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https://www.readbyqxmd.com/read/29339684/-2017-esc-focused-update-on-dual-antiplatelet-therapy-in-coronary-artery-disease-developed-in-collaboration-with-eacts-what-is-new
#1
EDITORIAL
Zeki Öngen
No abstract text is available yet for this article.
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29330312/high-sensitive-c-reactive-protein-and-dual-antiplatelet-in-intracranial-arterial-stenosis
#2
Jiejie Li, Anxin Wang, Xingquan Zhao, Liping Liu, Xia Meng, Jinxi Lin, Jing Jing, Xinying Zou, Yilong Wang, Yongjun Wang
OBJECTIVE: To determine the relationship of high-sensitive C-reactive protein (hsCRP) and the efficacy and safety of dual antiplatelet therapy in patients with and without intracranial arterial stenosis (ICAS) in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. METHODS: A subgroup of 807 patients with both magnetic resonance angiography images and hsCRP measurement was analyzed. Cox proportional hazards models were used to assess the interaction of hsCRP levels with the effects of dual and single antiplatelet therapy...
January 12, 2018: Neurology
https://www.readbyqxmd.com/read/29325634/relationship-of-aging-and-incident%C3%A2-comorbidities-to-stroke-risk-in-patients%C3%A2-with-atrial-fibrillation
#3
Tze-Fan Chao, Gregory Y H Lip, Chia-Jen Liu, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Jo-Nan Liao, Fa-Po Chung, Tzeng-Ji Chen, Shih-Ann Chen
BACKGROUND: When assessing ischemic stroke risk in patients with atrial fibrillation (AF), the CHA2DS2-VASc score is calculated based on the baseline risk factors, and the outcomes are determined after a follow-up period. However, the stroke risk in patients with AF does not remain static, and with time, patients get older and accumulate more comorbidities. OBJECTIVES: This study hypothesized that the "Delta CHA2DS2-VASc score," which reflects the change in score between baseline and follow-up, would be more predictive of ischemic stroke compared with the baseline CHA2DS2-VASc score...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29306877/process-evaluation-of-the-data-driven-quality-improvement-in-primary-care-dqip-trial-quantitative-examination-of-variation-between-practices-in-recruitment-implementation-and-effectiveness
#4
Tobias Dreischulte, Aileen Grant, Adrian Hapca, Bruce Guthrie
OBJECTIVES: The cluster randomised trial of the Data-driven Quality Improvement in Primary Care (DQIP) intervention showed that education, informatics and financial incentives for general medical practices to review patients with ongoing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets reduced the primary end point of high-risk prescribing by 37%, where both ongoing and new high-risk prescribing were significantly reduced. This quantitative process evaluation examined practice factors associated with (1) participation in the DQIP trial, (2) review activity (extent and nature of documented reviews) and (3) practice level effectiveness (relative reductions in the primary end point)...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29306484/meta-analysis-comparing-patent-foramen-ovale-closure-versus-medical-therapy-to-prevent-recurrent-cryptogenic-stroke
#5
Tomo Ando, Anthony A Holmes, Mohit Pahuja, Arshad Javed, Alenxandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L Grines, Sripal Bangalore
New evidence suggests that closure of a patent foramen ovale (PFO) plus medical therapy (MT; antiplatelet or anticoagulation) is superior to MT alone to prevent recurrent cryptogenic stroke. We performed a meta-analysis of randomized controlled trials that compared PFO closure plus MT with MT alone in patients with cryptogenic stroke. The efficacy end points were recurrent stroke, transient ischemia attack, and death. The safety end points were major bleeding and newly detected atrial fibrillation. Trials were pooled using random effects and fixed effects models...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29304263/the-prevalence-of-adverse-ocular-hemorrhagic-events-in-patients-utilizing-oral-anticoagulant-and-antiplatelet-therapy-in-routine-clinical-practice
#6
Dattanand M Sudarshana, Eleni K Konstantinou, Sruthi Arepalli, Fabiana Q Silva, Andrew P Schachat, Justis P Ehlers, Rishi P Singh
BACKGROUND AND OBJECTIVE: Previous literature assessing ocular hemorrhagic complications of anticoagulant/antiplatelet medications in routine clinical practice is limited. This study evaluates the prevalence of spontaneous ocular hemorrhagic events associated with anticoagulation/antiplatelet therapy. PATIENTS AND METHODS: A retrospective study was performed to identify patients taking anticoagulants (rivaroxaban [Xarelto; Janssen Pharmaceuticals, Beerse, Belgium], bivalirudin [Angiomax; The Medicines Company, Parsippany, NJ], lepirudin [Refludan; Bayer HealthCare Pharmaceuticals, Berlin, Germany], dabigatran [Pradaxa; Boehringer Ingelheim, Ingelheim am Rhein, Germany], and argatroban) and antiplatelet agents (clopidogrel [Plavix; Bristol-Myers Squibb, New York City, NY], prasugrel [Effient; Lilly Medical, Indianapolis, IN], and ticagrelor [Brilinta; AstraZeneca, Cambridge, UK]) who presented for an eye examination...
January 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/29299960/closure-of-patent-foramen-ovale-in-cryptogenic-stroke-has-the-story-come-to-an-end
#7
Jean-Louis Mas, Gilles Chatellier
Contrasting with three randomized trials that failed to show any superiority of patent foramen ovale closure over antithrombotic therapy, two trials recently reported lower rates of stroke recurrence among patients assigned to patent foramen ovale closure than among those assigned to antiplatelet therapy. In addition, one of the initially negative trials concluded in favor of patent foramen ovale closure after an extended follow-up period. A better selection of patients, the use of reference treatment groups that included patients who received antiplatelet therapy alone (rather than antiplatelet drugs or oral anticoagulants, according to physician preference), and a longer follow-up of patients, may explain the divergent findings across studies...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29297508/current-and-future-antiplatelet-therapies-emphasis-on-preserving-haemostasis
#8
REVIEW
James D McFadyen, Mathieu Schaff, Karlheinz Peter
Antiplatelet drugs, such as aspirin, P2Y12 antagonists, and glycoprotein (GP) IIb/IIIa inhibitors, have proved to be successful in reducing the morbidity and mortality associated with arterial thrombosis. These agents are, therefore, the cornerstone of therapy for patients with acute coronary syndromes. However, these drugs all carry an inherent risk of bleeding, which is associated with adverse cardiovascular outcomes and mortality. Thus, the potential benefits of more potent, conventional antiplatelet drugs are likely be offset by the increased risk of bleeding...
January 3, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29296881/recurrent-thrombosis-in-patients-with-antiphospholipid-antibodies-and-arterial-thrombosis-on-antithrombotic-therapy
#9
William G Jackson, Clara Oromendia, Ozan Unlu, Doruk Erkan, Maria T DeSancho
Management for patients with antiphospholipid syndrome (APS) and arterial thrombosis is controversial. There are no prospective data demonstrating the superiority of high- or moderate-intensity anticoagulation with vitamin K antagonists over antiplatelet agents. Using 2 antiphospholipid antibody databases (single center [New York Presbyterian Hospital] and multicenter [Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking]), we retrospectively collected demographic and clinical data of patients with APS and arterial thrombosis...
November 28, 2017: Blood Advances
https://www.readbyqxmd.com/read/29280403/ticagrelor-in-modern-cardiology-an-up-to-date-review-of-most-important-aspects-of-ticagrelor-pharmacotherapy
#10
Dorota Danielak, Marta Karaźniewicz-Łada, Franciszek Główka
Ticagrelor is a first drug of a new chemical class cyclopentyltriazolopyrimidines. It is an antiplatelet agent with a unique mechanism of action, allowing a direct and reversible competitive inhibition of P2Y12 receptor. According to newest guidelines, it is recommended for prevention of thrombotic events in patients with acute coronary syndromes. Moreover, it is preferred over clopidogrel, an older generation antiplatelet drug, and therefore gains more interest in modern cardiology and vascular medicine. Areas covered: This review is a comprehensive and thorough summary of the most important findings on ticagrelor...
December 27, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29280137/multi-site-investigation-of-strategies-for-the-implementation-of-cyp2c19-genotype-guided-antiplatelet-therapy
#11
Philip E Empey, James M Stevenson, Sony Tuteja, Kristin W Weitzel, Dominick J Angiolillo, Amber L Beitelshees, James C Coons, Julio D Duarte, Francesco Franchi, Linda J B Jeng, Julie A Johnson, Rolf P Kreutz, Nita A Limdi, Kristin A Maloney, Aniwaa Owusu Obeng, Josh F Peterson, Natasha Petry, Victoria M Pratt, Fabiana Rollini, Stuart A Scott, Todd C Skaar, Mark R Vesely, George A Stouffer, Russell A Wilke, Larisa H Cavallari, Craig R Lee
CYP2C19 genotype-guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building clinical decision support processes, providing patient and provider education, and integrating methods to support the translation of emerging evidence to clinical practice are barriers to broad adoption. In this report, we compare and contrast implementation strategies of 12 early adopters, describing solutions to common problems and initial performance metrics for each program...
December 26, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29278603/interventional-spine-and-pain-procedures-in-patients-on-antiplatelet-and-anticoagulant-medications-second-edition-guidelines-from-the-american-society-of-regional-anesthesia-and-pain-medicine-the-european-society-of-regional-anaesthesia-and-pain-therapy-the
#12
Samer Narouze, Honorio T Benzon, David Provenzano, Asokumar Buvanendran, José De Andres, Timothy Deer, Richard Rauck, Marc A Huntoon
The American Society of Regional Anesthesia and Pain Medicine (ASRA) 2012 survey of meeting attendees showed that existing ASRA anticoagulation guidelines for regional anesthesia were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors required separate guidelines for pain and spine procedures. In response, a guidelines committee was formed. After preliminary review of published complications reports and studies, the committee stratified interventional spine and pain procedures according to potential bleeding risk: low-, intermediate-, and high-risk procedures...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29278423/exercise-for-intermittent-claudication
#13
REVIEW
Risha Lane, Amy Harwood, Lorna Watson, Gillian C Leng
BACKGROUND: Exercise programmes are a relatively inexpensive, low-risk option compared with other, more invasive therapies for treatment of leg pain on walking (intermittent claudication (IC)). This is the fourth update of a review first published in 1998. OBJECTIVES: Our goal was to determine whether an exercise programme was effective in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication. Secondary objectives were to determine whether exercise was effective in preventing deterioration of underlying disease, reducing cardiovascular events, and improving quality of life...
December 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29243114/effect-of-cytochrome-p450-2c19-polymorphism-on-adverse-cardiovascular-events-after-drug-eluting-stent-implantation-in-a-large-hakka-population-with-acute-coronary-syndrome-receiving-clopidogrel-in-southern-china
#14
Zhixiong Zhong, Jingyuan Hou, Qifeng Zhang, Bin Li, Cunren Li, Zhidong Liu, Min Yang, Wei Zhong, Xuebo He, Hesen Wu, Miaocai Zhong, Pingsen Zhao
BACKGROUND AND OBJECTIVES: The objective of this study is to evaluate the effects of cytochrome P450 2C19 (CYP2C19) polymorphism on adverse cardiovascular events (MACE) in Hakka patients with acute coronary syndrome (ACS) receiving clopidogrel who had undergone coronary drug-eluting stent placement after percutaneous coronary intervention (PCI) in southern China. METHODS: Genotyping of CYP2C19 and MACE of 934 ACS patients with PCI on clopidogrel maintenance therapy were analyzed...
December 14, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29242919/association-of-novel-oral-antithrombotics-with-the-risk-of-intraocular-bleeding
#15
Katherine E Uyhazi, Todd Miano, Wei Pan, Brian L VanderBeek
Importance: Novel oral anticoagulation and antiplatelet therapies have become a mainstay of treatment for thromboembolic disease. However, the safety profile of these medications has not been completely characterized. Objective: To determine the risk of developing intraocular hemorrhages with novel oral antithrombotic therapy compared with that of traditional antithrombotic agents. Design, Setting, and Participants: In this retrospective cohort study, a large national insurance claims database was used to generate 2 parallel analyses...
December 14, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29241467/-bioresorbable-coronary-scaffolds-follow-up
#16
J Elias, J J Piek
Bioresorbable scaffolds have been developed as an alternative to current metal stents. Despite earlier acceptable short-term results, the recently published AIDA study found that the most-used resorbable scaffold (Absorb) presents an almost threefold increased risk of stent thrombosis than the metal XIENCE stent, short-term as well as long-term. Acute and subacute stent thrombosis probably occur because of inadequate dual antiplatelet therapy, suboptimal implantation technique or both. Late stent thrombosis is probably affected by absorption-related stent-strut discontinuity and factors affecting blood flow...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29228859/summary-of-2017-esc-guidelines-on-valvular-heart-disease-peripheral-artery-disease-stemi-and-on-dual-antiplatelet-therapy
#17
Guy Van Camp, Tine De Backer, Christophe Beauloye, Walter Desmet, Marc J Claeys
During the ESC congress in September 2017 in Barcelona, the new ESC guidelines were presented and are now available on the ESC website. The new guidelines cover management recommendations on following cardiovascular items: valvular heart disease, peripheral artery disease, ST elevation myocardial infarction (STEMI) and on dual antiplatelet therapy. The present document gives a summary of these guidelines and highlights the most important recommendations and changes in the management of these diseases. It will help to increase awareness about the new guidelines and may stimulate to consult the full document for specific items...
December 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29223431/international-trends-in-clinical-characteristics-and-oral-anticoagulation-treatment-for-patients-with-atrial-fibrillation-results-from-the-garfield-af-orbit-af-i-and-orbit-af-ii-registries
#18
MULTICENTER STUDY
Benjamin A Steinberg, Haiyan Gao, Peter Shrader, Karen Pieper, Laine Thomas, A John Camm, Michael D Ezekowitz, Gregg C Fonarow, Bernard J Gersh, Samuel Goldhaber, Sylvia Haas, Werner Hacke, Peter R Kowey, Jack Ansell, Kenneth W Mahaffey, Gerald Naccarelli, James A Reiffel, Alexander Turpie, Freek Verheugt, Jonathan P Piccini, Ajay Kakkar, Eric D Peterson, Keith A A Fox
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment. METHODS: Demographics, comorbidities, and stroke risk of the patients in the GARFIELD-AF (n=51,270), ORBIT-AF I (n=10,132), and ORBIT-AF II (n=11,602) registries were compared (overall N=73,004 from 35 countries). Stroke prevention therapies were assessed among patients with new-onset AF (≤6 weeks). RESULTS: Patients from GARFIELD-AF were less likely to be white (63% vs 89% for ORBIT-AF I and 86% for ORBIT-AF II) or have coronary artery disease (19% vs 36% and 27%), but had similar stroke risk (85% CHA2DS2-VASc ≥2 vs 91% and 85%) and lower bleeding risk (11% with HAS-BLED ≥3 vs 24% and 15%)...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29216785/orbit-score-an-useful-predictor-of-small-bowel-rebleeding-in-patients-under-chronic-anticoagulation
#19
Tiago Cúrdia Gonçalves, Cátia Arieira, Sara Monteiro, Bruno Rosa, Maria João Moreira, José Cotter
BACKGROUND AND STUDY AIMS: Available scoring systems to assess the risk for major bleeding in patients on chronic anticoagulation seem inadequate in predicting higher diagnostic yields of small bowel capsule endoscopy (SBCE) or higher rebleeding rates in patients with suspected small bowel bleeding. The aim of this study was to evaluate the ability of the new ORBIT score in predicting positive findings of SBCE or higher rebleeding rates in chronically anticoagulated patients with suspected small bowel bleeding...
December 7, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29214062/management-of-oral-antiplatelet-agents-and-anticoagulation-therapy-before-bronchoscopy
#20
REVIEW
Houssein A Youness, Jean Keddissi, Ilya Berim, Ahmed Awab
Although, bronchoscopy is a relatively safe procedure, small amount of bleeding in the airway can have serious consequences. Careful consideration of the risks of diagnostic and therapeutic bronchoscopic intervention can help minimize potential complications. With increasing number of patients using antiplatelet and anticoagulation therapies, strategies for minimizing thromboembolic and operative bleeding events need to be included in the risk and benefit analyses. Growing evidence suggests that aspirin is safe and does not increase bleeding during bronchoscopy...
September 2017: Journal of Thoracic Disease
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