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Gregory B Lim
No abstract text is available yet for this article.
March 22, 2018: Nature Reviews. Cardiology
Ilaria Cavallari, Giuseppe Patti
Platelets and the coagulation cascade play key roles in initiation, amplification, and perpetuation of acute coronary syndromes (ACS). In the past few years, there has been great progress in ACS antithrombotic treatment with the introduction of novel anticoagulants (fondaparinux and bivalirudin), more potent P2Y12 inhibitors (prasugrel and ticagrelor) and protease-activated receptor antagonists (vorapaxar). Nonetheless, patients with ACS frequently have recurrent ischemic events despite the use of currently recommended dual antiplatelet therapy, revascularization procedures as appropriate, and other evidence-based secondary preventive measures...
March 21, 2018: Internal and Emergency Medicine
Mohamed S ElGuindy, Ahmed M ElGuindy
Aneurysmal coronary artery disease (ACAD) comprises both coronary artery aneurysms (CAA) and coronary artery ectasia (CAE). The reported prevalence of ACAD varies widely from 0.2 to 10%, with male predominance and a predilection for the right coronary artery (RCA). Atherosclerosis is the commonest cause of ACAD in adults, while Kawasaki disease is the commonest cause in children and adolescents, as well as in the Far East. Most patients are asymptomatic, but when symptoms do exist, they are usually related to myocardial ischemia...
October 31, 2017: Global Cardiology Science & Practice
Akihide Konishi, Mami Ho, Yuko Shirai, Haruki Shirato
A prospective randomized clinical trial showed that the BioFreedom stent (Biosensors International), which is a polymer-free and carrier-free drug-coated stent, was significantly superior to a bare-metal stent (BMS) in patients at high bleeding risk who were receiving a 1-month course of dual antiplatelet therapy (DAPT). However, the stent thrombosis rate (2.01% for BioFreedom vs. 2.20% for BMS) was 4-6-fold higher than that of approved drug-eluting stents based on real-world data in Japan. Furthermore, the frequency of stent thrombosis at more than 1 month with the BioFreedom stent was slightly higher than that at less than 1 month...
March 21, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Thomas J Buell, Daniel M Raper, Dale Ding, Ching-Jen Chen, Kenneth C Liu
We report a case in which an intracranial dural arteriovenous fistula (DAVF) developed after endovascular treatment of a patient with idiopathic intracranial hypertension with venous sinus stenting (VSS). The pathogenesis may involve hemodynamic alterations secondary to increased poststenting venous sinus pressure, which may cause new arterial ingrowth into the fistulous sinus wall without capillary interposition. Despite administration of dual antiplatelet therapy, there may also be subclinical cortical vein thrombosis that contributed to DAVF formation...
March 21, 2018: Journal of Neurointerventional Surgery
Caiyun Jia, Ci Wei, Ming Hu, Jing Xu, Kun Niu, Chao Zhang, Peiyuan Lv, Ling Li, Yanhong Dong
OBJECTIVE: To investigate the clinical significance of antiplatelet aggregation therapy for patients diagnosed with acute cerebral infarction (ACI) complicated with the cerebral microbleeds (CMBs). METHODS: Thirty patients with ACI and 36 patients with intracerebral hemorrhage (ICH) were included in this research. Two groups, studied by susceptibility-weighted imaging (SWI), were compared in terms of the number, location, and severity of CMBs. Then, 30 cases of ACI patients were divided into CMBs sub-group and non-CMBs sub-group...
March 15, 2018: Journal of X-ray Science and Technology
Sachiyuki Tsukada, Motohiro Wakui
Background: Although studies have supported the utility of perioperative continuation of antiplatelet drugs, vasodilators, and cerebral ameliorators in most procedures, no study compared total volume of blood loss after total knee arthroplasty (TKA) in patients continuing and discontinuing these drugs. Methods: We retrospectively reviewed 266 consecutive patients undergoing TKA, and included 67 patients (25.2%) taking antiplatelet drugs, vasodilators, or cerebral ameliorators in this study...
March 2018: Arthroplasty Today
Zhengze Dai, Jie Gao, Shun Li, Rongrong Li, Zhaoyao Chen, Meng Liang, Xinfeng Liu, Gelin Xu
BACKGROUND AND PURPOSE: Platelet aggregation plays a vital role in the development of in-stent restenosis (ISR) after carotid angioplasty and stenting (CAS). Mean platelet volume (MPV) has been suggested as an index of platelet reactivity. This study aimed to investigate the association between MPV and ISR in CAS patients. METHODS: A total of 261 patients with CAS were enrolled. MPV was measured before CAS procedure. Digital subtraction angiography, computed tomographic angiography, or duplex ultrasonography was performed at 6 months and annually after the procedure...
March 20, 2018: Stroke; a Journal of Cerebral Circulation
Kristina Busygina, Janina Jamasbi, Till Seiler, Hans Deckmyn, Christian Weber, Richard Brandl, Reinhard Lorenz, Wolfgang Siess
Interaction of Von Willebrand factor (VWF) with platelet glycoprotein (GP) Ib and of collagen with GPVI is essential for thrombus formation on ruptured or eroded atherosclerotic plaques (atherothrombosis). GPIb and GPVI signal through Bruton tyrosine kinase (Btk) which can irreversibly be blocked by oral application of ibrutinib, an established therapy for chronic lymphocytic leukemia (CLL) with long term safety. We found that ibrutinib and the novel Btk-inhibitors acalabrutinib and ONO/GS-4059 block GPVI-dependent static platelet aggregation in blood exposed to human plaque homogenate and collagen but not to ADP or arachidonic acid...
March 20, 2018: Blood
Urmil Pandya, Jill Pattison, Chris Karas, Michael O'Mara
Patients with traumatic intracranial hemorrhage (ICH) with a clinical indication for antithrombotic medication present a clinical dilemma, burdened by the task of weighing the risks of hemorrhage expansion against the risk of thrombosis. We sought to determine the effect of subdural hemorrhage on the risk of hemorrhage expansion after administration of antithrombotic medication. Medical records of 1626 trauma patients admitted with traumatic ICH between March 1, 2008, and March 31, 2013, to a Level I trauma center were retrospectively reviewed...
March 1, 2018: American Surgeon
Benjamin E Peterson, Deepak L Bhatt
No abstract text is available yet for this article.
March 20, 2018: EuroIntervention
Amir Abukaresh, Rami Al-Abadlah, Bettina Böttcher, Khamis El-Essi
BACKGROUND: In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines. METHODS: For this clinical audit, we used simple random sampling to select files of patients admitted with the diagnosis of ischaemic stroke to the Al-Shifa Hospital...
February 21, 2018: Lancet
Frans Moll, Iris Baumgartner, Michael Jaff, Chuke Nwachuku, Marco Tangelder, Gary Ansel, George Adams, Thomas Zeller, John Rundback, Michael Grosso, Min Lin, Michele F Mercur, Erich Minar
PURPOSE: To report a randomized study that investigated the safety (risk of major bleeds) and potential efficacy of edoxaban, an oral anticoagulant that targets the major components of arterial thrombi, to prevent loss of patency following endovascular treatment (EVT). METHODS: Between February 2012 and June 2014, 203 patients who underwent femoropopliteal EVT were randomized to receive aspirin plus edoxaban or aspirin plus clopidogrel for 3 months in the Edoxaban in Peripheral Arterial Disease (ePAD) study ( ClinicalTrials...
April 2018: Journal of Endovascular Therapy
Guangtao Yao, Guohai Su, Keqing Li, Bin Li, Hongwei Dong
Objectives: Comparison of Ticagrelor vs clopidogrel in antiplatelet therapeutic effect of acute myocardial infarction patients undergoing percutaneous coronary intervention. Methods: The study focused on 2000 acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI) in our hospital from January 2013 to December 2015. To reduce the formation of acute stent thrombosis caused by clopidogrel resistance, we had two options, one was to double the dosage of clopidogrel, and the other was to substitute ticagrelor for clopidogrel...
December 2017: Saudi Journal of Biological Sciences
Agata Kosobucka, Piotr Michalski, Łukasz Pietrzykowski, Michał Kasprzak, Karolina Obońska, Tomasz Fabiszak, Mirosława Felsmann, Aldona Kubica
Introduction: A substantial subset of patients after myocardial infarction (MI) discontinue pivotal medication early after discharge. In particular, cessation of antiplatelet treatment may lead to catastrophic ischemic events. Thus, adherence to prescribed medication in patients after MI is an issue of medical and social concern. Purpose: The aim of the study was to evaluate the level of adherence to treatment using a newly developed scale in patients after MI treated with percutaneous coronary intervention...
2018: Patient Preference and Adherence
Alexander Kulik, Amy M Abreu, Viviana Boronat, Nicholas T Kouchoukos, Marc Ruel
RATIONALE: Saphenous vein graft disease remains a major limitation of coronary artery bypass graft surgery (CABG). Up to 20% of vein grafts will occlude within the first year after CABG despite standard aspirin antiplatelet therapy. However, more potent postoperative platelet inhibition with ticagrelor may improve graft patency. The goal of this study will be to evaluate the efficacy of ticagrelor, as compared to aspirin, for the prevention of saphenous vein graft occlusion following CABG...
March 15, 2018: Contemporary Clinical Trials
Tomas Vedin, Sebastian Svensson, Marcus Edelhamre, Mathias Karlsson, Mikael Bergenheim, Per-Anders Larsson
PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury...
March 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jay Giri, Ashwin Nathan
No abstract text is available yet for this article.
March 8, 2018: JACC. Cardiovascular Interventions
Mathieu Kerneis, C Michael Gibson, Gerald Chi, Roxana Mehran, Fahad AlKhalfan, Usama Talib, Seyedmahdi Pahlavani, Mahshid Mir, Christoph Bode, Jonathan L Halperin, Tarek Nafee, Eric D Peterson, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Keith A A Fox, Marc Cohen
OBJECTIVES: This study sought to assess whether there were significant interactions of procedural access strategies and lesion characteristics with bleeding and ischemic events among atrial fibrillation (AF) patients anticoagulated with rivaroxaban or warfarin following a percutaneous coronary intervention. BACKGROUND: Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear...
March 8, 2018: JACC. Cardiovascular Interventions
Xiao Yang, Massoud A Leesar, Hinan Ahmed, Vasili Lendel, Gerardo Rodriguez, Deniz Mutlu, Ian Cawich, Anand Prasad, Meagan Oglesby, Kostas Marmagkiolis, Nathanael E Phillips, Dijkstra Jouke, Joel Michalek, Qianqian Liu, Thomas Milner, Austin McElroy, Taylor Hoyt, Marc D Feldman, Mehmet Cilingiroglu
PURPOSE: To compare OCT identified white thrombus decline, neointimal hyperplasia and clinical outcomes of patients treated with ticagrelor plus aspirin with those patients treated with clopidogrel plus aspirin after peripheral interventions. BACKGROUND: Ticagrelor is a potent platelet inhibitor. In patients with coronary artery disease, ticagrelor and aspirin demonstrated reduced rates of stent thrombosis, compared to aspirin and clopidogrel. The clinical importance of potent antiplatelet inhibition after peripheral endovascular interventions is unknown...
February 23, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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