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https://www.readbyqxmd.com/read/28102731/microfluidic-whole-blood-testing-of-platelet-response-to-pharmacological-agents
#1
Ruizhi Li, Tilo Grosser, Scott L Diamond
Platelets present a number of intracellular and transmembrane targets subject to pharmacological modulation, either for cardiovascular disease reduction or as an unintended drug response. Microfluidic devices allow human blood to clot on a defined surface under controlled hemodynamic and pharmacological conditions. The potencies of a number of antiplatelet and anticancer drugs have been tested with respect to platelet deposition on collagen under flow. Inhibitors of cyclooxygenase-1 (COX-1) reduce platelet deposition, either when added ex vivo to blood or ingested orally by patients prior to testing...
January 19, 2017: Platelets
https://www.readbyqxmd.com/read/28102427/prospective-randomised-trial-of-the-time-dependent-antiplatelet-effects-of-500-mg-and-250-mg-acetylsalicylic-acid-i-%C3%A2-v-and-300-mg-p-%C3%A2-o-in-acs-acute
#2
Uwe Zeymer, Thomas Hohlfeld, Jürgen Vom Dahl, Raimund Erbel, Thomas Münzel, Ralf Zahn, Alexander Roitenberg, Stefanie Breitenstein, Ákos Ferenc Pap, Dietmar Trenk
Little is known about the onset of action after intravenous or oral administration of acetylsalicylic acid (ASA) in patients with acute coronary syndromes (ACS). The aim of the study was to compare intravenous 250 or 500 mg acetylsalicylic acid (ASA) with oral 300 mg in ASA naïve patients with ACS concerning the onset of antiplatelet effects measured by time dependent thromboxane inhibition. A total of 270 patients with ACS < 24 hours were randomised into one of three treatment arms comprising administration of a single dose of ASA as soon as possible after admission...
January 19, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28091833/the-gap-between-indicated-and-prescribed-stroke-prevention-therapies-in-a-high-risk-geriatric-population
#3
Mohammed Shurrab, Eugene Crystal, Denis O'Donnell, Hrishikesh Navare, Paula Neves, Rasha Khatib, Ilan Lashevsky, David Newman
PURPOSE: The use of oral anticoagulation (OAC) in the elderly population with atrial fibrillation (AF) treated in long-term care (LTC) facilities is inconsistent. We examined the magnitude and sources of the gap between indicated and prescribed OAC in the elderly population with AF. METHODS: We retrospectively scanned the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada. The diagnosis of AF was drawn from EMR. Different attributable risk factors for possible failure to prescribe OAC were examined...
January 16, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28089180/enteric-coating-and-aspirin%C3%A2-nonresponsiveness-in-patients%C3%A2-with-type%C3%A2-2%C3%A2-diabetes-mellitus
#4
Deepak L Bhatt, Tilo Grosser, Jing-Fei Dong, Douglas Logan, Walter Jeske, Dominick J Angiolillo, Andrew L Frelinger, Lanyu Lei, Juan Liang, Jason E Moore, Byron Cryer, Upendra Marathi
BACKGROUND: A limitation of aspirin is that some patients, particularly those with diabetes, may not have an optimal antiplatelet effect. OBJECTIVES: The goal of this study was to determine if oral bioavailability mediates nonresponsiveness. METHODS: The rate and extent of serum thromboxane generation and aspirin pharmacokinetics were measured in 40 patients with diabetes in a randomized, single-blind, triple-crossover study. Patients were exposed to three 325-mg aspirin formulations: plain aspirin, PL2200 (a modified-release lipid-based aspirin), and a delayed-release enteric-coated (EC) aspirin...
January 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#5
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28070883/pilot-of-a-computerised-antithrombotic-risk-assessment-tool-version-2-caratv2-0-for-stroke-prevention-in-atrial-fibrillation
#6
Yishen Wang, Beata Bajorek
BACKGROUND: The decision-making process for stroke prevention in atrial fibrillation (AF) requires a comprehensive assessment of risk vs. benefit and an appropriate selection of antithrombotic agents (e.g., warfarin, non-vitamin K antagonist oral anticoagulants [NOACs]). The aim of this pilot-test was to examine the impact of a customised decision support tool - the Computerised Antithrombotic Risk Assessment Tool (CARATV2.0) using antithrombotic therapy on a cohort of patients with AF...
January 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28068791/the-utilization-of-antithrombotic-therapy-in-older-patients-in-aged-care-facilities-with-atrial-fibrillation
#7
Bridget Frain, Ronald Castelino, Luke R Bereznicki
Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld in older people due to the risk and fear of hemorrhage. Although the underutilization of anticoagulants in patients with AF has been demonstrated internationally, few studies have been conducted among aged care residents. The aim of this study was to determine the utilization of anticoagulants among people with AF residing in aged care facilities...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28068274/dental-care-in-patients-with-antiphospholipid-syndrome-two-case-reports
#8
Karine Cestaro Mesquita, Carolina Rodrigues Teófilo, João Paulo Veloso Perdigão, Fabrício Bitu Sousa, Ana Paula Negreiros Nunes Alves, Wagner Araújo de Negreiros, Mário Rogério Lima Mota
Antiphospholipid syndrome (APS) is a prothrombotic autoimmune disease that may be classified as primary or secondary. Treatment consists of oral anticoagulant, antiplatelet, and/or immunosuppressant drugs. This report describes the dental treatment of 2 women with APS and multiple dental concerns, including periodontal disease, caries, and missing teeth. The invasive dental procedures were performed in an outpatient setting with hematologic monitoring and use of local hemostatic measures. Neither interruption of anticoagulant medications nor administration of blood products was necessary...
January 2017: General Dentistry
https://www.readbyqxmd.com/read/28065447/percutaneous-left-atrial-appendage-closure-followed-by-single-antiplatelet-therapy-short-and-mid-term-outcomes
#9
Zakaria Jalal, Marie-Lou Dinet, Nicolas Combes, Xavier Pillois, Pauline Renou, Igor Sibon, Xavier Iriart, Jean-Benoît Thambo
BACKGROUND: After left atrial appendage closure (LAAC), various antithrombotic protocols have been suggested, but the optimal post-procedural antithrombotic strategy is still under debate. AIMS: To investigate the efficacy and safety of LAAC with an AMPLATZER™ Cardiac Plug (ACP) device (St. Jude Medical, Minneapolis, MN, USA) followed by single antiplatelet therapy. METHODS: Consecutive patients with non-valvular atrial fibrillation and a contraindication for oral anticoagulants who underwent LAAC with an ACP device between 2012 and 2014 in two French centres were included...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28062249/extracranial-arterial-and-venous-thromboembolism-in-patients-with-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-trials
#10
Kang-Ling Wang, Harry R Büller, Shinya Goto, Chun-Yi Lin, En-Yu Lai, Chun-Chih Chiu, Chern-En Chiang, Robert P Giugliano
BACKGROUND: Thromboembolism prevention is central to atrial fibrillation (AF) management. Randomized controlled trials (RCTs) have primarily focused on stroke prevention. Detailed analyses of extracranial thromboembolic events, particularly in patients with low dose non-vitamin K antagonist oral anticoagulants (NOACs), are scarce. OBJECTIVES: To assess efficacy of NOACs in prevention of extracranial arterial and venous thromboembolism. METHODS: We searched PubMed, CENTRAL, and CINAHL through April 2016 for phase III RCTs of NOACs in patients with AF...
January 3, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28053157/blockade-of-protease-activated-receptor-4-par4-provides-robust-antithrombotic-activity-with-low-bleeding
#11
Pancras C Wong, Dietmar Seiffert, J Eileen Bird, Carol A Watson, Jeffrey S Bostwick, Mary Giancarli, Nick Allegretto, Ji Hua, David Harden, Jocelyne Guay, Mario Callejo, Michael M Miller, R Michael Lawrence, Jacques Banville, Julia Guy, Brad D Maxwell, E Scott Priestley, Anne Marinier, Ruth R Wexler, Michel Bouvier, David A Gordon, William A Schumacher, Jing Yang
Antiplatelet agents are proven efficacious treatments for cardiovascular and cerebrovascular diseases. However, the existing drugs are compromised by unwanted and sometimes life-threatening bleeding that limits drug usage or dosage. There is a substantial unmet medical need for an antiplatelet drug with strong efficacy and low bleeding risk. Thrombin is a potent platelet agonist that directly induces platelet activation via the G protein (heterotrimeric guanine nucleotide-binding protein)-coupled protease-activated receptors PAR1 and PAR4...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28050712/optimizing-the-use-of-oral-anticoagulant-therapy-for-atrial-fibrilation-in-primary-care-a-pharmacist-led-intervention
#12
Mandeep S Virdee, Derek Stewart
Background Updated evidence-based guidelines for the management of atrial fibrillation (AF) necessitate patient review, particularly with respect to oral anticoagulants, to ensure maximum health gain around stroke prophylaxis. Objective To quantify the level of anticoagulation utilisation in patients with a CHA2DS2-VASc ≥1/≥2 (male/female) according to evidence-based guidelines and to assess the impact of a pharmacist-led intervention to optimise therapy. Setting Fifteen general medical practices in Liverpool, North-West England with a practice population of 99,129...
January 3, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28045759/efficacy-and-safety-of-novel-oral-p2y12-receptor-inhibitors-in-st-segment-elevation-myocardial-infarction-patients-undergoing-pci-a-systematic-review-and-meta-analysis
#13
Jianjun Sun, Qian Xiang, Chao Li, Zining Wang, Kun Hu, Qiufen Xie, Yimin Cui
The efficacy and safety of novel oral P2Y12 receptor inhibitors (prasugrel and ticagrelor) are subjects of contention in ST-segment elevation myocardial infarction (STEMI) patients undergoing PCI, the optimal duration of therapy remains uncertain. We searched PubMed, Embase, Cochrane Library, CNKI, VIP, and WanFang Data to identify randomized controlled trials comparing novel oral P2Y12 receptor inhibitors to clopidogrel in STEMI patients undergoing PCI until February 2016. The primary efficacy and safety endpoint were all-cause mortality and major/minor bleeding...
January 3, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#14
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28042389/clinical-problems-with-antithrombotic-therapy-for-endoscopic-submucosal-dissection-for-gastric-neoplasms
#15
REVIEW
Toshiyuki Yoshio, Tsutomu Nishida, Yoshito Hayashi, Hideki Iijima, Masahiko Tsujii, Junko Fujisaki, Tetsuo Takehara
Endoscopic submucosal dissection (ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms, particularly for patients with comorbidities. Antithrombotic agents are used to prevent thrombotic events in patients with comorbidities such as cardio-cerebrovascular diseases and atrial fibrillation. With appropriate cessation, antithrombotic therapy does not increase delayed bleeding in low thrombosis-risk patients. However, high thrombosis-risk patients are often treated with combination therapy with antithrombotic agents and occasionally require the continuation of antithrombotic agents or heparin bridge therapy (HBT) in the perioperative period...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28042233/gastrointestinal-endoscopy-in-patients-on-anticoagulant-therapy-and-antiplatelet-agents
#16
REVIEW
Angelo Zullo, Cesare Hassan, Franco Radaelli
Periprocedural management of antithrombotics for gastrointestinal endoscopy is a common clinical issue, given the widespread use of these drugs for primary and secondary cardiovascular prevention. For diagnostic procedures, with or without biopsy, no adjustments in antithrombotics are usually needed. For operative procedures, balancing the risk of periprocedural hemorrhage with the continuation of antithrombotics against the chance of recurrent thromboembolic events with their discontinuation may be challenging...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28041899/left-atrial-appendage-closure-in-patients-with-atrial-fibrillation-and-previous-intracerebral-hemorrhage
#17
Pauline Renou, Jean-Benoît Thambo, Xavier Iriart, Stéphanie Nicot, Nathanael Kabore, Zakaria Jalal, Stéphane Olindo, Sabrina Debruxelles, Mathilde Poli, François Rouanet, Igor Sibon
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) may be considered in patients with atrial fibrillation and contraindication for long-term anticoagulation. This study aimed to assess the safety and efficacy of LAAC followed by single antiplatelet therapy in patients with atrial fibrillation and previous spontaneous intracerebral hemorrhage (ICH). METHODS: In this explorative, prospective, single-center study, consecutive patients who underwent LAAC because of previous spontaneous ICH over a period of 4 years were analyzed...
December 30, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28039007/pedicle-orientation-in-free-flap-microvascular-maxillofacial-reconstruction
#18
Daniel M Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid
Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral-nasal and oral-antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. Often, surgical reconstruction is preferred for patient quality of life and definitive restoration. Surgical reconstruction also avoids the difficulties encountered with fabricating an obturator in an irradiated field with the often-resultant microstomia...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28025925/contemporary-trends-in-oral-antiplatelet-agent-use-in-patients-treated-with-percutaneous-coronary-intervention-for-acute-coronary-syndrome
#19
Kibum Kim, Todd A Lee, Daniel R Touchette, Robert J DiDomenico, Amer K Ardati, Surrey M Walton
BACKGROUND: Recent trials demonstrated the efficacy of prasugrel and ticagrelor compared with clopidogrel in the reduction of cardiovascular complications in patients with acute coronary syndrome (ACS). However, it is unclear how use of the 3 antiplatelet medications has changed in commercially insured patients since the advent of the new agents. OBJECTIVES: To (a) describe the adoption of prasugrel and ticagrelor in patients who received percutaneous coronary intervention (PCI) for the onset of ACS and (b) explore patient factors associated with the selection of the drug to provide insight into utilization patterns of these antiplatelet agents...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28024166/an-east-asian-perspective-on-the-interaction-between-proton-pump-inhibitors-and-clopidogrel
#20
Duowu Zou, Khean-Lee Goh
Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for ARDs (Acid Related Disorders) including gastroesophageal reflux disease (GERD). They are also co-prescribed with oral anticoagulant agents (OAAs)and with dual-antiplatelet therapy (DAPT) for the treatment and prevention of gastrointestinal (GI) bleeding. Clopidogrel belongs to the drug class of thienopyridines, and is currently the most widely prescribed OAA either alone or in combination with aspirin...
December 26, 2016: Journal of Gastroenterology and Hepatology
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