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clopidogrel in stroke

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https://www.readbyqxmd.com/read/27894260/high-platelet-reactivity-affects-the-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention
#1
Jun-Jie Zhang, Xiao-Fei Gao, Zhen Ge, Nai-Liang Tian, Zhi-Zhong Liu, Song Lin, Fei Ye, Shao-Liang Chen
BACKGROUND: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation. METHODS: All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27892890/trial-design-rivaroxaban-for-the-prevention-of-major-cardiovascular-events-after-transcatheter-aortic-valve-replacement-rationale-and-design-of-the-galileo-study
#2
Stephan Windecker, Jan Tijssen, Gennaro Giustino, Ana H C Guimarães, Roxana Mehran, Marco Valgimigli, Pascal Vranckx, Robert C Welsh, Usman Baber, Gerrit-Anne van Es, Peter Wildgoose, Albert A Volkl, Ana Zazula, Karen Thomitzek, Melanie Hemmrich, George D Dangas
BACKGROUND: Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN: GALILEO is an international, randomized, open-label, event-driven, phase III trial in more than 1,520 patients without an indication for oral anticoagulation who underwent a successful TAVR (ClinicalTrials...
October 31, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27867289/amplatzer-cardiac-plug-for-stroke-prevention-in-patients-with-atrial-fibrillation-and-bigger-left-atrial-appendix-size
#3
Yoga Yuniadi, Dicky A Hanafy, Sunu B Raharjo, Ario Soeryo, IIf Yasmina, Amiliana M Soesanto
Left atrial appendage (LAA) dimensions have been shown as an independent predictor of higher risk for stroke in AF patients. Little data exist on the outcomes after LAA closure in patients with nonvalvular atrial fibrillation (NVAF) who have relatively bigger LAA size. This study aims to evaluate the results associated with LAA closure with the Amplatzer cardiac plug (ACP, AGA, St. Jude Medical, Minneapolis, MN) in bigger LAA size. A total of 25 patients with NVAF underwent LAA closure with the ACP device. All patients received short-term (up to 3 months) dual-antiplatelet therapy (clopidogrel and aspirin) after the procedure and aspirin only thereafter...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27865441/long-term-versus-short-term-dual-antiplatelet-therapy-was-similarly-associated-with-a-lower-risk-of-death-stroke-or-infarction-in-patients-with-acute-coronary-syndrome-regardless-of-underlying-kidney-disease
#4
Juan-Jesus Carrero, Christoph Varenhorst, Karin Jensevik, Karolina Szummer, Bo Lagerqvist, Marie Evans, Jonas Spaak, Claes Held, Stefan James, Tomas Jernberg
Scarce and conflicting evidence exists on whether clopidogrel is effective and whether dual antiplatelet treatment (DAPT) is safe in patients with acute coronary syndrome and chronic kidney disease (CKD). To study this, we performed an observational, prospective, multicenter cohort study of 36,001 patients of the SWEDEHEART registry. The exposure was DAPT prolonged after 3 months versus DAPT stopped at 3 months in consecutive patients with acute coronary syndrome and known serum creatinine. DAPT duration with clopidogrel and aspirin was assessed by dispensed tablets...
November 16, 2016: Kidney International
https://www.readbyqxmd.com/read/27850429/791-clopidogrel-decreases-the-risk-of-aspiration-pneumonia-in-patients-with-acute-ischemic-stroke
#5
Tae Jung Kim, Sang-Bae Ko
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27829964/safety-of-dual-antiplatelet-therapy-after-carotid-endarterectomy-for-prevention-of-restenosis-a-single-center-experience
#6
Miguel A Barboza, José Chang, Alvaro Hernández, Emmanuel Martínez, Huberth Fernández, Gerardo Quirós, Johanna Salazar, Allan Ramos-Esquivel, Alberto Maud
INTRODUCTION: The incidence of recurrent carotid stenosis after carotid endarterectomy varies from 1% to 37% with only 0-8% symptomatic restenosis. Safety of short-term (30 days) dual-antiplatelet therapy has not been established in this type of procedure. AIMS: To investigate the safety of dual antiplatelet therapy after carotid endarterectomy to prevent restenosis. METHODS: We retrospectively identified all the patients who underwent carotid endarterectomy (symptomatic or asymptomatic) treated at our center between July 2010 and July 2013 according to local protocols...
October 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27826643/association-between-antithrombotic-treatment-and-hemorrhagic-stroke-in-patients-with-atrial-fibrillation-a-cohort-study-in-primary-care
#7
Per Wändell, Axel C Carlsson, Martin Holzmann, Johan Ärnlöv, Sven-Erik Johansson, Jan Sundquist, Kristina Sundquist
OBJECTIVE: The objective of this study was to study the association between antithrombotic treatment and risk of hemorrhagic stroke (HS) in patients with atrial fibrillation (AF) treated in primary health care. METHODS: Study population included all adults (n = 12,215) 45 years and older diagnosed with AF at 75 primary care centers in Sweden 2001-2007. Outcome was defined as a first hospital episode with a discharge episode of HS after the AF diagnosis. Association between HS and persistent treatment with antithrombotic agents (warfarin, acetylsalicylic acid (ASA), clopidogrel) was explored using Cox regression analysis, with hazard ratios (HRs) and 95 % CIs...
November 8, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27823681/a-comparison-of-reduced-dose-prasugrel-and-standard-dose-clopidogrel-in-elderly-patients-with-acute-coronary-syndromes-undergoing-early-percutaneous-revascularization-design-and-rationale-of-the-randomized-elderly-acs-2-study
#8
Luca A Ferri, Nuccia Morici, Daniele Grosseto, Giovanni Tortorella, Irene Bossi, Paolo Sganzerla, Michele Cacucci, Girolamo Sibilio, Stefano Tondi, Anna Toso, Maurizio Ferrario, Nicola Gandolfo, Amelia Ravera, Matteo Mariani, Elena Corrada, Leonardo Di Ascenzo, Anna Sonia Petronio, Claudio Cavallini, Nadia Moffa, Stefano De Servi, Stefano Savonitto
BACKGROUND: Elderly patients display higher on clopidogrel platelet reactivity as compared with younger patients. Treatment with prasugrel 5mg has been shown to provide more predictable and homogenous antiplatelet effect, as compared with clopidogrel, suggesting the possibility of reducing ischemic events after an acute coronary syndrome (ACS) without increasing bleeding. STUDY DESIGN: The Elderly-ACS 2 study is a multicenter, randomized, parallel-group, open-label trial designed to demonstrate the superiority of a strategy of dual antiplatelet treatment using a reduced 5-mg daily dose of prasugrel over a standard strategy with a daily clopidogrel dose of 75mg in patients older than 74years with ACS (either ST- or non-ST-elevation myocardial infarction) undergoing early percutaneous revascularization...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27818831/safety-and-efficacy-of-acute-clopidogrel-load-in-patients-with-moderate-and-severe-ischemic-strokes
#9
Amir Shaban, Dominique J Monlezun, Natalia Rincon, Jonathan Tiu, Melisa Valmoria, Sheryl Martin-Schild
Objective. To study the safety and efficacy of a clopidogrel loading dose in patients with moderate and severe acute ischemic strokes. Background. The safety of clopidogrel loading has been extensively investigated in patients with minor strokes and transient ischemic attacks. Methods. Acute ischemic stroke patients presenting consecutively to our center from 07/01/08 to 07/31/13 were screened. Clopidogrel loading was defined as at least 300 mg dose (with or without aspirin) given within 6 hours of admission...
2016: Stroke Research and Treatment
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#10
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
November 3, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27811309/baseline-characteristics-of-the-3096-patients-recruited-into-the-triple-antiplatelets-for-reducing-dependency-after-ischemic-stroke-trial
#11
Philip Mw Bath, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Stuart Pocock, Annemarei Ranta, Thompson G Robinson, Katie Flaherty, Polly Scutt, Graham S Venables, Lisa J Woodhouse, Nikola Sprigg
BACKGROUND: The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. DESIGN: The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack...
November 3, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27806998/genetic-polymorphisms-and-clopidogrel-efficacy-for-acute-ischemic-stroke-or-transient-ischemic-attack-a-systematic-review-and-meta-analysis
#12
Yuesong Pan, Weiqi Chen, Yun Xu, Xingyang Yi, Yan Han, Qing-Wu Yang, Xin Li, Li'an Huang, S Claiborne Johnston, Xingquan Zhao, Liping Liu, Qi Zhang, Guangyao Wang, Yongjun Wang, Yilong Wang
BACKGROUND: -The association of genetic polymorphisms and clopidogrel efficacy in patients with ischemic stroke or transient ischemic attack (TIA) remains controversial. We performed a systematic review and meta-analysis to assess the association between genetic polymorphisms, especially CYP2C19 genotype, and clopidogrel efficacy for ischemic stroke or TIA. METHODS: -We conducted a comprehensive search of the PubMed and EMBASE from their inceptions to June 24, 2016...
November 2, 2016: Circulation
https://www.readbyqxmd.com/read/27792656/impact-of-proton-pump-inhibitor-use-on-the-comparative-effectiveness-and-safety-of-prasugrel-versus-clopidogrel-insights-from-the-treatment-with-adenosine-diphosphate-receptor-inhibitors-longitudinal-assessment-of-treatment-patterns-and-events-after-acute-coronary
#13
Larry R Jackson, Eric D Peterson, Lisa A McCoy, Christine Ju, Marjorie Zettler, Brian A Baker, John C Messenger, Douglas E Faries, Mark B Effron, David J Cohen, Tracy Y Wang
BACKGROUND: Proton pump inhibitors (PPIs) reduce gastrointestinal bleeding events but may alter clopidogrel metabolism. We sought to understand the comparative effectiveness and safety of prasugrel versus clopidogrel in the context of proton pump inhibitor (PPI) use. METHODS AND RESULTS: Using data on 11 955 acute myocardial infarction (MI) patients treated with percutaneous coronary intervention at 233 hospitals and enrolled in the TRANSLATE-ACS study, we compared whether discharge PPI use altered the association of 1-year adjusted risks of major adverse cardiovascular events (MACE; death, MI, stroke, or unplanned revascularization) and Global Use of Strategies To Open Occluded Arteries (GUSTO) moderate/severe bleeding between prasugrel- and clopidogrel-treated patients...
October 21, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27781044/clopidogrel-plus-aspirin-for-symptomatic-intracranial-atherosclerotic-stenosis-a-pilot-study
#14
Tareq Kass-Hout, Melanie Winningham, Omar Kass-Hout, Laura Henriquez, Frank Tong, Jacques Dion, Michael Cawley, Samir Belagaje, Michael Frankel, Aaron Anderson, Fadi Nahab
BACKGROUND AND PURPOSE: There are limited data on the optimal duration of dual antiplatelet therapy for secondary stroke prevention in patients with symptomatic intracranial atherosclerotic disease. METHODS: Consecutive patients presenting with high-grade (70-99%) symptomatic intracranial stenosis from January 1, 2011, to December 31, 2013, and evaluated within 30 days of the index event were eligible for this analysis. All patients underwent treatment with aspirin plus clopidogrel for a target duration of 12 months along with aggressive medical management based on the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) protocol; all patients were given gastrointestinal prophylaxis for the duration of their aspirin and clopidogrel treatment...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27776919/ischemic-stroke-in-a-patient-with-moderate-to-severe-inherited-factor-vii-deficiency
#15
Manasa Reddy, Bernard Tawfik, Chakri Gavva, Sean Yates, Nicole De Simone, Sandra L Hofmann, Siayareh Rambally, Ravi Sarode
Thrombosis is known to occur in patients with rare inherited bleeding disorders, usually in the presence of a thrombotic risk factor such as surgery and/or factor replacement therapy, but sometimes spontaneously. We present the case of a 72-year-old African American male diagnosed with congenital factor VII (FVII) deficiency after presenting with ischemic stroke, presumably embolic, in the setting of atherosclerotic carotid artery stenosis. The patient had an international normalized ratio (INR) of 2.0 at presentation, with FVII activity of 6% and normal Extem clotting time in rotational thromboelastometry...
October 17, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27744205/results-of-genotype-guided-antiplatelet-therapy-in-patients-who-undergone-percutaneous-coronary-intervention-with-stent
#16
Jesús Sánchez-Ramos, Cristina Lucía Dávila-Fajardo, Pablo Toledo Frías, Xando Díaz Villamarín, Luis Javier Martínez-González, Susana Martínez Huertas, Francisco Burillo Gómez, Juan Caballero Borrego, Alicia Bautista Pavés, Mª Carmen Marín Guzmán, José Antonio Ramirez Hernández, Concepción Correa Vilches, Jose Cabeza Barrera
BACKGROUND: Clopidogrel has provided beneficial effects in acute coronary syndrome and percutaneous coronary intervention. Different polymorphisms have been associated with differences in clopidogrel response. The aim of this study was to check if CYP2C19/ABCB1-genotype-guided strategy reduces the rates of cardiovascular events and bleeding. METHODS: This experimental study included patients undergoing percutaneous coronary intervention with stent. The prospective genotype-guided strategy (intervention group) was compared against a retrospective non-tailored strategy (control group)...
September 26, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27738237/effect-of-estimated-glomerular-filtration-rate-decline-on-the-efficacy-and-safety-of-clopidogrel-with-aspirin-in-minor-stroke-or-transient-ischemic-attack-chance-substudy-clopidogrel-in-high-risk-patients-with-acute-nondisabling-cerebrovascular-events
#17
Yilun Zhou, Yuesong Pan, Yu Wu, Xingquan Zhao, Hao Li, David Wang, S Claiborne Johnston, Liping Liu, Chunxue Wang, Xia Meng, Yilong Wang, Yongjun Wang
BACKGROUND AND PURPOSE: Patients with chronic kidney disease (CKD) are at a particularly high risk for ischemic and bleeding events. Limited data exist as to the efficacy and safety of clopidogrel in stroke patients with renal dysfunction. Therefore, we sought to assess the impact of decreased kidney function on clinical outcomes for stroke patients on clopidogrel-aspirin treatment. METHODS: Patients in the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) were randomized to clopidogrel-aspirin or aspirin-alone treatment...
November 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27735912/-budget-impact-analysis-of-antiplatelet-therapy-with-ticagrelor-and-clopidogrel-in-patients-with-acute-coronary-syndrome-after-coronary-artery-bypass-surgery
#18
S K Zyryanov, D Yu Belousov, E V Afanas'eva, E V Dumchenko
AIM: Clinical and economic examinations were made to study whether it is appropriate to use antiplatelet therapy (APT) with ticagrelor in combination with acetylsalicylic acid (ASA) versus a combination of clopidogrel and ASA in patients with acute coronary syndrome (ACS) following coronary artery bypass surgery (CABS). MATERIAL AND METHODS: A budget impact analysis was used. Data on the efficiency and safety of APT were taken from a relevant analysis in the subgroups of the randomized controlled trial PLATO...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27715344/pharmacokinetics-and-pharmacodynamics-of-ticagrelor-in-the-treatment-of-cardiac-ischemia
#19
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27663414/factors-associated-with-initial-prasugrel-versus-clopidogrel-selection-for-patients-with-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-insights-from-the-treatment-with-adp-receptor-inhibitors-longitudinal-assessment-of-treatment
#20
Amit N Vora, Eric D Peterson, Lisa A McCoy, Mark B Effron, Kevin J Anstrom, Douglas E Faries, Marjorie E Zettler, Gregg C Fonarow, Brian A Baker, Gregg W Stone, Tracy Y Wang
BACKGROUND: Few studies have examined how antiplatelet therapies are selected during the routine care of acute myocardial infarction patients, particularly relative to the patient's estimated mortality and bleeding risks. METHODS AND RESULTS: We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE-ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection...
September 23, 2016: Journal of the American Heart Association
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