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ANTIPLATELET AGENTS

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https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#1
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27920074/a-critical-appraisal-of-aspirin-in-secondary-prevention-is-less-more
#2
Giuseppe Gargiulo, Stephan Windecker, Pascal Vranckx, Charles Michael Gibson, Roxana Mehran, Marco Valgimigli
Aspirin represents the sine qua non for antiplatelet pharmacotherapy in patients with cardiovascular diseases because of its well-established role in secondary prevention and its widespread availability and affordability. Historical studies, conducted in an era that bears little resemblance to contemporary clinical practice, demonstrated large reductions in thrombotic risk when aspirin was compared with placebo, thus forming the evidence base promulgated in practice guidelines and recommendations. P2Y12 inhibitors have mostly been studied in addition to aspirin; dual-antiplatelet therapy proved superiority compared with aspirin monotherapy for the prevention of ischemic events, despite increased bleeding risks...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27919193/treatment-of-giant-cell-arteritis-a-literature-review
#3
Bénédicte Watelet, Maxime Samson, Hubert de Boysson, Boris Bienvenu
Giant cells arteritis (GCA) is the most common vasculitis in people over 50 years. Despite the frequency of this disease, there is currently no international consensus on its therapeutic modalities. The aim of this study was to conduct a review of the international literature on the treatment of GCA, whatever the clinical pattern. Oral corticosteroids remain the cornerstone treatment, possibly preceded by intravenous bolus in complicated forms. In cases of glucocorticoid dependence or glucocorticoid-related side effects, a glucocorticoid-sparing agent may be necessary...
December 6, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27917717/reversal-agents-for-oral-antiplatelet-and-anticoagulant-treatment-during-bleeding-events-current-strategies
#4
Peter Raimondi, Elaine M Hylek, Konstantinos N Aronis
There is an increasing prevalence of cardiovascular diseases that warrant antithrombotic therapy. Antithrombotic therapy includes antiplatelet agents and anticoagulation therapy with vitamin K antagonists (VKAs) or non-Vitamin K oral anticoagulants (NOACs). Antithrombotic therapy is associated with increased rates of bleeding. In this review we summarize the evidence and provide strategies for the management of severe bleeding in the setting of antithrombotic therapy. There is limited data on the management of bleeding in the setting of antiplatelet therapy...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27917716/antithrombotic-treatment-management-in-patients-with-intracerebral-hemorrhage-reversal-and-restart
#5
Dimitrios Giakoumettis, George A Alexiou, Dimitrios A Vrachatis, Kostas Themistoklis, Pantelis Stathis, Manolis Vavuranakis, Marios S Themistocleous
BACKGROUND: Intracerebral hemorrhage is the pathological accumulation of blood within the brain. It is a type of stroke more likely to be lethal or to severely disable the patient and results from a wide variety of causes. On the other hand antithrombotic therapy is used for the prevention or/and the therapy of thromboembolic episodes. Antithrombotic drugs are very effective in reducing risk or mortality rate after a thromboembolic event, yet they are associated with significant hemorrhages...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27917715/antiplatelet-agents-and-anticoagulants-in-patients-with-chronic-kidney-disease-from-pathophysiology-to-clinical-practice
#6
Jens Lutz, Kerstin Jurk
Progressive impairment of renal function can lead to uremia, which is associated with thus increasing the risk of bleeding as well as thrombosis. Furthermore, many patients with chronic kidney disease (CKD) have an indication for an anticoagulation or antiplatelet therapy due to atrial fibrillation, coronary artery disease, thromboembolic disease, or peripheral artery disease. The treatment usually includes vitamin-K antagonists (VKAs) and/or platelet aggregation inhibitors. The direct oral anticoagulants (DOACs) inhibiting factor Xa or thrombin activity represent an alternative for heparins and VKAs...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27917712/the-role-of-antiplatelet-therapy-in-primary-prevention-a-review
#7
Lauge Østergaard, Emil L Fosbøl, Matthew T Roe
The efficacy of antiplatelet therapy for the secondary prevention of cardiovascular disease after an ischemic event is well established. However, the role for antiplatelet therapy for the primary prevention of cardiovascular disease is more complex because of the interplay of efficacy vs safety in individuals without established cardiovascular disease who have a relatively low, but linear trajectory of cardiovascular risk. Several large randomized trials have investigated the efficacy and safety of antiplatelet therapy (primarily aspirin) for patients without established cardiovascular disease...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27909541/validation-of-the-has-bled-tool-in-atrial-fibrillation-patients-receiving-rivaroxaban
#8
Gorman Ew, Perkel D, Dennis D, Yates J, Heidel Re, Wortham D
Background: Atrial fibrillation (Afib) patients are at an increased risk of stroke. Patients at moderate to high risk of stroke typically receive antithrombotics, placing them at an increased risk of bleeding. The HAS-BLED tool has been validated in Afib patients receiving warfarin for prediction of major bleeding events. Although HAS-BLED has been researched in patients receiving warfarin, this tool has not been validated with the novel anticoagulant rivaroxaban. Methods: The trial design was retrospective case-control approved by the Institutional Review Board at University of Tennessee Medical Center...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909508/arguments-to-apply-epinephrine-for-pocket-hematoma-reduction-the-maitre-study
#9
REVIEW
Nikolay Ilov Md, Nikolay Ilov Md, Anatoly Nechepurenko Md, Albert Abdulkadyrov, Damir Paskeev, Elena Damrina, Elena Kulikova, Marina Terent'eva, Dinara Stompel, Dmitry Tarasov Md
Pocket hematoma (PH) is a common complication of implantations of cardiac electrophysiological devices with occurring at a particularly high rate in patients on oral anticoagulation or antiplatelet treatment. Different pharmacological agents with hemostatic effect are used to avoid PH. We supposed that the vasoconstrictor effects of epinephrine may reduce bleeding extent and be effective in prevention of PH. Maitre is the first clinical trial conducted with an aim to show the safety and efficacy of epinephrine in PH prophylaxis...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908822/how-admission-to-a-vascular-surgery-department-improves-medical-treatment-in-patients-with-lower-extremity-peripheral-arterial-disease
#10
M Thiney, N Della Schiava, P Feugier, P Lermusiaux, J Ninet, A Millon, A Long
OBJECTIVES: All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin converting enzyme (ACE) inhibitors or Angiotensin receptor blockers (ARBs), and HMG-CoA-reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the number of patients who received best medical treatment at admission and at discharge from a vascular surgery department...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908388/the-unknown-association-of-ppis-with-chest-pain-in-patients-with-known-treated-coronary-artery-disease-a-diagnostic-dilemma
#11
Fahad Javed, Stephen Ramee
Patients with coronary artery disease (CAD) are destined to lifelong antiplatelet therapy in form of aspirin (acetylsalicylic acid) alone, or in combination with other P2Y2 inhibitors. Proton pump inhibitors (PPIs) are the preferred agents for the treatment and prophylaxis of gastrointestinal injury associated with nonsteroidal anti-inflammatory drug or acetylsalicylic acid or both,(1) but recent data has raised questions about their association with negative cardiovascular events. We report 2 cases of patients with known CAD presented with chest pain mimicking angina pectoris that successfully resolved on discontinuation of the PPIs...
July 2016: Current Problems in Cardiology
https://www.readbyqxmd.com/read/27906917/efficacy-and-safety-of-tc-325-hemospraytm-for-non-variceal-upper-gastrointestinal-bleeding-at-middlemore-hospital-the-early-new-zealand-experience
#12
Hannah Giles, Dinesh Lal, Stephen Gerred, Paul Casey, Alasdair Patrick, Derek Luo, Ravinder Ogra
AIMS: A case series to review early experiences with HemosprayTM for a variety of non-variceal upper gastrointestinal bleeding (UGIB) at Middlemore Hospital. METHODS: HemosprayTM was administered therapeutically as first line or rescue at the discretion of the endoscopist. All cases of UGIB requiring HemosprayTM at Middlemore Hospital were identified to the investigator who undertook analysis of electronic and hard copy notes. RESULTS: Between October 2013 and July 2016, 36 patients were treated endoscopically with HemosprayTM...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27903391/-current-status-of-warfarin-therapy-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-analysis
#13
S J Zhao, H W Zhao, X P Wang, C Y Gao, Y H Qin, H X Cai, B Y Chen, J J Cao
Objective: To investigate the current status of warfarin therapy and the related factors in patients with nonvalvular atrial fibrillation(NVAF) based on data from a single center. Methods: We analyzed clinical data including baseline clinical characteristics, complications, concomitant medications and anti-thrombotic treatment in patients who were admitted to our hospital with NVAF from January 2014 to June 2014. The data were analyzed by t test, Chi-square test, fisher exact test and binary logistic regression analysis for the above indexes with warfarin utilization...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27893176/desmopressin-for-treatment-of-platelet-dysfunction-and-reversal-of-antiplatelet-agents-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#14
M J R Desborough, K A Oakland, G Landoni, M Crivellari, C Doree, L J Estcourt, S J Stanworth
BACKGROUND: Platelet dysfunction, including that caused by antiplatelet agents, increases the risk of perioperative bleeding. The optimal management of patients with platelet dysfunction undergoing surgery is unclear. OBJECTIVES: To assess whether desmopressin reduces perioperative allogeneic red cell transfusion and bleeding for patients with platelet dysfunction. PATIENTS/METHODS: We searched for randomised controlled trials in The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Embase, the Transfusion Evidence Library and ISI Web of Science to 7(th) July 2016...
November 28, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#15
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/27886816/pretreatment-with-antiplatelet-agents-in-the-setting-of-percutaneous-coronary-intervention-when-and-which-drugs
#16
REVIEW
Davide Capodanno, Dominick J Angiolillo
Administering antiplatelet agents before coronary angiography to patients referred to elective or urgent percutaneous coronary intervention (PCI) requires a careful evaluation of advantages and disadvantages associated with platelet inhibition to avoid overtreatment on one side and undertreatment on the other. The delicate balance between ischemic protection and bleeding demands the ability to undertake risk stratification and individualized decisions, which is particularly challenging in the setting of ad hoc PCI and urgent procedures...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27884500/different-impact-of-aspirin-on-renal-progression-in-patients-with-predialysis-advanced-chronic-kidney-disease-with-or-without-previous-stroke
#17
Kuang-Chih Hsiao, Jing-Yang Huang, Chun-Te Lee, Tung-Wei Hung, Yung-Po Liaw, Horng-Rong Chang
BACKGROUND: The benefit of reducing the risk of stroke against increasing the risk of renal progression associated with antiplatelet therapy in patients with advanced chronic kidney disease (CKD) is controversial. METHODS: We enrolled 1301 adult patients with advanced CKD treated with erythropoiesis stimulating agents from January 1, 2002 to June 30, 2009 from the 2005 Longitudinal Health Insurance Database in Taiwan. All of the patients were followed until the development of the primary or secondary endpoints, or the end of the study (December 31, 2011)...
November 21, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27881268/antithrombotic-therapy-and-direct-medical-costs-in-patients-with-acute-coronary-syndrome-in-shanghai-china
#18
Jeff J Guo, Yun Chen, Wenmin Du, Hongying Peng, Rui Wang, Ying Xia, Ping Xin, Patricia R Wigle, Emmanuel A Papadimitropoulos
BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide. OBJECTIVES: To describe patient profile, treatment patterns, and disease burden for patients with ACS. METHODS: A retrospective descriptive cohort study was conducted. Data were obtained from electronic medical records from seven Shanghai medical centers. Patients with at least one primary diagnosis of ACS from 2006 to 2012 were included. Patient ACS-related antithrombotic medication use, laboratory tests, key comorbidities, health care utilization, and direct medical costs were examined...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27859947/long-term-use-of-proton-pump-inhibitors-and-prevalence-of-disease-and-drug-related-reasons-for-gastroprotection-a-cross-sectional-population-based-study
#19
Susanna M Wallerstedt, Johan Fastbom, Johannes Linke, Sigurd Vitols
PURPOSE: To analyse the prevalence of long-term use of proton pump inhibitors (PPI) with respect to underlying diseases and drugs, and to find predictors for such treatment when an evident rationale for the PPI treatment is lacking. METHODS: The study cohort consisted of individuals, ≥65 years in 2010, residing in the Region Västra Götaland during 2005-2010. For individuals with and without long-term use of PPI in 2010, we investigated the prevalence of an underlying diagnosis, that is, an acid-related disease during the five preceding years, as well as concomitant long-term use of antiplatelet agents or cyclooxygenase inhibitors...
November 16, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27857999/do-age-and-anticoagulants-affect-the-natural-history-of-acute-subdural-hematomas
#20
Brandon P Lucke-Wold, Ryan C Turner, Darnell Josiah, Chelsea Knotts, Sanjay Bhatia
Acute subdural hematoma is a serious complication following traumatic brain injury. Large volume hematomas or those with underlying brain injury can cause mass effect, midline shift, and eventually herniation of the brain. Acute subdural hematomas in the young are associated with high-energy trauma and often have underlying contusions, while acute subdural hematomas in the elderly are associated with minor trauma and an absence of underlying contusions, even though the elderly are more likely to be on anticoagulants or anti-platelet therapy...
2016: Arch Emerg Med Crit Care
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