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clopidogrel in stroke

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https://www.readbyqxmd.com/read/29154813/one-year-outcomes-of-prasugrel-versus-ticagrelor-in-acute-myocardial-infarction-treated-with-primary-angioplasty-the-prague-18-study
#1
Zuzana Motovska, Ota Hlinomaz, Petr Kala, Milan Hromadka, Jiri Knot, Ivo Varvarovsky, Jaroslav Dusek, Jiri Jarkovsky, Roman Miklik, Richard Rokyta, Frantisek Tousek, Petra Kramarikova, Michal Svoboda, Bohumil Majtan, Stanislav Simek, Marian Branny, Jan Mrozek, Pavel Cervinka, Jiri Ostransky, Petr Widimsky
BACKGROUND: Early outcomes of patients in the PRAGUE-18 study did not find any significant differences between two potent P2Y12 inhibitors. OBJECTIVE: The one-year follow-up of the PRAGUE-18 study focused on (1) a comparison of efficacy and safety between prasugrel and ticagrelor, and (2) on the risk of major ischemic events related to an economically motivated post-discharge switch to clopidogrel. METHODS: A total of 1,230 patients with acute myocardial infarction (MI) treated with primary PCI were randomized to prasugrel or ticagrelor with an intended treatment duration of 12 months...
November 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29151439/clopidogrel-or-ticagrelor-in-acute-coronary-syndrome-patients-treated-with-newer-generation-drug-eluting-stents-change-dapt
#2
Paolo Zocca, Liefke C van der Heijden, Marlies M Kok, Marije M Löwik, Marc Hartmann, Martin G Stoel, J W Louwerenburg, Frits H A F de Man, Gerard C M Linssen, Iris L Knottnerus, Carine J M Doggen, K Gert van Houwelingen, Clemens von Birgelen
AIMS: Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). METHODS AND RESULTS: CHANGE DAPT (clinicaltrials.gov: NCT03197298) assessed 2,062 consecutive real-world ACS patients, treated by percutaneous coronary intervention (PCI), the primary composite endpoint being net adverse clinical and cerebral events (NACCE: all-cause death, any myocardial infarction, stroke or major bleeding)...
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29133611/author-response-risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#3
Yuesong Pan, Yilong Wang, Yongjun Wang
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29133610/letter-re-risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#4
Jose Gutierrez, Tim Lekic
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29132090/the-potential-use-of-transdermal-drug-delivery-for-the-prophylaxis-and-management-of-stroke-and-coronary-artery-disease
#5
REVIEW
Kevin Ita
In 2013, cardiovascular disease was responsible for 30.8% (800,937) of all 2,596,993 deaths, or approximately 1 of every 3 deaths while stroke caused about 1 of every 20 deaths in the United States [1]. To put it in context, about 795,000 people continue to have a new or recurrent stroke (ischemic or hemorrhagic) [1] in the USA. Mechanical vascular recanalization and thrombolysis with tissue plasminogen activator are the only clinically useful approaches available now for the management of ischemic stroke [2]...
June 4, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#6
M Spartalis, E Tzatzaki, E Spartalis, C Damaskos, A Athanasiou, D Moris, M Politou
OBJECTIVE: Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#7
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29129512/thieno-2-3-b-pyridine-derivatives-are-potent-anti-platelet-drugs-inhibiting-platelet-activation-aggregation-and-showing-synergy-with-aspirin
#8
Naif K Binsaleh, Catherine A Wigley, Kathryn A Whitehead, Michelle van Rensburg, Johannes Reynisson, Lisa I Pilkington, David Barker, Sarah Jones, Nina C Dempsey-Hibbert
Drugs which inhibit platelet function are commonly used to prevent blood clot formation in patients with Acute Coronary Syndromes (ACS) or those at risk of stroke. The thieno[3,2-c]pyridine class of therapeutic agents, of which clopidogrel is the most commonly used, target the P2Y12 receptor, and are often used in combination with acetylsalicylic acid (ASA). Six thieno[2,3-b]pyridine were assessed for in vitro anti-platelet activity; all derivatives showed effects on both platelet activation and aggregation, and showed synergy with ASA...
November 7, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29126156/antithrombotic-therapy-after-myocardial-infarction-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#9
Gorav Batra, Leif Friberg, David Erlinge, Stefan James, Tomas Jernberg, Bodil Svennblad, Lars Wallentin, Jonas Oldgren
Aims: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with myocardial infarction and atrial fibrillation is uncertain. In this study, we compared antithrombotic regimes with regard to a composite cardiovascular outcome of all-cause mortality, myocardial infarction or ischaemic stroke and major bleeds. Methods and results: Patients between October 2005 and December 2012 were identified in Swedish registries, n = 7,116...
November 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29126112/risk-scoring-to-guide-anti-platelet-therapy-post-percutaneous-coronary-intervention-pci-for-acute-coronary-syndrome-acs-results-in-improved-clinical-outcomes
#10
S Antoniou, M Colicchia, O Guttmann, K Rathod, P Wright, S Fhadil, C Knight, A K Jain, E J Smith, A Mathur, R Weerackody, A Wragg, D A Jones
Objective: To use the GRACE and CRUSADE scores to risk stratify anti-platelet treatment post Acute Coronary Syndrome (ACS). Methods: This was a prospective registry of 3374 patients undergoing PCI for ACS between 2013-2015 at a UK cardiac centre. Patients with either low GRACE or high CRUSADE risk scores were stratified to clopidogrel therapy otherwise ticagrelor was used. The primary end-point was major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction, stroke, or target vessel revascularization with bleeding rates as a secondary outcome, assessed at a median follow-up of 1...
November 8, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29121759/comparison-of-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-and-non-randomized-studies
#11
Hussam Watti, Khagendra Dahal, Henock G Zabher, Pavan Katikaneni, Kalgi Modi, Abdulrahman Abdulbaki
BACKGROUND: The newer oral P2Y12 receptor antagonists (i.e. prasugrel and ticagrelor) are recommended over clopidogrel for patients with acute coronary syndrome (ACS) going for percutaneous coronary intervention (PCI). As the superiority of one agent over the other remains unclear, we designed a systematic review and meta-analysis of these agents in patients with ACS undergoing PCI. METHODS: PUBMED, EMBASE, Cochrane CENTRAL, CINAHL and manual search were performed through 11/02/2016...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29103068/antiplatelet-therapy-for-secondary-prevention-of-vascular-disease-complications
#12
REVIEW
Rahul R Goli, Mayur M Contractor, Ashwin Nathan, Sony Tuteja, Taisei Kobayashi, Jay Giri
PURPOSE OF REVIEW: Platelets are activated upon interaction with injured vascular endothelium to form a primary hemostatic plug. Pathogenic thrombosis driven by platelet aggregation can occur in the setting of vascular disease leading to ischemic events. The use of antiplatelet agents has become a mainstay for prevention of the secondary complications of vascular disease. This review summarizes seminal and recent literature related to this area. RECENT FINDINGS: Aspirin is a cornerstone of antiplatelet therapy for coronary artery disease and cerebrovascular disease for prevention of myocardial infarction, stroke, and vascular death...
November 4, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29102571/multisite-investigation-of-outcomes-with%C3%A2-implementation-of-cyp2c19-genotype-guided-antiplatelet-therapy-after-percutaneous-coronary-intervention
#13
Larisa H Cavallari, Craig R Lee, Amber L Beitelshees, Rhonda M Cooper-DeHoff, Julio D Duarte, Deepak Voora, Stephen E Kimmel, Caitrin W McDonough, Yan Gong, Chintan V Dave, Victoria M Pratt, Tameka D Alestock, R David Anderson, Jorge Alsip, Amer K Ardati, Brigitta C Brott, Lawrence Brown, Supatat Chumnumwat, Michael J Clare-Salzler, James C Coons, Joshua C Denny, Chrisly Dillon, Amanda R Elsey, Issam S Hamadeh, Shuko Harada, William B Hillegass, Lindsay Hines, Richard B Horenstein, Lucius A Howell, Linda J B Jeng, Mark D Kelemen, Y M Lee, Oyunbileg Magvanjav, May Montasser, David R Nelson, Edith A Nutescu, Devon C Nwaba, Ruth E Pakyz, Kathleen Palmer, Josh F Peterson, Toni I Pollin, Alison H Quinn, Shawn W Robinson, Jamie Schub, Todd C Skaar, D Max Smith, Vindhya B Sriramoju, Petr Starostik, Tomasz P Stys, James M Stevenson, Nicholas Varunok, Mark R Vesely, Dyson T Wake, Karen E Weck, Kristin W Weitzel, Russell A Wilke, James Willig, Richard Y Zhao, Rolf P Kreutz, George A Stouffer, Philip E Empey, Nita A Limdi, Alan R Shuldiner, Almut G Winterstein, Julie A Johnson
OBJECTIVES: This multicenter pragmatic investigation assessed outcomes following clinical implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention (PCI). BACKGROUND: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after PCI. METHODS: After clinical genotyping, each institution recommended alternative antiplatelet therapy (prasugrel, ticagrelor) in PCI patients with a loss-of-function allele...
October 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29101117/double-dose-versus-standard-dose-clopidogrel-according-to-smoking-status-among-patients-with-acute-coronary-syndromes-undergoing-percutaneous-coronary-intervention
#14
Matthias Bossard, Christopher B Granger, Jean-Francois Tanguay, Gilles Montalescot, David P Faxon, Sanjit S Jolly, Petr Widimsky, Kari Niemela, Philippe Gabriel Steg, Madhu K Natarajan, Peggy Gao, Keith A A Fox, Salim Yusuf, Shamir R Mehta
BACKGROUND: Prior Studies have suggested better outcomes in smokers compared with nonsmokers receiving clopidogrel ("smoker's paradox"). The impact of a more intensive clopidogrel regimen on ischemic and bleeding risks in smokers with acute coronary syndromes requiring percutaneous coronary interventions remains unclear. METHODS AND RESULTS: We analyzed 17 263 acute coronary syndrome patients undergoing percutaneous coronary intervention from the CURRENT-OASIS 7 (Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Symptoms) trial, which compared double-dose (600 mg day 1;150 mg days 2-7; then 75 mg daily) versus standard-dose (300 mg day 1; then 75 mg daily) clopidogrel in acute coronary syndrome patients...
November 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29094912/recurrent-ischemic-stroke-strategies-for-prevention
#15
Rupal Oza, Kristen Rundell, Miriam Garcellano
Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke...
October 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29094604/ticagrelor-versus-clopidogrel-in-east-asian-patients-with-acute-coronary-syndromes-a-meta-analysis-of-randomized-trials
#16
Bin Wu, Houwen Lin, Ruoyan Gai Tobe, Le Zhang, Ben He
AIM: To determine whether ticagrelor or clopidogrel provides the best outcomes for East-Asian patients with acute coronary syndrome (ACS). MATERIALS & METHODS: Identification and interrogation of electronic databases through 26 July 2016 revealed fully randomized and controlled trials wherein primary efficacy end points were major adverse cardiovascular events and all-cause death among East-Asian patients with ACS. Major bleeding and noncoronary artery bypass grafts major bleeding were primary safety end points...
November 2, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29092916/use-of-oral-anticoagulants-in-combination-with-antiplatelet-s-in-atrial-fibrillation
#17
Caroline Sindet-Pedersen, Laila Staerk, Morten Lamberts, Thomas Alexander Gerds, Jeffrey S Berger, Anders Nissen Bonde, Jannik Langtved Pallisgaard, Morten Lock Hansen, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
OBJECTIVES: To investigate temporal trends in the use of non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in combination with aspirin and/or clopidogrel in patients with atrial fibrillation (AF) following acute myocardial infarction (MI) and/or percutaneous coronary intervention (PCI). METHODS: Using Danish nationwide registries, all patients with AF who survived 30 days after discharge from MI and/or PCI between 22 August 2011 and 30 September 2016 were identified...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29084062/antiplatelet-therapy-after-stroke-should-it-differ-in-the-acute-and-chronic-phase-after-stroke
#18
Xinyi Leng, Thomas W Leung, K S Lawrence Wong
PURPOSE OF REVIEW: Reviewing existing evidence regarding well tolerated and effective antiplatelet treatment in patients with acute or chronic, noncardioembolic ischemic stroke and transient ischemic attack (TIA). RECENT FINDINGS: For patients with high-risk stroke or TIA, for instance, minor stroke or high-risk TIA, or stroke of atherosclerotic origin with evidence suggesting risk of artery-to-artery embolism or with high-grade, symptomatic arterial stenosis, early initiated, short-term dual antiplatelet (e...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29081978/device-closure-for-patent-foramen-ovale-following-cryptogenic-stroke-a-survey-of-current-practice-in-the-uk
#19
Katherine Von Klemperer, Aleksander Kempny, Christopher William Pavitt, John C Janssen, Anselm Uebing, Edward Nicol
Patent foramen ovale (PFO) closure for cryptogenic stroke remains controversial due to a lack of conclusive randomised controlled data. Many experts feel PFO closure is indicated in selected cases; however, national and international guideline recommendations differ. We surveyed the UK cardiologists, stroke physicians and neurologists, seeking to determine specialist interpretation of the evidence base, and to gain an insight into the current UK practice. The British Cardiac Society and British Society of Stroke physicians distributed our survey which was performed using an online platform...
2017: Open Heart
https://www.readbyqxmd.com/read/29081474/cardiovascular-and-bleeding-risks-in-acute-myocardial-infarction-newly-treated-with-ticagrelor-vs-clopidogrel-in-taiwan
#20
Cheng-Han Lee, Ching-Lan Cheng, Yea-Huei Kao Yang, Ting-Hsing Chao, Ju-Yi Chen, Yi-Heng Li
BACKGROUND: There are few data on ticagrelor in Asian patients. This study evaluated clinical outcomes with ticagrelor and clopidogrel in Taiwanese patients with acute myocardial infarction (AMI).Methods and Results:We used the Taiwan National Health Insurance Research Database to identify 27,339 AMI patients aged ≥18 years between January 2012 and December 2014, and only patients who survived greater than or equal to 30 days after AMI and took dual antiplatelet therapy were included...
October 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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