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https://www.readbyqxmd.com/read/28742645/quality-improvement-in-management-of-acute-coronary-syndrome-continuing-medical-education-and-peer-coaching-improve-antiplatelet-medication-adherence-and-reduce-hospital-readmissions
#1
Amy Larkin, Michael LaCouture, Kathleen Geissel, Peri Barr, Eric R Bates, Christopher P Cannon, Deepak L Bhatt
BACKGROUND: Reducing hospital readmissions and improving patient adherence to antiplatelet medications after an acute coronary syndrome (ACS) event are important goals for improving patient health and decreasing healthcare costs. Nearly half of patients will have a secondary event within 1 year of the initial ACS event. Quality improvement (QI) initiatives that include continuing medical education and peer coaching may improve physician practice patterns and, therefore, patient outcomes...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742195/the-use-of-susceptibility-weighted-imaging-to-detect-cerebral-microbleeds-after-lacunar-infarction
#2
L Shao, M Wang, X-H Ge, H-D Huang, L Gao, J-C Qin
OBJECTIVE: To study the value of susceptibility-weighted imaging (SWI) technology to detect cerebral microbleeds (CMBs) in senile cerebral lacunar infarction patients; and to evaluate the complicated cerebral hemorrhage risk after patients with CMBs took aspirin, an antiplatelet medication or received anticoagulant therapy. PATIENTS AND METHODS: MRI scanning, using GRE-T2*WI, SWI and FSE sequences (T1WI, T2WI, and T2FLAIR), was performed on the three groups: (1) a cerebral lacunar infarction group; (2) cerebral lacunar infarction with cerebral microbleeds (CMBs) group; and (3) a healthy elderly group...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#3
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740396/antithrombotic-prophylaxis-of-atrial-fibrillation-in-an-italian-real-world-setting-a-retrospective-study
#4
Giuliano Ermini, Valentina Perrone, Chiara Veronesi, Luca Degli Esposti, Giuseppe Di Pasquale
OBJECTIVES: The aims of this study were to assess the prevalence of diagnosed atrial fibrillation (AF), the drug use in patients with AF in terms of antithrombotic (AT) strategies used and the compliance with treatment, and to describe the characteristics of patients affected by AF in relation to treatment. METHODS: The data collected were provided from databases of general practitioners (GPs) of the Local Health Unit of Bologna in Italy. From January 1, 2009, to December 31, 2012, all subjects aged ≥18 years followed by the 44 GPs enrolled in the study were evaluated, and the subjects with a diagnosis of AF were included in the analysis...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28739563/efficacy-of-new-low-dose-oral-anticoagulants-in-recalcitrant-livedoid-vasculopathy
#5
Fumina Furukawa, Megumi Mizawa, Teruhiko Makino, Tadamichi Shimizu
Livedoid vasculopathy (LV) is a thrombotic skin disease characterised by recurrent painful ulcerations and irreversible scar formation on the lower legs, which is caused by occlusion of the cutaneous microcirculation. Edoxaban is one of new oral anticoagulants. It directly inhibits factor Xa in the coagulation pathway and prevents thrombus formation. A 17-year-old Japanese male presented with a 1-year history of recalcitrant cutaneous ulcers and livedo racemosa on his lower extremities. Initially, the ulcers were treated with antiplatelets therapies; however, he experienced recurrence of ulcerations during summer time...
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28736385/thromboembolic-risk-bleeding-outcomes-and-effect-of-different-antithrombotic-strategies-in-very-elderly-patients-with-atrial-fibrillation-a-sub-analysis-from-the-prefer-in-af-prevention-of-thromboembolic-events-european-registry-in-atrial-fibrillation
#6
Giuseppe Patti, Markus Lucerna, Ladislav Pecen, Jolanta M Siller-Matula, Ilaria Cavallari, Paulus Kirchhof, Raffaele De Caterina
BACKGROUND: Increasing age predisposes to both thromboembolic and bleeding events in patients with atrial fibrillation; therefore, balancing risks and benefits of antithrombotic strategies in older populations is crucial. We investigated 1-year outcome with different antithrombotic approaches in very elderly atrial fibrillation patients (age ≥85 years) compared with younger patients. METHODS AND RESULTS: We accessed individual patients' data from the prospective PREFER in AF (PREvention oF thromboembolic events-European Registry in Atrial Fibrillation), compared outcomes with and without oral anticoagulation (OAC), and estimated weighed net clinical benefit in different age groups...
July 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28736132/high-on-treatment-platelet-reactivity-to-adenosine-diphosphate-predicts-ischemic-events-of-minor-stroke-and-transient-ischemic-attack
#7
Zilong Rao, Huaguang Zheng, Fei Wang, Anxin Wang, Liping Liu, Kehui Dong, Xingquan Zhao, Yibin Cao, Yilong Wang
BACKGROUND: This study aimed to evaluate the relationship between thromboelastography adenosine diphosphate maximum amplitude (TEG-ADPMA) and recurrent ischemic events in patients with minor ischemic stroke or high-risk transient ischemic attack (TIA). METHODS: A total of 265 patients received dual antiplatelet therapy were consecutively enrolled. High on-treatment platelet reactivity (HTPR) to ADP was assessed by TEG-ADPMA and detected the CYP2C19 genotype; recurrent ischemic events were followed up for 90 days after onset...
July 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28736131/variation-in-organization-of-transient-ischemic-attack-care-in-the-netherlands-a-nationwide-survey-study
#8
Fenna Floortje Muller, Frank de Beer, Marieke Christine Visser
BACKGROUND: Previous research has shown the importance of urgent initiation of antiplatelet therapy after transient ischemic attack (TIA) to reduce the risk of stroke. Many hospitals in the Netherlands have therefore implemented rapid pathways for assessment of patients with TIA. Dutch stroke guidelines lack clear directives for organization of TIA assessment and thus allow for variation. The aim of this study was to investigate variation in organization of TIA assessment in Dutch hospitals...
July 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28736052/-new-oral-anticoagulants-in-coronary-artery-disease
#9
Guillaume Cayla, Florence Leclercq, Luc Cornillet, Bertrand Ledermann, Laurent Schmutz, Benoit Lattuca
Antiplatelet therapy is essential for the prevention of recurrent cardiovascular events in stable and unstable coronary artery disease. Oral anticoagulants have been rarely used for treatment of coronary artery disease. The new direct oral anticoagulants offer various molecules and dosages and may be used in coronary artery disease. Dedicated studies are currently being conducted to confirm the optimal doses and the ideal association of antithrombotic drugs in different settings of coronary artery disease.
July 20, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28734880/dual-versus-single-antiplatelet-regimen-with-or-without-anticoagulation-in-transcatheter-aortic-valve-replacement-indirect-comparison-and-meta-analysis
#10
Monica Verdoia, Lucia Barbieri, Matteo Nardin, Harry Suryapranata, Giuseppe De Luca
INTRODUCTION AND OBJECTIVES: There is uncertainty on the correct management of antithrombotic therapies after transcatheter aortic valve replacement (TAVR), with dual antiplatelet therapy (DAPT) being currently recommended on an empirical basis. The aim of the present meta-analysis was to assess the safety and effectiveness of DAPT in patients undergoing TAVR. METHODS: Studies comparing different antithrombotic regimens after TAVR were included. The primary endpoint was 30-day overall mortality...
July 19, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28734158/interaction-between-platelet-derived-micrornas-and-cyp2c19-2-genotype-on-clopidogrel-antiplatelet-responsiveness-in-patients-with-acs
#11
Li Peng, Jun Liu, Liuan Qin, Jia Liu, Shaozhi Xi, Caiyi Lu, Tong Yin
BACKGROUND: Both platelet-derived microRNAs and the genotype of CYP2C19*2 were implicated for the variability of clopidogrel antiplatelet responsiveness. However, their interaction on the antiplatelet responsiveness of clopidogrel in patients with acute coronary syndrome (ACS) remains unknown. METHODS: Consecutive clopidogrel-treated patients with ACS were recruited, with their antiplatelet responsiveness evaluated by the relative platelet inhibition (RI), as measured by light transmittance aggregometry (LTA) at baseline and 5days' after the maintenance treatment of clopidogrel...
July 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28733910/a-review-study-to-evaluate-holmium-yag-laser-lithotripsy-with-flexible-ureteroscopy-in-patients-on-ongoing-oral-anticoagulant-therapy
#12
Bulent Altay, Bulent Erkurt, Selami Albayrak
The objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified...
July 22, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28733742/self-expandable-metal-stents-for-the-extraction-of-common-bile-duct-stones-in-patients-receiving-dual-antiplatelet-agents-a-pilot-study
#13
Eunae Cho, Chang Hwan Park, Chung Hwan Jun, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew
BACKGROUND: Endoscopic sphincterotomy or endoscopic papillary balloon dilatation during endoscopic retrograde cholangiopancreatography (ERCP) are associated with a high risk of bleeding in patients receiving dual antiplatelet agents (APAs). However, the discontinuation of antiplatelet agents increases the risk of thromboembolic events in these patients. To date, the placement of self-expandable metal stents (SEMSs) in patients receiving dual APAs has not been well investigated. The aim of this study was to evaluate the feasibility and safety of SEMS placement for the removal of common bile duct (CBD) stones in patients in whom APAs were not discontinued...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733607/two-year-follow-up-of-vascular-events-in-peripheral-arterial-disease-treated-with-antiplatelet-agents-a-prospective-observational-multicenter-cohort-study-season
#14
Yukihito Higashi, Tetsuro Miyata, Hiroshi Shigematsu, Hideki Origasa, Masatoshi Fujita, Hiroshi Matsuo, Hiroaki Naritomi, Hiroaki Matsuda, Masahide Nakajima, Hideto Awano
The present analysis was intended to evaluate the real-world management of peripheral arterial disease (PAD) in Asia, and to explore cardiovascular events in patients with PAD undergoing antiplatelet therapy over 2 years of follow-up. The Surveillance of cardiovascular Events in Antiplatelet-treated arteriosclerosis Obliterans patients in JapaN (SEASON) registry is a prospective observational multicenter study of cardiovascular events in antiplatelet-treated patients with PAD in Japan. The SEASON registry included 11,375 patients who were scheduled to receive treatment for PAD...
July 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28732709/effects-of-antithrombotic-therapy-on-bleeding-after-endoscopic-submucosal-dissection-a-systematic-review-and-meta-analysis
#15
REVIEW
Jiaqi Dong, Kunyan Wei, Jiaqi Deng, Xi Zhou, Xiaomei Huang, MingMing Deng, Muhan Lü
BACKGROUND AND AIMS: Bleeding is the most common adverse event after ESD. Although several studies have been reported about the use of antithrombotic agents and post-ESD bleeding, many issues remain controversial. We conducted a meta-analysis and systematic review to evaluate the effects of antithrombotic therapy for post-ESD bleeding. METHODS: Published literature was searched from online databases, and all studies were inclusive until January 2017. Standard forms were used to extract data by 2 independent reviewers...
July 18, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28727358/-antiplatelet-therapy-in-secondary-stroke-prevention
#16
Lorenz Hirt, Emmanuel Carrera
New studies have refined the role of antiplatelet therapy in secondary prevention after noncardioembolic strokes. The first line antiplatelet therapy remains Aspirin. Clopidogrel and the combination aspirine plus dipyridamole are suitable alternatives with a slightly better protection. Ticagrelor, a reversible P2Y12 receptor inhibitor used in cardiology, has not demonstrated its superiority to Aspirin. Early after stroke, a double antiplatelet therapy combining Aspirin and clopidogrel is increasingly administered as a recent study demonstrated a decrease in the incidence of cerebrovascular events after a minor stroke or high-risk TIA...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727357/-spontaneous-carotid-and-vertebral-dissections
#17
Roman Sztajzel, Fabienne Perren, Patrik Michel
Dissections of the cervical arteries account for approximately 15-20 % of all strokes in young patients. Clinically they present with laterocervical and/or hemicranial pain associated to a Horner syndrome in case of carotid dissection and a posterior cervical pain associated to headache in the occipital area in case of vertebral dissection. A multifactorial origin is often suggested, resulting from the combination of a weakness of the arterial wall, hereditary or not, of environmental factors such minor trauma or a previous infection and also of the presence of a certain number of vascular risk factors such as high blood pressure or migraines...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726655/influence-of-beta-blockers-and-ivabradine-on-long-term-prognosis-of-patients-with-stable-angina
#18
T Ilashchuk, O Glubochenko, B Senyuk, N Bachuk-Ponich, I Lukashevich
The purpose of the study was to evaluate the influence of beta-blockers and ivabradine on long-term prognosis of patients with stable angina. 90 patients with stable angina that have been involved in present study along with nitrates, antiplatelet agents and statins received bisoprolol (Group I), carvedilol (Group II) and ivabradine (Group III). We analyzed the following indicators: patient adherence to treatment, cases of myocardial infarction and circulatory decompensation, which resulted in necessity of patient's hospitalization during the year of observation, calculating the probability of achieving a key prognostic endpoint by patient using the concept of the odds ratio and determination of important components in the progression of the disease...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28725328/heterozygous-familial-hypercholesterolemia-with-apoe-haplotype-a-prospective-harbinger-of-a-catastrophic-cardiovascular-event
#19
Glenmore Lasam, Siddesh Shambhu, Robert Fishberg
We report a very young man with heterozygous familial hypercholesterolemia (FH) with APOE haplotype and a significant cardiac family history who underwent cardiac catheterization for intermittent episodes of exertional dyspnea and was noted to have a severe triple vessel coronary artery disease (CAD). He underwent coronary artery bypass graft (CABG) surgery which was uneventful. He was discharged on antiplatelet, beta blocker, nitrate, and statin. On routine health maintenance evaluation, he had no cardiac complaints and had been tolerating well his activities of daily living...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#20
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
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