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Clopidogrel AND Aspirin

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https://www.readbyqxmd.com/read/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#1
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28331925/biological-effects-of-ticagrelor-over-clopidogrel-in-patients-with-stable-coronary-artery-disease-and-chronic-obstructive-pulmonary-disease
#2
Gianluca Campo, Francesco Vieceli Dalla Sega, Rita Pavasini, Giorgio Aquila, Francesco Gallo, Francesca Fortini, Elisabetta Tonet, Paolo Cimaglia, Annamaria Del Franco, Gabriele Pestelli, Alessandro Pecoraro, Marco Contoli, Cristina Balla, Simone Biscaglia, Paola Rizzo, Roberto Ferrari
Patients with SCAD and concomitant COPD are at high risk of cardiovascular adverse events, due to chronic inflammation, responsible of endothelial dysfunction, oxidative stress and heightened platelet reactivity (PR). The objective of this randomised clinical trial was to test if ticagrelor is superior to clopidogrel in improving endothelial function in patients with stable coronary artery disease (SCAD) and concomitant chronic obstructive pulmonary disease (COPD). Forty-six patients with SCAD and COPD undergoing percutaneous coronary intervention (PCI) were randomly assigned to receive clopidogrel (n=23) or ticagrelor (n=23) on top of standard therapy with aspirin...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28329746/genotyping-platelet-activation-and-cardiovascular-outcome-in-patients-after-percutaneous-coronary-intervention-two-pieces-of-the-puzzle-of-clopidogrel-resistance
#3
Gerasimos Siasos, Evangelos Oikonomou, Manolis Vavuranakis, Eleni Kokkou, Konstantinos Mourouzis, Sotiris Tsalamandris, Marina Zaromitidou, Stamatios Kioufis, Vasiliki Tsigkou, Spyridon Deftereos, Christodoulos Stefanadis, Dimitris Tousoulis
OBJECTIVES: Individual platelet responses to antiplatelet therapy depend on genetic, cellular, and clinical factors. CYP2C19 and P2Y12 receptor polymorphisms are implicated in platelet responses to antiplatelet treatment. We aimed to evaluate the impact of CYP2C19 and C34T P2Y12 genotyping on platelet reactivity and cardiovascular outcome in patients after percutaneous coronary intervention (PCI) on clopidogrel treatment. METHODS: We enrolled 408 patients with stable coronary artery disease (CAD) receiving aspirin and clopidogrel (75 mg/day) 1 month after PCI...
March 22, 2017: Cardiology
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#4
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28320981/relationship-between-thromboelastography-and-long-term-ischemic-events-as-gauged-by-the-response-to-clopidogrel-in-patients-undergoing-elective-percutaneous-coronary-intervention
#5
Xumin Hou, Wenzheng Han, Qian Gan, Yuan Liu, Weiyi Fang
Ischemic events after percutaneous coronary intervention (PCI) remain a major concern for patients with coronary heart disease (CHD). The aim of the current study was to investigate whether thromboelastography (TEG) was a satisfactory technique to measure platelet function in vitro in order to improve risk stratification and the individual response to antiplatelet therapy. The diagnostic and prognostic utility of the maximum amplitude of adenosine diphosphate induced platelet-fibrin clots (MAADP) was measured with TEG in 759 patients undergoing elective PCI...
March 19, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28320608/antithrombotic-agents-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-network-meta-analysis
#6
Alexander C Fanaroff, Vic Hasselblad, Matthew T Roe, Deepak L Bhatt, Stefan K James, Ph Gabriel Steg, C Michael Gibson, E Magnus Ohman
BACKGROUND: Nine oral antithrombotic medications currently available in the United States and Europe have been studied in clinical trials for secondary prevention of cardiac events following acute coronary syndrome (ACS). Few combinations of these medications have been directly compared, and studies have used multiple different comparator regimens. METHODS: We performed a systematic review and network meta-analysis of randomized controlled trials evaluating one or more available oral antithrombotic therapies in patients with ACS or prior myocardial infarction (MI)...
March 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318511/effect-of-tailored-antiplatelet-therapy-to-reduce-recurrent-stent-thrombosis-and-cardiac-death-after-a-first-episode-of-stent-thrombosis
#7
Thea C Godschalk, Laura M Willemsen, Bastiaan Zwart, Thomas O Bergmeijer, Paul Willem A Janssen, Johannes C Kelder, Christian M Hackeng, Jurriën M Ten Berg
The recurrence rate of coronary stent thrombosis (ST) is high. Patients with ST often demonstrate high on-treatment platelet reactivity (HPR). It is suggested that patients at high risk of atherothrombotic events, that is patients with ST, could benefit from tailored antiplatelet therapy (APT). This study evaluated whether tailored APT, based on platelet function testing, reduced the rate of cardiac death and/or recurrent ST at 1 year after ST, compared with a historical cohort of patients with ST without tailored APT...
February 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#8
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28298800/a-case-of-subclavian-artery-aneurysm-with-history-of-ischemic-heart-disease-operated-under-cervical-epidural-anesthesia
#9
Amrita Rath, J Abhinay, Sandeep Loha, Atul Kumar Singh
Subclavian artery aneurysm is usually operated under general anesthesia (GA), but in specific situations, it can also be conducted under regional anesthesia (RA) such as cervical epidural anesthesia (CEA). A 48-year-old male presented with chief complaint of progressive swelling in the right side of the neck for the past 3 months following trauma. He was diagnosed as subclavian artery aneurysm, and surgical intervention was advised. He had previous history of angina 4 months back for which tablet aspirin 75 mg and tablet clopidogrel 75 mg once daily was prescribed...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28294864/-thromboxane-a2-mechanisms-of-synthesis-and-intracellular-signaling-system-of-realization
#10
E F Barinov
One of major complications of ischemic heart disease is myocardial infarction, which develops as a result of thrombosis at the site of ruptured atherosclerotic plaque. Platelets activation and aggregation are the key events of this process. The efficiency of aspirin and/or clopidogrel use is limited by residual platelet reactivity what indicates the need to explore its mechanisms. This review covers intracellular signaling systems involved in realization of effects of the main platelet agonists in order to specify new molecules for the target therapy in case of aspirin resistance...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28294854/-registry-of-acute-coronary-syndromes-record-3-characteristics-of-patients-and-treatment-during-initial-hospitalization
#11
A D Erlikh, N A Gratsiansky On Behalf Of Record-Participants
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month. RESULTS: Number of included pts was 2370 (39% women, mean age 64...
April 2016: Kardiologiia
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
#12
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/28290236/efficacy-of-cilostazol-based-dual-antiplatelet-treatment-in-patients-undergoing-carotid-artery-stenting
#13
Ichiro Nakagawa, Hun Soo Park, Takeshi Wada, Shohei Yokoyama, Syuichi Yamada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: It is essential that patients undergoing carotid artery stenting (CAS) receive optimal antiplatelet inhibition. Although a reduction in platelet reactivity and improved clinical outcomes occur when using adjunctive cilostazol with dual antiplatelet therapy, this can lead to an increased risk of hemorrhagic complications. Therefore, our current study examined patients undergoing CAS and evaluated the impact of cilostazol-based dual antiplatelet treatment on the outcomes. METHODS: Between 2010 and 2015, 137 consecutive patients underwent CAS...
March 14, 2017: Neurological Research
https://www.readbyqxmd.com/read/28289237/impact-of-glycemic-control-on-efficacy-of-clopidogrel-in-transient-ischemic-attack-or-minor-stroke-patients-with-cyp2c19-genetic-variants
#14
Yi Lin, Anxin Wang, Jiejie Li, Jinxi Lin, David Wang, Xia Meng, Lixian Ou, Weiqi Chen, Xingquan Zhao, Liping Liu, Yilong Wang, Yongjun Wang
BACKGROUND AND PURPOSE: Dysglycemia may influence the predictive value of CYP2C19 loss-of-function allele for clinical efficacy of antiplatelet drug, but the role of glycated albumin (GA) remains unclear in patients with stroke on antiplatelet drugs. METHODS: The CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) included 2933 patients who had GA levels and CYP2C19 genotyping. Cox proportional hazards model was used to assess the interaction between CYP2C19 loss-of-function allele (*2, *3) carrier status and the effect of antiplatelet therapy based on their GA levels...
March 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28284524/evaluation-of-atrial-fibrillation-management-and-cardiovascular-risk-profile-in-atrial-fibrillation-patients-a-cross-sectional-survey
#15
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/28280103/association-of-genetic-variant-and-platelet-function-in-patients-undergoing-neuroendovascular-stenting
#16
Xin-Gang Li, Ning Ma, Shu-Sen Sun, Zhe Xu, Wei Li, Yong-Jun Wang, Xin Yang, Zhong-Rong Miao, Zhi-Gang Zhao
INTRODUCTION: The risk of recurrent ischaemic events is related to platelet function, which is often assessed by thromboelastography (TEG). TEG has high interindividual variability. OBJECTIVE: To identify causal variants associated with TEG parameters in patients who receive aspirin and clopidogrel after intra- or extracranial stenting. METHODS: Patients who underwent stenting for extracranial or intracranial stenosis (70-99%) were recruited into the study...
March 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28279968/newly-formed-reticulated-platelets-undermine-pharmacokinetically-short-lived-antiplatelet-therapies
#17
Paul C Armstrong, Thomas Hoefer, Rebecca B Knowles, Arthur Tucker, Melissa A Hayman, Plinio M Ferreira, Melissa V Chan, Timothy D Warner
OBJECTIVE: Aspirin together with thienopyridine P2Y12 inhibitors, commonly clopidogrel, is a cornerstone of antiplatelet therapy. However, many patients receiving this therapy display high on-treatment platelet reactivity, which is a major therapeutic hurdle to the prevention of recurrent thrombotic events. The emergence of uninhibited platelets after thrombopoiesis has been proposed as a contributing factor to high on-treatment platelet reactivity. Here, we investigate the influences of platelet turnover on platelet aggregation in the face of different dual-antiplatelet therapy strategies...
March 9, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28279076/triple-antithrombotic-therapy-with-aspirin-p2y12-inhibitor-and-warfarin-after-percutaneous-coronary-intervention
#18
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/28277861/state-transition-model-vorapaxar-added-to-standard-antiplatelet-therapy-to-prevent-thrombosis-post-myocardial-infarction-or-peripheral-artery-disease
#19
Mark Du, Monica Chase, Mustafa Oguz, Glenn Davies
OBJECTIVE: To evaluate long-term health benefits and risks of adding vorapaxar (VOR) to the standard care antiplatelet therapy (SC) of aspirin and/or clopidogrel, among a population with a recent myocardial infarction (MI) and/or peripheral artery disease (PAD). RESEARCH DESIGN AND METHODS: In a state-transition model, patients transition between health states (event-free, recurrent MI, stroke, death), while at risk of experiencing non-transition-related revascularization and non-fatal bleeding events...
March 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28277060/thrombelastographic-hypercoagulability-and-antiplatelet-therapy-after-coronary-artery-bypass-surgery-teg-cabg-trial-a-randomized-controlled-trial
#20
Sulman Rafiq, Pär I Johansson, Klaus F Kofoed, Jens T Lund, Peter S Olsen, Simon Bentsen, Daniel A Steinbrüchel
A hypercoagulable state has, in observational studies, been associated with increased risk of thromboembolic events. The aim of this trial was to study whether dual antiplatelet therapy (DAPT) with clopidogrel in addition to aspirin could reduce the rate of graft occlusions, thromboembolic events, and death compared to aspirin monotherapy in hypercoagulable patients undergoing coronary artery bypass surgery. A total of 1683 patients were screened for eligibility, among which 165 patients were randomized and 133 patients underwent multislice computed tomography scan to evaluate their grafts...
February 22, 2017: Platelets
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