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DAPT agents

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https://www.readbyqxmd.com/read/28267471/a-randomized-clinical-trial-comparing-long-term-clopidogrel-vs-aspirin-monotherapy-beyond-dual-antiplatelet-therapy-after-drug-eluting-coronary-stent-implantation-design-and-rationale-of-the-harmonizing-optimal-strategy-for-treatment-of-coronary-artery-stenosis
#1
Heesun Lee, Bon-Kwon Koo, Kyung Woo Park, Eun-Seok Shin, Sang Wook Lim, Seung-Woon Rha, Jang-Whan Bae, Dong Woon Jeon, Seok-Kyu Oh, Seung-Ho Hur, Bum-Su Kim, Jung-Hee Lee, Tae-Ho Park, Nam Ho Lee, Hyo-Soo Kim
Percutaneous coronary intervention (PCI) has been developed by drug-eluting stent (DES), but stent implantation has brought the issue of stent thrombosis and optimal antiplatelet therapy. Guidelines recommend at least 6- to 12 months of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor such as clopidogrel. Beyond DAPT after PCI with DES, however, there has been still a debate for antiplatelet regimen. Therefore, we report on the upcoming HOST-EXAM trial (NCT02044250), which will evaluate the efficacy and safety of aspirin and clopidogrel monotherapies beyond DAPT after DES implantation...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28255102/randomized-angiographic-and-intravascular-ultrasound-comparison-of-dual-antiplatelet-therapy-vs-triple-antiplatelet-therapy-to-reduce-neointimal-tissue-proliferation-in-diabetic-patients
#2
Maria Fernanda Zuliani Mauro, J Armando Mangione, J Ribamar Costa, Ricardo Costa, Luiz Alberto Piva E Mattos, Rodolfo Staico, Fausto Feres, Dimytri Siqueira, Amanda Sousa, Alexandre Abizaid
BACKGROUND: Previous studies have suggested a benefit of cilostazol in addition to standard dual-antiplatelet therapy (DAPT), reducing in-stent late luminal loss and restenosis after percutaneous coronary intervention (PCI) with bare-metal and drug-eluting stent (DES) implantation. However, there is a paucity of intravascular ultrasound (IVUS) assessment of neointimal tissue hyperplasia (NIH) after triple-antiplatelet therapy (TAPT), especially in diabetic patients treated with DES. METHODS: This prospective, placebo-controlled trial was conducted in diabetic patients randomized (1:1) to receive either standard DAPT (aspirin and clopidogrel) vs TAPT with cilostazol for a minimum of 12 months after PCI with Endeavor zotarolimus-eluting stent (E-ZES)...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#3
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28130038/autophagy-contributes-to-4-amino-2-trifluoromethyl-phenyl-retinate-induced-differentiation-in-human-acute-promyelocytic-leukemia-nb4-cells
#4
Yue Li, Ge Li, Ke Wang, Ya-Ya Xie, Ren-Peng Zhou, Yao Meng, Ran Ding, Jin-Fang Ge, Fei-Hu Chen
As a classic differentiation agent, all-trans retinoic acid (ATRA) has been widely used in treatment of acute promyelocytic leukemia (APL). However, clinical application of ATRA has limitations. Our previous studies suggested that 4-Amino-2-Trifluoromethyl-Phenyl Retinate (ATPR), a novel all-trans retinoic acid (ATRA) derivative designed and synthesized by our team, could induce differentiation of APL cells in vivo and in vitro. To explore the underlying mechanism of ATPR, the effect of ATPR on autophagy of APL cells was observed in the present study...
January 25, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28042389/clinical-problems-with-antithrombotic-therapy-for-endoscopic-submucosal-dissection-for-gastric-neoplasms
#5
REVIEW
Toshiyuki Yoshio, Tsutomu Nishida, Yoshito Hayashi, Hideki Iijima, Masahiko Tsujii, Junko Fujisaki, Tetsuo Takehara
Endoscopic submucosal dissection (ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms, particularly for patients with comorbidities. Antithrombotic agents are used to prevent thrombotic events in patients with comorbidities such as cardio-cerebrovascular diseases and atrial fibrillation. With appropriate cessation, antithrombotic therapy does not increase delayed bleeding in low thrombosis-risk patients. However, high thrombosis-risk patients are often treated with combination therapy with antithrombotic agents and occasionally require the continuation of antithrombotic agents or heparin bridge therapy (HBT) in the perioperative period...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28024166/an-east-asian-perspective-on-the-interaction-between-proton-pump-inhibitors-and-clopidogrel
#6
Duowu Zou, Khean-Lee Goh
Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for ARDs (Acid Related Disorders) including gastroesophageal reflux disease (GERD). They are also co-prescribed with oral anticoagulant agents (OAAs)and with dual-antiplatelet therapy (DAPT) for the treatment and prevention of gastrointestinal (GI) bleeding. Clopidogrel belongs to the drug class of thienopyridines, and is currently the most widely prescribed OAA either alone or in combination with aspirin...
December 26, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27959713/prevention-of-bleeding-in-patients-with-atrial-fibrillation-undergoing-pci
#7
RANDOMIZED CONTROLLED TRIAL
C Michael Gibson, Roxana Mehran, Christoph Bode, Jonathan Halperin, Freek W Verheugt, Peter Wildgoose, Mary Birmingham, Juliana Ianus, Paul Burton, Martin van Eickels, Serge Korjian, Yazan Daaboul, Gregory Y H Lip, Marc Cohen, Steen Husted, Eric D Peterson, Keith A Fox
Background In patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) with placement of stents, standard anticoagulation with a vitamin K antagonist plus dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor and aspirin reduces the risk of thrombosis and stroke but increases the risk of bleeding. The effectiveness and safety of anticoagulation with rivaroxaban plus either one or two antiplatelet agents are uncertain. Methods We randomly assigned 2124 participants with nonvalvular atrial fibrillation who had undergone PCI with stenting to receive, in a 1:1:1 ratio, low-dose rivaroxaban (15 mg once daily) plus a P2Y12 inhibitor for 12 months (group 1), very-low-dose rivaroxaban (2...
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#8
REVIEW
Mikhail S Dzeshka, Richard A Brown, Davide Capodanno, Gregory Y H Lip
Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27809553/endoscopic-resection-of-colorectal-polyps-in-patients-on-antiplatelet-therapy-an-evidence-based-guidance-for-clinicians
#9
Gema Plumé Gimeno, Marco Bustamante-Balén, Carla Satorres Paniagua, Francia Carolina Díaz Jaime, Maria José Cejalvo Andújar
Due to the rising prevalence of coronary heart disease, endoscopists are more frequently performing a polypectomy in patients on antiplatelet therapy (APT) and dual antiplatelet therapy (DATP). Despite the availability of several guidelines with regard to the management of antiplatelet drugs during the periprocedure period, there is still variability in the current clinical practice. This may be influenced by the low quality of the evidence supporting recommendations, because most of the studies dealing with APT and polypectomy are observational and retrospective, and include mainly small (< 10 mm) polyps...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27757726/risk-and-benefits-of-triple-therapy-in-patients-undergoing-coronary-stent-implantation-requiring-oral-anticoagulation-a-meta-analysis-of-16-studies
#10
Lucia Barbieri, Monica Verdoia, Alon Schaffer, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Patients with coronary artery disease who undergo stent implantation and have concomitant indication for long-term oral anticoagulation represent a considerable proportion of the overall population. To date there is still no consensus about the optimal antithrombotic strategy to choose in this kind of patients, due to the difficult balance between an increased risk of bleeding and thromboembolic complications. Therefore, the aim of this study was to perform a meta-analysis to evaluate the risk and benefits of triple antithrombotic therapy versus dual antithrombotic therapy in patients undergoing coronary stent implantation, requiring long-term oral anticoagulation...
December 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27753144/melatonin-rescues-cardiac-thioredoxin-system-during-ischemia-reperfusion-injury-in-acute-hyperglycemic-state-by-restoring-notch1-hes1-akt-signaling-in-a-membrane-receptor-dependent-manner
#11
Liming Yu, Chongxi Fan, Zhi Li, Jian Zhang, Xiaodong Xue, Yinli Xu, Guolong Zhao, Yang Yang, Huishan Wang
Stress hyperglycemia is commonly observed in patients suffering from ischemic heart disease. It not only worsens cardiovascular prognosis but also attenuates the efficacies of various cardioprotective agents. This study aimed to investigate the protective effect of melatonin against myocardial ischemia-reperfusion (MI/R) injury in acute hyperglycemic state with a focus on Notch1/Hes1/Akt signaling and intracellular thioredoxin (Trx) system. Sprague Dawley rats were subjected to MI/R surgery and high-glucose (HG, 500 g/L) infusion (4 mL/kg/h) to induce temporary hyperglycemia...
January 2017: Journal of Pineal Research
https://www.readbyqxmd.com/read/27723533/new-oral-anticoagulants-and-dual-antiplatelet-therapy-focus-on-apixaban
#12
REVIEW
Francesco Pelliccia, Fabiana Rollini, Giuseppe Marazzi, Cesare Greco, Carlo Gaudio, Dominick J Angiolillo, Giuseppe Rosano
The combination of AF and coronary artery disease not only is a common clinical setting, it is also a complex setting to deal with anticoagulation and antiplatelet therapy, and it is associated with significantly higher mortality rates. Unfortunately, there are no sufficient data available to optimally guide clinical practice in such settings. This review focuses specifically on newer oral anticoagulants (NOACs) associated with dual antiplatelet therapy (DAPT) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI)...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27698877/inhibition-of-%C3%AE-secretase-activity-synergistically-enhances-tumour-necrosis-factor-related-apoptosis-inducing-ligand-induced-apoptosis-in-t-cell-acute-lymphoblastic-leukemia-cells-via-upregulation-of-death-receptor-5
#13
Lisa M Greene, Seema M Nathwani, Daniela M Zisterer
T-cell acute lymphoblastic leukemia (T-ALL) is a rare and aggressive hematopoietic malignancy prone to relapse and drug resistance. Half of all T-ALL patients exhibit mutations in Notch1, which leads to aberrant Notch1 associated signaling cascades. Notch1 activation is mediated by the γ-secretase cleavage of the Notch1 receptor into the active intracellular domain of Notch1 (NCID). Clinical trials of γ-secretase small molecule inhibitors (GSIs) as single agents for the treatment of T-ALL have been unsuccessful...
October 2016: Oncology Letters
https://www.readbyqxmd.com/read/27577194/pericardial-tamponade-due-to-haemorrhagic-pericardial-effusion-as-a-complication-of-prasugrel-a-case-report
#14
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...
August 30, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27575814/dual-antiplatelet-therapy-is-associated-with-prolonged-survival-after-lower-extremity-revascularization
#15
Peter A Soden, Sara L Zettervall, Klaas H J Ultee, Bruce E Landon, A James O'Malley, Philip P Goodney, Randall R DeMartino, Shipra Arya, Marc L Schermerhorn
BACKGROUND: Dual antiplatelet therapy (DAPT) after coronary stenting prolongs survival by preventing both in-stent thrombosis and other cardiovascular atherothrombotic events. Patients with peripheral artery disease (PAD) typically have a heavy burden of unrevascularized coronary artery disease and also stand to benefit from increased atherothrombotic protection with DAPT. The potential benefit of DAPT compared with aspirin alone in patients with PAD is not well described. METHODS: We identified all patients undergoing an initial elective lower extremity revascularization (bypass or endovascular) from 2003 to 2016 in the Vascular Quality Initiative registry discharged on aspirin or aspirin plus a thienopyridine antiplatelet agent (DAPT)...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27533996/dual-antiplatelet-therapy-optimal-timing-management-and-duration
#16
REVIEW
Pierre Sabouret, Sophie K Rushton-Smith, Mathieu Kerneis, Johanne Silvain, Jean-Philippe Collet, Gilles Montalescot
Platelet activation and aggregability play a key role in the genesis of arterial thrombus secondary to plaque rupture. For coronary patients, inhibition of platelet function is crucial to decrease the rate of major adverse cardiac events but may expose them to excess bleeding risk. Switching P2Y12 inhibitors is common, yet the clinical consequences are unknown. The aim of this review is to provide an overview of the evidence from randomized, clinical trials and epidemiological studies, with a focus on the optimal duration of dual antiplatelet therapy (DAPT) and appropriate agent and dose selection...
July 2015: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27533756/impact-of-renal-impairment-on-platelet-reactivity-and-clinical-outcomes-during-chronic-dual-antiplatelet-therapy-following-coronary-stenting
#17
Long Zhe Guo, Moo Hyun Kim, Chang Heon Shim, Sun Young Choi, Victor L Serebruany
AIMS: Clinical utilization of dual antiplatelet therapy (DAPT) in patients with renal impairment (RI) following percutaneous coronary interventions (PCI) represents an urgent, unmet need choosing optimal agents, duration of treatment, and potential dose/regimen adjustment. The lack of any large randomized trials specifically in RI patients, and the absence of the uniformed clinical data reporting policy, clouds the reality. Moreover, triaging RI patients is problematic due to ongoing kidney deterioration, and the fact that RI patients are prone to both vascular occlusions and bleeding...
July 2016: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27510478/duration-of-dual-antiplatelet-therapy-after-coronary-stenting
#18
Gerasimos Siasos, Konstantinos Mourouzis, Evangelos Oikonomou, Manolis Vavuranakis, Georgia Vogiatzi, Alexandros Briasoulis, Nikolaos Papageorgiou, Theodore G Papaioannou, Thodoris Zografos, Angeliki Papapanagiotou, Athanasios G Papavassiliou, Christodoulos Stefanadis, Dimitris Tousoulis
BACKGROUND: Dual antiplatelet therapy (DAPT) is one of the cornerstones of coronary artery disease (CAD) treatment. Standard DAPT requires one of, P2Y12 receptor inhibitors, clopidogrel, prasugrel or ticagrelor as an adjunct therapy to aspirin administration. The decision over DAPT duration depends on the evaluation of thrombotic risk and the assessment of the probability for major bleeding events. METHODS: The goal of this work was to identify which would be the appropriate combination of antiplatelet agents and the optimal duration of DAPT, based on the patient's medical history and clinical characteristics...
2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27477306/long-term-use-of-dual-antiplatelet-therapy-for-the-secondary-prevention-of-atherothrombotic-events-meta-analysis-of-randomized-controlled-trials
#19
REVIEW
Zaher Fanari, Amratash Malodiya, Sandra A Weiss, Sumaya Hammami, Paul Kolm, William S Weintraub
BACKGROUND: The potential benefit of long-term dual antiplatelet therapy (DAPT) for secondary prevention of atherothrombotic events is unclear. Data from different randomized controlled trials (RCT) using different agents in different subgroups showed inconsistent results. METHODS: We performed a systematic review and meta-analysis from RCTs that tested different prolonged durations of DAPT for secondary prevention. Long term DAPT arm was defined as those receiving DAPT for more than 12months...
January 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27475877/similar-efficacy-and-safety-of-daptomycin-versus-linezolid-for-treatment-of-vancomycin-resistant-enterococcal-bloodstream-infections-a-meta-analysis
#20
REVIEW
Ming Zhao, Liang Liang, Liwei Ji, Di Chen, Yatong Zhang, Yuanchao Zhu, Khilna Patel
Daptomycin and linezolid are the most commonly used antibiotics for bloodstream infection caused by vancomycin-resistant enterococci (VRE-BSI). However, the best therapeutic agent to treat VRE-BSI remains to be established. In order to provide evidence for an optimal treatment decision, a systematic review and meta-analysis was performed comparing the efficacy and safety of daptomycin and linezolid for the treatment of VRE-BSI. After thorough searching of relevant studies from MEDLINE, EMBASE, Clinicaltrials...
September 2016: International Journal of Antimicrobial Agents
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