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Clopidogrel AND Aspirin

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https://www.readbyqxmd.com/read/28634365/different-levels-of-blood-pressure-different-benefit-from-dual-antiplatelet-therapy-in-minor-stroke-or-tia-patients
#1
Jie Xu, Yongli Tao, Hao Li, Hongqiu Gu, Xuewei Xie, Xia Meng, Yuming Xu, Yilong Wang, Yongjun Wang
The study aimed to evaluate whether the benefits of dual antiplatelet therapy would be influenced by blood pressure (BP) levels, among acute minor stroke or transient ischemic attack (TIA). In CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling cerebrovascular Events) trail, Patients were stratified by systolic BP (SBP) and diastolic BP (DBP) level measured on admission, respectively, using the supine position BP within 24 hours after symptoms onset. The primary efficacy outcome was stroke recurrence, bleeding was the safety outcome...
June 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28630782/remote-assessment-of-platelet-function-in-patients-with-acute-stroke-or-transient-ischaemic-attack
#2
Philip M Bath, Jane May, Katie Flaherty, Lisa J Woodhouse, Natalia Dovlatova, Sue C Fox, Timothy J England, Kailash Krishnan, Thompson G Robinson, Nikola Sprigg, Stan Heptinstall, Tardis Investigators
BACKGROUND: The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. METHODS: Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28619235/morphological-and-pharmacological-determinants-of-peri-procedural-myocardial-infarction-following-elective-stent-implantation-optical-coherence-tomography-sub-analysis-of-the-prasfit-elective-study
#3
Kenzo Uzu, Toshiro Shinke, Hiromasa Otake, Tomofumi Takaya, Tsuyoshi Osue, Masamichi Iwasaki, Hiroto Kinutani, Akihide Konishi, Masaru Kuroda, Hachidai Takahashi, Daisuke Terashita, Ken-Ichi Hirata, Shigeru Saito, Masato Nakamura, Junya Shite, Takashi Akasaka
BACKGROUND: Previous studies have suggested that peri-procedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) is associated with adverse short- and long-term outcomes, and several morphological predictors of PMI have been studied. However, the determinants of PMI under novel anti-platelet therapy are not fully elucidated. METHODS AND RESULTS: PRASFIT-Elective is a multicenter, parallel-group study of PCI patients in non-acute settings receiving either prasugrel or clopidogrel in addition to aspirin...
June 12, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28618904/antiplatelet-and-antithrombotic-treatment-for-secondary-prevention-in-ischaemic-heart-disease
#4
Maddalena Lettino, Sergio Leonardi, Elia De Maria, Sigrun Halvorsen
Platelets play a key role in the pathogenesis of acute coronary syndromes and this is why antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in preventing recurrent myocardial infarction, stroke and cardiovascular death. Aspirin is the most used agent and still remains the first choice drug for lifelong administration in secondary prevention after myocardial infarction. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has significantly improved the outcome of patients with acute coronary syndromes despite an increased risk of bleeding complications...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28617992/antiplatelet-therapy-and-the-risk-of-hepatocellular-carcinoma-in-chronic-hepatitis-b-patients-on-antiviral-treatment
#5
Minjong Lee, Goh Eun Chung, Jeong-Hoon Lee, Sohee Oh, Joon Yeul Nam, Young Chang, Hyeki Cho, Hongkeun Ahn, Young Youn Cho, Jeong-Ju Yoo, Yuri Cho, Dong Hyeon Lee, Eun Ju Cho, Su Jong Yu, Dong Ho Lee, Jeong Min Lee, Yoon Jun Kim, Jung-Hwan Yoon
Antiplatelet therapy has shown protective effects against hepatocellular carcinoma (HCC) in preclinical studies. However, it is unclear whether antiplatelet therapy lowers the risk of HCC in patients with chronic hepatitis B (CHB). A retrospective analysis was conducted of data from 1,674 CHB patients, enrolled between January 2002 and May 2015, whose serum hepatitis B virus (HBV) DNA levels were suppressed by antivirals to <2,000 IU/mL. The primary and secondary outcomes were development of HCC and bleeding events, respectively...
June 15, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28616861/medical-therapy-and-recurrent-ischemic-events-in-high-risk-patients-surviving-their-myocardial-infarction-for-at-least-12%C3%A2-months-comparison-of-patients-with-st-elevation-versus-non-st-elevation-myocardial-infarction
#6
Uwe Zeymer, Katrin Riedel, Michael Hahn
INTRODUCTION: Data about treatments and recurrent ischemic events in patients surviving their most recent myocardial infarction event-free for at least 12 months are scarce. METHODS: In a retrospective data analysis, charts of patients who had a myocardial infarction 1-3 years ago with an event-free period of at least 12 months after the index event and at least one high risk factor were centrally collected and analyzed. Here we compare patients with ST elevation myocardial infarction (STEMI) versus non-ST elevation myocardial infarction (NSTEMI)...
June 14, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28616432/effect-of-pretreatment-with-omega-3-supplement-on-cardiac-necrosis-markers-in-chronic-kidney-disease-patients-undergoing-elective-percutaneous-coronary-intervention
#7
Farzaneh Foroughinia, Maryam Foroozmehr
OBJECTIVE: Studies have demonstrated the direct relation between elevation in cardiac necrosis markers and increased risk of cardiovascular complications after percutaneous coronary intervention (PCI) in chronic kidney disease (CKD) patients. In this study, we sought to evaluate the effect of omega-3 on creatine kinase-MB (CK-MB) and troponin-I in CKD patients undergoing elective PCI. METHODS: Eighty CKD patients, candidate for elective PCI, were randomly assigned into two groups: Group A - receiving omega-3 (2...
April 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28612911/short-term-efficacy-and-safety-of-three-different-antiplatelet-regimens-in-diabetic-patients-treated-with-primary-percutaneous-coronary-intervention-a-randomized-study
#8
Yang Liu, Hengliang Liu, Yibin Hao, Zhenxuan Hao, Guoying Geng, Wenjie Han, Qi Chen, Danli Wang, Lingzhi Liu, Kailong Jia, Yuxin Zhou
BACKGROUND: This study aimed to investigate the efficacy and safety of dual and triple antiplatelet therapy (DAPT and TAPT) in patients with diabetes and acute ST segment elevation myocardial infarction (D-STEMI), who had undergone primary percutaneous coronary intervention (PCI). METHODS: We designed a phase IV, single-center, randomized, double-blind, placebo-controlled study. The D-STEMI patients (N=258) were randomly divided into three groups. Control group A (85 patients), was treated with aspirin and clopidogrel; group B (87 patients) received aspirin, clopidogrel, and tirofiban; and group C (86 patients) was treated with aspirin, ticagrelor, and tirofiban...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28611833/open-label-phase-i-clinical-study-to-assess-the-safety-and-efficacy-of-cilostazol-in-patients-undergoing-internal-carotid-artery-stent-placement
#9
Ameer E Hassan, Haralabos Zacharatos, Mikayel Grigoryan, Wondwossen G Tekle, Amir Khan, Farhan Siddiq, Gustavo J Rodriguez, Ramachandra Tummala, Bharathi Jagadeesan, M Fareed K Suri, Adnan I Qureshi
BACKGROUND: One-month dual antiplatelet treatment, with aspirin and clopidogrel, following internal carotid artery stent placement is the current standard of care to prevent in-stent thrombosis. Cilostazol, an antiplatelet drug, has been demonstrated to have a safety profile comparable to aspirin and clopidogrel. OBJECTIVE: To evaluate the safety and clinical efficacy of cilostazol and aspirin therapy following internal carotid artery stent placement up to 1 month postprocedure...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28608165/platelet-related-biomarkers-and-their-response-to-inhibition-with-aspirin-and-p2y12-receptor-antagonists-in-patients-with-acute-coronary-syndrome
#10
Angela Lowenstern, Robert F Storey, Megan Neely, Jie-Lena Sun, Dominick J Angiolillo, Christopher P Cannon, Anders Himmelmann, Kurt Huber, Stefan K James, Hugo A Katus, Joao Morais, Agneta Siegbahn, Phillippe Gabriel Steg, Lars Wallentin, Richard C Becker
The PLATelet inhibition and patient Outcomes (PLATO) trial showed that treatment with ticagrelor reduced the rate of death due to vascular causes, myocardial infarction and stroke when compared to clopidogrel in patients with ST-elevation or non-ST-elevation acute coronary syndrome (ACS). While the comparative benefit of ticagrelor over clopidogrel increased over time, event rates accrued in both groups during the study period. The purpose of our biomarker-based exploratory analysis was to determine whether long-term platelet inhibition may be associated with platelet adaptation...
June 12, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28606584/impact-of-a-modified-anti-thrombotic-guideline-on-stroke-in-children-supported-with-a-pediatric-ventricular-assist-device
#11
David N Rosenthal, Chacy A Lancaster, Doff B McElhinney, Sharon Chen, MaryLyn Stein, Aileen Lin, Lan Doan, Jenna M Murray, Mary Alice Gowan, Katsuhide Maeda, Olaf Reinhartz, Christopher S Almond
BACKGROUND: Stroke is the most feared complication associated with the Berlin Heart EXCOR pediatric ventricular assist device (VAD), the most commonly used VAD in children, and affects 1 in 3 children. We sought to determine whether a modified anti-thrombotic guideline, involving more intense platelet inhibition and less reliance on platelet function testing, is associated with a lower incidence of stroke. METHODS: All children supported with the EXCOR at Stanford from 2009 to 2014 were divided into 2 cohorts based on the primary anti-thrombotic guideline used to prevent pump thrombosis: (1) the Edmonton Anti-thrombotic Guideline (EG) cohort, which included children implanted before September 2012 when dual anti-platelet therapy was used with doses titrated to Thromboelastrography/PlateletMapping (TEG/PM); and (2) the Stanford Modified Anti-thrombotic Guideline (SG) cohort, which included children implanted on or after September 2012 when triple anti-platelet therapy was used routinely and where doses were uptitrated to high, weight-based dosing targets, with low-dose steroids administered as needed for inflammation...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28606562/the-efficacy-and-safety-of-3-types-of-interventions-for-stroke-prevention-in-patients-with-cardiovascular-and-cerebrovascular-diseases-a-network-meta-analysis
#12
Qian Sun, Shumei Chang, Songtao Lu, Yajing Zhang, Yajun Chang
PURPOSE: The goal of this study was to compare the relative efficacy and safety of different types of interventions for stroke prevention in patients with cardiovascular and cerebrovascular diseases. METHODS: This network meta-analysis (NMA) was conducted with a random effects model of Bayesian framework using Stata version 12.0. Odds ratios (ORs) and their credible intervals (CrIs) were applied for the efficacy and safety evaluation of various medical interventions, including aspirin, dipyridamole, ticlopidine, warfarin, and apixaban...
June 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28605779/use-of-the-dual-antiplatelet-therapy-score-to-guide-treatment-duration-after-percutaneous-coronary-intervention
#13
Raffaele Piccolo, Giuseppe Gargiulo, Anna Franzone, Andrea Santucci, Sara Ariotti, Andrea Baldo, Carlo Tumscitz, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
Background: The dual-antiplatelet therapy (DAPT) score was developed to identify patients more likely to derive harm (score <2) or benefit (score ≥2) from prolonged DAPT after percutaneous coronary intervention (PCI). Objective: To evaluate the safety and efficacy of DAPT duration according to DAPT score. Design: Retrospective assessment of DAPT score-guided treatment duration in a randomized clinical trial. (ClinicalTrials.gov: NCT00611286)...
June 13, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28604225/the-impact-of-clinical-and-genetic-factors-on-ticagrelor-and-clopidogrel-antiplatelet-therapy
#14
Vacis Tatarunas, Nora Kupstyte, Remigijus Zaliunas, Agne Giedraitiene, Vaiva Lesauskaite
AIM: To determine clinically significant factors which may alter the effect of dual antiplatelet therapy with aspirin and ticagrelor or clopidogrel in patients who had undergone percutaneous coronary intervention and stent implantation. MATERIALS & METHODS: The study included 378 patients. All the patients had undergone percutaneous coronary intervention and stent implantation. Platelet aggregation and genotyping for CYP2C19 *2 (rs4244285) and CYP4F2 (rs2108622, rs1558139, rs3093135 and rs2074902) was performed...
June 12, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28600334/how-i-utilize-laboratory-monitoring-of-antiplatelet-therapies
#15
Alan D Michelson, Deepak L Bhatt
Antiplatelet therapy is of proven benefit in coronary artery disease and a number of other clinical settings. This article briefly reviews platelet function, molecular targets of antiplatelet agents and clinical indications for antiplatelet therapy before focusing on a frequent question to hematologists about the two most commonly used antiplatelet therapies: Could the patient be aspirin "resistant" or clopidogrel "resistant"? If so, should results of a platelet function test be used to guide the dose or type of antiplatelet therapy? Whether or not such guided therapy is of clinical benefit to patients has been a source of controversy...
June 9, 2017: Blood
https://www.readbyqxmd.com/read/28597175/distribution-of-cyp2c19-polymorphisms-in-mongolian-and-han-nationals-and-the-choice-of-specific-antiplatelet-drugs
#16
Jing Li, YueXi Wang, HuPing Wang
Background Individualized medication reviews may improve our understanding of the distribution of CYP2C19 polymorphisms in ethnic populations. Objective To evaluate differences in CYP2C19 gene polymorphisms between Mongolian and Han nationals and determine the effect of adjustments of antiplatelet treatments according to the genetic profile in patients undergoing percutaneous coronary intervention (PCI). Setting Prospective, observational, single-center study. Methods 397 patients diagnosed with acute coronary syndrome were enrolled...
June 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28589365/variability-of-platelet-response-to-clopidogrel-is-not-related-to-adverse-cardiovascular-events-in-patients-with-stable-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#17
Szymon Olędzki, Zdzisława Kornacewicz-Jach, Krzysztof Safranow, Radosław Kiedrowicz, Barbara Gawrońska-Szklarz, Maria Jastrzębska, Jarosław Gorący
BACKGROUND: Antiplatelet response to clopidogrel and its influence upon the risk of cardiovascular adverse events among patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI) has not been investigated fully. METHODS: Two hundred eleven patients treated with aspirin and clopidogrel were included in the study. Immediately before PCI, residual platelet reactivity testing with impedance aggregometry assay and a single-nucleotide polymorphism genotyping analysis targeting variants of CYP2C19, ABCB1, and PON1 genes was performed...
June 6, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28588165/immediate-short-term-outcome-of-using-single-bolus-eptifibatide-in-percutaneous-coronary-intervention-a-randomized-control-study
#18
S A Ahsan, K S Haque, J Arzu, M Mahmood, N Fatema, M N Hasan
The purpose of this study was to assess the immediate and short term outcome of single bolus dose of eptifibatide in elective percutaneous coronary intervention (PCI). We enrolled 146 patients who underwent elective PCI from May 2013 to May 2014 in University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Among 146 patients, seventy four patients received single bolus dose of eptifibatide (10 mg intra coronary single bolus dose) just after crossing the lesion were selected as case...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28587584/strategies-to-optimize-dual-antiplatelet-therapy-after-coronary-artery-stenting-in-acute-coronary-syndrome
#19
Bridget Paravattil, Hazem Elewa
The use of aspirin and a P2Y12 receptor antagonist as dual antiplatelet therapy (DAPT) has become the treatment of choice in patients with acute coronary syndrome (ACS) and percutaneous coronary intervention to prevent recurrent thrombotic events. Although DAPT is beneficial for most patients, few patients still experience recurrent thrombotic events and increased bleeding episodes. This article reviews current literature to identify various approaches that may enhance the DAPT benefit-risk ratio in patients with ACS...
July 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28587360/the-value-of-sonoclot-detection-technology-to-guide-the-clinical-medication-of-the-perioperative-anticoagulation-and-antiplatelet-therapy-in-patients-with-acute-myocardial-infarction-undergoing-emergent-pci
#20
Wu-Xiao Yang, Chun-Lin Lai, Fu-Heng Chen, Ji-Rong Wang, You-Rui Ji, Dong-Xia Wang
The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function...
June 2017: Experimental and Therapeutic Medicine
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