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https://www.readbyqxmd.com/read/29782272/-duration-and-timing-of-initiation-of-therapy-with-platelet-p2y12-inhibitors-in-the-treatment-of-patients-with-acute-coronary-syndrome
#1
S V SHalaev, Z M Safiullina
In recent years, the issues of choice of an agent for dual antiplatelet therapy (DAPT) as well as timing of initiation and duration of DAPT in patients with acute coronary syndrome (ACS) have been actively discussed. In this article we present data of major randomized trials of clopidogrel and novel P2Y12 inhibitors - prasugrel, ticagrelor, cangrelor - assessing strategy of administration of antiaggregants in patients with ACS before coronary angiography / percutaneous coronary intervention. The article also contains analysis of differences between recommendations of the European Society of Cardiology and American College of Cardiology/American Heart Association on therapy with oral P2Y12 inhibitors in the management of patients with ACS...
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29781069/dual-and-triple-antithrombotic-therapies-current-patterns-of-practice-and-controversies
#2
Mark Crowther, John Eikelboom
Dual antiplatelet therapy (DAPT) has been the cornerstone of antithrombotic management for patients undergoing percutaneous coronary intervention (PCI). Despite low-quality evidence, triple antithrombotic therapy involving acetylsalicylic acid, clopidogrel and warfarin or non-vitamin K antagonist oral anticoagulant (NOAC) has been recommended in patients with concomitant atrial fibrillation undergoing PCI, who require long-term oral anticoagulation, although such strategy is associated with a substantially increased risk of bleeding compared with DAPT...
May 21, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29669424/impact-of-chronic-antiplatelet-therapy-on-infarct-size-and-bleeding-in-patients-with-acute-myocardial-infarction
#3
Jeness Campodonico, Nicola Cosentino, Valentina Milazzo, Mara Rubino, Monica De Metrio, Ivana Marana, Marco Moltrasio, Marco Grazi, Gianfranco Lauri, Alice Bonomi, Fabrizio Veglia, Elisa Chiorino, Emilio Assanelli, Antonio L Bartorelli, Giancarlo Marenzi
BACKGROUND: Patients hospitalized with acute myocardial infarction (AMI) are often on prior single antiplatelet therapy (SAPT) or a dual antiplatelet therapy (DAPT). Whether chronic SAPT or DAPT is beneficial or associated with an increased risk in AMI is still controversial. METHODS AND RESULTS: We prospectively enrolled 1718 consecutive patients with AMI (798 ST-segment elevation myocardial infarction and 920 non-ST-segment elevation myocardial infarction) who were divided according to their chronic APT (no APT, SAPT, or DAPT)...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#4
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29599096/antithrombotic-therapy-trends-in-non-valvular-atrial-fibrillation-patients-undergoing-percutaneous-coronary-stent-implantation-results-from-a-survey-among-fellows-at-the-japanese-college-of-cardiology
#5
Daisuke Fukamachi, Atsushi Hirayama, Katsumi Miyauchi, Satoshi Yasuda, Hisao Ogawa, Hiroshi Ito, Hiroyuki Daida
BACKGROUND: Antithrombotic therapy with oral anticoagulants (OAC) in patients with atrial fibrillation (AF) after stent implantation, where dual antiplatelet therapy (DAPT) is also recommended, is not established. Antithrombotic therapies prescribed vary widely among cardiologists and may change year by year, according to the accumulation of new evidence. METHODS: A questionnaire-based survey concerning the antithrombotic therapy prescribed for OAC-treated AF patients who underwent stent implantation was conducted from 2014 to 2016...
March 26, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29596078/reduction-in-postpercutaneous-coronary-intervention-angina-in-addition-to-gastrointestinal-events-in-patients-on-combined-proton-pump-inhibitors-and-dual-antiplatelet-therapy-a-systematic-review-and-meta-analysis
#6
Muhammad Y Khan, Waqas J Siddiqui, Chikezie Alvarez, Sandeep Aggarwal, Syed F Hasni, Asyia Ahmad, Howard Eisen
BACKGROUND: Primary percutaneous coronary intervention (PCI) is a standard treatment in patients with acute coronary syndrome. Studies have shown that proton pump inhibitors (PPIs) can potentially attenuate the antiplatelet effects of P2Y12 inhibitors with associated adverse cardiovascular outcomes. MATERIALS AND METHODS: Medline was searched using Pubmed from inception to 8 November 2017 for randomized control trials studying the effect of PPIs on coronary artery disease with concomitant use of dual antiplatelet therapy (DAPT)...
March 28, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29582407/in-vitro-activity-of-linezolid-daptomycin-and-n-acetylcysteine-agents-on-staphylococcus-aureus-biofilms-in-the-ventriculoperitoneal-shunt-model
#7
Tuba Kuruoglu, Mehmet Emin Onger, Derya Bayirli Turan, Enis Kuruoglu
AIM: In this study, the effect of N-acetylcysteine (NAC) alone and in combination with linezolid (LIN) and daptomycin (DAPT) was examined on methicillin-sensitive Staphylococcus aureus (MSSA) biofilm formation. MATERIAL AND METHODS: Twelve groups (each containing six molds) of standard ventriculoperitoneal shunts were infected with MSSA. By using microbiological and electron microscopic evaluation methods, NAC was evaluated, alone and in combination with DAPT and LIN, in terms of preventing and eliminating biofilm capacity...
March 11, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29549436/real-world-antithrombotic-therapies-and-clinical-outcomes-after-second-generation-drug-eluting-stent-implantation-in-patients-with-atrial-fibrillation-a-multi-center-cohort-study
#8
Hisao Otsuki, Junichi Yamaguchi, Kazuho Kamishima, Hiroyuki Arashi, Nobuhisa Hagiwara
Previous reports have focused on cardiovascular and bleeding events in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, antithrombotic treatment strategies and clinical outcomes after second-generation drug-eluting stents (DES) implantation in AF patients remain to be determined. We enrolled 244 consecutive AF patients treated with second-generation DES. The study population was derived from multi-center AF registry (including 8 centers in Japan) from 2010 to 2012...
March 16, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29548674/meta-analysis-of-antithrombotic-therapy-in-atrial-fibrillation-after-percutaneous-coronary-intervention
#9
Safi U Khan, Muhammad U Khan, Ali Raza Ghani, Ahmad N Lone, Adeel Arshad, Edo Kaluski
Current clinical practice prefers oral anticoagulation (OAC) plus dual antiplatelet therapy (DAPT) in atrial fibrillation (AF) after percutaneous coronary intervention (PCI). We conducted a meta-analysis to test the hypothesis that the superiority of OAC plus DAPT is mainly endorsed by observational studies (OSs); conversely, randomized clinical trials (RCTs) have suggested that OAC plus a single antiplatelet (SAP) agent is a safer and equally effective approach. Nine studies (4 RCTs and 5 OSs) were selected using MEDLINE, EMBASE, and CENTRAL (Inception, October 31, 2017)...
May 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29490066/dual-antiplatelet-therapy-combining-aspirin-and-ticagrelor-for-intracranial-stenting-procedures-a-retrospective-single-center-study-of-154-consecutive-patients-with-unruptured-aneurysms
#10
Ana Paula Narata, Aymeric Amelot, Richard Bibi, Denis Herbreteau, Denis Angoulvant, Yves Gruel, Kevin Janot
BACKGROUND: Dual antiplatelet therapy (DAPT) associating aspirin + clopidogrel is commonly utilized in neurovascular interventions despite unpredictable clopidogrel efficacy with 4% to 50% of patients considered nonresponders. Ticagrelor is an antiplatelet agent with low resistance rates but unknown efficacy and safety in neurovascular patients. OBJECTIVE: To evaluate frequency of ischemic and hemorrhagic events in patients treated with aspirin and ticagrelor when associated with perioperative heparin bolus for unruptured aneurysms treated with intracranial stents...
February 26, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29475527/2018-canadian-cardiovascular-society-canadian-association-of-interventional-cardiology-focused-update-of-the-guidelines-for-the-use-of-antiplatelet-therapy
#11
Shamir R Mehta, Kevin R Bainey, Warren J Cantor, Marie Lordkipanidzé, Guillaume Marquis-Gravel, Simon D Robinson, Matthew Sibbald, Derek Y So, Graham C Wong, Joseph G Abunassar, Margaret L Ackman, Alan D Bell, Raymond Cartier, James D Douketis, Patrick R Lawler, Michael S McMurtry, Jacob A Udell, Sean van Diepen, Subodh Verma, G B John Mancini, John A Cairns, Jean-François Tanguay
Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29458246/antiplatelet-therapy-in-stemi-undergoing-primary-pci-when-which-one-and-how-long
#12
Giorgio Baralis, Roberta Rossini, Giuseppe Musumeci
Reperfusion therapy for patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) involves primary percutaneous coronary intervention (PPCI) and concomitant dual antiplatelet therapy (DAPT) with combination of a P2Y12 inhibitor and acetylsalicylic acid (ASA). Decision regarding DAPT can be challenging clinically in the modern era with the evolution of newer stents, more potent antiplatelet agents and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
February 19, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29447773/percutaneous-coronary-intervention-and-antiplatelet-therapy-in-patients-with-atrial-fibrillation-receiving-apixaban-or-warfarin-insights-from-the-aristotle-trial
#13
David Kopin, W Schuyler Jones, Matthew W Sherwood, Daniel M Wojdyla, Lars Wallentin, Basil S Lewis, Freek W A Verheugt, Dragos Vinereanu, M Cecilia Bahit, Sigrun Halvorsen, Kurt Huber, Alexander Parkhomenko, Christopher B Granger, Renato D Lopes, John H Alexander
BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are reported. Of the 18,201 trial participants, 316 (1.7%) underwent PCI (152 in apixaban group, 164 in warfarin group). RESULTS: At the time of PCI, 84% (267) were on study drug (either apixaban or warfarin)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29349596/concomitant-use-of-antiplatelets-and-anticoagulants-in-patients-with-coronary-heart-disease-and-atrial-fibrillation-what-do-recent-clinical-trials-teach-us
#14
REVIEW
David H Lam, Sean M Bell, Ravi S Hira
PURPOSE OF REVIEW: Coronary heart disease (CHD) and atrial fibrillation (AF) are among the most common cardiovascular diseases. A significant proportion of patients have both CHD and AF and are at increased risk for thrombotic complications. Current therapy for CHD and AF includes antiplatelet and anticoagulant medications, respectively. Patients with concurrent CHD and AF may be prescribed dual antiplatelet therapy (DAPT) in addition to anticoagulation, which increases their bleeding risk...
January 19, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#15
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29338536/p2y-12-receptor-inhibitors-an-evolution-in-drug-design-to-prevent-arterial-thrombosis
#16
REVIEW
Danny Kupka, Dirk Sibbing
P2Y12 inhibitors are a critical component of dual antiplatelet therapy (DAPT), which is the superior strategy to prevent arterialthrombosis in patients with acute coronary syndromes (ACS) and undergoing stent implantation.. Areas covered: Basic science articles, clinical studies, and reviews from 1992-2017 were searched using Pubmed library to collet impactful literature. After an introduction to the purinergic receptor biology, this review summarizes current knowledge on P2Y12 receptor inhibitors. Furthermore, we describe the subsequent improvements of next-generation P2Y12 receptor inhibitors facing the ambivalent problem of bleeding events versus prevention of arterial thrombosis in a variety of clinical settings...
March 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#17
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29195825/meta-analysis-of-the-safety-and-efficacy-of-the-oral-anticoagulant-agents-apixaban-rivaroxaban-dabigatran-in-patients-with-acute-coronary-syndrome
#18
REVIEW
Safi U Khan, Adeel Arshad, Irbaz Bin Riaz, Swapna Talluri, Fahad Nasir, Edo Kaluski
The significance of adding new oral anticoagulants (NOACs) to antiplatelet therapy in patients with acute coronary syndrome (ACS) is unclear. We conducted a meta-analysis to assess the safety and efficacy of adding NOACs (apixaban, rivaroxaban, and dabigatran) to single antiplatelet agent (SAP) or dual antiplatelet therapy (DAPT) in patients with ACS. Seven randomized controlled trials were selected using PubMed or MEDLINE, Scopus, and Cochrane library (inception to August 2017). The summary measure was random effects hazard ratio (HR) with 95% confidence interval (CI)...
February 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#19
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/29103068/antiplatelet-therapy-for-secondary-prevention-of-vascular-disease-complications
#20
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
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