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clopidogrel in stroke

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https://www.readbyqxmd.com/read/28317790/clinical-events-beyond-one-year-after-an-acute-coronary-syndrome-insights-from-the-reclose-2-acs-study
#1
Guido Parodi, Benedetta Bellandi, Giuseppe Tarantini, Fernando Scudiero, Renato Valenti, Rossella Marcucci, Angela Migliorini, Niccolò Marchionni, Anna Maria Gori, Chiara Zocchi, David Antoniucci
AIMS: The optimal duration of dual antiplatelet therapy after an acute coronary syndrome (ACS) is still unknown and debated. We sought to assess the incidence of adverse clinical events beyond 12 months after an ACS in patients treated by percutaneous coronary intervention (PCI) and clopidogrel. METHODS AND RESULTS: Among 1,592 consecutive ACS patients treated by PCI enrolled in the RECLOSE 2-ACS study and without event within one year, 1,310 (82%) patients presented at least one risk factor such as age ≥65 years, diabetes, prior myocardial infarction (MI), chronic kidney disease and multivessel coronary disease...
March 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#2
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28289237/impact-of-glycemic-control-on-efficacy-of-clopidogrel-in-transient-ischemic-attack-or-minor-stroke-patients-with-cyp2c19-genetic-variants
#3
Yi Lin, Anxin Wang, Jiejie Li, Jinxi Lin, David Wang, Xia Meng, Lixian Ou, Weiqi Chen, Xingquan Zhao, Liping Liu, Yilong Wang, Yongjun Wang
BACKGROUND AND PURPOSE: Dysglycemia may influence the predictive value of CYP2C19 loss-of-function allele for clinical efficacy of antiplatelet drug, but the role of glycated albumin (GA) remains unclear in patients with stroke on antiplatelet drugs. METHODS: The CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) included 2933 patients who had GA levels and CYP2C19 genotyping. Cox proportional hazards model was used to assess the interaction between CYP2C19 loss-of-function allele (*2, *3) carrier status and the effect of antiplatelet therapy based on their GA levels...
March 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28277861/state-transition-model-vorapaxar-added-to-standard-antiplatelet-therapy-to-prevent-thrombosis-post-myocardial-infarction-or-peripheral-artery-disease
#4
Mark Du, Monica Chase, Mustafa Oguz, Glenn Davies
OBJECTIVE: To evaluate long-term health benefits and risks of adding vorapaxar (VOR) to the standard care antiplatelet therapy (SC) of aspirin and/or clopidogrel, among a population with a recent myocardial infarction (MI) and/or peripheral artery disease (PAD). RESEARCH DESIGN AND METHODS: In a state-transition model, patients transition between health states (event-free, recurrent MI, stroke, death), while at risk of experiencing non-transition-related revascularization and non-fatal bleeding events...
March 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28257284/pharmacogenomics-and-tailored-polypharmacy-an-80-year-old-lady-with-rosuvastatin-associated-rhabdomyolysis-and-maprotiline-related-ogilvie-s-syndrome%C3%A2
#5
Katherina B Sreter, Blazenka Barisic, Sanja Popovic-Grle
What is known and objectives: Multiple adverse drug reactions (ADRs) are expected, and thus should be prevented in the elderly comorbid patient on polypharmacy. Rosuvastatin is commonly prescribed for the treatment and prevention of atherosclerotic diseases, and in rare cases, is associated with rhabdomyolysis. Maprotiline is a tetracyclic antidepressant, infrequently used in the United States, but seemingly more broadly in European countries. Acute colonic pseudo-obstruction (Ogilvie's syndrome) caused by maprotiline has thus far, to our knowledge, not yet been described in the literature...
March 3, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28247292/design-and-development-of-clopidogrel-bisulfate-gastroretentive-osmotic-formulation-using-quality-by-design-tools
#6
Nilesh Desai, Ravindra Purohit
Clopidogrel bisulfate (CBS) is antiplatelet drug and it is becoming a drug of choice in the treatment and management of prevention of heart attacks and strokes. CBS is stable and soluble in acidic pH; therefore, retention in stomach for prolonged period appears to be beneficial for controlling the bioavailability. The gastroretentive osmotic system (GROS) facilitates prolonged retention of drug in stomach and provides zero-order drug release. A complex formulation like GROS poses many challenges, and QbD tools can help in designing robust formulation which takes all aspects of product and process development in order to deliver a robust product...
February 28, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28202699/association-of-multiple-infarctions-and-icas-with-outcomes-of-minor-stroke-and-tia
#7
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...
March 14, 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
#8
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 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28141599/gastrointestinal-hemorrhage-related-to-fluoxetine-in-a-patient-with-stroke
#9
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
#10
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
Essentials Platelet reactivity is correlated with thrombotic risk after percutaneous coronary intervention (PCI). Hematocrit (HCT) is associated with platelet reactivity as measured with the VerifyNow P2Y12 assay. We tested a formula proposed to correct VerifyNow measurements for HCT in 978 PCI patients. Correcting platelet reactivity for HCT did not improve the prediction of thrombotic events after PCI. SUMMARY: Background High on-treatment platelet reactivity is predictive for the occurrence of atherothrombotic events following percutaneous coronary interventions (PCIs)...
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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