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Makoto Mizuno, Yusuke Ito, Atsuhiro Sugidachi
Few effective porcine models of myocardial infarction (MI) related to platelet thrombus formation are available. In this study, we established a novel porcine MI model and examined the effect of dual antiplatelet therapy (DAPT) with aspirin and prasugrel, a P2Y12 antagonist, using this MI model. Thrombotic MI was photochemically induced using rose bengal. Male miniature pigs were divided into 3 treatment groups: Sham, MI, and DAPT. In the DAPT group, aspirin (10mg/kg, p.o.) and prasugrel (1mg/kg, p.o.) were administered 4h before photo-irradiation...
July 14, 2018: European Journal of Pharmacology
Gerald Chi, Mathieu Kerneis, Arzu Kalayci, Yuyin Liu, Roxana Mehran, Christoph Bode, Jonathan L Halperin, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Marc Cohen, Eric D Peterson, Keith A A Fox, C Michael Gibson
BACKGROUND: The tradeoff in safety versus efficacy in substituting a non-vitamin K antagonist oral anticoagulant for a vitamin K antagonist (VKA) in the stented atrial fibrillation patient has not been quantitatively evaluated. METHODS: Based on summary data from the PIONEER AF-PCI and RE-DUAL PCI trials, 4 antithrombotic regimens were compared with VKA-based triple therapy: (1) rivaroxaban (riva) 15 mg daily + P2Y12 inhibitor, (2) riva 2.5 mg twice daily + P2Y12 inhibitor + aspirin, (3) dabigatran (dabi) 110 mg twice daily + P2Y12 inhibitor, and (4) dabi 150 mg twice daily + P2Y12 inhibitor...
June 13, 2018: American Heart Journal
Dennis G Maki
No abstract text is available yet for this article.
July 17, 2018: Annals of Internal Medicine
Hongjie Chen, Eileen M McGowan, Nina Ren, Sara Lal, Najah Nassif, Fatima Shad-Kaneez, Xianqin Qu, Yiguang Lin
Cardiovascular disease (CVD) is the leading cause of death in the world and our approach to the control and management of CVD mortality is limited. Nattokinase (NK), the most active ingredient of natto, possesses a variety of favourable cardiovascular effects and the consumption of Natto has been linked to a reduction in CVD mortality. Recent research has demonstrated that NK has potent fibrinolytic activity, antihypertensive, anti-atherosclerotic, and lipid-lowering, antiplatelet, and neuroprotective effects...
2018: Biomarker Insights
Masami Shingaki, Kiyofumi Morishita, Toshio Baba, Tsuyoshi Shibata, Kohei Narayama
PURPOSE: Often, we experience cases of aneurysm shrinkage and no aneurysm shrinkage after successful endovascular aortic aneurysm repair (EVAR), without postoperative endoleaks. We studied these cases to ascertain the predictive factors for aneurysm shrinkage. METHODS: From 2007 to 2014, we selected 255 cases that comprised aneurysm shrinkage (> 4 mm) and no-shrinkage cases (shrinkage from 0 to 4 mm). Excluding 36 cases of endoleaks, 43 cases without one-year follow-up CT scan, and 3 cases of aortic dissection, we assessed 93 cases of aneurysm shrinkage (S group) and 80 cases of no aneurysm shrinkage (N group) at one-year follow-up...
July 13, 2018: Annals of Vascular Surgery
Thomas Gremmel, Bettina Gisslinger, Heinz Gisslinger, Simon Panzer
Patients with myeloproliferative neoplasms (MPN) are at an increased risk of thrombotic events even during antiplatelet therapy. with aspirinIn the current study, we sought to investigate the association of the platelet count with the inhibitory potential of . antiplatelet therapy in MPN. We determined arachidonic acid (AA)- and adenosine diphosphate (ADP)-inducible platelet reactivity by multiple electrode aggregometry in 93 patients with essential thrombocythemia, polycythemia vera or primary myelofibrosis...
June 13, 2018: Translational Research: the Journal of Laboratory and Clinical Medicine
Jan Pluta, Barbara Nicińska, Michał Ciurzyński, Janusz Trzebicki
BACKGROUND: Platelets are responsible for primary haemostasis. Patients with suspected platelet dysfunction require prompt clinical assessment when qualifying for emergency surgical procedures. The purpose of this article is to present our experience in platelet function assessment using whole-blood multiple electrode aggregometry (MEA) in various clinical conditions. CASE REPORTS: Retrospective analysis of three patients with thrombocytopathy associated with normal platelet counts was performed using standard laboratory tests complemented by MEA...
July 16, 2018: Anaesthesiology Intensive Therapy
Suneela Mehta, Rod Jackson, Romana Pylypchuk, Katrina Poppe, Sue Wells, Andrew J Kerr
Background: Cardiovascular disease (CVD) risk prediction equations are primarily used in clinical settings to inform individual risk management decisions. We sought to develop and validate alternative equations derived solely from linked routinely collected national health data that could be applied countrywide to inform population health planning. Methods: Individual-level linkage of eight administrative health datasets identified all New Zealand residents aged 30-74 years in contact with publicly funded health services during 2006 with no previous hospitalizations for CVD or heart failure, and with complete data on eight pre-specified predictors...
July 12, 2018: International Journal of Epidemiology
Krista Nuotio, Petra Ijäs, Hanna M Heikkilä, Suvi M Koskinen, Jani Saksi, Pirkka Vikatmaa, Pia Sorto, Laura Mäkitie, Henrietta Eriksson, Sonja Kasari, Heli Silvennoinen, Leena Valanne, Mikko I Mäyränpää, Petri T Kovanen, Lauri Soinne, Perttu J Lindsberg
INTRODUCTION: Every fifth ischemic stroke is caused by thromboembolism originating from an atherosclerotic carotid artery plaque. While prevention is the most cost-effective stroke therapy, antiplatelet and cholesterol-lowering drugs have a ceiling effect in their efficacy. Therefore, discovery of novel pathophysiologic targets are needed to improve the primary and secondary prevention of stroke. This article provides a detailed study design and protocol of HeCES2, an observational prospective cohort study with the objective to investigate the pathophysiology of carotid atherosclerosis...
July 16, 2018: Annals of Medicine
Rita Marinheiro, Leonor Parreira, Pedro Amador, Isabel Silvestre, Carla Antunes, Rui Caria
BACKGROUND: Therapeutic uncertainty is inherent in decisions in patients with patent foramen ovale (PFO) and cryptogenic stroke. We aimed to determine clinical implications of PFO identification in transesophageal echocardiography (TEE) after a cryptogenic ischemic stroke. METHODS: Consecutive TEE done between 2011 and 2015 in patients with previous cryptogenic stroke was evaluated. Clinical implications of PFO identification (closure and/or medical therapy) were retrieved from the medical records and discharge summaries...
July 14, 2018: Journal of Echocardiography
John D Horowitz, Peter R Sage
No abstract text is available yet for this article.
July 2018: Circulation. Cardiovascular Interventions
Woo Jin Jang, Sung Gyun Ahn, Young Bin Song, Seung-Hyuk Choi, Woo Jung Chun, Ju Hyeon Oh, Sung Woo Cho, Bum Sung Kim, Jung Han Yoon, Bon-Kwon Koo, Cheol Woong Yu, Yang Soo Jang, Seung-Jea Tahk, Hyo-Soo Kim, Hyeon-Cheol Gwon, Sung Yun Lee, Joo-Yong Hahn
BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306)...
July 2018: Circulation. Cardiovascular Interventions
Bernadette Aliprandi-Costa, Lucy Morgan, Lan-Chi Snell, Mario D Souza, Leonard Kritharides, John French, David Brieger, Isuru Ranasinghe
BACKGROUND: Increased access to reperfusion for ST elevation myocardial infarction (STEMI) has contributed to reduced mortality internationally. We describe temporal trends in pre-hospital care, in-hospital management and outcomes of the STEMI population in Australia. METHODS: Temporal trends with multiple regression analysis on the management and outcomes of STEMI patients enrolled across 46 Australian hospitals in the Australian cohort of the Global Registry of Acute Coronary Events (GRACE) and the Cooperative National Registry of Acute Coronary Care Guideline Adherence and Clinical Events (CONCORDANCE) between February 1999 and August 2016...
June 11, 2018: Heart, Lung & Circulation
Malgorzata M Bala, Elżbieta Paszek, Wiktoria Lesniak, Dorota Wloch-Kopec, Katarzyna Jasinska, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by the presence of antiphospholipid (aPL) antibodies that have prothrombotic activity. Antiphospholipid antibodies are associated with an increased risk of pregnancy complications (recurrent miscarriage, premature birth, intrauterine growth retardation) and thrombotic events (both arterial and venous). The most common thrombotic events include brain ischaemia (stroke or transient ischaemic attack) and deep vein thrombosis...
July 13, 2018: Cochrane Database of Systematic Reviews
Yoonsun Mo, Ayse Karakas-Torgut, Antony Q Pham
OBJECTIVE: The aim of this study is to assess patterns of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in an inpatient hospital setting. METHODS: A retrospective chart review was conducted at the Brookdale University Hospital and Medical Center (BUHMC) from January 2014 to November 2016. All adult patients admitted to the BUHMC who were treated with a DOAC for at least 3 days were screened. Among them, those who received selected interacting drugs at any time during the course of DOAC therapy were included in this study...
January 1, 2018: Journal of Pharmacy Practice
Dorota Danielak, Marta Karaźniewicz-Łada, Franciszek Główka
The introduction of ticagrelor, one of the first directly-acting oral antiplatelet drugs, provided new possibilities in the prevention of thrombotic events in patients with acute coronary syndromes (ACS). Current guidelines recommend ticagrelor in dual antiplatelet therapy with aspirin over clopidogrel for prevention of stent thrombosis in patients with ACS. Moreover, in the management of ACS, lipid-lowering treatment with high-intensity statin therapy is advised for secondary prevention of cardiovascular events over the long term...
July 12, 2018: Drugs
Beata Krasinska, Angelika Osińska, Maciej Osinski, Aleksandra Krasinska, Piotr Rzymski, Andrzej Tykarski, Zbigniew Krasiński
Introduction: Cardiovascular (CV) diseases remain a leading global cause of death. It has been proven that the use of acetylsalicylic acid (ASA) in secondary prevention reduces the CV risk, while the benefits of ASA in primary prevention have recently been debated. The aim of the study was to compare the antiplatelet effect of standardised tomato extract (STE) and ASA in hypertensive patients with high CV risk. Material and methods: The study involved high-risk patients with arterial hypertension (AH) randomly assigned to one of two groups: group 1 included 33 patients receiving ASA and group 2 included 32 patients receiving STE...
June 2018: Archives of Medical Science: AMS
Jan Pluta, Barbara Nicińska, Janusz Trzebicki
Platelets play an essential role in haemostasis. Assessment of their function is vital for anaesthesiologists evaluating haemostatic potential, especially during emergency operations. The monitoring of platelets function had been implemented into the European recommendations for management of perioperative and posttraumatic bleeding. One of the diagnostic methods described in the recommendations is multiple electrode aggregometry. As antiplatelet therapy becomes more widely used in modern medicine, this method, in contrast to standard laboratory tests, can significantly help to identify patients with drug-induced thrombocytopaty...
July 12, 2018: Anaesthesiology Intensive Therapy
Mikko T Holmberg, Aleksi Tornio, Maria Paile-Hyvärinen, E Katriina Tarkiainen, Mikko Neuvonen, Pertti J Neuvonen, Janne T Backman, Mikko Niemi
CYP3A enzymes participate in the elimination of ticagrelor and the bioactivation of clopidogrel and prasugrel. We studied the effects of functional CYP3A genetic variants (CYP3A4*22; rs35599367 and CYP3A5*3; rs776746) on the pharmacokinetics and pharmacodynamics of ticagrelor, clopidogrel, and prasugrel. Six healthy volunteers with the CYP3A4*1/*22 and CYP3A5*3/*3 genotype (CYP3A4*22 carriers), eight with the CYP3A4*1/*1 and CYP3A5*1/*3 genotype (CYP3A5 expressors), and 11 to 13 with the CYP3A4*1/*1 and CYP3A5*3/*3 genotypes (controls) ingested single doses of ticagrelor, clopidogrel, and prasugrel on separate occasions...
July 11, 2018: Clinical Pharmacology and Therapeutics
Saana Pihlasviita, Olli S Mattila, Juhani Ritvonen, Gerli Sibolt, Sami Curtze, Daniel Strbian, Heini Harve, Mikko Pystynen, Markku Kuisma, Turgut Tatlisumak, Perttu J Lindsberg
OBJECTIVES: To clarify diagnostic accuracy and consequences of misdiagnosis in the admission evaluation of stroke-code patients in a neurologic emergency department with less than 20-minute door-to-thrombolysis times. METHODS: Accuracy of admission diagnostics was studied in an observational cohort of 1,015 stroke-code patients arriving by ambulance as candidates for recanalization therapy between May 2013 and November 2015. Immediate admission evaluation was performed by a stroke neurologist or a neurology resident with dedicated stroke training, primarily utilizing CT-based imaging...
July 11, 2018: Neurology
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