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https://www.readbyqxmd.com/read/28721209/recent-advances-in-preventing-stroke-recurrence
#1
REVIEW
J David Spence
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%...
2017: F1000Research
https://www.readbyqxmd.com/read/28719412/new-oral-antiplatelet-medications
#2
(no author information available yet)
No abstract text is available yet for this article.
August 17, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28697899/hiv-and-coronary-disease-when-secondary-prevention-is-insufficient
#3
Ana Sofia Carvalho, Rui Osório Valente, Luís Almeida Morais, Pedro Modas Daniel, Ramiro Sá Carvalho, Lurdes Ferreira, Rui Cruz Ferreira
Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal)...
July 8, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28697492/incidence-and-causes-for-early-ticagrelor-discontinuation-a-real-world-dutch-registry-experience
#4
Thomas O Bergmeijer, Paul W A Janssen, Mathijs van Oevelen, Dymphie van Rooijen, Thea C Godschalk, Johannes C Kelder, Vera H M Deneer, Victor L Serebruany, Jurriën M Ten Berg
OBJECTIVES: The PLATO trial revealed superiority of ticagrelor over clopidogrel for the prevention of atherothrombotic events in patients with acute coronary syndrome. However, adverse events such as bleeding, dyspnea, and bradycardia were frequently reported, potentially leading to excess early ticagrelor discontinuation (ETD), later confirmed in the PEGASUS trial. We here evaluated the incidence and causes for ETD in a real-world patient cohort in a high-volume nonacademic percutaneous coronary intervention center in the Netherlands...
July 12, 2017: Cardiology
https://www.readbyqxmd.com/read/28681581/risk-analysis-of-new-oral-anticoagulants-for-gastrointestinal-bleeding-and-intracranial-hemorrhage-in-atrial-fibrillation-patients-a-systematic-review-and-network-meta-analysis
#5
Wei-Wei Xu, Shen-Jiang Hu, Tao Wu
BACKGROUND: Antithrombotic therapy using new oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) has been generally shown to have a favorable risk-benefit profile. Since there has been dispute about the risks of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH), we sought to conduct a systematic review and network meta-analysis using Bayesian inference to analyze the risks of GIB and ICH in AF patients taking NOACs. METHODS: We analyzed data from 20 randomized controlled trials of 91 671 AF patients receiving anticoagulants, antiplatelet drugs, or placebo...
July 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28679854/acute-occlusions-of-dual-layer-carotid-stents-after-endovascular-emergency-treatment-of-tandem-lesions
#6
Umut Yilmaz, Heiko Körner, Ruben Mühl-Benninghaus, Andreas Simgen, Catherine Kraus, Silke Walter, Stefanie Behnke, Klaus Faßbender, Wolfgang Reith, Marcus M Unger
BACKGROUND AND PURPOSE: A new generation of carotid artery stents that uses a second micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. The purpose of this study was to compare acute occlusion rates of these new dual-layer stents with those of single-layer stents in the setting of emergency carotid artery stenting with intracranial mechanical thrombectomy in acute ischemic stroke. METHODS: Consecutive patients with acute tandem (intra- and extracranial) lesions of the anterior circulation who were endovascularly treated at our institution were identified from our registry of neuroendovascular interventions...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28668363/-antiplatelet-therapy-in-patient-undergoing-angioplasty-for-peripheral-artery-disease
#7
Serge Kownator
Antiplatelet therapy in patients undergoing PTA/Stenting for PAD relies on low quality evidences. Most interventionists provide a loading dose of clopidogrel in addition to aspirin followed by dual antiplatelet therapy for a duration of 1 to 3 months after PTA. The rational of this strategy relies mostly on the results of studies dedicated to coronary angioplasty. Ongoing trials with direct oral anticoagulants will perhaps provide new data in order to improve the practice.
June 28, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28661936/revisiting-the-role-of-steroids-and-aspirin-in-the-management-of-acute-kawasaki-disease
#8
Anita Dhanrajani, Rae S M Yeung
PURPOSE OF REVIEW: Kawasaki disease is an acute multisystem childhood vasculitis with a predilection for the coronary arteries. The role of corticosteroids and acetyl salicylic acid (ASA) in the treatment of acute Kawasaki disease are matters of ongoing debate and changing attitudes from one extreme to the other. Recent work has provided new evidence to guide our thinking about these two therapeutic agents, which will be the focus of this review. RECENT FINDINGS: Corticosteroids are effective and well tolerated in Kawasaki disease, both as initial adjunctive treatment in those at high-risk for poor outcome, and as rescue therapy after failed intravenous immunoglobulin (IVIG)...
June 28, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28650349/new-oral-antiplatelet-medications
#9
Travis Jeffords
New and more potent oral antiplatelet agents have shown better clinical outcomes over the last few years. This article reviews the latest oral antiplatelet therapies available, their indications and contraindications, genetic resistance, and major drug interactions.
June 22, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28644213/platelet-pathophysiology-pharmacology-and-function-in-coronary-artery-disease
#10
Homam Ibrahim, Neal S Kleiman
Platelets play a key role in the pathophysiology of coronary artery disease and acute coronary syndromes. Our understanding of platelet function in thrombus formation has increased considerably, resulting in the development of clinically effective treatment strategies and identification of new targets. An underappreciated platelet function is their contribution toward acute and chronic inflammatory processes including atherogenesis. In this review, we discuss the role of platelets in atherosclerosis and thrombosis, platelet function testing, and the pharmacology of currently available antiplatelet drugs...
June 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28643297/recommendations-for-the-use-of-bioresorbable-vascular-scaffolds-in-percutaneous-coronary-interventions-2017-revision
#11
B Everaert, J J Wykrzykowska, J Koolen, P van der Harst, P den Heijer, J P Henriques, R van der Schaaf, B de Smet, S H Hofma, R Diletti, A Weevers, J Hoorntje, P Smits, R J van Geuns
BACKGROUND: To eliminate some of the potential late limitations of permanent metallic stents, the bioresorbable coronary stents or 'bioresorbable vascular scaffolds' (BVS) have been developed. METHODS: We reviewed all currently available clinical data on BVS implantation. RESULTS: Since the 2015 position statement on the appropriateness of BVS in percutaneous coronary interventions, several large randomised trials have been presented. These have demonstrated that achieving adequate 1 and 2 year outcomes with these first-generation BVS is not straightforward...
July 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28641646/-clinical-characteristics-and-long-term-outcome-of-125-chinese-young-patients-with-essential-thrombocythemia
#12
Rong-Feng Fu, Xiao-Fan Liu, Wei Liu, Yue-Ting Huang, Yun-Fei Chen, Hui-Yuan Li, Man-Kai Ju, Ren-Chi Yang, Lei Zhang
OBJECTIVE: To investigate the clinical characteristics and long-term outcome of Chinese young patients (≤40 years) with essential thrombocythemia(ET), and to develop a thrombosis predicting model specific for young patients with ET, so as to provide a new evidence for risk stratification and treatment. METHODS: Medical records of 125 Chinese young patients with newly diagnosed of ET were retrospectively analyzed. RESULTS: The median age at diagnosis was 32 (18-40) years old, with 37 males and 88 females...
June 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28632424/the-progress-in-the-research-of-antiplatelet-agents-1995-2017
#13
Oscar Benimana, Lulu Zhao, Yi Kong, Zhiyu Li, Zhouling Xie
Antiplatelet therapy displays a critical role in the treatment and prevention of antithrombotic disorders. Many new antiplatelet agents have been developed following the emergence of various clinical limitations of classical antiplatelet drugs. This review covers mainly the recent advances in the development of P2Y12 antagonists and GPIIb/IIIa antagonists. Meanwhile, it summarizes promising approaches to new platelet surface receptors such as prostanoid EP3 receptor, thromboxane A2 prostanoid receptor, protease-activated receptors, GPIb-IX-V receptor and P-selectin...
June 20, 2017: Future Medicinal Chemistry
https://www.readbyqxmd.com/read/28629303/dual-antiplatelet-therapy-beyond-one-year-in-patients-after-stent-placement-a-review
#14
Jacob D Sumner, Brianna Zinser, Andrew Smith
PURPOSE: To review the evidence on the safety and efficacy of the continued use of dual antiplatelet therapy (DAPT) beyond 12 months after stent placement in patients following an acute coronary syndrome (ACS) event. SUMMARY: Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a focused update on the duration of DAPT in patients with coronary artery disease (CAD). The update makes new recommendations about the duration of DAPT in light of recently performed studies investigating this topic...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28618904/antiplatelet-and-antithrombotic-treatment-for-secondary-prevention-in-ischaemic-heart-disease
#15
Maddalena Lettino, Sergio Leonardi, Elia De Maria, Sigrun Halvorsen
Platelets play a key role in the pathogenesis of acute coronary syndromes and this is why antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in preventing recurrent myocardial infarction, stroke and cardiovascular death. Aspirin is the most used agent and still remains the first choice drug for lifelong administration in secondary prevention after myocardial infarction. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has significantly improved the outcome of patients with acute coronary syndromes despite an increased risk of bleeding complications...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28602895/risk-factors-for-sub-optimal-utilization-of-statins-and-antiplatelet-therapy-in-patients-undergoing-revascularization-for-symptomatic-peripheral-arterial-disease
#16
Andrew J Meltzer, Art Sedrakyan, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The objective of this study is to identify risk factors for sub-optimal medical therapy (defined as reported antiplatelet and statin use) among patients undergoing lower extremity bypass (LEB) and percutaneous interventions (PVI) for symptomatic peripheral arterial disease (PAD). METHODS: The Vascular Study Group of Greater New York (VSGGNY) database was used to identify all patients undergoing PVI or LEB for PAD (2011-2013). Bivariate analyses were performed to identifycharacteristics of patients who were not prescribed statins and/or antiplatelet agents prior to revascularization...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28600983/hpw-rx40-prevents-human-platelet-activation-by-attenuating-cell-surface-protein-disulfide-isomerases
#17
Po-Hsiung Kung, Pei-Wen Hsieh, Ying-Ting Lin, Jia-Hau Lee, I-Hua Chen, Chin-Chung Wu
Protein disulfide isomerase (PDI) present at platelet surfaces has been considered to play an important role in the conformational change and activation of the integrin glycoprotein IIb/IIIa (GPIIb/IIIa) and thus enhances platelet aggregation. Growing evidences indicated that platelet surface PDI may serve as a potential target for developing of a new class of antithrombotic agents. In the present study, we investigated the effects of HPW-RX40, a chemical derivative of β-nitrostyrene, on platelet activation and PDI activity...
May 29, 2017: Redox Biology
https://www.readbyqxmd.com/read/28597739/one-year-and-longer-dual-antiplatelet-therapy-after-an-acute-coronary-syndrome-a-belgian-position-paper
#18
Peter R Sinnaeve, Walter Desmet, Olivier Descamps, Sofie Gevaert, Guy De Backer, Philippe Kolh, Mathias Vrolix, Philippe Van De Borne, Antoine De Meester, Marc J Claeys, Christophe Beauloye
Acute coronary syndrome patients receive DAPT up to one year after their initial event. Exceptions to the guideline-recommended one-year rule, however, are not uncommon. The reasoning behind shorter treatments, such as unacceptable bleeding risk or urgent surgery, should be well documented in the patient's charts and discharge letter. Based on recent evidence, patients at high risk for repetitive events should continue on low-dose ticagrelor without a significant interruption at one year and indefinitely in the absence of excess bleeding risk...
February 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28596467/-embolic-stroke-of-undetermined-source
#19
Teruyuki Hirano
A new clinical construct, embolic stroke of undetermined source (ESUS) was established as a therapeutically relevant entity, which are defined as a non-lacunar infarction without proximal arterial stenosis or cardioembolic sources, with a clear indication for anticoagulation, especially with direct oral anticoagulant (DOAC). The possible embolic sources include covert atrial fibrillation, arterial stenosis with <50%, low-risk emboligenic cardiac sources, aortic plaque, cancer-associated, and paradoxical embolism...
June 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28592700/thrombosis-in-diabetes-a-shear-flow-effect
#20
REVIEW
Erik Westein, Thomas Hoefer, Anna C Calkin
Cardiovascular events are the major cause of morbidity and mortality in Type 2 diabetes (T2D). This condition is associated with heightened platelet reactivity, contributing to increased atherothrombotic risk. Indeed, individuals with diabetes respond inadequately to standard antiplatelet therapy. Furthermore, they often experience recurrent events as well as side effects that include excess bleeding. This highlights the need for identification of novel regulators of diabetes-associated thrombosis to target for therapeutic intervention...
June 15, 2017: Clinical Science (1979-)
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