomatic cerebral atherosclerosis including intracranial atherosclerosis (ICAS) is associated with a high risk of recurrent stroke. Antithrombotic agents are the mainstay of therapy in these patients. Several studies have found anticoagulation (warfarin) to increase the risk of bleeding events and have an efficacy no better than that of aspirin. Therefore, anticoagulants are not widely used unless patients develop recurrent ischemic symptoms despite receiving antiplatelet therapy. Because ICAS progression is not uncommon and the risk of stroke recurrence is high when aspirin monotherapy is used, dual antiplatelet agents may be needed at least in the early disease stage...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27959717/ticagrelor-versus-clopidogrel-in-symptomatic-peripheral-artery-disease
#18
RANDOMIZED CONTROLLED TRIAL
William R Hiatt, F Gerry R Fowkes, Gretchen Heizer, Jeffrey S Berger, Iris Baumgartner, Peter Held, Brian G Katona, Kenneth W Mahaffey, Lars Norgren, W Schuyler Jones, Juuso Blomster, Marcus Millegård, Craig Reist, Manesh R Patel
Background Peripheral artery disease is considered to be a manifestation of systemic atherosclerosis with associated adverse cardiovascular and limb events. Data from previous trials have suggested that patients receiving clopidogrel monotherapy had a lower risk of cardiovascular events than those receiving aspirin. We wanted to compare clopidogrel with ticagrelor, a potent antiplatelet agent, in patients with peripheral artery disease. Methods In this double-blind, event-driven trial, we randomly assigned 13,885 patients with symptomatic peripheral artery disease to receive monotherapy with ticagrelor (90 mg twice daily) or clopidogrel (75 mg once daily)...
5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27939386/impact-of-an-interaction-between-clopidogrel-and-selective-serotonin-reuptake-inhibitors
#19
Katsiaryna Bykov, Sebastian Schneeweiss, Macarius M Donneyong, Yaa-Hui Dong, Niteesh K Choudhry, Joshua J Gagne
Clopidogrel is a pro-drug that requires activation by the cytochrome P450 (CYP) enzyme system. Patients receiving clopidogrel are often treated with selective serotonin reuptake inhibitors (SSRIs) for co-existing depression. SSRIs that inhibit the CYP2C19 enzyme have the potential to reduce the effectiveness of clopidogrel. Using 5 US databases (1998 to 2013), we conducted a cohort study of adults who initiated clopidogrel while being treated with either an SSRI that inhibits CYP2C19 (fluoxetine and fluvoxamine) or a noninhibiting SSRI...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27928736/antiplatelet-agents-in-hemodialysis
#20
REVIEW
Massimiliano Migliori, Vincenzo Cantaluppi, Alessia Scatena, Vincenzo Panichi
Patients affected by cardiovascular disease (CVD) are treated with antiplatelet agents (AA) and/or anticoagulant drugs, which are fundamental in the management of stroke, coronary atherosclerotic disease, peripheral vascular disease and atrial fibrillation. CVD is the most important cause of death in chronic renal failure (CRF). Death rates from myocardial infarction (MI) and from all other cardiac causes exceed those for the general population. Incidence of MI in CRF is triple that in the general population...
December 8, 2016: Journal of Nephrology
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