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Oral antiplatelet

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https://www.readbyqxmd.com/read/29150806/ticagrelor-a-review-in-long-term-secondary-prevention-of-cardiovascular-events
#1
Zaina T Al-Salama, Gillian M Keating, Susan J Keam
Ticagrelor (Brilique(®)) is an orally administered P2Y12 inhibitor. A long-term (maintenance) regimen of ticagrelor 60 mg twice daily is indicated in the EU for coadministration with low-dose aspirin 75-150 mg/day for the secondary prevention of atherothrombotic events in high-risk patients with a history of myocardial infarction (MI) of at least 1 year. Approval is based on the results of the PEGASUS-TIMI 54 trial that compared ticagrelor with placebo (in conjunction with low-dose aspirin) in stable patients who had had a spontaneous MI 1-3 years prior to enrolment and were at high risk of atherothrombotic events...
November 18, 2017: Drugs
https://www.readbyqxmd.com/read/29146276/perioperative-management-of-oral-anticoagulation-in-patients-undergoing-implantation-of-subcutaneous-implantatble-defibrillator
#2
Muhammad R Afzal, Divyesh Mehta, Christopher Evenson, Daniel Pinkhas, Auroa Badin, Dilesh Patel, Michael K Essandoh, Hemant Godara, Jaret Tyler, Mahmoud Houmsse, Zhenguo Liu, Steven J Kalbfleisch, John D Hummel, Ralph Augostini, Raul Weiss, Emile G Daoud, Toshimasa Okabe
BACKGROUND: The perioperative anticoagulation management for subcutaneous implantable cardioverter defibrillator (S-ICD) is still evolving. OBJECTIVE: To assess whether it is safe to perform S-ICD implantation with uninterrupted warfarin. METHODS: This is a single-center retrospective review of patients undergoing S-ICD implantation during 10/2012 to 6/2017. The most common indication for the implantation was primary prevention of sudden cardiac death...
November 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#3
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29121410/medication-management-of-patients-undergoing-transcatheter-aortic-valve-replacement
#4
Bethany A Kalich, J Erin Ledford, Ian B Hollis
Aortic stenosis (AS) is the most common form of valvular heart disease. A detailed diagnostic workup is necessary to promptly stage and classify disease severity to determine the optimal management. Medical therapy and valvuloplasty are options that fail to delay or reverse disease progression. Surgical aortic valve replacement (SAVR) is curative but has significant limitations for some patient populations. A newer option, transcatheter aortic valve replacement (TAVR), has become more widely available to patients with intermediate- or high-operative risk...
November 9, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29118712/comparative-long-term-effect-of-three-anti-p2y12-drugs-after-percutaneous-angioplasty-an-observational-study-based-on-electronic-drug-adherence-monitoring
#5
Valentina Forni Ogna, Isabelle Bassi, Isabelle Menetrey, Olivier Muller, Eric Tousset, Pierre Fontana, Eric Eeckhout, Chin B Eap, Bernard Vrijens, Michel Burnier, Grégoire Wuerzner
Aims: Dual platelet inhibition using anti-P2Y12 drugs and aspirin is the standard of care in patients after percutaneous coronary interventions (PCI). Prasugrel and ticagrelor have been shown to be more potent than clopidogrel with less high on-treatment platelet reactivity. Whether differences in long-term adherence to these drugs can partly explain different antiplatelet efficacy has not been studied so far. The objective was to compare the long-term P2Y12 receptor inhibition and drug adherence to different anti-P2Y12 drugs, and to assess the impact of adherence on the pharmacodynamic effect...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29117741/%C3%AE-thromboglobulin-may-not-reflect-platelet-activation-during-haemodialysis-with-the-hepran-membrane
#6
Solbjørg Sagedal, Leiv Sandvik, Olav Klingenberg, Per Morten Sandset
BACKGROUND: When blood passes through the extracorporeal circuit during haemodialysis (HD) undesirable effects including platelet degranulation and coagulation activation take place. β-thromboglobulin (β-TG) is a sensitive marker of platelet activation. The aim of this study was to investigate platelet degranulation and coagulation activation during HD with the heparin-coated dialysis membrane HeprAN. METHODS: Four HD sessions were evaluated in each of 12 chronic HD patients...
December 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29107192/renal-function-and-risk-of-stroke-and-bleeding-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-comparison-between-uninterrupted-direct-oral-anticoagulants-and-warfarin-administration
#7
Satoshi Yanagisawa, Yasuya Inden, Aya Fujii, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Yoshihiro Ikai, Yusuke Sakamoto, Rei Shibata, Toyoaki Murohara
BACKGROUND: The effect of uninterrupted oral anticoagulant use in patients with chronic kidney disease (CKD) during catheter ablation for atrial fibrillation (AF) is not fully understood. OBJECTIVE: The present study aimed to evaluate safety and efficacy of periprocedural uninterrupted direct oral anticoagulant (DOAC) use compared with uninterrupted warfarin in patients undergoing catheter ablation for AF, stratified by various renal function groups. METHODS: A total of 2,091 patients were retrospectively included...
October 26, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29106831/-transcatheter-aortic-valve-thrombosis
#8
D Leguay, S Duval, M Leroux, A Monnier, Y Davienne, C Brasselet
GOALS: Transcatheter aortic valve or leaflets thrombosis are mainly misapprehended. It negatively impacts the long-term efficiency of such prosthesis. Moreover, its incidence is presumably higher than previously described. EPIDEMIOLOGY: Recently reported subclinical leaflet thrombosis, occurring between first to third months after implantation, is about 10to 15%. All prosthesis are concerned by potential thrombosis. DIAGNOSIS: Transcatheter aortic valve thrombosis is usually detected on the basis of increased transvalvular pressure gradients or symptoms at routine follow-up...
October 26, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29095764/oral-surgery-in-patients-under-antithrombotic-therapy-perioperative-bleeding-as-a-significant-risk-factor-for-postoperative-hemorrhage
#9
Amanda L Rocha, Alessandra F Souza, Maria A P Martins, Marina G Fraga, Denise V Travassos, Ana C B Oliveira, Daniel D Ribeiro, Tarcília A Silva
: To investigate perioperative and postoperative bleeding, complications in patients under therapy with anticoagulant or antiplatelet drugs submitted to oral surgery. To evaluate the risk of bleeding and safety for dental surgery, a retrospective chart review was performed. Medical and dental records of patients taking oral antithrombotic drugs undergoing dental surgery between 2010 and 2015 were reviewed. Results were statistically analyzed using Fisher's exact test, t test or the χ test. One hundred and seventy-nine patients underwent 293 surgical procedures...
October 31, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29095443/the-benefits-and-risks-of-oral-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome
#10
Tariq Ahmad, Rhian Davies, Peter Alagona
This newsletter aims to provide an overview of the currently available evidence pertaining to the benefits and risks of oral antiplatelet therapies, with a focus on balancing ischemic and bleeding risk to optimize patient outcomes.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29092916/use-of-oral-anticoagulants-in-combination-with-antiplatelet-s-in-atrial-fibrillation
#11
Caroline Sindet-Pedersen, Laila Staerk, Morten Lamberts, Thomas Alexander Gerds, Jeffrey S Berger, Anders Nissen Bonde, Jannik Langtved Pallisgaard, Morten Lock Hansen, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
OBJECTIVES: To investigate temporal trends in the use of non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in combination with aspirin and/or clopidogrel in patients with atrial fibrillation (AF) following acute myocardial infarction (MI) and/or percutaneous coronary intervention (PCI). METHODS: Using Danish nationwide registries, all patients with AF who survived 30 days after discharge from MI and/or PCI between 22 August 2011 and 30 September 2016 were identified...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29092730/bioequivalence-and-pharmacokinetic-pharmacodynamic-correlation-of-clopidogrel-in%C3%A2-healthy-thai-subjects%C3%A2
#12
Malinee Chunsangchan, Pajaree Chariyavilaskul, Wannarasmi Ketchart, Nantaporn Prompila, Supeecha Wittayalertpanya
Clopidogrel is an antiplatelet drug, selectively binding to the platelet P2Y12 receptor of adenosine diphosphate. Clopidogrel is a prodrug modified through active metabolite in the liver by two steps of CYP enzyme. The active metabolite is responsible for inhibiting platelet aggregation. OBJECTIVE: The study aimed to assess the bioequivalence of clopidogrel 75 mg generic and reference drugs and to investigate the correlation between pharmacokinetics of active metabolites and its antiplatelet activities...
October 26, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29075924/contemporary-use-of-p2y12-inhibitors-in-patients-with-st-segment-elevation-myocardial-infarction-referred-to-primary-percutaneous-coronary-interventions-in-poland-data-from-orpki-national-registry
#13
Tomasz Rakowski, Zbigniew Siudak, Artur Dziewierz, Krzysztof Plens, Paweł Kleczyński, Dariusz Dudek
According to guidelines, it is recommended to give P2Y12 inhibitors (preferably ticagrelor or prasugrel) at the time of first medical contact in patients with STEMI. However, in real life antiplatelet treatment strategies are different among countries. We analyzed data on antiplatelet treatment in STEMI patients included into Polish ORPKI national registry. A total of 23,139 STEMI patients from 153 invasive cardiology centers were reported in ORPKI registry between September 2015 and August 2016. Finally 19,437 patients from 122 centers (immediate PCI in 94%) were included into the analysis (lack of ticagrelor or prasugrel usage reported in 31 centers)...
October 26, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29071559/successful-retinal-blood-flow-augmentation-after-extracranial-intracranial-bypass
#14
Tackeun Kim, Min Jai Cho, Sang Jun Park, Moon-Ku Han, Davendra Hari Ojar, Chang Wan Oh, Jae Seung Bang
A 61-year-old woman visited us with recent onset right-side weakness. Magnetic resonance imaging showed ischemic changes at the left internal border zone due to occlusive disease affecting the left proximal internal carotid artery. Prompt oral dual antiplatelet therapy and intravenous fluid were administered with subsequent induced hypertension and without reperfusion therapy. Although the hemiparesis was improved, she complained of a new-onset transient left-side monocular visual loss. Fluorescein angiography confirmed delayed perfusion in the left eye...
October 25, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29071124/management-of-anticoagulation-in-hip-fractures-a-pragmatic-approach
#15
Rafik Yassa, Mahdi Yacine Khalfaoui, Ihab Hujazi, Hannah Sevenoaks, Paul Dunkow
Hip fractures are common and increasing with an ageing population. In the United Kingdom, the national guidelines recommend operative intervention within 36 hours of diagnosis. However, long-term anticoagulant treatment is frequently encountered in these patients which can delay surgical intervention. Despite this, there are no set national standards for management of drug-induced coagulopathy pre-operatively in the context of hip fractures.The aim of this study was to evaluate the management protocols available in the current literature for the commonly encountered coagulopathy-inducing agents...
September 2017: EFORT open reviews
https://www.readbyqxmd.com/read/29064875/perioperative-patient-blood-management-to-improve-outcomes
#16
Neel Desai, Nick Schofield, Toby Richards
Anemia is common in elective surgery and is an independent risk factor for morbidity and mortality. Historical management of anemia has focused on the use of allogeneic blood transfusion but this in itself is not without risk. It too has been independently associated with morbidity and mortality, let alone the costs and relative shortage of this resource. In recognition of this, patient blood management (PBM) shifts the focus from the product to the patient and views the patient's own blood as a resource that should be conserved and managed appropriately as a standard of care...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29045310/risk-of-stroke-after-transcatheter-prosthetic-aortic-valve-implant-with-aortic-bioprosthesis-subclinical-thrombosis-and-possible-therapeutic-implications
#17
Giuseppe Di Pasquale, Gloria V Coutsoumbas, Silvia Zagnoni
: Many factors could increase the risk of stroke after transcatheter prosthetic aortic valve implant, mainly related to the procedure itself, or to the type of valvular prosthesis, or to the presence of atrial fibrillation. There is a wide variability in the antithrombotic treatment utilized in clinical practice, as far as the choice of drugs (anticoagulant, single or dual antiplatelet treatment), and its optimal duration. The most popular therapeutic strategy, also recommended by the Scientific Societies, is dual antiplatelet (aspirin and clopidogrel) for the first 3-6 months then switching to single antiplatelet (usually aspirin), limiting oral anticoagulant therapy only to those patients with other primary indication to the treatment...
October 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29043405/-focused-update-on-dual-antiplatelet-treatment-esc-guidelines-2017
#18
A Schäfer, J Bauersachs
Dual antiplatelet treatment (DAPT) is a cornerstone of maintenance medication of patients following elective percutaneous coronary interventions or an acute coronary syndrome (ACS), e. g. ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina. In recent years the inclusion of P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. Following the introduction of the modern generation of drug-eluting stents for elective coronary interventions, the duration of the necessary DAPT has been clearly reduced...
October 17, 2017: Herz
https://www.readbyqxmd.com/read/29042978/antiplatelet-drug-ticagrelor-delays-gastric-ulcer-healing-in-rats
#19
Jing-Jing Li, Xin-Ying Wu, Jing-Lou Chen, Guan-Rong Chen, Jun Xu, Ye Gu, Hong-Ping Song
Adenosine diphosphate P2Y12 receptor antagonist clopidogrel is not sufficiently safe for the gastric mucosa in patients with high risk of peptic ulcer, since it may impair healing of gastric erosions. However, the safety of the novel P2Y12 receptor antagonist ticagrelor in the gastric mucosa has not been elucidated to date. The present study aimed to examine whether ticagrelor delays gastric ulcer healing and to elucidate the involved mechanisms. Gastric kissing ulcers were produced in rats by luminal application of acetic acid solution, and ticagrelor was administered at dose of 10 or 20 mg/kg/day orally for 7 days...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29037012/medical-treatment-of-intracranial-atherosclerosis-an-update
#20
REVIEW
Jong S Kim, Oh Young Bang
For patients with symptomatic intracranial atherosclerosis (ICAS), antithrombotic agents are the mainstay of therapy. Anticoagulation (warfarin) is not widely used since it is not more effective than aspirin and carries a high risk of bleeding. New oral anticoagulants are showing promise, but their use has not been investigated in appropriate clinical trials. Since the recurrent stroke risk is high with aspirin monotherapy, dual antiplatelets are considered in the early stage of symptomatic ICAS. Based on the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) results, aspirin plus clopidogrel has been recommended...
September 2017: Journal of Stroke
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