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enoxaparin clopidogrel

Fathima Aaysha Cader, M Maksumul Haq, Sahela Nasrin, Md Rezaul Karim
BACKGROUND: Striking an adequate balance between bleeding risks and prevention of stent thrombosis can be challenging in the setting of percutaneous coronary intervention (PCI) with drug eluting stents (DES) in acute myocardial infarction (MI). This is more pronounced in patients treated with both low molecular weight heparin (LMWH) and dual antiplatelet therapy (DAPT). Prasugrel, a second generation thienopyridine with more potent platelet inhibition capability, is associated with significant bleeding risks...
2016: BMC Cardiovascular Disorders
Edina Cenko, Beatrice Ricci, Sasko Kedev, Oliver Kalpak, Lucian Câlmâc, Zorana Vasiljevic, Božidarka Knežević, Mirza Dilic, Davor Miličić, Olivia Manfrini, Akos Koller, Maria Dorobantu, Lina Badimon, Raffaele Bugiardini
BACKGROUND: The objectives of this study were to evaluate the incidence of no-reflow as independent predictor of adverse events and to assess whether baseline pre-procedural treatment options may affect clinical outcomes. METHODS: Data were derived from the ISACS-TC registry (NCT01218776) from October 2010 to January 2015. No-reflow was defined as post-PCI TIMI flow grades 0-1, in the absence of post-procedural significant (≥25%) residual stenosis, abrupt vessel closure, dissection, perforation, thrombus of the original target lesion, or epicardial spasm...
November 1, 2016: International Journal of Cardiology
Zhanqi Wang, Hongliang Cong, Zheng Li, Lanfang Zhang, Fang Zhang, Xiangxin Li
OBJECTIVE: To investigate the safety of implantation permanent pacemaker (PM) at different times in patients with dual antiplatelet (DAPT) therapy after implantation of drug-eluting stent (DES). METHODS: A total of 105 patients who implanted pacemakers with DAPT therapy (clopidogrel and aspirin) after implantation of DES admitted to our hospital from January 2009 to January 2015 were enrolled in the study. The patients were divided into 3 groups: dual antiplatelet therapy (DAP) group: implanting PM within 3 months after coronary stenting, continuous DAPT during perioperative period; low molecular weight heparin (LMWH) bridging group: implanting PM within 3 to 6 months after coronary stenting, DAPT interruption for 5 days replaced with subcutaneous injection of enoxaparin (1 mg/kg), twice per day, enoxaparin was stopped 12 h before operation; asprin group, implanting PM after coronary stenting 6 months, clopidogrel interruption for 5 days...
May 10, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Luján Iavecchia, Ahmad Safiya, David Salat, Mònica Sabaté, Montse Bosch, Alfons Biarnés, Angels Camps, Dolors Castellà, Pilar Lalueza, Verònica Pons, Jordi Teixidor, Maria M Villar, Antònia Agustí
This study aimed to describe the impact of implementing a protocol on the perioperative management of patients admitted for hip fracture treated with anti-thrombotics. A protocol was designed based on recommendations from the American College of Chest Physicians (ACCP). After its implementation (May 2012), information on anti-thrombotic management was collected from admission to three months after surgery in retrospective (October 2011-March 2012) and prospective (October 2012-March 2013) cohorts. Patients' thromboembolic risk was classified into high, moderate or low according to the ACCP categories...
May 6, 2016: Basic & Clinical Pharmacology & Toxicology
Rajnish K Gupta, Matthew D McEvoy
BACKGROUND AND OBJECTIVES: Decision support tools have been demonstrated to improve adherence to medical guidelines; however, smartphone applications (apps) have not been studied in this regard. In a collaboration between Vanderbilt University and the American Society of Regional Anesthesia and Pain Medicine (ASRA), the ASRA Coags Regional app was created to be a decision support tool for the 2010 published guideline on regional anesthesia for patients receiving anticoagulation. This is a review of the distribution and usage of this app...
May 2016: Regional Anesthesia and Pain Medicine
María Asunción Esteve-Pastor, Diana Hernández-Romero, Mariano Valdés, Francisco Marín
The pathophysiology of acute coronary syndrome (ACS) involves platelet activation and thrombus formation after the rupture of atherosclerotic plaques. Thrombin is generated at the blood-plaque interface in association with cellular membranes on cells and platelets. Thrombin also amplifies the response to the tissue injury, coagulation and platelet response, so the treatment of ACS is based on the combined use of both antiplatelet (such as aspirin, clopidogrel, prasugrel and ticagrelor) and antithrombotic drugs (unfractionated heparin, enoxaparin, fondaparinux and bivalirudin)...
2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Peter R Sinnaeve, Thierry Danays, Kris Bogaerts, Frans Van de Werf, Paul W Armstrong
Elderly patients constitute a large and growing proportion of ST-elevation myocardial infarction (STEMI) patients, yet they have been under-represented or even excluded from reperfusion trials. Despite evidence that fibrinolysis improves outcomes irrespective of age, many elderly STEMI patients still remain undertreated or subject to major delays to primary percutaneous coronary intervention (PCI). The fear of an excessive risk of intracranial hemorrhage (ICH) in these patients can lead to avoidance of potentially life-saving reperfusion treatment, despite the fact that current STEMI guidelines do not exclude the elderly from a pharmaco-invasive strategy...
February 2016: Drugs & Aging
Moussa Abi Ghanem, Elie Saliba, Jihad Irani, Roula Darwish, Nadine Kawkabani, Toni Yared, Charbel Naim, Bassam Abu Khalil
BACKGROUND: Low molecular weight heparins are replacing unfractionated heparin in practice prior to cardiac surgery. This study examines postoperative (post-op) bleeding indicators in patients who received enoxaparin and underwent elective isolated first time coronary artery bypass graft. METHODS: A total of 125 consecutive patients who underwent this procedure between 2009 and 2011 at one tertiary center were reviewed and divided into three groups: Group A (n = 50) received the last dose of enoxaparin between 12 and 24 hours before surgery, Group B (n = 25) received the last dose before 24 hours and Group C (n = 50) did not receive enoxaparin...
October 2015: Le Journal Médical Libanais. the Lebanese Medical Journal
Giuseppe Gargiulo, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
INTRODUCTION: Percutaneous coronary intervention (PCI) is a milestone for treating coronary artery disease (CAD). Antithrombotic therapy is essential to prevent ischemic complications, including the microvascular no-reflow, while minimizing bleeding events. AREAS COVERED: This overview discusses available and developing drugs for PCI including anticoagulants, antiplatelets and treatment of no-reflow. EXPERT OPINION: For years unfractionated heparin (UFH) has been the unique anticoagulant to be used before and during PCI...
2016: Expert Opinion on Pharmacotherapy
Thórir S Sigmundsson, Daníel Arnarson, Arnar Rafnsson, Viðar Magnússon, Gunnar Thór Gunnarsson, Gestur Thorgeirsson
INTRODUCTION: ST-segment Elevation Myocardial Infarction (STEMI) is a life-threatening disease and good outcome depends on early restoration of coronary blood flow. Primary percutaneous coronary intervention (PPCI) is the treatment of choice if performed within 120 minutes of first medical contact (FMC) but in case of anticipated long transport or delays, pre-hospital fibrinolysis is indicated. The aim was to study transport times and adherence to clinical guidelines in patients with STEMI transported from outside of the Reykjavik area to Landspitali University Hospital in Iceland...
January 2016: Læknablađiđ
Vishal R Tandon, Rubeena Maqbool, Iram Kahkashan, Rashmi Sharma, Vijay Khajuria, Zahid Gillani
Combination of aspirin, clopidogrel and enoxaparin remains the standard treatment for acute coronary syndrome (ACS) but is known to increase the incidence of upper gastrointestinal bleed (UGIB). We hereby report an unusual case of gastrointestinal bleed (GIB) as it resulted inspite of proton pump inhibitor (PPI) prophylaxis within the second day of treatment in a post-menopausal woman (PMW) with high first dose of aspirin clopidogrel dual combination in a patient of ACS.
July 2015: Journal of Mid-life Health
J Hernández-García, J J Giménez-Ruiz, J M Dueñas-Jurado
INTRODUCTION: The aim is to evaluate the outcomes obtained from the implementation of a pre-hospital thrombolysis protocol in 3 rural emergency care teams, as well as delays and strategies of reperfusion applied in the treatment of the ST-segment elevation myocardial infarction. MATERIAL AND METHODS: Retrospective cohort study (n=52) with historical control (n=20) of the patients assisted for ST-segment elevation myocardial infarction. Medical emergency care teams, hospital, computerized medical history and ARIAM register reports were revised, obtaining epidemiological and clinical features, off-hospital management, reperfusion, time intervals and mortality...
October 16, 2015: Semergen
Zaher Fanari, Sandra Weiss, William S Weintraub
Acute coronary syndromes (ACS) are associated with high rates of morbidity and mortality. The advances of antiplatelet and anticoagulation therapy over several years time have resulted in improved in cardiac outcomes, but with increased health care costs. Multiple cost-effectiveness studies have been performed to evaluate the use of available antiplatelet agents and anticoagulation in the setting of both ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS)...
December 2015: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Raffaele Bugiardini, Maria Dorobantu, Zorana Vasiljevic, Sasko Kedev, Božidarka Knežević, Davor Miličić, Lucian Calmac, Dijana Trninic, Irfan Daullxhiu, Edina Cenko, Beatrice Ricci, Paolo Emilio Puddu, Olivia Manfrini, Akos Koller, Lina Badimon
OBJECTIVE: We sought explore the relative benefits of unfractionated heparin (UFH) compared with enoxaparin, alone or in combination with clopidogrel, in ST-segment elevation myocardial infarction (STEMI) patients not undergoing reperfusion therapy. METHODS: This is a propensity score study from The International Survey on Acute Coronary Syndromes in Transition Countries (ISACS-TC/NCT01218776) on patients admitted between October 2010-June 2013. There were a total of 1175 STEMI patients who did not receive mechanical or pharmacological reperfusion...
July 2015: Atherosclerosis
Michalis N Gionis, Christos V Ioannou, Nikolaos Kontopodis, Konstantinos Balalis, Ismail Elalamy, Grigoris T Gerotziafas
BACKGROUND: Aim. The aim of this study was to investigate biological resistance to enoxaparin and rebound effect after prophylaxis withdrawal, using thrombin generation (TG) assay. METHODS: Fifteen-patients undergoing femoro-popliteal bypass grafting (enoxaparin 4000 antiXaIU+75 mg clopidogrel), and 15-patients undergoing total-hip-replacement (THR) (enoxaparin alone). TG-assay parameters (lag-time, endogenous-thrombin-potential, peak-, time-to-peak, and Mean-Rate-Index) were assessed to investigate heparin resistance and rebound effect after prophylaxis interruption...
April 2016: International Angiology: a Journal of the International Union of Angiology
Sinan Demirtas, Oguz Karahan, Suleyman Yazıcı, Orkut Guclu, Ahmet Calıskan, Orhan Tezcan, Ibrahim Kaplan, Celal Yavuz
The aim of this study was to investigate whether anticoagulant and antiaggregant agents have protective effects against oxidative damage induced by peripheral ischemia-reperfusion (I/R). Groups were created as follows: control group, I/R group (sham group), I/R plus acetylsalicylic acid (Group I), I/R+clopidogrel (Group II), I/R+rivaroxaban (Group III), I/R+bemiparin sodium (Group IV), and I/R+enoxaparin sodium (Group V). In Groups I, II, III, IV, and V, drugs were administered daily for 1 week before I/R creation...
March 2015: Kaohsiung Journal of Medical Sciences
Mohammad Javad Fatemi, Kamal S Forootan, Seyed Ziaaddin S Jalali, Seyed Jaber Mousavi, Mir Sepehr Pedram
BACKGROUND: Necrosis of skin flaps is considered as an important complication in reconstructive surgery. We conducted an experimental study to investigate the efficacy of low-molecular weight heparin, clopidogrel and their combination to improve the flap survival. METHODS: Forty male, adult Sprague-Dawlay rats were divided randomly into 4 groups. Standard rectangular, distally based dorsal random pattern skin flap was elevated. To prevent the graft effect, a sterile sheet was put under the flap...
July 2012: World Journal of Plastic Surgery
Mohammadreza Farahzadi, Akbar Shafiee, Ali Bozorgi, Mehran Mahmoudian, Saeed Sadeghian
Acute coronary syndromes are considered as a global major health-care problem, and Iran as a developing country is of no exception. We aimed to investigate the degree of adherence to American College of Cardiology and American Heart Association (ACC/AHA) guideline for the management of non-ST-segment elevation myocardial infarction (NSTEMI) in patients who presented to the emergency department at Tehran Heart Center. Data of the patients who presented with acute chest pain to the emergency department of Tehran Heart Center within 1 year and were diagnosed as NSTEMI by the cardiologist in charge were included...
March 2015: Critical Pathways in Cardiology
Xingyang Yi, Wanzhang Chi, Chun Wang, Biao Zhang, Jing Lin
BACKGROUND AND PURPOSE: Dual antiplatelet therapy (DAT) with clopidogrel and aspirin has been shown to confer greater protection against early neurological deterioration (END) and early recurrent ischemic stroke (ERIS) than aspirin alone in patients who have experienced an acute ischemic stroke. However, few studies have compared the effects of anticoagulation therapy with low-molecular-weight heparin (LMWH), DAT, and aspirin. METHODS: Patients with acute ischemic stroke (n=1,467) were randomized to therapy groups receiving aspirin (200 mg daily for 14 days, followed by 100 mg daily for 6 months), DAT (200 mg of aspirin and 75 mg of clopidogrel daily for 14 days, then 100 mg of aspirin daily for 6 months), or LMWH (4,000 antifactor Xa IU of enoxaparin in 0...
January 2015: Journal of Clinical Neurology
Carla Carnovale, Tatiana Brusadelli, Maria Luisa Casini, Francesca Renda, Sara Ruggieri, Giuseppe Pimpinella, Sonia Radice, Emilio Clementi
BACKGROUND: Studies investigating drug-induced anaemia are relatively scarce and mostly related to specific drugs or patients with specific pathologies. OBJECTIVE: To analyse all reports of suspected drug-induced anaemias recorded in the National Pharmacovigilance Database of the Italian Medicines Agency. METHOD: The cases of suspected drug-induced anaemias analysed were those retrieved from the Italian National Pharmacovigilance Database from January 2001 to December 2013...
February 2015: International Journal of Clinical Pharmacy
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