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https://www.readbyqxmd.com/read/28528236/-management-of-the-bleeding-risk-associated-with-antiplatelet-agents
#1
A-C Martin, S Houssany-Pissot, D Zlotnik, G Taylor, A Godier
Like all antithrombotic drugs, antiplatelet agents expose to a risk of bleeding complications. Clinical research has extensively focused on the efficacy of these drugs to reduce ischemic events. The bleeding risk associated with them was solely considered as an inevitable and acceptable complication. When two new potent P2Y12-receptor inhibitors, prasugrel and ticagrelor, were marketed, the risk of major bleeding increased. These new agents have modified the balance between the absolute risk reduction in ischemic events and the absolute risk increase in bleeding events...
May 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28526024/protective-effect-on-the-coronary-microcirculation-of-patients-with-diabetes-by-clopidogrel-or-ticagrelor-predict-study-rationale-and-design-a-randomized-multicenter-clinical-trial-using-intracoronary-multimodal-physiology
#2
Enrico Cerrato, Alicia Quirós, Mauro Echavarría-Pinto, Hernan Mejia-Renteria, Andres Aldazabal, Nicola Ryan, Nieves Gonzalo, Pilar Jimenez-Quevedo, Luis Nombela-Franco, Pablo Salinas, Iván J Núñez-Gil, José Ramón Rumoroso, Antonio Fernández-Ortiz, Carlos Macaya, Javier Escaned
BACKGROUND: In diabetic patients a predisposed coronary microcirculation along with a higher risk of distal particulate embolization during primary percutaneous intervention (PCI) increases the risk of peri-procedural microcirculatory damage. However, new antiplatelet agents, in particular Ticagrelor, may protect the microcirculation through its adenosine-mediated vasodilatory effects. METHODS: PREDICT is an original, prospective, randomized, multicenter controlled study designed to investigate the protective effect of Ticagrelor on the microcirculation during PCI in patient with diabetes mellitus type 2 or pre-diabetic status...
May 19, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#3
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28521259/von-willebrand-factor-and-its-cleaving-protease-adamts13-balance-in-coronary-artery-vessels-lessons-learned-from-thrombotic-thrombocytopenic-purpura-a-narrative-review
#4
REVIEW
Nuccia Morici, Silvia Cantoni, Francesco Panzeri, Alice Sacco, Chiara Rusconi, Miriam Stucchi, Fabrizio Oliva, Marco Cattaneo
BACKGROUND: Deficiency of the von Willebrand factor-cleaving protease ADAMTS13 is central to the pathophysiology of thrombotic thrombocytopenic purpura (TTP), a microangiopathic syndrome that presents as an acute medical emergency. In this review we will explore the evidence of a two-way relationship between TTP and ACS. Moreover, we will review the evidence emerged from epidemiological studies of an inverse relationship between the plasma levels of ADAMTS13 and the risk of ACS. METHODS AND RESULTS: Pubmed, MEDLINE and EMBASE, CINHAL, COCHRANE and Google Scholar databases were searched from inception to January 2017...
May 12, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28509568/low-body-weight-and-clinical-outcomes-in-acute-coronary-syndrome-patients-results-of-the-achilles-registry
#5
José Miguel Rivera-Caravaca, Juan M Ruiz-Nodar, Antonio Tello-Montoliu, María Asunción Esteve-Pastor, Andrea Veliz-Martínez, Esteban Orenes-Piñero, Mariano Valdés, Vicente Pernias-Escrig, Miriam Sandin-Rollán, Nuria Vicente-Ibarra, Manuel J Macías-Villanego, Elena Candela-Sánchez, Teresa Lozano, Luna Carrillo-Alemán, Francisco Marín
BACKGROUND: Being overweight increases the risk of cardiovascular diseases and mortality. However, among high-body-weight patients with established acute coronary syndrome (ACS) this evidence is not clear. In this scenario, a low body weight (LBW) has been proposed to confer higher prognostic risk and higher bleeding risk with new P2Y12 inhibitors. AIMS: We aimed to examine differences in mortality, catheterizations/revascularizations, antiplatelet therapy and ischemic/bleeding adverse events between ACS patients with LBW...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28504270/antiplatelet-therapy-new-score-for-predicting-bleeding-risk-after-dapt
#6
Bastiaan Zwart, Jurriën M Ten Berg
No abstract text is available yet for this article.
May 15, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28504052/adenosine-a2a-receptor-agonists-with-potent-antiplatelet-activity
#7
Eduardo Fuentes, Manuel Fuentes, Julio Caballero, Iván Palomo, Sonja Hinz, Ali El-Tayeb, Christa E Müller
Selected adenosine A2A receptor agonists (PSB-15826, PSB-12404, and PSB-16301) have been evaluated as new antiplatelet agents. In addition, radioligand-binding studies and receptor-docking experiments were performed in order to explain their differential biological effects on a molecular level. Among the tested adenosine derivatives, PSB-15826 was the most potent compound to inhibit platelet aggregation (EC50 0.32 ± 0.05 µmol/L) and platelet P-selectin cell-surface localization (EC50 0.062 ± 0.2 µmol/L), and to increase intraplatelets cAMP levels (EC50 0...
May 15, 2017: Platelets
https://www.readbyqxmd.com/read/28503909/genetic-risk-score-and-cardiovascular-mortality-in-a-southern-european-population-with-coronary-artery-disease
#8
Andreia Pereira, Maria Isabel Mendonca, Ana Célia Sousa, Sofia Borges, Sónia Freitas, Eva Henriques, Mariana Rodrigues, Ana Isabel Freitas, Graça Guerra, Ilídio Ornelas, Décio Pereira, António Brehm, Roberto Palma Dos Reis
Several genetic risk scores (GRS) have been associated with cardiovascular disease; their role, however, in survival from proven coronary artery disease (CAD) have yielded conflicting results. OBJECTIVE: The objective of this study was to evaluate long-term cardiovascular mortality according to the genetic risk score in a Southern European population with CAD. METHODS: A cohort of 1464 CAD patients with angiographic proven CAD were followed up prospectively for up to 58...
May 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28497183/rapid-contralateral-progression-of-focal-cerebral-arteriopathy-distinguished-from-rnf213-related-moyamoya-disease-and-fibromuscular-dysplasia
#9
Yoshio Araki, Yasushi Takagi, Yohei Mineharu, Hatasu Kobayashi, Susumu Miyamoto, Toshihiko Wakabayashi
BACKGROUND: Focal cerebral arteriopathy includes unifocal or multifocal lesions that are unilateral or bilateral. Large- and/or medium-sized vessels are involved and can be visualized on angiography. CASE REPORT: We report a case of cerebral infarction in a 9-year-old Japanese female who presented with a transient ischemic attack. Steno-occlusion involving the distal part of the internal carotid artery, proximal middle cerebral artery, and anterior cerebral artery was observed...
May 11, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28497174/stability-assessment-of-a-new-antithrombotic-small-peptide-arg-gly-asp-trp-arg-rgdwr-and-its-derivative
#10
Lijun Yang, Litao Zhang, Lihong Yan, Haifeng Zheng, Peifen Lu, Junjun Chen, Jie Dai, Haibiao Sun, Yong Xu, Tao Yang
OBJECTIVE: To assess the stabilities of Arg-Gly-Asp-Trp-Arg (RGDWR, designated as RWR), a new patented antithrombotic small peptide, and its derivative with ω-aminocaprylic acid on its N-terminus (ωRWR). RESULTS: RWR in rat plasma was decreased by between 32 and 48% after 4 h incubation on ice, indicating its instability in plasma. In contrast, ωRWR in plasma remained at 96-107%. Concentration changes were within 6.2% for ωRWR after storage in various conditions...
May 11, 2017: Biotechnology Letters
https://www.readbyqxmd.com/read/28495117/first-experience-with-the-watchman-flx-occluder-for-percutaneous-left-atrial-appendage-closure
#11
Julia Seeger, Ralf Birkemeyer, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: We aimed to evaluate efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyze procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. METHODS AND RESULTS: Twelve consecutive non-valvular atrial fibrillation patients (age 76.6±7.8years) at high risk for stroke (CHA2DS2-VASc-Score 5.5±0.9) and bleeding (HAS-BLED-Score 3.8±0.9), received LAA closure with the Watchman FLX...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28487393/potent-thrombolytic-effect-of-n-acetylcysteine-on-arterial-thrombi
#12
Sara Martinez de Lizarrondo, Clément Gakuba, Bradley A Herbig, Yohann Repessé, Carine Ali, Cécile V Denis, Peter Lenting, Emmanuel Touzé, Scott L Diamond, Denis Vivien, Maxime Gauberti
Background -Platelet crosslinking during arterial thrombosis involves von Willebrand Factor (VWF) multimers. Therefore, proteolysis of VWF appears promising to disaggregate platelet-rich thrombi and restore vessel patency in acute thrombotic disorders such as ischemic stroke, acute coronary syndrome or acute limb ischemia. N-Acetylcysteine (NAC, a clinically approved mucolytic drug) can reduce intrachain disulfide bonds in large polymeric proteins. In the present study, we postulated that NAC might cleave the VWF multimers inside occlusive thrombi, thereby leading to their dissolution and arterial recanalization...
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28480345/thulium-laser-vaporesection-of-the-prostate-can-we-operate-without-interrupting-oral-antiplatelet-anticoagulant-therapy
#13
Tarik Emre Sener, Salvatore Butticè, Luciano Macchione, Christopher Netsch, Yiloren Tanidir, Laurian Dragos, Rosa Pappalardo, Carlo Magno
PURPOSE: Thulium vaporesection of the prostate (ThuVARP) is a new and safe approach for patients receiving anticoagulant therapy in whom transurethral resection of the prostate (TURP) may possess a high bleeding risk. We aimed to demonstrate the efficacy and safety of ThuVARP in patients receiving oral antiplatelet/anticoagulant (OAP/OAC) therapy. MATERIALS AND METHODS: A total of 103 patients who underwent ThuVARP between 2011 and 2013 were enrolled in the study...
May 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28476509/three-case-report-of-embolic-stroke-of-undetermined-source
#14
Jia Li, Xue-Zhi Yang, Yi-Ping Wang, Xiao-Li Chen, Xu Zhang
BACKGROUND: Embolic stroke of undetermined source (ESUS) is a new clinical construct. It signifies that the embolus in the thromboembolic ischemic stroke is of unknown origin. The anticoagulants are usually prescribed for antithrombotic prophylaxis, but whether it is appropriate for all patients with ESUS is still unknown. METHODS AND RESULTS: In this article, we describe 3 cases of ESUS, all of whose antithrombotic therapy was antiplatelet medication, and the 3 patients had no recurrence on 3- to 7-month follow-up...
May 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28473431/first-us-experience-with-pipeline-flex-with-shield-technology-using-aspirin-as-antiplatelet-monotherapy
#15
Ricardo A Hanel, Pedro Aguilar-Salinas, Leonardo Bc Brasiliense, Eric Sauvageau
Flow diversion has revolutionised the treatment of intracranial aneurysms, and the Pipeline Embolization Device (PED) remains the only flow diverter (FD) approved in the USA. However, thromboembolic events remain an issue for FDs. Attempting to minimise these incidents, a newer PED has been developed with the use of covalent bonding of phosphorylcholine onto the Pipeline device that has been known as Shield Technology (PED Shield), which in vitro has demonstrated a significant reduction in material thrombogenicity...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28472526/glycoprotein-iib-iiia-inhibitors-in-prevention-and-rescue-treatment-of-thromboembolic-complications-during-endovascular-embolization-of-intracranial-aneurysms
#16
David Dornbos, Joel S Katz, Patrick Youssef, Ciarán J Powers, Shahid M Nimjee
Thromboembolic complications remain a major risk of endovascular neurosurgery during the treatment of intracranial aneurysms, despite the use of therapeutic heparinization and oral antiplatelet therapy when indicated. Glycoprotein (GP) IIb/IIIa inhibitors target a nonredundant pathway of platelet aggregation following adhesion and activation. Initially established and implemented in the cardiovascular arena, this drug class has provided a new tool in the neurovascular armamentarium as well. Numerous case reports, case series, and retrospective reviews have evaluated the safety and efficacy of abciximab, eptifibatide, and tirofiban in the treatment of acute thromboembolic complications during the endovascular treatment of intracranial aneurysms...
May 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28463894/antiplatelet-treatments-recent-evidence-from-randomized-controlled-trials
#17
Birgit Vogel, Usman Baber
PURPOSE OF REVIEW: To provide an overview of selected randomized studies reported over the last 2 years evaluating antiplatelet therapies in patients with either acute or stable manifestations of atherosclerosis. RECENT FINDINGS: From large outcome trials included evidence for reduced risk of ischemic events associated with use of ticagrelor and aspirin versus aspirin alone, albeit with an increased bleeding risk in patients with stable coronary artery disease and history of myocardial infarction...
April 29, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28462134/new-4-substituted-benzoyl-%C3%AE-d-glycoside-from-the-fruit-pulp-of-terminalia-belerica-with-antiplatelet-and-antioxidant-potency
#18
Vaseem Ahmad Ansari, Muhammad Arif, Md Sarfaraj Hussain, Hefazat Hussain Siddiqui, Rakesh Kumar Dixit
BACKGROUND: The fruit Terminalia belerica is a rich source of vitamins, acids, and nutraceuticals which have free radical scavenging activity. Thus, the ethanolic extract of fruit and its isolated compound (Tb-01) were intended to estimate antiplatelet and antioxidant activities. METHODS: The ethanolic extract was submitted to Si-gel CC and the compound was isolated. The compound Tb-01 was characterized as benzoyl-β-D-(4'→10″ geranilanoxy)-pyranosides on the basis of spectral data [ultra violet (UV), infrared (IR), (1)H nuclear magnetic resonance (NMR), (13)C NMR, and Mass Spectroscopy] and chemical analyses...
December 2016: Integr Med Res
https://www.readbyqxmd.com/read/28454794/reduced-duration-of-dual-antiplatelet-therapy-using-an-improved-drug-eluting-stent-for-percutaneous-coronary-intervention-of-the-left-main-artery-in-a-real-world-all-comer-population-rationale-and-study-design-of-the-prospective-randomized-multicenter-ideal
#19
Miguel E Lemmert, Keith Oldroyd, Paul Barragan, Maciej Lesiak, Robert A Byrne, Evgeny Merkulov, Joost Daemen, Yoshinobu Onuma, Karen Witberg, Robert-Jan van Geuns
BACKGROUND: Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. STUDY DESIGN: IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28449833/rational-medical-therapy-is-the-key-to-effective-cardiovascular-disease-prevention
#20
REVIEW
J David Spence
In an era in which medicine personalized on the basis of genotyping is being proposed, it is timely to recognize that existing therapies could be markedly improved if they were on the basis of more effective application of principles on the basis of available phenotyping. Blood pressure control, which is poor on a worldwide basis, is a major opportunity to reduce cardiovascular risk. There are many genetic variants that have a small effect on blood pressure, but specific therapies are not available for most of them...
May 2017: Canadian Journal of Cardiology
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