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antiplatelete therapy

Sisir Siddamsetti, Senthil Balasubramanian, Srikanth Yandrapalli, Aviral Vij, Udit Joshi, Gilbert Tang, Vamsi Kodumuri
The present American College of Cardiology/American Heart Association guidelines (Grade IIb, level of evidence C) recommend dual antiplatelet therapy (DAPT) with aspirin and clopidogrel for 6 months followed by lifelong aspirin after transcathter aortic valve implantation (TAVI). However, studies that have compared DAPT to single antiplatelet therapy (SAPT) after TAVI have questioned this recommendation as DAPT has been associated with more bleeding events compared with SAPT. We performed a meta-analysis of all the trials that compared DAPT to SAPT in patients who underwent TAVI...
October 15, 2018: American Journal of Cardiology
Maria-Ioanna Stefanou, Dominik Rath, Vera Stadler, Hardy Richter, Florian Hennersdorf, Henning F Lausberg, Mario Lescan, Simon Greulich, Sven Poli, Meinrad P Gawaz, Ulf Ziemann, Annerose M Mengel
Background: Cardiac myxoma (CM) is the most frequent, cardiac benign tumor and is associated with enhanced risk for cerebrovascular events (CVE). Although surgical CM excision is the only curative treatment to prevent CVE recurrence, in recent reports conservative treatment with antiplatelet or anticoagulant agents in high-risk patients with CM-related CVE has been discussed. Methods: Case records at the University Hospital of Tübingen between 2005 and 2017 were screened to identify patients with CM-related CVE...
2018: Frontiers in Neurology
Yung-Ho Hsu, Yu-Chun Yen, Yi-Chun Lin, Li-Chin Sung
BACKGROUND: In this study, we evaluated the effects of various medications on the patency of vascular access (VA) for hemodialysis. METHODS: We analyzed data from the Longitudinal Health Insurance Database of Taiwan. We adopted a case-control study design within a cohort of patients who had received regular hemodialysis between 2002 and 2012; 34,354 patients with first VA failure were identified, and the duration from VA creation date to the first VA failure date was calculated...
2018: PloS One
Kanchana Manakeng, Phongsak Prasertphol, Kunwadee Phongpao, Suporn Chuncharunee, Dalina Tanyong, Suchin Worawichawong, Saovaros Svasti, Pornthip Chaichompoo
Pulmonary arterial hypertension (PAH) is a serious complication in β-thalassemia. The mechanism of PAH development is believed to be through chronic platelet activation and red cell (RBC) membrane abnormality contributing to a hypercoagulable state and thrombosis, which consequently leads to the development of PAH. Extracellular vesicles (EVs) shed from the plasma membrane of platelets and RBCs are found to be associated with thrombotic risk. This study aimed to investigate the involvement of phosphatidylserine (PS)-bearing cells and EVs in accelerating the progression of the hypercoagulable state in transfusion-dependent thalassemia (TDT) patients...
October 18, 2018: Annals of Hematology
Samer Al Said, Christoph Bode, Daniel Duerschmied
The prevention of atherothrombotic events is an essential therapeutic goal in the treatment of patients with arteriosclerotic diseases. After plaque rupture, a rapidly growing thrombus can lead to acute vascular occlusion and thus heart attack, stroke or limb ischaemia. The acute therapy combines anticoagulation and platelet inhibition. However, the only available therapy so far in the primary and secondary prevention of stable patients is the platelet inhibitors aspirin and clopidogrel. Despite the use of antiplatelet therapies, including aspirin and P2Y12 -receptor antagonists, some patients with artery disease continue to experience recurrent cardiovascular ischaemic events due to excessive thrombin generation beyond the acute period...
October 17, 2018: Hämostaseologie
Hans-Christoph Diener, Christian Gerloff, David E Thaler, Jochen Wöhrle
PURPOSE OF REVIEW: This review summarises the results of randomised trials comparing closure of patent foramen ovale (PFO) with antithrombotic therapy in patients with cryptogenic stroke. RECENT FINDINGS: Initially, three randomised trials failed to show superiority of PFO closure over antithrombotic therapy in patients with cryptogenic stroke. Three recently performed trials and the prolongation of an earlier trial provided evidence that PFO closure in patients with cryptogenic stroke and an age range of 18-60 years is superior to stroke prevention with antiplatelet therapy...
October 17, 2018: Current Neurology and Neuroscience Reports
Rahul Sharma
No abstract text is available yet for this article.
October 16, 2018: Annals of Internal Medicine
Eran Glikson, Uri Chavkin, Ory Madgar, Doron Sagiv, Gabriel Nakache, Arkadi Yakirevitch, Michael Wolf, Eran E Alon
OBJECTIVES/HYPOTHESIS: To describe the characteristics and severity of epistaxis in patients taking factor Xa inhibitors novel anticoagulants. STUDY DESIGN: Retrospective cohort study. METHODS: A study of adult patients hospitalized due to spontaneous epistaxis under the treatment of warfarin, rivaroxaban, or apixaban between the years 2011 and 2017 was performed. A control group of patients under antiplatelet therapy (acetylsalicylic acid, clopidogrel) was included...
October 16, 2018: Laryngoscope
Joseph Pultar, Patricia P Wadowski, Simon Panzer, Thomas Gremmel
Antiplatelet agents significantly reduce mortality and morbidity in ischemic heart disease, cerebrovascular disease and peripheral artery disease (PAD), and are therefore part of guideline-driven daily medical treatment in these patients. Due to its beneficial effects in the secondary prevention of atherothrombotic events, aspirin remains the most frequently prescribed antiplatelet agent in cardiovascular disease. In patients with acute coronary syndromes (ACS) and in those undergoing angioplasty with stent implantation dual antiplatelet therapy with aspirin and an adenosine diphosphate (ADP) receptor antagonist is indicated...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Juliana Maria Dantas Mendonça Borges, Fernanda Oliveira de Carvalho, Isla Alcântara Gomes, Mario Borges Rosa, Antonio Carlos Sobral Sousa
Background: When prescribing antiplatelet agents, physicians face the challenge of protecting patients from thromboembolic events without inducing bleeding damage. However, especially in the perioperative period, the use of these medications requires a carefully balanced assessment of their risks and benefits. Objective: To conduct a systematic review to check whether the antiplatelet agent is to be maintained or suspended in the perioperative period of noncardiac surgeries...
2018: Therapeutics and Clinical Risk Management
Veysel Ozan Tanik, Tufan Cinar, Emre Arugaslan, Yavuz Karabag, Mert Ilker Hayiroglu, Metin Cagdas, Ibrahim Rencuzogullari, Mahmut Uluganyan
The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy (PRECISE-DAPT) score predicts the bleeding risk in patients treated with dual antiplatelet treatment after primary percutaneous coronary intervention (pPCI). This study aimed to determine the predictive value of the admission PRECISE-DAPT score for in-hospital mortality in patients with ST elevation myocardial infarction (STEMI) treated with pPCI. Of the 1418 patients enrolled, the study population was divided into 2 groups: PRECISE-DAPT score ≥25 and PRECISE-DAPT score <25...
October 15, 2018: Angiology
A Wolfromm, J Dallemagne
Thrombocytopenia is defined by a platelet level below 150 G/l. However, the limit of 100 G/l seems more appropriate to determine which thrombocytopenia will require further investigation. Initially, a thorough medical history should be performed as well as screening for any signs of bleeding. After having excluded the presence of platelet aggregates, it should be determined whether thrombocytopenia is isolated or associated with other abnormalities (cytopenias, coagulation disorder, abnormal renal or liver tests)...
2018: Revue Médicale de Bruxelles
Thomas A Zelniker, Christian T Ruff, Elliott M Antman, Robert P Giugliano
BACKGROUND: Patients with atrial fibrillation and concomitant coronary artery disease (CAD) are at higher risk for myocardial infarction or cardiovascular death, often require antiplatelet therapy and are therefore exposed to an increased risk of bleeding. This meta-analysis aimed to compare the efficacy and safety profile of non-vitamin K antagonist oral anticoagulants (NOACs) with warfarin in patients with atrial fibrillation and concomitant CAD. MATERIALS AND METHODS: We performed a trial-level meta-analysis of CAD subgroups from four trials of NOAC versus warfarin in patients with atrial fibrillation, comparing the primary trial endpoints (efficacy: stroke or systemic embolic event; safety: International Society on Thrombosis and Haemostasis major bleeding) in patients with versus those without CAD, and used interaction testing to assess for treatment effect modification...
October 15, 2018: European Heart Journal. Acute Cardiovascular Care
Jae Yoon Park, Wei Guo, Mohammed Al-Hijji, Abdallah El Sabbagh, Kebede H Begna, Thomas M Habermann, Thomas E Witzig, Bradley R Lewis, Amir Lerman, Joerg Herrmann
BACKGROUND: Cancer and cardiovascular diseases are the two leading causes of death in industrialized countries. Optimal management of life-threatening presentations of both of their diseases can pose significant challenges. The current study aimed to address the incidence, management, and outcome of acute coronary syndromes (ACS) in patients with active hematological malignancies. METHODS: This retrospective registry-based cohort study included adults with active leukemia or lymphoma who were hospitalized at Mayo Clinic Rochester from 01/01/2004 to 12/31/2014...
October 5, 2018: International Journal of Cardiology
José M de la Torre Hernández
No abstract text is available yet for this article.
September 15, 2018: International Journal of Cardiology
Alfonso Ielasi, Gianluca Campo, Bernardo Cortese, Massimo Leoncini, Attilio Varricchio, Salvatore Brugaletta, Enrico Favaretto, Massimo Fineschi, Davide Piraino, Paolo Calabria, Francesco Granata, Francesco Pisano, Marco Mussardo, Azeem Latib, Maurizio Tespili
BACKGROUND: data from clinical experiences with Absorb bioresorbable scaffold (BRS) in STEMI raised concerns among clinicians about the device safety because a noteworthy scaffold thrombosis (ScT) rate was reported at early and long-term follow-up. Nevertheless, pre-specified technical suggestions of how to perform an optimal BRS procedure in STEMI were lacking. In this study we sought to assess the 1-year results following a pre-specified BRS implantation strategy in ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI (pPCI)...
October 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Arnav Kumar, Kimi Sato, Kinjal Banerjee, Jyoti Narayanswami, Jorge Betancor, Vivek Menon, Divyanshu Mohananey, Anil Kumar Anumandla, Abhishek C Sawant, Amar Krishnaswamy, E Murat Tuzcu, Wael Jaber, Stephanie Mick, Lars G Svensson, Zoran B Popović, Eugene H Blackstone, Samir R Kapadia
OBJECTIVES: We investigated the hemodynamic durability of the transcatheter aortic valves (TAVs) using the updated Valve Academic Research Consortium-2 (VARC-2) criteria. BACKGROUND: The updated VARC-2 consensus criteria combine flow-dependent and flow-independent echocardiographic parameters for hemodynamic assessment of TAVR. Data on the hemodynamic durability of TAV and clinical risk factors associated with valve hemodynamic deterioration (VHD) are lacking. METHODS: All patients (n = 276) who received TAV between 2006 and 2012 and had ≥2 follow-up echocardiograms were studied...
October 12, 2018: Catheterization and Cardiovascular Interventions
V-E Bret, B Pougault, A Guy, S Castet, Y Huguenin, X Pillois, C James, M Fiore
Light transmission aggregometry (LTA) is still considered as the "gold standard" for platelet function assessment but, as acompletely manual technology, it is labour intensive. This challenge can be overcome by performing platelet aggregometry in anautomated method on a routine coagulation analyzer. We aimed to compare and correlate results obtained from a traditional manual LTA solution realized in our Reference Center with an optimized automated system using CE-marked agonist reagents. Platelet rich plasma from patients with suspected platelet disorders, von Willebrand disease or antiplatelet therapy have been assessed using a wide range of agonist concentrations...
October 12, 2018: Platelets
Matthew W Sherwood, Amit N Vora
PURPOSE OF REVIEW: This review aims to describe the current evidence and consensus recommendations around antiplatelet and anticoagulant management in three common clinical scenarios in transcatheter aortic valve replacement (TAVR): (1) recent percutaneous coronary intervention (PCI) preceding TAVR, (2) atrial fibrillation (AF) management in patients undergoing TAVR, and (3) bioprosthetic valve thrombosis management in TAVR. RECENT FINDINGS: Several small clinical trials have evaluated the use of single vs...
October 11, 2018: Current Cardiology Reports
Stephanie Q Ko, Linda R Valsdottir, Jordan B Strom, Yu-Chen Cheng, Atsushi Hirayama, Po-Hong Liu, Naoki Yanagisawa, Hsuan Yen, Changyu Shen, Robert W Yeh
The duration and type of dual antiplatelet therapy (DAPT) prescribed to patients after percutaneous coronary intervention (PCI) involves carefully balancing reduced ischemia and increased bleeding risk for individual patients. Whereas multiple bleeding risk scores exist, the performance of these models to predict long-term bleeding in the setting of DAPT across different settings and populations is unclear. Therefore, we performed a systematic review and meta-analysis to compare the performance of current bleeding risk prediction scores for predicting major long-term bleeding events in patients on DAPT post-PCI...
September 8, 2018: American Journal of Cardiology
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