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https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#1
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28543216/bridging-with-tirofiban-during-oral-antiplatelet-interruption-a-single-center-case-series-analysis-including-patients-on-hemodialysis
#2
Elizabeth A Walker, William E Dager
INTRODUCTION: Surgical patients requiring an interruption in dual-antiplatelet therapy (DAPT) within 6 months of cardiac stenting are at risk for thrombotic events. Bridging with short-acting intravenous antiplatelet agents has been proposed to minimize the risk of thrombotic and hemorrhagic complications. METHODS: This was a retrospective analysis of a tirofiban bridging strategy that did not use an initial bolus loading dose. Tirofiban infusions were initiated 24to 48 hours after the last oral antiplatelet dose at a rate of 0...
May 23, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28540489/endoscopy-in-patients-on-antiplatelet-agents-and-anticoagulants
#3
REVIEW
Andrew M Veitch
Management of patients on anticoagulant or antiplatelet therapy undergoing endoscopy presents a balance of risks between haemorrhage due to the procedure, and thrombosis due to discontinuation of antithrombotic therapy. Haemorrhage is usually controllable endoscopically, but thrombosis could, on occasion, result in myocardial infarction or stroke, with permanent disability or death. For elective procedures, there is adequate time to plan best management of antithrombotic therapy. International guidelines have been published, but recommendations are based on limited evidence and consultation with appropriate medical specialists, and the patient is important...
May 25, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28540312/rivaroxaban-as-an-antithrombotic-agent-in-a-patient-with-st-segment-elevation-myocardial-infarction-and-left-ventricular-thrombus-a-case-report
#4
Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Naveen Anand Seecheran
The incidence of left ventricular (LV) thrombi in the setting of an anterior myocardial infarction has declined significantly since the advent of primary percutaneous coronary intervention coupled with contemporary antithrombotic strategies in ST-segment elevation myocardial infarctions (STE-ACS). Despite oral anticoagulation with the currently accepted, standard-of-care vitamin K antagonist, warfarin, major bleeding complications still arise. Rivaroxaban is a novel, direct oral factor X anticoagulant that has several advantageous properties, which can attenuate bleeding risk...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28523173/thrombotic-responses-to-coronary-stents-bioresorbable-scaffolds-and-the-kounis-hypersensitivity-associated-acute-thrombotic-syndrome
#5
REVIEW
Nicholas G Kounis, Ioanna Koniari, Anastasios Roumeliotis, Grigorios Tsigas, George Soufras, Nicholas Grapsas, Periklis Davlouros, George Hahalis
Percutaneous transluminal coronary angioplasty with coronary stent implantation is a life-saving medical procedure that has become, nowadays, the most frequent performed therapeutic procedure in medicine. Plain balloon angioplasty, bare metal stents, first and second generation drug-eluting stents, bioresorbable and bioabsorbable scaffolds have offered diachronically a great advance against coronary artery disease and have enriched our medical armamentarium. Stented areas constitute vulnerable sites for endothelial damage, endothelial dysfunction, flow turbulence, hemorheologic changes, platelet dysfunction, coagulation changes and fibrinolytic disturbances...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28512068/potentially-increased-incidence-of-scaffold-thrombosis-in-patients-treated-with-absorb-bvs-who-terminated-dapt-before-18-months
#6
Cordula M Felix, Georgios J Vlachojannis, Alexander J J IJsselmuiden, Jiang M Fam, Peter C Smits, Wouter J Lansink, Roberto Diletti, Felix Zijlstra, Evelyn S Regar, Eric Boersma, Yoshinobu Onuma, Robert J M van Geuns
AIMS: The aim of this study was to investigate the impact of dual antiplatelet therapy (DAPT) termination on late and very late scaffold thrombosis (ScT) in patients treated with the Absorb bioresorbable vascular scaffold (BVS). METHODS AND RESULTS: Data from the registries of three centres were pooled (808 patients). To investigate the effect of DAPT termination on ScT after a minimum of six months, we selected a subgroup ("DAPT study cohort" with 685 patients) with known DAPT status >6 months and excluded the use of oral anticoagulants and early ScT...
May 18, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28506477/medical-therapy-and-intervention-do-not-improve-uncomplicated-isolated-mesenteric-artery-dissection-outcomes-over-observation-alone
#7
Jacob W Loeffler, Hideaki Obara, Naoki Fujimura, Paul Bove, Daniel H Newton, Sara L Zettervall, Andre S van Petersen, Robert H Geelkerken, Kristofer M Charlton-Ouw, Sherene Shalhub, Niten Singh, Arnaud Roussel, Natalia O Glebova, Michael P Harlander-Locke, Warren J Gasper, Misty D Humphries, Peter F Lawrence
OBJECTIVE: Isolated dissection of the mesenteric vessels is rare but increasingly recognized. This study aimed to evaluate patient characteristics, primary treatment, and subsequent outcomes of mesenteric dissection using multi-institutional data. METHODS: All patients at participant hospitals between January 2003 and December 2015 with dissection of the celiac artery (or its branches) or dissection of the superior mesenteric artery (SMA) were included. Patients with an aortic dissection were excluded...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#8
Nathaniel Moulson, Stephen A LaHaye, Olivier F Bertrand, Jimmy MacHaalany
OBJECTIVES: To determine the role of warfarin (WF) prophylaxis in the prevention of left ventricular thrombus (LVT) formation and subsequent embolic complications following an anterior ST elevation myocardial infarction (STEMI) complicated by reduced left ventricular ejection fraction (LVEF) and wall motion abnormalities. BACKGROUND: The role of oral anticoagulation prophylaxis, in addition to dual antiplatelet therapy (DAPT), in the current era of percutaneous coronary intervention has not been well studied, despite being a class IIb recommendation in the AHA/ACC STEMI guidelines...
May 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28497845/comparison-of-dual-antiplatelet-therapy-versus-oral-anticoagulation-following-transcatheter-aortic-valve-replacement-a-retrospective-single-center-registry-analysis
#9
Erik W Holy, Julia Kebernik, Abdelhakim Allali, Mohamed El-Mawardy, Gert Richardt, Mohamed Abdel-Wahab
BACKGROUND: The choice of optimal antithrombotic regimen after transcatheter aortic valve replacement (TAVR) remains a matter of debate. The objective of this study was to compare both efficacy and safety outcomes based on the type of antithrombotic therapy prescribed after TAVR METHODS: This is a retrospective analysis of 514 consecutive patients treated with either dual antiplatelet therapy (DAPT) (n = 315; 61.3%) or oral anticoagulation (OAC) plus clopidogrel (n = 199; 38.7%) for a minimum of 3 month after TAVR followed by antiplatelet monotherapy or OAC only, respectively...
May 12, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28489475/antithrombotic-strategies-for-preventing-long-term-major-adverse-cardiovascular-events-in-patients-with-non-valvular-atrial-fibrillation-who-undergo-percutaneous-coronary-intervention
#10
Manan Pareek, Deepak L Bhatt, Jürrien M Ten Berg, Steen D Kristensen, Erik L Grove
Balancing the risk of recurrent ischemia and bleeding among patients with non-valvular atrial fibrillation who undergo percutaneous coronary intervention (PCI) is challenging. Postprocedural antithrombotic therapy aims to reduce the risk related to coronary artery disease, stent placement, and atrial fibrillation, with acceptable risks of bleeding. Areas covered: This review summarizes evidence and recommendations related to long-term antithrombotic strategies in such patients. An overview of the findings from recent meta-analyses and select observational studies is provided, and important completed and ongoing randomized trials are described in detail...
June 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#11
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28480345/thulium-laser-vaporesection-of-the-prostate-can-we-operate-without-interrupting-oral-antiplatelet-anticoagulant-therapy
#12
Tarik Emre Sener, Salvatore Butticè, Luciano Macchione, Christopher Netsch, Yiloren Tanidir, Laurian Dragos, Rosa Pappalardo, Carlo Magno
PURPOSE: Thulium vaporesection of the prostate (ThuVARP) is a new and safe approach for patients receiving anticoagulant therapy in whom transurethral resection of the prostate (TURP) may possess a high bleeding risk. We aimed to demonstrate the efficacy and safety of ThuVARP in patients receiving oral antiplatelet/anticoagulant (OAP/OAC) therapy. MATERIALS AND METHODS: A total of 103 patients who underwent ThuVARP between 2011 and 2013 were enrolled in the study...
May 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28472526/glycoprotein-iib-iiia-inhibitors-in-prevention-and-rescue-treatment-of-thromboembolic-complications-during-endovascular-embolization-of-intracranial-aneurysms
#13
David Dornbos, Joel S Katz, Patrick Youssef, Ciarán J Powers, Shahid M Nimjee
Thromboembolic complications remain a major risk of endovascular neurosurgery during the treatment of intracranial aneurysms, despite the use of therapeutic heparinization and oral antiplatelet therapy when indicated. Glycoprotein (GP) IIb/IIIa inhibitors target a nonredundant pathway of platelet aggregation following adhesion and activation. Initially established and implemented in the cardiovascular arena, this drug class has provided a new tool in the neurovascular armamentarium as well. Numerous case reports, case series, and retrospective reviews have evaluated the safety and efficacy of abciximab, eptifibatide, and tirofiban in the treatment of acute thromboembolic complications during the endovascular treatment of intracranial aneurysms...
May 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28465300/randomized-trial-comparing-the-effects-of-ticagrelor-versus-clopidogrel-on-myocardial-perfusion-in-patients-with-coronary-artery-disease
#14
Matthieu Pelletier-Galarneau, Chad R R N Hunter, Kathryn J Ascah, Rob S B Beanlands, Girish Dwivedi, Robert A deKemp, Benjamin J W Chow, Terrence D Ruddy
BACKGROUND: Ticagrelor is a P2Y12 receptor inhibitor used in acute coronary syndromes to reduce platelet activity and to decrease thrombus formation. Ticagrelor is associated with a reduction in mortality incremental to that observed with clopidogrel, potentially related to its non-antiplatelet effects. Evidence from animal models indicates that ticagrelor potentiates adenosine-induced myocardial blood flow (MBF) increases. We investigated MBF at rest and during adenosine-induced hyperemia in patients with stable coronary artery disease treated with ticagrelor versus clopidogrel...
May 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28457807/safety-and-efficacy-of-anti-thrombotic-regimens-in-patients-with-percutaneous-coronary-intervention-requiring-oral-anticoagulation-a-traditional-and-network-meta-analysis
#15
REVIEW
Safi U Khan, Muhammad A Saleem, Amirahwaty Abdullah, Subash Ghimire, Manidhar Lekkala, Hammad Rahman, Ahmad N Lone, Edo Kaluski
BACKGROUND: Previous reports have been inconsistent in generating a consensus for optimal treatment strategy for patients with percutaneous coronary intervention (PCI) who also require oral anticoagulation (OAC). We conducted a traditional and network meta-analysis to evaluate the safety and efficacy of anti-thrombotic regimens in this subset of patients. METHODS: 30 articles were recovered through preferred reporting items for systematic reviews and meta-analyses (PRISMA) using MEDLINE, EMBASE and Cochrane Central Register of Controlled Clinical Trials (CENTRAL) from inception to December 2016...
April 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28456792/implications-of-cha2ds2-vasc-score-in-stroke-patients-with-atrial-fibrillation-an-analysis-of-938-korean-patients
#16
Jaechun Hwang, Jong-Won Chung, Mi Ji Lee, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, Oh Young Bang
BACKGROUND AND AIMS: The aim of this study was to investigate the stroke mechanisms and associated conditions influencing the decision regarding stroke thromboprophylaxis in patients with atrial fibrillation (AF) plus ischemic stroke, according to the CHA2DS2-VASc score. METHODS: We evaluated 938 consecutive patients with a diagnosis of AF plus transient ischemic attack/ischemic stroke. Based on the CHA2DS2-VASc scores, patients were stratified as score 0 or 1 (n = 151), score 2 (n = 146), score 3 (n = 213), score 4 (n = 185), or score ≥5 (n = 243)...
April 29, 2017: European Neurology
https://www.readbyqxmd.com/read/28449833/rational-medical-therapy-is-the-key-to-effective-cardiovascular-disease-prevention
#17
REVIEW
J David Spence
In an era in which medicine personalized on the basis of genotyping is being proposed, it is timely to recognize that existing therapies could be markedly improved if they were on the basis of more effective application of principles on the basis of available phenotyping. Blood pressure control, which is poor on a worldwide basis, is a major opportunity to reduce cardiovascular risk. There are many genetic variants that have a small effect on blood pressure, but specific therapies are not available for most of them...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28446026/medical-therapy-before-carotid-endarterectomy
#18
Daniele Bissacco, Michele Carmo, Iacopo Barbetta, Raffaello Dallatana, Piergiorgio G Settembrini
We evaluated the evolution of chronic medical therapy in patients admitted for carotid endarterectomy (CEA) over a 13-year period and to analyze the difference in medical treatment between symptomatic and asymptomatic patients. A retrospective study was conducted on patients treated between 2002 and 2015. The use of antiplatelets (acetylsalicylic acid [ASA], ticlopidine, and clopidogrel), oral anticoagulant therapy (OAT), statins and antihypertensives (angiotensin-converting enzyme inhibitors [ACE-I]/angiotensin receptor blockers [ARBs], β-blockers [BB]) administration was evaluated...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28438043/comparative-effectiveness-and-safety-analysis-of-dual-antiplatelet-therapies-within-an-integrated-delivery-system
#19
James C Coons, Carlo J Iasella, Tyler Chanas, Nan Wang, Kiersten Williams, Anthony Boyd, John Lyons, Jamie Eckardt, Lindsey Rihtarchik, Alison Merkel, Alexandra Chambers, Lara S Lemon, Randall Smith, Christopher R Ensor
BACKGROUND: Dual antiplatelet therapy is a mainstay of care for percutaneous coronary intervention (PCI) patients; however, uncertainty exists in real-world practice about comparative effectiveness and safety outcomes. OBJECTIVE: To evaluate outcomes of different oral P2Y12 inhibitors in PCI patients. METHODS: We retrospectively studied patients treated between July 1, 2010, and December 31, 2013. Patients received clopidogrel, prasugrel, ticagrelor, or more than 1 antiplatelet (switch) during PCI...
April 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28431413/novel-oral-anticoagulants-and-trauma-the-results-of-a-prospective-american-association-for-the-surgery-of-trauma-multi-institutional-trial
#20
Leslie Kobayashi, Galinos Barmparas, Patrick Bosarge, Carlos V Brown, Marko Bukur, Matthew M Carrick, Richard D Catalano, Jan Holly-Nicolas, Kenji Inaba, Stephen Kaminski, Amanda L Klein, Tammy Kopelman, Eric J Ley, Ericca M Martinez, Forrest O Moore, Jason Murry, Raminder Nirula, Douglas Paul, Jacob Quick, Omar Rivera, Martin Schreiber, Raul Coimbra
BACKGROUND: The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. METHODS: This was a prospective observational trial across 16 trauma centers...
May 2017: Journal of Trauma and Acute Care Surgery
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