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Oral antiplatelet

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https://www.readbyqxmd.com/read/28329215/triple-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-a-viewpoint
#1
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/28317619/membranoproliferative-glomerulonephritis-in-pregnancy
#2
Devika Nair, Laura Kidd, N Kevin Krane
BACKGROUND: Membranoproliferative glomerulonephritis (MPGN) is an uncommon form of glomerulonephritis and it can be particularly difficult to predict outcomes and manage women with this disorder during pregnancy. MATERIALS AND METHODS: The management of 3 successful pregnancies in women with MPGN from 1 center and previously described cases from the world literature are reviewed. This includes a number of large studies of pregnancy in women with underlying glomerular disease as well as small case series and individual reports...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28300867/consistent-platelet-inhibition-with-ticagrelor-60-mg-twice-daily-following-myocardial-infarction-regardless-of-diabetes-status
#3
Mark R Thomas, Dominick J Angiolillo, Marc P Bonaca, Ramzi A Ajjan, Heather M Judge, Fabiana Rollini, Francesco Franchi, Arif J Ahsan, Deepak L Bhatt, Julia F Kuder, Philippe Gabriel Steg, Marc Cohen, Rangasamy Muthusamy, Marc S Sabatine, Robert F Storey
Diabetes increases cardiovascular risk and reduces pharmacodynamic response to some oral antiplatelet drugs. This study aimed to determine whether ticagrelor 60 mg twice daily (bid) provided potent and consistent platelet inhibition in patients with vs without diabetes in the PEGASUS-TIMI 54 platelet function substudy. Out of 180 patients studied, 58 patients were randomised to and had received at least four weeks of ticagrelor 60 mg bid, with 20 (34 %) having diabetes, 58 patients received ticagrelor 90 mg bid, with 12 (21 %) having diabetes, and 64 patients received placebo, with 18 (28 %) having diabetes...
March 16, 2017: Thrombosis and Haemostasis
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
#4
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/28290994/derivation-and-validation-of-the-predicting-bleeding-complications-in-patients-undergoing-stent-implantation-and-subsequent-dual-antiplatelet-therapy-precise-dapt-score-a-pooled-analysis-of-individual-patient-datasets-from-clinical-trials
#5
Francesco Costa, David van Klaveren, Stefan James, Dik Heg, Lorenz Räber, Fausto Feres, Thomas Pilgrim, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Philippe Gabriel Steg, Thomas Zanchin, Tullio Palmerini, Lars Wallentin, Deepak L Bhatt, Gregg W Stone, Stephan Windecker, Ewout W Steyerberg, Marco Valgimigli
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor prevents ischaemic events after coronary stenting, but increases bleeding. Guidelines support weighting bleeding risk before the selection of treatment duration, but no standardised tool exists for this purpose. METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290900/-to-whom-among-patients-survivors-an-acute-coronary-syndrome-can-be-strengthened-two-antiplatelet-therapy-with-oral-anticoagulants
#6
E P Panchenko
No abstract text is available yet for this article.
October 2016: Kardiologiia
https://www.readbyqxmd.com/read/28284524/evaluation-of-atrial-fibrillation-management-and-cardiovascular-risk-profile-in-atrial-fibrillation-patients-a-cross-sectional-survey
#7
Gediminas Račkauskas, Vytautas Zabiela, Germanas Marinskis, Arvydas Baranauskas, Deimilė Balkutė, Justina Alunderytė, Aras Puodžiūkynas, Tomas Kazakevičius, Vilius Kviesulaitis, Audrius Aidietis
OBJECTIVE: The aim of this study to investigate the most frequent risk factors of atrial fibrillation (AF), co-morbidities, complications associated with AF and the use of anticoagulants and other medications in patients who were referred to university hospitals in Lithuania. MATERIALS AND METHODS: This cross-sectional study enrolled consecutive inpatients and outpatients with AF presenting to cardiologists in the two biggest Lithuanian university hospitals from November 2013 to May 2014...
February 20, 2017: Medicina
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#8
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28279076/triple-antithrombotic-therapy-with-aspirin-p2y12-inhibitor-and-warfarin-after-percutaneous-coronary-intervention
#9
Nathan J Verlinden, James C Coons, Carlo J Iasella, Sandra L Kane-Gill
BACKGROUND: Triple antithrombotic therapy is used in patients who require systemic anticoagulation and undergo percutaneous coronary intervention (PCI) requiring dual antiplatelet therapy. Bleeding with this combination is significant; however, few studies have described outcomes with the use of newer oral P2Y12 inhibitors in this setting. OBJECTIVES: We aimed to compare outcomes among patients prescribed triple therapy with prasugrel or ticagrelor compared to triple therapy with clopidogrel in patients who underwent PCI and required warfarin...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28278524/management-of-thrombotic-antiphospholipid-syndrome
#10
Cecilia Beatrice Chighizola, Maria Gabriella Raimondo, Pier Luigi Meroni
Persistent serum positivity for antiphospholipid antibodies (aPL) is required to diagnose antiphospholipid syndrome (APS), an autoimmune disease characterized by recurrent vascular thrombosis and/or pregnancy morbidity. The current therapeutic management of patients with thrombotic APS aims at preventing recurrences and long-term complications by attenuating the procoagulant state. There is overall consensus to reserve moderate-intensity anticoagulation to aPL-positive patients with a previous venous thrombosis; the therapeutic options for those with a history of arterial event comprise antiplatelet agents and high-intensity anticoagulation...
March 9, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28268087/longer-term-oral-antiplatelet-use-in-stable-post-myocardial-infarction-patients-insights-from-the-long-term-risk-clinical-management-and-healthcare-resource-utilization-of-stable-coronary-artery-disease-tigris-observational-study
#11
Shaun G Goodman, Jose C Nicolau, Gema Requena, Andrew Maguire, Stefan Blankenberg, Ji Yan Chen, Christopher B Granger, Richard Grieve, Stuart J Pocock, Tabassome Simon, Satoshi Yasuda, Ana Maria Vega, David Brieger
OBJECTIVE: To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions. METHODS: Patients ≥50years with prior MI 1-3years ago and ≥1 risk factor (age ≥65years, diabetes, 2nd prior MI >1yr ago, multivessel CAD, creatinine clearance 15-<60ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904)...
February 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28267384/comparison-of-p2y12-inhibitors-for-mortality-and-stent-thrombosis-in-patients-with-acute-coronary-syndromes-single-center-study-of-10-793-consecutive-real-world-patients
#12
Rebecca Gosling, Momina Yazdani, Yasir Parviz, Ian R Hall, Ever D Grech, Julian P Gunn, Robert F Storey, Javaid Iqbal
Three oral platelet P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are available for reducing the risk of cardiovascular death and stent thrombosis in patients with acute coronary syndromes (ACS). We sought to compare the efficacy of these antiplatelet drugs in contemporary practice. Data were collected for 10 793 consecutive ACS patients undergoing coronary angiography at Sheffield, UK (2009-2015). Since prasugrel use was mostly restricted to the STEMI subgroup, clopidogrel and ticagrelor were compared for all ACS patients, and all three agents were compared in the STEMI subgroup...
March 7, 2017: Platelets
https://www.readbyqxmd.com/read/28264245/clinical-course-and-results-of-surgery-for-chronic-subdural-hematomas-in-patients-on-drugs-affecting-hemostasis
#13
Tomasz Andrzej Dziedzic, Przemysław Kunert, Andrzej Marchel
OBJECTIVE: An apparent increase of use of drugs affecting hemostasis in our neurosurgical department since the 1990s has encouraged us to investigate whether these drugs influence the clinical course and results of surgery for chronic subdural hematoma (CSDH). METHODS: This retrospective analysis included 178 patients admitted for CSDH from 2007 to 2011 who were divided into two groups: on drugs affecting hemostasis (40; 22%) and no bleeding disorders (138; 78%)...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28264200/monitoring-antiplatelet-therapy
#14
Rachel Orme, Heather M Judge, Robert F Storey
The increasing use of antiplatelet therapy, particularly aspirin and oral P2Y12 inhibitors, in the prevention and management of arterial thrombosis, has stimulated extensive pharmacodynamic studies and research into tailored antiplatelet regimens. Many different methodologies have been studied for monitoring antiplatelet drugs and some are now well validated and used in clinical practice. However, clinical studies of tailored antiplatelet therapy have not convincingly demonstrated a benefit of this approach in patients treated with aspirin and clopidogrel, coupled with the fact that more potent antiplatelet therapies have more consistent effects compared with clopidogrel and so may reduce the rationale for monitoring...
March 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28258727/comparison-of-baseline-characteristics-and-inhospital-outcomes-of-patients-and-use-of-bare-metal-versus-drug-eluting-stents-during-percutaneous-coronary-intervention-2005-to-2015-at-a-single-tertiary-hospital
#15
Romain Didier, Michael A Gaglia, Michael J Lipinski, Edward Koifman, Sarkis Kiramijyan, Smita Negi, Jiaxiang Gai, Rebecca Torguson, Augusto D Pichard, Ron Waksman
With steady growth in the use of drug-eluting stents (DES), the indications for bare metal stents (BMS) have significantly changed over the last decade. This study aims to describe trends in the use of BMS and the evolution of the population receiving them over the past 10 years and determine patient characteristics associated with using BMS. Consecutive patients who underwent percutaneous coronary intervention (PCI) at the Washington Hospital Center from January 2005 through March 2015 were included. Baseline characteristics and inhospital outcomes of patients who underwent PCI with BMS versus DES were compared during 2 different time periods: from 2005 to 2010 and from 2011 to 2015...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28249084/effect-of-short-procedural-duration-with-bivalirudin-on-increased-risk-of-acute-stent-thrombosis-in-patients-with-stemi-a-secondary-analysis-of-the-horizons-ami-randomized-clinical-trial
#16
Hector Tamez, Duane S Pinto, Ajay J Kirtane, Claire Litherland, Robert W Yeh, George D Dangas, Roxana Mehran, Efthymios N Deliargyris, Guillermo Ortiz, C Michael Gibson, Gregg W Stone
Importance: Bivalirudin has been associated with reduced bleeding and mortality during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). However, increased rates of acute stent thrombosis (AST) have been noted when bivalirudin is discontinued at the end of the procedure, which is perhaps related to this medication's short half-life. Objectives: To evaluate the clinical effect of procedure duration on AST when either bivalirudin or heparin plus glycoprotein IIb/IIIa receptor inhibitor (GPI) is used...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28245322/association-of-antithrombotic-drug-use-with-subdural-hematoma-risk
#17
David Gaist, Luis Alberto García Rodríguez, Maja Hellfritzsch, Frantz Rom Poulsen, Bo Halle, Jesper Hallas, Anton Pottegård
Importance: Incidence of subdural hematoma has been reported to be increasing. To what extent this is related to increasing use of antithrombotic drugs is unknown. Objectives: To estimate the association between use of antithrombotic drugs and subdural hematoma risk and determine trends in subdural hematoma incidence and antithrombotic drug use in the general population. Design, Setting, and Participants: Case-control study of 10 010 patients aged 20 to 89 years with a first-ever subdural hematoma principal discharge diagnosis from 2000 to 2015 matched by age, sex, and calendar year to 400 380 individuals from the general population (controls)...
February 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28244558/assessing-the-appropriateness-of-oral-anticoagulation-for-atrial-fibrillation-in-advanced-frailty-use-of-stroke-and-bleeding-risk-prediction-models
#18
R O'Caoimh, E Igras, A Ramesh, B Power, K O'Connor, R Liston
BACKGROUND: Atrial fibrillation (AF) is common among frail older adults. Oral anticoagulation (OAC) is particularly challenging for these due to overlapping stroke and bleeding risk factor profiles. OBJECTIVE: To compare the utility of stroke and haemorrhage risk-prediction instruments in the treatment of AF among frail older adults. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: Frail residents in four nursing homes with a Clinical Frailty Scale score ≥5 (median 7±0)...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28238711/efficacy-and-safety-of-ticagrelor-versus-aspirin-in-acute-stroke-or-transient-ischaemic-attack-of-atherosclerotic-origin-a-subgroup-analysis-of-socrates-a-randomised-double-blind-controlled-trial
#19
Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Michael D Hill, Jenny Jonasson, Scott E Kasner, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong, S Claiborne Johnston
BACKGROUND: Ticagrelor is an effective antiplatelet therapy for patients with coronary atherosclerotic disease and might be more effective than aspirin in preventing recurrent stroke and cardiovascular events in patients with acute cerebral ischaemia of atherosclerotic origin. Our aim was to test for a treatment-by-ipsilateral atherosclerotic stenosis interaction in a subgroup analysis of patients in the Acute Stroke or Transient Ischaemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) trial...
February 23, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28237404/pharmacogenetics-in-cardiovascular-diseases-state-of-the-art-and-implementation-recommendations-of-the-french-national-network-of-pharmacogenetics-rnpgx
#20
Fabien Lamoureux, Thomas Duflot
The use of genomic markers to predict drug response and effectiveness has the potential to improve healthcare by increasing drug efficacy and minimizing adverse effects. Polymorphisms associated with inter-individual variability in drug metabolism, transport, or pharmacodynamics of major cardiovascular drugs have been identified. These include single nucleotide polymorphisms (SNP) affecting clinical outcomes in patients receiving antiplatelet agents, oral anticoagulants and statins. Based on clinical evidence supporting genetic testing in the management of cardiovascular diseases using these drug classes, this short review presents clinical guidance regarding current pharmacogenetics implementation in routine medical practice...
January 30, 2017: Thérapie
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