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https://www.readbyqxmd.com/read/28528236/-management-of-the-bleeding-risk-associated-with-antiplatelet-agents
#1
A-C Martin, S Houssany-Pissot, D Zlotnik, G Taylor, A Godier
Like all antithrombotic drugs, antiplatelet agents expose to a risk of bleeding complications. Clinical research has extensively focused on the efficacy of these drugs to reduce ischemic events. The bleeding risk associated with them was solely considered as an inevitable and acceptable complication. When two new potent P2Y12-receptor inhibitors, prasugrel and ticagrelor, were marketed, the risk of major bleeding increased. These new agents have modified the balance between the absolute risk reduction in ischemic events and the absolute risk increase in bleeding events...
May 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28526024/protective-effect-on-the-coronary-microcirculation-of-patients-with-diabetes-by-clopidogrel-or-ticagrelor-predict-study-rationale-and-design-a-randomized-multicenter-clinical-trial-using-intracoronary-multimodal-physiology
#2
Enrico Cerrato, Alicia Quirós, Mauro Echavarría-Pinto, Hernan Mejia-Renteria, Andres Aldazabal, Nicola Ryan, Nieves Gonzalo, Pilar Jimenez-Quevedo, Luis Nombela-Franco, Pablo Salinas, Iván J Núñez-Gil, José Ramón Rumoroso, Antonio Fernández-Ortiz, Carlos Macaya, Javier Escaned
BACKGROUND: In diabetic patients a predisposed coronary microcirculation along with a higher risk of distal particulate embolization during primary percutaneous intervention (PCI) increases the risk of peri-procedural microcirculatory damage. However, new antiplatelet agents, in particular Ticagrelor, may protect the microcirculation through its adenosine-mediated vasodilatory effects. METHODS: PREDICT is an original, prospective, randomized, multicenter controlled study designed to investigate the protective effect of Ticagrelor on the microcirculation during PCI in patient with diabetes mellitus type 2 or pre-diabetic status...
May 19, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28523947/potentiation-of-trap-6-induced-platelet-dense-granule-release-by-blockade-of-p2y12-signaling-with-mrs2395
#3
Annachiara Mitrugno, Rachel A Rigg, Nicole B Laschober, Anh T P Ngo, Jiaqing Pang, Craig D Williams, Joseph E Aslan, Owen J T McCarty
The release of ADP from platelet dense granules and its binding to platelet P2Y12 receptors is key to amplifying the initial hemostatic response and propagating thrombus formation. P2Y12 has thus emerged as a therapeutic target to safely and effectively prevent secondary thrombotic events in patients with acute coronary syndrome or a history of myocardial infarction. Pharmacological inhibition of P2Y12 receptors represents a useful approach to better understand the signaling mediated by these receptors and to elucidate the role of these receptors in a multitude of platelet hemostatic and thrombotic responses...
May 19, 2017: Platelets
https://www.readbyqxmd.com/read/28515278/critical-role-of-p2y12-receptor-in-regulation-of-th17-differentiation-and-experimental-autoimmune-encephalomyelitis-pathogenesis
#4
Chaoyan Qin, Jinfeng Zhou, Yuan Gao, Weiming Lai, Cuixia Yang, Yingying Cai, Shuai Chen, Changsheng Du
Adenosine 5'-diphosphate is a key endogenous cell-signaling molecule that can activate P2 purinergic receptor family members. ADP-P2Y signaling is reported to be associated with inflammation, but its function in T cell differentiation and autoimmune diseases pathogenesis is unclear. In this study, we found that the P2Y12 receptor was upregulated in the peripheral immune tissues of experimental autoimmune encephalomyelitis (EAE) mice. Deficiency of P2Y12 led to a reduced peak severity and cumulative disease score in EAE mice, followed by a dramatic reduction of leukocyte infiltration and less extensive demyelination...
May 17, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28510709/clopidogrel-instead-of-prasugrel-or-ticagrelor-after-1%C3%A2-month-in-stabilized-acs-patients-back-to-square-one-for-dapt
#5
Peter R Sinnaeve, Frans Van de Werf
No abstract text is available yet for this article.
May 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28510646/benefit-of-switching-dual-antiplatelet-therapy-after-acute-coronary-syndrome-the-topic-timing-of-platelet-inhibition-after-acute-coronary-syndrome-randomized-study
#6
Thomas Cuisset, Pierre Deharo, Jacques Quilici, Thomas W Johnson, Stéphanie Deffarges, Clémence Bassez, Guillaume Bonnet, Laurent Fourcade, Jean Philippe Mouret, Marc Lambert, Valentine Verdier, Pierre Emmanuel Morange, Marie Christine Alessi, Jean Louis Bonnet
Aims: Newer P2Y12 blockers (prasugrel and ticagrelor) demonstrated significant ischaemic benefit over clopidogrel after acute coronary syndrome (ACS). However, both drugs are associated with an increase in bleeding complications. The objective of the present study was to evaluate the benefit of switching dual antiplatelet therapy (DAPT) from aspirin plus a newer P2Y12 blocker to aspirin plus clopidogrel 1 month after ACS. Methods and results: We performed an open-label, monocentric, and randomized trial...
May 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#7
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28506579/-initial-management-of-st-elevation-myocardial-infarction-in-2014-from-guidelines-to-practices-survey-of-176-french-interventional-cardiologists
#8
E Capilla, R Poyet, A-V Tortat, F-X Brocq, F Pons, S Kerebel, C Jego, G R Cellarier
BACKGROUND: Real life management of myocardial infarction has not recently been evaluated in France. AIMS: To describe ST-elevation myocardial infarction management in France in 2014 and to compare it with current guidelines. METHODS: A multicentre study was performed. An e-mail questionnaire was sent to French interventional cardiologists. Demographic data of interventional cardiologists, procedural aspects of percutaneous coronary intervention, antithrombotic treatments and patient rehabilitation have been investigated...
May 12, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28503981/platelet-reactivity-influences-clot-structure-as-assessed-by-fractal-analysis-of-viscoelastic-properties
#9
Rebecca B Knowles, Matthew J Lawrence, Plinio M Ferreira, Melissa A Hayman, Lindsay A D'Silva, Sophie N Stanford, Ahmed Sabra, Arthur T Tucker, Karl M Hawkins, Phylip R Williams, Timothy D Warner, Phillip A Evans
Despite the interwoven nature of platelet activation and the coagulation system in thrombosis, few studies relate both analysis of protein and cellular parts of coagulation in the same population. In the present study, we use matched ex vivo samples to determine the influences of standard antiplatelet therapies on platelet function and use advanced rheological analyses to assess clot formation. Healthy volunteers were recruited following fully informed consent then treated for 7 days with single antiplatelet therapy of aspirin (75 mg) or prasugrel (10 mg) or with dual antiplatelet therapy (DAPT) using aspirin (75 mg) plus prasugrel (10 mg) or aspirin (75 mg) plus ticagrelor (90 mg)...
May 15, 2017: Platelets
https://www.readbyqxmd.com/read/28487152/effects-of-ticagrelor-on-neointimal-hyperplasia-and-endothelial-function-compared-with-clopidogrel-and-prasugrel-in-a-porcine-coronary-stent-restenosis-model
#10
Hyun Kuk Kim, Myung Ho Jeong, Kyung Seob Lim, Jung Ha Kim, Han Chul Lim, Min Chul Kim, Young Joon Hong, Sung Soo Kim, Keun-Ho Park, Kyoung-Sig Chang
BACKGROUND: Several investigations have been conducted to evaluate the off-target effects of ticagrelor. The aim of the present study was to evaluate the off-target effects of ticagrelor such as neointimal formation and endothelial function after drug-eluting stent implantation in a porcine restenosis model. METHODS: A total of 30 pigs were randomly allocated based on the following P2Y12 inhibitor: (1) clopidogrel 300mg loading plus 75mg maintenance (n=10); (2) prasugrel 60mg loading plus 10mg maintenance (n=10); (3) ticagrelor 180mg loading plus 180mg maintenance (n=10)...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28476519/the-underutilisation-of-dual-antiplatelet-therapy-in-acute-coronary-syndrome
#11
Malcolm Anastasius, Jerrett K Lau, Karice Hyun, Mario D'Souza, Anushka Patel, Jamie Rankin, Darren Walters, Craig Juergens, Bernadette Aliprandi-Costa, Andrew T Yan, Shaun G Goodman, Derek Chew, David Brieger
BACKGROUND: Despite guideline recommendation of dual antiplatelet therapy (DAPT) in treating ACS, DAPT is underutilized. Our objective was to determine independent predictors of DAPT non-prescription in ACS and describe pattern of DAPT prescription over time. METHODS: Patients presenting to 41 Australian hospitals with an ACS diagnosis between 2009 and 2016 were stratified according to discharge prescription with DAPT and single antiplatelet therapy (SAPT) or no antiplatelet therapy...
April 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28475757/a-multicenter-cohort-comparison-study-of-the-safety-efficacy-and-cost-of-ticagrelor-compared-to-clopidogrel-in-aneurysm-flow-diverter-procedures
#12
Justin M Moore, Nimer Adeeb, Hussain Shallwani, Raghav Gupta, Apar S Patel, Christoph J Griessenauer, Roy Youn, Adnan Siddiqui, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND: Thromboembolic and hemorrhagic complications are among the most feared adverse events in the endovascular treatment of aneurysms, and this is particularly the case for flow diverter devices. Dual antiplatelet therapy has become standard of care; however, the safety, efficacy, and cost profiles of newer antiplatelet agents are not well characterized in the neurovascular context. OBJECTIVE: To compare the safety, efficacy, and cost of one of these newer agents, ticagrelor, to the most frequently used agent, clopidogrel...
May 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28475282/risk-of-intracranial-hemorrhage-in-ground-level-fall-with-antiplatelet-or-anticoagulant-agents
#13
Michael Ganetsky, Gregory Lopez, Tara Coreanu, Victor Novack, Steven Horng, Nathan I Shapiro, Kenneth A Bauer
OBJECTIVES: Anticoagulant and antiplatelet medications are known to increase the risk and severity of traumatic intracranial hemorrhage (tICH), even with minor head trauma. Most studies on bleeding propensity with head trauma are retrospective, based on trauma registries, or include heterogeneous mechanisms of injury. The goal of this study was to determine the rate of tICH from only a common low-acuity mechanism of injury, that of a ground level fall, in patients taking one or more of the following antiplatelet or anticoagulant medications: aspirin, warfarin, prasugrel, ticagrelor, dabigatran, rivaroxaban, apixaban or enoxaparin...
May 5, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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/28463894/antiplatelet-treatments-recent-evidence-from-randomized-controlled-trials
#15
Birgit Vogel, Usman Baber
PURPOSE OF REVIEW: To provide an overview of selected randomized studies reported over the last 2 years evaluating antiplatelet therapies in patients with either acute or stable manifestations of atherosclerosis. RECENT FINDINGS: From large outcome trials included evidence for reduced risk of ischemic events associated with use of ticagrelor and aspirin versus aspirin alone, albeit with an increased bleeding risk in patients with stable coronary artery disease and history of myocardial infarction...
April 29, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28459500/gender-related-differences-in-antiplatelet-treatment-patterns-and-outcome-insights-from-the-greekantiplatelet-grape-registry
#16
I Xanthopoulou, P Davlouros, S Deftereos, M Hamilos, G Sitafidis, I Kanakakis, M Vavouranakis, J Goudevenos, J Lekakis, D Alexopoulos
AIMS: Data on the clinical impact of gender in 'real life' acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), receiving clopidogrel, prasugrel or ticagrelor are limited. We aimed to investigate sex-based differences in clinical outcome of those patients. METHODS: In a prospective, observational, multicenter, cohort study 2047 patients were recruited into the GReekAntiPlatElet (GRAPE) Registry and were followed-up until 1 year for major adverse cardiovascular events (MACE, composite of death, non fatal myocardial infarction,urgent revascularization and stroke) and bleeding events [Bleeding Academic Research Consortium (BARC) classification]...
April 29, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28446521/comparison-of-ticagrelor-pharmacokinetics-and-pharmacodynamics-in-stemi-and-nstemi-patients-pinpoint-protocol-for-a-prospective-observational-single-centre-study
#17
Piotr Adamski, Małgorzata Ostrowska, Joanna Sikora, Karolina Obońska, Katarzyna Buszko, Magdalena Krintus, Grażyna Sypniewska, Michał Piotr Marszałł, Marek Koziński, Jacek Kubica
INTRODUCTION: The most common classification of acute myocardial infarction (AMI) is based on electrocardiographic findings and distinguishes ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Both types of AMI differ concerning their epidemiology, clinical approach and early outcomes. Ticagrelor is a P2Y12 receptor inhibitor, constituting the first-line treatment for STEMI and NSTEMI. According to available data, STEMI may be associated with lower plasma concentration of ticagrelor in the first hours of AMI, but currently there are no studies directly comparing ticagrelor pharmacokinetics or antiplatelet effect in patients with STEMI versus NSTEMI...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28438043/comparative-effectiveness-and-safety-analysis-of-dual-antiplatelet-therapies-within-an-integrated-delivery-system
#18
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/28435448/inhibition-of-platelet-function-using-liposomal-nanoparticles-blocks-tumor-metastasis
#19
Yinlong Zhang, Jingyan Wei, Shaoli Liu, Jing Wang, Xuexiang Han, Hao Qin, Jiayan Lang, Keman Cheng, Yiye Li, Yingqiu Qi, Greg J Anderson, Saraswati Sukumar, Suping Li, Guangjun Nie
Extensive evidence has shown that platelets support tumor metastatic progression by inducing epithelial-mesenchymal transition of cancer cells and by shielding circulating tumor cells from immune-mediated elimination. Therefore, blocking platelet function represents a potential new avenue for therapy focused on eliminating metastasis. Here we show that liposomal nanoparticles bearing the tumor-homing pentapeptide CREKA (Cys-Arg-Glu-Lys-Ala) can deliver a platelet inhibitor, ticagrelor, into tumor tissues to specifically inhibit tumor-associated platelets...
2017: Theranostics
https://www.readbyqxmd.com/read/28433569/vitamin-d-binding-protein-rs7041-polymorphism-and-high-residual-platelet-reactivity-in-patients-receiving-dual-antiplatelet-therapy-with-clopidogrel-or-ticagrelor
#20
Monica Verdoia, Veronica Daffara, Patrizia Pergolini, Roberta Rolla, Paolo Marino, Giorgio Bellomo, Alessandro Carriero, Giuseppe De Luca
BACKGROUND: Vitamin D deficiency represents a major health problem in general population, especially for its association with cardiovascular disorders and thrombotic risk, even in patients on dual antiplatelet therapy (DAPT). Vitamin D Binding Protein (VDBP) is the main transporter of vitamin D in the bloodstream and genetic polymorphisms of this protein have been shown to account for a significant variability of vitamin D levels and its systemic effects. Contrasting data have linked the rs7041 T→G substitution with cardiovascular disease...
April 19, 2017: Vascular Pharmacology
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