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https://www.readbyqxmd.com/read/28904820/successful-cerebral-thrombectomy-for-a-nonagenarian-with-stroke-in-the-subacute-phase-after-transcatheter-aortic-valve-implantation
#1
Kazuya Matsuo, Atsushi Fujita, Jun Tanaka, Tomoaki Nakai, Masaaki Kohta, Kohkichi Hosoda, Toshiro Shinke, Ken-Ichi Hirata, Eiji Kohmura
BACKGROUND: Thromboembolic events are infrequent but serious complications of transcatheter aortic valve implantation (TAVI), occurring in 2.3-10% of the patients. However, the cause of post-TAVI stroke is unclear. CASE DESCRIPTION: A 90-year-old female underwent transfemoral-TAVI for severe aortic stenosis. Ten days later, she presented with an ischemic stroke of the left middle cerebral artery territory due to new-onset atrial fibrillation (NOAF). She underwent emergent endovascular thrombectomy with good reperfusion approximately 6 hours after onset of symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28902580/patent-foramen-ovale-closure-or-antiplatelet-therapy-for-cryptogenic-stroke
#2
Lars Søndergaard, Scott E Kasner, John F Rhodes, Grethe Andersen, Helle K Iversen, Jens E Nielsen-Kudsk, Magnus Settergren, Christina Sjöstrand, Risto O Roine, David Hildick-Smith, J David Spence, Lars Thomassen
Background The efficacy of closure of a patent foramen ovale (PFO) in the prevention of recurrent stroke after cryptogenic stroke is uncertain. We investigated the effect of PFO closure combined with antiplatelet therapy versus antiplatelet therapy alone on the risks of recurrent stroke and new brain infarctions. Methods In this multinational trial involving patients with a PFO who had had a cryptogenic stroke, we randomly assigned patients, in a 2:1 ratio, to undergo PFO closure plus antiplatelet therapy (PFO closure group) or to receive antiplatelet therapy alone (antiplatelet-only group)...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28902434/biologically-active-quinoline-and-quinazoline-alkaloids-part-i
#3
REVIEW
Xiao-Fei Shang, Susan L Morris-Natschke, Ying-Qian Liu, Xiao Guo, Xiao-Shan Xu, Masuo Goto, Jun-Cai Li, Guan-Zhou Yang, Kuo-Hsiung Lee
Quinoline and quinazoline alkaloids, two important classes of N-based heterocyclic compounds, have attracted tremendous attention from researchers worldwide since the 19th century. Over the past 200 years, many compounds from these two classes were isolated from natural sources, and most of them and their modified analogs possess significant bioactivities. Quinine and camptothecin are two of the most famous and important quinoline alkaloids, and their discoveries opened new areas in antimalarial and anticancer drug development, respectively...
September 13, 2017: Medicinal Research Reviews
https://www.readbyqxmd.com/read/28883227/utilization-of-anticoagulant-and-antiplatelet-agents-among-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention%C3%A3-retrospective-cohort-study-using-a-nationwide-claims-database-in-japan
#4
Fumiko Ono, Shiro Tanaka, Yoko M Nakao, Koji Kawakami
BACKGROUND: The European Society of Cardiology recommends a risk-based antithrombotic strategy for patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI) based on CHA2DS2-VASc and HAS-BLED scores. However, because it is unclear if that strategy can be generalized to Asians, we aimed to describe antithrombotic therapies among Japanese patients.Methods and Results:Using a nationwide claims database in Japan, this retrospective cohort study identified AF patients who underwent PCI from April 1, 2014 to March 31, 2015...
September 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28882733/-risk-of-fatal-non-fatal-events-in-patients-with-previous-coronary-heart-disease-acute-myocardial-infarction-and-treatment-with-non-steroidal-anti-inflammatory-drugs
#5
REVIEW
L Muñoz Olmo, J Juan Armas, J J Gomariz García
BACKGROUND: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk...
September 4, 2017: Semergen
https://www.readbyqxmd.com/read/28875522/developments-in-the-synthesis-of-the-antiplatelet-and-antithrombotic-drug-s-clopidogrel
#6
REVIEW
Aamer Saeed, Danish Shahzad, Muhammad Faisal, Fayaz Ali Larik, Hesham R El-Seedi, Pervaiz Ali Channar
S-(+)-Methyl 2-(2-chlorophenyl)-2-(6,7-dihydrothieno[3,2-c]pyridin-5(4H)-yl)acetate, also known as (S)-clopidogrel, is marketed under the trade names Plavix and Iscover. It is a potent thienopyridine-class of antithrombotic and antiplatelet drug (antiaggregant). Among the two available stereoisomers of clopidogrel, for pharmaceutical activities only the S-enantiomer is applicable, as no antithrombotic activity is observed in the R-enantiomer and causes political upheavals and social turmoil in animal experiments...
September 6, 2017: Chirality
https://www.readbyqxmd.com/read/28875481/proteinuria-predicts-resistance-to-antiplatelet-therapy-in-ischemic-stroke
#7
Gemlyn George, Nikul Patel, Cecilia Jang, David Wheeler, Sridhara S Yaddanapudi, Jonathan Dissin, Ramani Balu, Janani Rangaswami
The occurrence of a stroke while on antiplatelet agents presents a therapeutic dilemma. One of the main causes for recurrent strokes is antiplatelet resistance more commonly known as high on treatment platelet reactivity (HTPR). Prior studies have established that proteinuria is associated with HTPR following myocardial infarction. Here, we investigated whether dipstick proteinuria correlates with HTPR in patients presenting with stroke. We performed a retrospective cohort analysis of 102 patients admitted for a recurrent ischemic stroke that had either a VerifyNow aspirin or VerifyNow clopidogrel laboratory test performed to assess platelet reactivity...
September 5, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28870883/percutaneous-renal-artery-revascularization-after-prolonged-ischemia-secondary-to-blunt-trauma-pooled-cohort-analysis
#8
Younes Jahangiri, Zachary Ashwell, Khashayar Farsad
PURPOSE: We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma. METHODS: All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success...
September 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28856602/pharmacokinetic-profiles-of-ticagrelor-orodispersible-tablets-in-healthy-western-and-japanese-subjects
#9
Renli Teng, Maria Hammarberg, Glenn F Carlson, Sara Bokelund-Singh, Terese Ruderfelt, Eva Blychert
BACKGROUND AND OBJECTIVES: Ticagrelor is an antiplatelet agent for patients with acute coronary syndrome or a history of myocardial infarction. Two studies compared pharmacokinetic profiles of orodispersible (OD) ticagrelor tablets versus immediate-release (IR) tablets in Western and Japanese subjects. METHODS: Both studies were open-label, randomized, crossover, single-center trials. Thirty-six healthy subjects (94% white, 6% other race; Western study NCT02400333) and 42 Japanese healthy subjects (Japanese study NCT02436577) received a single 90-mg ticagrelor dose as an OD tablet [with/without water, and via a nasogastric tube (Western study only)], and an IR tablet; washout between treatments was ≥7 days...
August 30, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28854078/changes-in-treatment-patterns-and-incremental-health-care-utilization-due-to-p2y12-associated-complications-in-patients-with-acute-coronary-syndrome
#10
Ami Vyas, Lori D Bash, Mehul D Patel, Ross J Simpson
BACKGROUND: P2Y12 antiplatelet therapy (APT) is highly efficacious in reducing the incidence of ischemic events in patients with acute coronary syndrome (ACS); however, it is associated with several adverse complications. Data on P2Y12-associated complications and adherence to APT are sparse. OBJECTIVE: To describe the characteristics, frequency of P2Y12-associated complications, adherence and persistence to P2Y12 APT, and health care utilization among ACS patients on P2Y12 APT...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28844979/tailoring-naringenin-conjugates-with-amplified-and-triple-antiplatelet-activity-profile-rational-design-synthesis-human-plasma-stability-and-in-vitro-evaluation
#11
Evgenios Stylos, Maria V Chatziathanasiadou, Antonis Tsiailanis, Tahsin F Kellici, Maria Tsoumani, Androniki D Kostagianni, Maria Deligianni, Alexandros D Tselepis, Andreas G Tzakos
BACKGROUND: The current standard-of-care antiplatelet therapy in cardiovascular disease patients is consisted of cyclooxygenase-1 (COX-1) inhibitor aspirin, along with a platelet receptor P2Y12 antagonist. Recently, the triple antiplatelet therapy with aspirin, a P2Y12 receptor antagonist and a protease activated receptor-1 (PAR-1) antagonist, has been suggested for the secondary prevention of atherothrombotic events, however presented an increased risk of bleeding. Therefore, the quest for novel antiplatelet agents simultaneously targeting the three pathways with improved efficacy/safety profile is of immense importance...
August 24, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28844552/the-national-norwegian-carotid-study-time-from-symptom-onset-to-surgery-is-too-long-resulting-in-additional-neurological-events
#12
K E Kjørstad, S T Baksaas, D Bundgaard, E Halbakken, T Hasselgård, T Jonung, G T Jørgensen, J J Jørgensen, A H Krog, K Krohg-Sørensen, E Laxdal, S R Mathisen, G V Oskarsson, S Seljeskog, I Settemsdal, M Vetrhus, B A Viddal, J Wesche, F Aasgaard, E Mattsson
OBJECTIVE/BACKGROUND: The objective was to observe for 1 year all patients in Norway operated on for symptomatic carotid stenosis with respect to (i) the time from the index event to surgery and neurological events during this time; (ii) the level in the healthcare system causing delay of surgical treatment; and (iii) the possible relationship between peri-operative use of platelet inhibitors and neurological events while awaiting surgery. METHODS: This was a prospective national multicentre study of a consecutive series of symptomatic patients...
August 24, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28842683/a-novel-ruthenium-ii-derived-organometallic-compound-tq-6-potently-inhibits-platelet-aggregation-ex-vivo-and-in-vivo-studies
#13
Chih-Hsuan Hsia, Marappan Velusamy, Joen-Rong Sheu, Themmila Khamrang, Thanasekaran Jayakumar, Wan-Jung Lu, Kuan-Hung Lin, Chao-Chien Chang
Arterial thrombosis plays a key role in cardiovascular diseases. Hence, developing more effective antithrombotic agents is necessary. We designed a ruthenium (II)-derived complex, [Ru(η(6)-cymene)2-(1H-benzoimidazol-2-yl)-quinoline Cl]BF4 (TQ-6), as a new antiplatelet drug. TQ-6 (0.3 µM) exhibited extremely strong inhibitory activity against platelet aggregation, Src, and Syk phosphorylation stimulated by agonists in human platelets. In collagen-activated platelets, TQ-6 also inhibited ATP-release, [Ca(+2)]i, P-selectin expression, FITC-PAC-1 binding, and hydroxyl radical formation, as well as the phosphorylation of phospholipase Cγ2, protein kinase C, mitogen-activated protein kinases, and Akt...
August 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28838471/risk-of-early-adverse-events-after-clopidogrel-discontinuation-in-patients-undergoing-short-term-dual%C3%A2-antiplatelet%C3%A2-therapy-an-individual-participant-data-analysis
#14
Raffaele Piccolo, Fausto Feres, Alexandre Abizaid, Martine Gilard, Marie-Claude Morice, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Deepak L Bhatt, Tullio Palmerini, Gregg W Stone, Stephan Windecker, Marco Valgimigli
OBJECTIVES: The study sought to evaluate the presence of a clinically relevant rebound phenomenon after dual antiplatelet therapy (DAPT) discontinuation in randomized trials. BACKGROUND: It is currently unknown whether clopidogrel discontinuation after short-term DAPT is associated with an early hazard of ischemic events. METHODS: The authors performed an individual participant data analysis and aggregate meta-analysis. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of cardiac death, myocardial infarction (MI), or stroke...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28837205/triggering-receptor-expressed-on-myeloid-cells-1-a-new-player-in-platelet-aggregation
#15
Lucie Jolly, Jeremie Lemarie, Kevin Carrasco, Batric Popovic, Marc Derive, Amir Boufenzer, Sebastien Gibot
Triggering Receptor Expressed on Myeloid cells-1 (TREM-1) is an immunoreceptor initially known to be expressed on neutrophils and monocytes/macrophages. TREM-1 acts as an amplifier of the inflammatory response during both infectious and aseptic inflammatory diseases. Another member of the TREM family, The Triggering receptor expressed on myeloid cells Like Transcript-1 (TLT-1) is exclusively expressed in platelets and promotes platelet aggregation. As the gene that encodes for TLT-1 is located in the TREM-1 gene cluster, this prompted us to investigate the expression of TREM-1 on platelets...
August 30, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28831996/update-on-antithrombotic-therapy-after-percutaneous-coronary-revascularisation
#16
REVIEW
Thomas Cuisset, Freek W A Verheugt, Laura Mauri
For relief of coronary obstruction, percutaneous coronary intervention has become a standard-of-care procedure over the past 40 years. Nonetheless, optimal outcomes after coronary stenting require careful attention to antithrombotic therapy. This review aims to summarise the current available evidence and discusses how to integrate scientific knowledge into clinical decisions. In recent years, improvement and modifications of drugs and devices have changed the field tremendously, and substantially benefitted patient outcomes...
August 19, 2017: Lancet
https://www.readbyqxmd.com/read/28831288/uncertain-associations-of-major-bleeding-and-concurrent-use-of-antiplatelet-agents-and-chinese-medications-a-nested-case-crossover-study
#17
Hsin-Hui Tsai, Hsiang-Wen Lin, Chiu-Lin Tsai, Felix K Yam, Sheng-Shing Lin
Despite the evidence that some commonly used Chinese medications (CMs) have antiplatelet/anticoagulant effects, many patients still used antiplatelets combined with CMs. We conducted a nested case-crossover study to examine the associations between the concomitant use of antiplatelets and CMs and major bleeding using population-based health database in Taiwan. Among the cohort of 79,463 outpatients prescribed antiplatelets (e.g., aspirin and clopidogrel) continuously, 1,209 patients hospitalized with new occurring bleeding in 2012 and 2013 were included...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28830606/thrombin-generation-assays-for-global-evaluation-of-the-hemostatic-system-perspectives-and-limitations
#18
Rita Carolina Figueiredo Duarte, Cláudia Natália Ferreira, Danyelle Romana Alves Rios, Helton José Dos Reis, Maria das Graças Carvalho
The existing techniques to evaluate hemostasis in clinical laboratories are not sensitive enough to detect hypercoagulable and mild hypocoagulable states. Under different experimental conditions, the thrombin generation test may meet these requirements. This technique evaluates the overall balance between procoagulant and anticoagulant forces and has provided new insights in our understanding of the coagulation cascade, as well as of the diagnosis of hypocoagulability and hypercoagulability conditions. Thrombin generated in the thrombin generation test can be quantified as platelet-rich or platelet-poor plasma using the calibrated automated thrombogram method, which monitors the cleavage of a fluorogenic substrate that is simultaneously compared to the known thrombin activity in a non-clotting plasma sample...
July 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/28826683/perioperative-management-of-dual-antiplatelet-therapy-in-patients-with-new-generation-drug-eluting-metallic-stents-and-bioresorbable-vascular-scaffolds-undergoing-elective-noncardiac-surgery
#19
REVIEW
Michael Essandoh, Adam A Dalia, Mazen Albaghdadi, Barry George, Nicoleta Stoicea, Muhammad Shabsigh, Sunil V Rao
Dual-antiplatelet therapy (DAPT) is considered mandatory after new-generation drug-eluting coronary stent implantation to reduce ischemic complications such as stent thrombosis, but the need for DAPT makes the timing of elective surgery difficult. Interrupting DAPT places patients at risk for stent thrombosis, and surgery in the setting of DAPT may lead to bleeding. The 2016 American College of Cardiology/American Heart Association guideline recommends delaying elective noncardiac surgery for a minimum 6-month period to reduce ischemic risks after the implantation of a second-generation metallic drug-eluting stent (DES)...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28809046/platelet-transfusion-to-reverse-antiplatelet-therapy-before-decompressive-surgery-in-patients-with-intracranial-haemorrhage
#20
M Baschin, S Selleng, J-P Zeden, A Westphal, T Kohlmann, H W Schroeder, A Greinacher, T Thiele
BACKGROUND: Platelet concentrates (PC) are transfused to improve primary haemostasis before urgent neurosurgery in patients with intracranial haemorrhage (ICH) receiving antiplatelet therapy (APT). It is unresolved, whether PCs increase the risk for major cardio- and cerebrovascular adverse events. We evaluated a standardized transfusion regimen to reverse APT in patients with ICH who required decompressive neurosurgery. METHODS: Analysed were consecutive patients between 2012 and 2014...
August 14, 2017: Vox Sanguinis
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