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Albert Ariza-Solé, Francesc Formiga, Alfredo Bardají, Ana Viana-Tejedor, Oriol Alegre, Fernando de Frutos
No abstract text is available yet for this article.
April 18, 2018: Revista Española de Cardiología
Aleksandra Gasecka, Rienk Nieuwland, Edwin van der Pol, Najat Hajji, Agata Ćwiek, Kinga Pluta, Michał Konwerski, Krzysztof J Filipiak
BACKGROUND: Activated platelets release platelet extracellular vesicles (PEVs). Adenosine diphosphate (ADP) receptors P2Y1 and P2Y12 both play a role in platelet activation, The present hypothesis herein is that the inhibition of these receptors may affect the release of PEVs. METHODS: Platelet-rich plasma from 10 healthy subjects was incubated with saline, P2Y1 antagonist MRS2179 (100 µM), P2Y12 antagonist ticagrelor (1 µM), and a combination of both antagonists...
April 19, 2018: Cardiology Journal
Ayhan Yildirim, Heinz-Theo Lübbers, Ali Yildirim
Antiplatelet agents with the active ingredients acetylsalicylic acid (Aspirin® protect 100), clopidogrel (Iscover®, Plavix®), prasugrel (Efient®) or ticagrelor (Brilique™) prevent the clumping of platelets and thus the formation of small clots at constrictions of the coronary arteries or on the metal struts of stents in the coronary artery or in bypass grafts. Large-scale studies have shown that taken regularly, these drugs can extend life and help prevent heart attacks. Especially in patients with newly implanted stents, the combination of the above-mentioned agents prevents sudden complete occlusion of the vessel concerned...
April 15, 2018: Swiss Dental Journal
Min Chul Kim, Myung Ho Jeong, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Tae Hoon Ahn, Ki Bae Seung, Dong-Ju Choi, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyoung-Kook Hwang, Shung Chull Chae, Seung Ho Hur, Kwang Soo Cha, Seok Kyu Oh, Jei Keon Chae
BACKGROUND: There is little information regarding comparison of ticagrelor and prasugrel in patients with ST-segment elevation myocardial infarction (STEMI). We sought to compare clinical outcomes between ticagrelor and prasugrel in STEMI.Methods and Results:A total of 1,440 patients with STEMI who underwent successful primary percutaneous coronary intervention were analyzed; the data were obtained from the Korea Acute Myocardial Infarction Registry-National Institutes of Health. Of the patients, 963 received ticagrelor, and 477 received prasugrel...
April 12, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
R Kevin Rogers, William R Hiatt, Manesh R Patel, Mehdi H Shishehbor, Robin White, Naeem D Khan, Narinder P Bhalla, W Schuyler Jones, Cecilia C Low Wang
There is limited evidence to guide clinical decision-making for antiplatelet therapy in peripheral artery disease (PAD) in the setting of lower extremity endovascular treatment. The Ticagrelor in Peripheral Artery Disease Endovascular Revascularization Study (TI-PAD) evaluated the role of ticagrelor versus aspirin as monotherapy in the management of patients following lower extremity endovascular revascularization. The trial failed to recruit the targeted number of patients, likely due to aspects of the design including the lack of option for dual antiplatelet therapy, and inability to identify suitable patients at study sites...
April 1, 2018: Vascular Medicine
Nathalie R Wingert, Jéssica B Ellwanger, Lívia M Bueno, Caren Gobetti, Cássia V Garcia, Martin Steppe, Elfrides E S Schapoval
Simultaneous analysis of drug compounds and their impurities of degradation and synthesis became constant in the modern pharmaceutical analysis. Likewise, analytical techniques must improve sensitivity and selectivity for the monitoring of pharmaceutical products, allowing a full assessment of impurities in drug products and, therefore, ensure safety and efficacy of pharmacological treatments. The application of Quality by Design (QbD) principles has proved to be feasible on the elaboration of analytical methods, allowing the comprehensive evaluation and measurement of different analytical parameters and their effects on critical properties of the methodology in development...
April 3, 2018: European Journal of Pharmaceutical Sciences
Axel Van Damme, Philippe Vanderheeren, Tine De Backer, Françine Desimpel
Case A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain...
April 6, 2018: Acta Clinica Belgica
Alessandro Lupi, Roberta Della Bona, Emanuele Meliga, Davide Capodanno, Alon Schaffer, Angelo S Bongo, Giovanni Gaudio, Luigina Guasti, Dimitrios Alexopoulos, Marco Valgimigli, Italo Porto
BACKGROUND:  Early escalation from clopidogrel to new generation P2Y12 inhibitors is common practice in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Real-world data about this strategy, however, are limited. METHODS:  From 2012 to 2015, 1,057 consecutive STEMI patients treated with pPCI in an Italian hub-and-spoke network were prospectively included in an observational registry (RENOVAMI, ClinicalTrials...
April 4, 2018: Thrombosis and Haemostasis
Craig R Lee, Vindhya B Sriramoju, Alexandra Cervantes, Lucius A Howell, Nicholas Varunok, Shivanshu Madan, Kasey Hamrick, Melissa J Polasek, John Andrew Lee, Megan Clarke, Jonathan D Cicci, Karen E Weck, George A Stouffer
BACKGROUND: CYP2C19 loss-of-function (LOF) alleles impair clopidogrel effectiveness after percutaneous coronary intervention. The feasibility, sustainability, and clinical impact of using CYP2C19 genotype-guided dual antiplatelet therapy (DAPT) selection in practice remains unclear. METHODS: A single-center observational study was conducted in 1193 patients who underwent percutaneous coronary intervention and received DAPT after implementation of an algorithm that recommends CYP2C19 testing in high-risk patients and alternative DAPT (prasugrel or ticagrelor) in LOF allele carriers...
April 2018: Circulation. Genomic and precision medicine
Alberto Garay, Albert Ariza-Solé, Francesc Formiga, Sergio Raposeiras-Roubín, Emad Abu-Assi, José C Sánchez-Salado, Victòria Lorente, Oriol Alegre, Jose Paulo Simao Henriques, Fabrizio D'Ascenzo, Jorge Saucedo, José Ramón González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Claudio Moretti, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, José María García-Acuña, Danielle Southern, Emilio Alfonso, Belén Terol, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Francesca Giordana, Fiorenzo Gaita, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahashi, Kenji Sakata, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev, Angel Cequier
BACKGROUND:  A poor ability of recommended risk scores for predicting in-hospital bleeding has been reported in elderly patients with acute coronary syndromes (ACS). No study assessed the prediction of post-discharge bleeding in the elderly. The new BleeMACS score (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome), was designed to predict post-discharge bleeding in ACS patients. We aimed to assess the predictive ability of the BleeMACS score in elderly patients...
April 3, 2018: Thrombosis and Haemostasis
Guanqi Zhao, Mengge Zhou, Changsheng Ma, Yong Huo, Sidney C Smith, Gregg C Fonarow, Junbo Ge, Yaling Han, Jing Liu, Yongchen Hao, Jun Liu, Xiao Wang, Kathryn A Taubert, Louise Morgan, Dong Zhao, Shaoping Nie
BACKGROUND: Elderly patients with acute coronary syndrome (ACS) are at high risk for ischemic and bleeding events. This study aimed to evaluate the clinical effectiveness and safety of dual loading antiplatelet therapy for patients 75 years and older undergoing percutaneous coronary intervention for ACS. METHODS AND RESULTS: The Improving Care for Cardiovascular Disease in China-ACS project was a collaborative study of the American Heart Association and Chinese Society of Cardiology...
March 30, 2018: Journal of the American Heart Association
Niccolò Lombardi, Ersilia Lucenteforte, Monica Torrini, Daniela Balzi, Alessandro Barchielli, Alessandro Mugelli, Alfredo Vannacci
INTRODUCTION: The aim of the current study was to define the rate of emergency department visits for late-onset dyspnea in acute coronary syndrome patients treated with ticagrelor. METHODS: We conducted a population-based study on about 850 000 residents of Florence metropolitan area, by using data from healthcare records. RESULTS: Between 2012 and 2014, 1073 subjects in Florence metropolitan area had at least one prescription of ticagrelor...
March 29, 2018: Journal of Cardiovascular Medicine
Oliver Borst, Patrick Münzer, Nada Alnaggar, Sascha Geue, Roland Tegtmeyer, Dominik Rath, Michal Droppa, Peter Seizer, Stefan Heitmeier, Johan W M Heemskerk, Lisa K Jennings, Robert F Storey, Dominick J Angiolillo, Bianca Rocca, Henri Spronk, Hugo Ten Cate, Meinrad Gawaz, Tobias Geisler
Very low-dose (VLD) factor Xa (FXa) inhibition, in combination with acetylsalicylic acid (ASA) and clopidogrel, is associated with improved outcomes in patients with acute coronary syndrome (ACS) with a tolerable bleeding risk profile. To date, there are no data documenting platelet inhibition and the anticoagulatory effects of VLD FXa inhibition on top of guideline-adherent dual-antiplatelet therapy (DAPT) in patients with ACS. Patients with non-ST-elevation myocardial infarction (NSTEMI) receiving oral DAPT (ASA + clopidogrel, n = 20; or ASA + ticagrelor, n = 20) were prospectively enrolled in a nonrandomized study...
March 27, 2018: Blood Advances
Anne Bertling, Anke C Fender, Lisa Schüngel, Michael Rumpf, Kira Mergemeier, Georg Geißler, Walter Sibrowski, Reinhard Kelsch, Johannes Waltenberger, Joseph A Jakubowski, Beate E Kehrel
BACKGROUND: Platelet transfusion is the conventional approach to restore platelet function during acute bleeds or surgery, but successful outcome depends on the specific antiplatelet therapy. Notably ticagrelor is associated with inadequate recovery of platelet function after platelettransfusion. We examined whether plasma and/or platelets from ticagrelor-treated patients influence donor platelet function, in comparison with clopidogrel and prasugrel. METHODS: Platelet transfusion was mimicked ex vivo by mixing naïve donor platelet-rich plasma (PRP) or gel-filtered platelets (GFP) in defined proportions with PRP, plasma or GFP from cardiovascular patients receiving standard care including medication with prasugrel, clopidogrel or ticagrelor (n=20 each)...
March 26, 2018: Journal of Thrombosis and Haemostasis: JTH
Ryan G D'Angelo, Thaddeus McGiness, Laura H White
OBJECTIVE: To synthesize the literature and provide guidance to practitioners regarding double therapy (DT) and triple therapy (TT) in patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI). DATA SOURCES: PubMed and MEDLINE (January 2000 to February 2018) were searched using the following terms: atrial fibrillation, myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, anticoagulation, dual-antiplatelet therapy, clopidogrel, aspirin, ticagrelor, prasugrel, and triple therapy...
March 1, 2018: Annals of Pharmacotherapy
Luca Spiezia, Ahmed Al Mamary, Elena Campello, Daniele Piazza, Sara Maggiolo, Fabio Dalla Valle, Massimo Napodano, Paolo Simioni
Dual antiplatelet therapy is recommended in patients undergoing primary percutaneous coronary intervention (p-PCI) for ST-segment elevation myocardial infarction (STEMI). Pre-analytical variables may influence platelet function analysis results. Our aim was to evaluate the on-treatment platelet reactivity in peripheral artery vs coronary blood in patients with STEMI. We enrolled one hundred and nine patients who consecutively underwent p-PCI at Cardiology Unit of Padua University Hospital between June 2014 and June 2015...
March 26, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
J J Micklewright, J A Layhadi, S J Fountain
BACKGROUND AND PURPOSE: The Gi-coupled, ADP-activated P2Y12 receptor is well characterised as playing a key role in platelet activation via crosstalk with P2Y1 in ADP-evoked intracellular Ca2+ response. There is limited knowledge on the role of P2Y12 in ADP-evoked Ca2+ responses in other blood cells. Here we investigate the role of P2Y12 receptor activation in modulation of ADP-evoked Ca2+ responses in human THP-1 monocytic cells. EXPERIMENTAL APPROACH: A combination of intracellular Ca2+ measurements, RT-PCR, immunocytochemistry, leukocyte isolation and siRNA-mediated gene knockdown were used to identify the role of P2Y12 receptor activation...
March 25, 2018: British Journal of Pharmacology
Robert Edfors, Anders Sahlén, Karolina Szummer, Henrik Renlund, Marie Evans, Juan-Jesus Carrero, Jonas Spaak, Stefan K James, Bo Lagerqvist, Christoph Varenhorst, Tomas Jernberg
OBJECTIVES: We aimed to analyse outcomes of ticagrelor and clopidogrel stratified by estimated glomerular filtration rate (eGFR) in a large unselected cohort of patients with acute myocardial infarction (MI). METHODS: We used follow-up data in MI survivors discharged on ticagrelor or clopidogrel enrolled in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies registry. The association between ticagrelor versus clopidogrel and the primary composite outcome of death, MI or stroke and the secondary outcome rehospitalisation with bleeding diagnosis at 1 year, was studied using adjusted Cox proportional hazards models, stratifying after eGFR levels...
March 24, 2018: Heart: Official Journal of the British Cardiac Society
Ilaria Cavallari, Giuseppe Patti
Platelets and the coagulation cascade play key roles in initiation, amplification, and perpetuation of acute coronary syndromes (ACS). In the past few years, there has been great progress in ACS antithrombotic treatment with the introduction of novel anticoagulants (fondaparinux and bivalirudin), more potent P2Y12 inhibitors (prasugrel and ticagrelor) and protease-activated receptor antagonists (vorapaxar). Nonetheless, patients with ACS frequently have recurrent ischemic events despite the use of currently recommended dual antiplatelet therapy, revascularization procedures as appropriate, and other evidence-based secondary preventive measures...
March 21, 2018: Internal and Emergency Medicine
X Y Zhao, J X Li, X F Tang, Y Xian, J J Xu, Y Song, L Jiang, L J Xu, J Chen, Y Zhang, L Song, L J Gao, Z Gao, J Zhang, Y Wu, S B Qiao, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To evaluate the predictive value of GRACE discharge score on the long-term out-of-hospital coronary thrombotic events (CTE) after percutaneous coronary intervention (PCI) with drug-eluting stents. Methods: Present study was a prospective, observational, single center study. 10 724 consecutive patients underwent PCI in Fuwai Hospital between January and December 2013 were included, stents were implanted with conventional method. After PCI, patients were prescribed aspirin 100 mg once daily indefinitely, and either clopidogrel 75 mg once daily or ticagrelor 90 mg twice daily for at least 1 year...
March 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
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