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Antithrombotic therapy

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https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#1
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28337781/rationale-and-design-of-a-multicenter-international-and-collaborative-coronary-artery-aneurysm-registry-caar
#2
Iván J Núñez-Gil, Luis Nombela-Franco, Rodrigo Bagur, Mario Bollati, Enrico Cerrato, Emilio Alfonso, Christoph Liebetrau, José María De la Torre Hernandez, Benjamín Camacho, Rafael Mila, Ignacio J Amat-Santos, Fernando Alfonso, Ramón Rodríguez-Olivares, Santiago J Camacho Freire, Íñigo Lozano, Víctor Alfonso Jiménez Díaz, Davide Piraino, Roberto Adriano Latini, Gisela Feltes, Jose Antonio Linares, Massimo Mancone, Alfonso Ielasi, Alejandro Sánchez-Grande Flecha, Agustín Fernández Cisnal, Fabrizio Ugo, Jesús M Jiménez Mazuecos, Pierluigi Omedè, Marco Pavani, Pedro A Villablanca, Boshra F Louka, Antonio Fernández-Ortiz
Coronary artery aneurysm is defined as a coronary dilation that exceeds the diameter of adjacent segments or the diameter of the patient's largest normal coronary vessel by 1.5×. It is an uncommon disease that has been diagnosed with increasing frequency since the widespread appearance of coronary angiography. The published incidence varies from 1.5% to 5%, suggesting male dominance and a predilection for the right coronary artery. Although several causes have been described, atherosclerosis accounts for ≥50% of coronary aneurysms in adults...
March 24, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28335516/marine-diterpenes-molecular-modeling-of-thrombin-inhibitors-with-potential-biotechnological-application-as-an-antithrombotic
#3
Rebeca Cristina Costa Pereira, André Luiz Lourenço, Luciana Terra, Paula Alvarez Abreu, Valéria Laneuville Teixeira, Helena Carla Castro
Thrombosis related diseases are among the main causes of death and incapacity in the world. Despite the existence of antithrombotic agents available for therapy, they still present adverse effects like hemorrhagic risks which justify the search for new options. Recently, pachydictyol A, isopachydictyol A, and dichotomanol, three diterpenes isolated from Brazilian marine brown alga Dictyota menstrualis were identified as potent antithrombotic molecules through inhibition of thrombin, a key enzyme of coagulation cascade and a platelet agonist...
March 20, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28334544/-antiplatelet-thromboprophylaxis-of-arterial-vascular-diseases-and-organovascular-ischemic-diseases
#4
Peter Gavorník, Andrej Dukát, Ľudovít Gašpar, Eva Gavorníková, Naďa Hučková, Anna Petrášová, Gabriela Gubo, Iveta Gašparová, Lujza Sabolová
Antiplatelet therapy by acetylsalicylic acid (ASA, aspirin) provided pivotal advances in the prevention and treatment of organovascular (angiovascular, cardiovascular, cerebrovascular, extremitovascular, renovascular, genitovascular, mesenteriointestinokolonovascular, bronchopulmovascular, oculovascular, otovascular and other) arterial ischemic diseases. Currently available antiplatelet drugs have some limitations which might be overcomed by improved dosing regimens, use of combination of agents affecting different platelet functions and, in particular, by the new antiplatelet drugs (new arterial antithrombotics) with distinct pharmacodynamic properties offering new advantages, including faster onset of action, greater potency, and reversibility of effects...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28330690/subclinical-leaflet-thrombosis-in-surgical-and-transcatheter-bioprosthetic-aortic-valves-an-observational-study
#5
Tarun Chakravarty, Lars Søndergaard, John Friedman, Ole De Backer, Daniel Berman, Klaus F Kofoed, Hasan Jilaihawi, Takahiro Shiota, Yigal Abramowitz, Troels H Jørgensen, Tanya Rami, Sharjeel Israr, Gregory Fontana, Martina de Knegt, Andreas Fuchs, Patrick Lyden, Alfredo Trento, Deepak L Bhatt, Martin B Leon, Raj R Makkar
BACKGROUND: Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter valve replacement (TAVR) and surgical aortic valve replacement (SAVR) has been found with CT imaging. The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR...
March 19, 2017: Lancet
https://www.readbyqxmd.com/read/28329215/triple-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-a-viewpoint
#6
Jennifer C V Gwyn, Mark R Thomas, Paulus Kirchhof
Patients undergoing percutaneous coronary intervention (PCI) are treated with dual antiplatelet therapy to reduce the risk of subsequent myocardial infarction (MI) and stent thrombosis. Approximately 5-10% of patients undergoing PCI also have atrial fibrillation (AF). Patients with AF have an additional requirement for anticoagulation, as dual antiplatelet therapy alone is insufficient to adequately reduce the risk of stroke in patients with AF. However, it is now well established that combining anticoagulants with dual antiplatelet therapy also causes a significant increase in the risk of bleeding...
March 13, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28325639/gemini-acs-1-toward-unearthing-the-antithrombotic-therapy-cornerstone-for-acute-coronary-syndromes
#7
Paul A Gurbel, Udaya S Tantry
No abstract text is available yet for this article.
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#8
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28320608/antithrombotic-agents-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-network-meta-analysis
#9
Alexander C Fanaroff, Vic Hasselblad, Matthew T Roe, Deepak L Bhatt, Stefan K James, Ph Gabriel Steg, C Michael Gibson, E Magnus Ohman
BACKGROUND: Nine oral antithrombotic medications currently available in the United States and Europe have been studied in clinical trials for secondary prevention of cardiac events following acute coronary syndrome (ACS). Few combinations of these medications have been directly compared, and studies have used multiple different comparator regimens. METHODS: We performed a systematic review and network meta-analysis of randomized controlled trials evaluating one or more available oral antithrombotic therapies in patients with ACS or prior myocardial infarction (MI)...
March 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28319521/warfarin-and-aspirin-versus-warfarin-alone-for-prevention-of-embolic-events-in-patients-with-a-heartmate-ii%C3%A2-left-ventricular-assist-device
#10
Joseph S Van Tuyl, Ian B Hollis, Khalid A Alburikan, Richard Tran, Brian P Murray, Jo E Rodgers, Jason N Katz, Brett C Sheridan
Acquired von Willebrand disease increases bleeding risk in patients implanted with a continuous-flow left ventricular assist device. Lower aspirin doses decrease the risk of bleeding without an increased risk of embolic events. No published studies in the U.S. have compared the incidence of bleeding and thrombotic events between antithrombotic regimens with and without aspirin. A single-center, retrospective analysis was conducted of adult patients implanted with a HM II. Patients received warfarin and aspirin 81 mg daily or warfarin alone...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28318007/myocardial-infarction-in-a-neonate-lessons-for-neonatal-and-internal-medicine
#11
Werner Streif
Due to the lack of evidence-based guidelines, management strategies for neonatal MI should be individualized and administered largely at the discretion of responsible treating teams. Supportive care with a focus on preserving adequate circulation and antithrombotic therapy with a view to restoring vascular patency are the mainstays of treatment. Thrombolytic therapy of neonatal MI includes a chance to completely restore myocardial function. Understanding the resilience of the neonatal heart and mechanism of cardiac cell repair in neonates may spark novel treatment strategies for severe MI in the large number of affected individuals in an aging population...
March 20, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28317626/one-year-survival-is-not-affected-by-gastrointestinal-bleeding-after-percutaneous-coronary-interventions
#12
Kyari Sumayin Ngamdu, Wael El Mallah, Alok Dwivedi, Rabab Mohsin, Sherif Elhanafi, Yi Jia, Luis A Alvarado, Debabrata Mukherjee, Marc J Zuckerman
BACKGROUND: Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes, and early antithrombotic agents as well as 1-year dual antiplatelet therapy are required for adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within 1 year after PCI to those who did not develop bleeding. METHODS: A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28317289/stroke-recurrence-in-patients-with-atrial-fibrillation-concomitant-carotid-artery-stenosis-doubles-the-risk
#13
H Lehtola, K E J Airaksinen, P Hartikainen, J E K Hartikainen, A Palomäki, I Nuotio, A Ylitalo, T Kiviniemi, P Mustonen
BACKGROUND AND PURPOSE: Atrial fibrillation (AF) and significant carotid artery stenosis (CAS) often coexist in patients with acute stroke but whether CAS affects the stroke recurrence rate in anticoagulated AF patients is largely unknown. The effect of concomitant CAS on both short- and long-term prognosis after stroke in patients with AF was evaluated. METHODS: The multicentre, retrospective FibStroke registry included AF patients with an ischaemic stroke or transient ischaemic attack (TIA) during 2003-2012...
March 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28302280/blunt-cerebrovascular-injury-in-children
#14
Stephen J Fenton, Robert J Bollo
Blunt cerebrovascular injury in children is an uncommon occurrence that if missed and left untreated can result in devastating long-term neurologic consequences. Diagnosis can be readily obtained by a computed tomographic angiogram of the head and neck. If confirmed, treatment with antithrombotic therapy dramatically reduces the risk of a cerebrovascular accident. The difficulty lies in determining which child should be screened for such an injury. Several institutions have come up with criteria for screening...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28295638/effect-of-direct-oral-anticoagulants-on-the-risk-of-delayed-bleeding-after-gastric-endoscopic-submucosal-dissection
#15
Toshiyuki Yoshio, Hideomi Tomida, Ryuichiro Iwasaki, Yusuke Horiuchi, Masami Omae, Akiyoshi Ishiyama, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida, Junko Fujisaki, Takuya Yamada, Eiji Mita, Tomoyuki Ninomiya, Kojiro Michitaka, Masahiro Igarashi
OBJECTIVES: Anticoagulants are used to prevent thromboembolic event. Direct oral anticoagulants (DOACs) are our new choice; however, their effect on the bleeding risk for endoscopic treatment has not been reported. We aimed to assess the clinical effect of DOACs compared to warfarin for gastric endoscopic submucosal dissection (ESD). METHODS: We retrospectively studied 97 patients on anticoagulants treated 108 gastric neoplasms with ESD in three referral institutes...
March 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28291892/association-of-preceding-antithrombotic-treatment-with-acute-ischemic-stroke-severity-and-in-hospital-outcomes-among-patients-with-atrial-fibrillation
#16
MULTICENTER STUDY
Ying Xian, Emily C O'Brien, Li Liang, Haolin Xu, Lee H Schwamm, Gregg C Fonarow, Deepak L Bhatt, Eric E Smith, DaiWai M Olson, Lesley Maisch, Deidre Hannah, Brianna Lindholm, Barbara L Lytle, Michael J Pencina, Adrian F Hernandez, Eric D Peterson
Importance: Antithrombotic therapies are known to prevent stroke for patients with atrial fibrillation (AF) but are often underused in community practice. Objectives: To examine the prevalence of patients with acute ischemic stroke with known history of AF who were not receiving guideline-recommended antithrombotic treatment before stroke and to determine the association of preceding antithrombotic therapy with stroke severity and in-hospital outcomes. Design, Setting, and Participants: Retrospective observational study of 94 474 patients with acute ischemic stroke and known history of AF admitted from October 2012 through March 2015 to 1622 hospitals participating in the Get With the Guidelines-Stroke program...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28289746/advances-in-anticoagulation-management-of-patients-undergoing-cardioversion-of-nonvalvular-atrial-fibrillation
#17
Georgios Benetos, Maria Bonou, Konstantinos Toutouzas, Panagiotis Diamantopoulos, Nora Viniou, John Barbetseas
Atrial fibrillation (AF) is a major cause of stroke. The restoration of sinus rhythm through cardioversion, either chemical or electrical is a common practice. Interestingly, there is an incremental increase from the baseline risk for embolisation in the immediate post-cardioversion period, with most events occurring within 10 days from cardioversion. Especially patients with recent onset AF show the lowest rates of antithrombotic therapy, while having a high stroke risk. Despite the increased risk for embolisation, anticoagulation in patients undergoing cardioversion of atrial fibrillation is often inadequate...
March 14, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28289668/the-efficacy-of-laparoscopic-cholecystectomy-without-discontinuation-in-patients-on-antithrombotic-therapy
#18
Jong Hyuk Yun, Hae Il Jung, Hyoung Uk Lee, Moo-Jun Baek, Sang Ho Bae
PURPOSE: Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries in the world today. However, there is no consensus regarding whether LC can be performed in patients with acute cholecystitis while on antithrombotic therapy. The objective of our study was to describe postoperative outcomes of patients who underwent emergent LC without interruption to antithrombotic therapy. METHODS: We performed a retrospective review of patients who underwent LC for acute cholecystitis while on antithrombotic therapy from 2010 to 2015 at Soonchunhyang Universtiy Cheonan Hospital...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28286764/phase-i-and-phase-ii-therapies-for-acute-ischemic-stroke-an-update-on-currently-studied-drugs-in-clinical-research
#19
REVIEW
Cesar Reis, Onat Akyol, Wing Mann Ho, Camila Araujo, Lei Huang, Richard Applegate Ii, John H Zhang
Acute ischemic stroke is a devastating cause of death and disability, consequences of which depend on the time from ischemia onset to treatment, the affected brain region, and its size. The main targets of ischemic stroke therapy aim to restore tissue perfusion in the ischemic penumbra in order to decrease the total infarct area by maintaining blood flow. Advances in research of pathological process and pathways during acute ischemia have resulted in improvement of new treatment strategies apart from restoring perfusion...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28284365/initiation-and-duration-of-dual-antiplatelet-therapy-after-inpatient-percutaneous-coronary-intervention-with-stent-implantation-in-germany-an-electronic-healthcare-database-cohort-study
#20
Andres Luque Ramos, Christoph Ohlmeier, Dirk Enders, Roland Linder, Dirk Horenkamp-Sonntag, Jürgen H Prochaska, Rafael Mikolajczyk, Edeltraut Garbe
BACKGROUND: Studies assessing the routine outpatient dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in Germany are scarce. The aim of this study was (i) to investigate the initiation and duration of DAPT after inpatient PCI with stent implantation in Germany, and (ii) to identify factors associated with DAPT discontinuation during the recommended treatment period. METHODS: This retrospective cohort study was based on data from a large German electronic healthcare database of the years 2004 to 2009...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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