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Anees Musallam, Eli I Lev, Ariel Roguin
We describe, to the best of our knowledge, the first incidence of stent thrombosis in a patient treated with ticagrelor, who exhibited high on-treatment platelet reactivity (HTPR) according to platelet reactivity testing. He was on clopidrogel and tested for platelet reactivity using the VerifyNow P2Y12 assay. The test showed a PRU of 249 and only 12% platelet inhibition. The patient was then switched to ticagrelor, with a loading dose of 180 mg given. The patient had stent thrombosis three weeks later with an acute myocardial infarction (MI)...
February 2015: European Heart Journal. Acute Cardiovascular Care
Nat Dumrongmongcolgul, Charoen Mankongpaisarnrung, Grerk Sutamtewagul, Nattamol Hosiriluck, Timothy Chen, Alexander Trujillo, Nicholas Dcunha, Kenneth Nugent, Leigh Ann Jenkins
The etiology of thrombocytosis can be classified into reactive and essential forms. The rate of thromboembolic events is higher in essential thrombocytosis, and these events include strokes, transient ischemic attacks, retinal artery or retinal vein occlusions, digital ischemia, and acute coronary syndrome. In a study of 732 medical and surgical patients with thrombocytosis, 88% had reactive thrombocytosis. Patients with reactive thrombocytosis do not require cytoreductive medications or antiplatelet treatment...
2013: Case Reports in Cardiology
Priscilla Bevan, Ashvini Menon, Richard Bunton
Spontaneous chest wall hematoma is rare and has been associated with neoplasms and arteriovenous malformations. However, the increasing use of anticoagulant and antiplatelet agents has increased the clinical presentation of spontaneous hematomas. Clopidrogel and aspirin are antiplatelet agents widely used in the treatment of peripheral vascular, cerebrovascular, and coronary artery disease. Although bleeding is a known adverse effect, only a small number of cases of hematomas associated with antiplatelet agents have been described...
February 2014: Canadian Journal of Cardiology
I V Maev, A A Samsonov, V A Godilo-Godlevskiĭ, D N Andreev, D T Dicheva
Current clinical practice lays special emphasis on drug interactions. High rates of cardiovascular morbidity and acid-dependent diseases dictates the necessity of antiaggregation and antisecretory therapy. The former uses a variety of medicines with acetylsalicylic acid (ASA) and clopidogrel being the most popular ones. Therapy using drugs with different mechanisms of action on the thrombocytic component of homeostasis appears to be especially promising as having synergic antiplatelet effect. The most common variant of antiplatelet therapy is a combination of ASA and clopidogrel usually referred to as double antiplatelet therapy (DAP)...
2013: Klinicheskaia Meditsina
G Guarnieri, A Lavanga, F Granato, P Vassallo, C Cavaliere, E Capobianco, R Izzo, G Ambrosanio, M Muto
This paper illustrates two cases of stent-in-stenting treatment of unruptured, symptomatic, fusiform intracerebral aneurysms. Two unruptured symptomatic fusiform intracerebral aneurysms were treated by the stent-in-stent only technique. The first patient, a 35-year-old woman, had a partially thrombosed fusiform aneurysm in the left carotid siphon with the chief complaint of headache and left ophthalmoplegia. The second patient, a 60-year-old man, had a symptomatic fusiform aneurysm of the left V4 with recurrent transient ischemic attacks...
June 2010: Neuroradiology Journal
Amir Gal-Oz, Yehuda G Wolf, Galia Rosen, Haggai Sharon, Idit F Schwartz, Gil Chernin
BACKGROUND: The Chimney graft (CG) procedure is one of the novel modification techniques of the endovascular aneurysm repair (EVAR) surgery to treat suprarenal and juxtarenal abdominal aortic aneurysms. Other indications for the use of CG placement include thoracic and thoracoabdominal aneurysms with supraortic branches orifice involvement and cases of common iliac artery aneurysms with or without internal iliac artery involvement. The technique is used in patients who due to aortic-neck morphology and lack of adequate fixation and/or sealing zones are not eligible for standard EVAR...
March 26, 2013: BMC Nephrology
Ying-Hua Li, Hong-Wu Xu, Liu-Xue Zhang
The reaction between methyl (R)-2-(2-chloro-phen-yl)-2-hy-droxy-acetate and 3-nitro-benzene-sulfonyl chloride gave the title compound, C(15)H(12)ClNO(7)S, which is a promising inter-mediate for the synthesis of Clopidrogel, an anti-platelet drug used in the prevention of strokes and heart attacks. In the crystal, mol-ecules are linked through C-H⋯O interactions, and there is also a short Cl⋯O contact present [Cl⋯O = 3.018 (2) Å].
June 1, 2012: Acta Crystallographica. Section E, Structure Reports Online
D Alexopoulos, A Panagiotou, I Xanthopoulou, D Komninakis, G Kassimis, P Davlouros, C Fourtounas, D Goumenos
BACKGROUND: High on-treatment platelet reactivity (HTPR) is frequent in patients on hemodialysis (HD) receiving clopidrogel. OBJECTIVES: The primary aim of this study was to determine the antiplatelet effects of prasugrel vs. high-dose clopidogrel in patients on HD with HTPR. PATIENTS/METHODS: We performed a prospective, single-center, single-blind, investigator-initiated, randomized, crossover study to compare platelet inhibition by prasugrel 10 mg day(-1) with that by high-dose 150 mg day(-1) clopidogrel in 21 patients on chronic HD with HTPR...
December 2011: Journal of Thrombosis and Haemostasis: JTH
Rachel Thompson
No abstract text is available yet for this article.
June 2011: Nature Reviews. Gastroenterology & Hepatology
C Büning, M Zeitz
Luminal inflammation of the intestine is a trigger of numerous gastrointestinal and non-gastrointestinal diseases. Several mechanisms have an impact on luminal inflammation, such as antibiotic or immunosuppressive therapies. In this paper recent data and new therapeutic approaches are reported concerning gastrointestinal and non-gastrointestinal diseases, for example eosinophilic esophagitis, irritable bowel syndrome, Crohn's disease and hepatic encephalopathy. In addition, recommendations are provided for the concurrent medication with proton pump inhibitors (PPIs) with respect to cardiovascular and gastrointestinal complications in patients in whom dual antiplatelet therapy including clopidrogel is indicated...
June 2011: Deutsche Medizinische Wochenschrift
Ophir Schein, Omer Wolf, Moshe Westreich, Avshalom Shalom
BACKGROUND: Many patients undergoing cutaneous surgery are treated with aspirin due to its proven advantages. Discontinuation of aspirin prior to surgery is still controversial. We conducted a large-scale, prospective study to evaluate the safety of dermatologic surgery in patients receiving aspirin. OBJECTIVES: The authors' objectives were to evaluate the complication rate in patients undergoing cutaneous surgery while treated with aspirin. METHODS: All patients operated on solely by one plastic surgeon were included in the study...
April 2010: Harefuah
Z Monhart, H Grünfeldová, P Janský, J Zvárová, V Faltus
INTRODUCTION: The aim of this research was to describe (demographic data and cardiovascular disease risk factors) a non-selected patient population with acute myocardial infarction and to evaluate the applied diagnostic and therapeutic approaches. PATIENTS AND METHODS: Data on 3,184 cases of acute myocardial infarction from non-PCI hospitals in Cáslav, Chrudim, Jindrichův Hradec, Kutná Hora, Písek and Znojmo were entered in a pilot register between 2003 and 2007...
January 2010: Vnitr̆ní Lékar̆ství
Mehmet Akbulut, Makbule Kutlu, Yilmaz Ozbay, Veli Polat, Mehmet Nail Bilen, Adil Baydas, Yakup Altas
We investigated the effects of clopidogrel on reperfusion and inflammatory process in STEMI. A total of 175 STEMI patients with similar clinical characteristics were included to this study. One was the standard pharmacological reperfusion therapy group (group 1, n : 90), who received 300 mg aspirin, 70 U/kg bolus, and 12 U/kg/hr continuous infusion of unfractioned heparin and accelerated t-PA. Clopidogrel 450 mg loading and 75 mg/d thereafter was added to standard reperfusion therapy in the other group (group 2, n : 85)...
2009: Mediators of Inflammation
Hennie Lombaard, Priya Soma-Pillay, El-Marie Farrell
The most important causes of acute collapse in pregnancy are pulmonary embolism, amniotic fluid embolism, acute coronary syndrome, thrombosed mechanical prosthetic heart valves, acute aortic dissection, cerebrovascular incidents and anaesthetic complications like failed intubation, anaphylaxis, and problems relating to regional or local anaesthetic agents. The management is based on supporting the different organ systems that are affected. The diagnosis of pulmonary embolism is based on a clinical suspicion supported by certain diagnostic test...
June 2009: Best Practice & Research. Clinical Obstetrics & Gynaecology
Guillermo N Vaccarino, Jorge Thierer, Mariano Albertal, Mariano Vrancic, Fernando Piccinini, Mariano Benzadón, Hernán Raich, Daniel O Navia
OBJECTIVE: The aim of our study was to evaluate the impact of recent clopidrogel use before off-pump coronary artery bypass grafting on the postoperative risk of bleeding. METHODS: During the period January 2003 to December 2006, 1104 consecutive patients underwent off-pump coronary artery bypass grafting. Patients were divided into two groups according to the recent use of clopidrogel (within 7 days). We performed a propensity score to further adjust for differences between the patients with and without recent use of clopidrogel...
February 2009: Journal of Thoracic and Cardiovascular Surgery
S A Huston, D Hawkins
Economic evaluation plays an important role during almost all stages of pharmaceutical design and use. This paper reviews the recent pharmacoeconomic literature on the use of anticoagulants for acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI). Both ACS and PCI are common reasons for hospitalization and contribute significantly to costs of care. ACS and PCI practice standards are still evolving. For ACS enoxaparin does appear to be more cost-effective around the globe than unfractionated heparin (UFH) when clopidrogel and glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors are not used...
2008: Current Pharmaceutical Design
Rodrigo Montagna M, René Asenjo G, Raimundo Morris C, Mario Ortiz O, Mauricio Cereceda B
Atrial fibrillation is the most common sustained arrhythmia in clinical practice and is associated to thromboembolic complications. Anticoagulation with vitamin K antagonists is clearly useful to reduce the incidence of emboli, but associated with important limitations. Therefore, there is an active search for medications that are more effective and simpler to prescribe and manage. Synthetic pentasaccharides of heparin such as idraparinux for parenteral use, showed promising results. Direct inhibitors of thrombin were also useful for the prevention of thromboembolism...
August 2007: Revista Médica de Chile
René-Marc Flipo
OBJECTIVES: Some studies have recently suggested a potential pharmacodynamic interaction between aspirin and some non-selective non-steroidal anti-inflammatory drugs (NSAIDs). We have evaluated the reality of this pharmacodynamic interaction and analyse its clinical pertinence. METHODS: Literature review (Medline search - December 2005). RESULTS: Several ex vivo studies show that some non-selective NSAIDs can block the active site of Cox1 thus preventing aspirin from exerting its platelet anti-aggregating cardio-preventive action...
September 2006: La Presse Médicale
René-Marc Flipo
OBJECTIVES: Some studies have recently suggested a potential pharmacodynamic interaction between aspirin and some non-selective non-steroidal anti-inflammatory drugs (NSAIDs). We have evaluated the reality of this pharmacodynamic interaction and analyse its clinical pertinence. METHODS: Literature review (Medline search - December 2005). RESULTS: Several ex vivo studies show that some non-selective NSAIDs can block the active site of Cox1 thus preventing aspirin from exerting its platelet anti-aggregating cardio-preventive action...
September 2006: La Presse Médicale
Jose Martinez-Ojeda, Jose Martinez-Toro
The management of an ST elevation myocardial infarction has undergone significant changes in the past few years. Fibrinolytic agents have become more and more clot specific increasing their efficacy. However, percutaneous coronary intervention, along with its adjuvant therapy (glycoprotein IIB/IIIA receptor inhibitors and clopidrogel), have come to challenge fibrinolytic use. Many studies have demonstrated the benefits of percutaneous coronary intervention as compared to fibrinolysis in the management of acute myocardial infarction by decreasing infarct size, myocardial function loss, and mortality...
October 2005: Boletín de la Asociación Médica de Puerto Rico
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