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https://www.readbyqxmd.com/read/28438043/comparative-effectiveness-and-safety-analysis-of-dual-antiplatelet-therapies-within-an-integrated-delivery-system
#1
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/28425039/disaggregation-following-agonist-induced-platelet-activation-in-patients-on-dual-antiplatelet-therapy
#2
Patricia P Wadowski, Beate Eichelberger, Christoph W Kopp, Joseph Pultar, Daniela Seidinger, Renate Koppensteiner, Irene M Lang, Simon Panzer, Thomas Gremmel
Disaggregation as the difference between maximal and final platelet aggregation by light transmission aggregometry indicates the stability of platelet aggregates. We evaluated the extent of disaggregation after platelet stimulation with adenosine diphosphate (ADP), arachidonic acid (AA), collagen, epinephrine, and thrombin receptor-activating peptide (TRAP)-6 in 323 patients on dual antiplatelet therapy with daily aspirin and clopidogrel (group 1), prasugrel (group 2), or ticagrelor (group 3) therapy. All patients in group 1 underwent elective angioplasty and stenting, whereas all patients included in groups 2 and 3 suffered from acute coronary syndromes (STEMI or NSTEMI) and underwent urgent PCI...
April 19, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28420804/contemporary-trends-and-outcomes-associated-with-the-preprocedural-use-of-oral-p2y12-inhibitors-in-patients-undergoing-percutaneous-coronary-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#3
Devraj Sukul, Milan Seth, Simon R Dixon, Akshay Khandelwal, Thomas A LaLonde, Hitinder S Gurm
OBJECTIVES: We sought to describe trends in the use of preprocedural P2Y12 inhibitors and their clinical impact in patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Oral P2Y12 inhibitors are ubiquitously used medications; however, the specific timing of initial P2Y12 inhibitor administration remains intensely debated. METHODS: Our study population comprised 74,053 consecutive patients undergoing PCI at 47 hospitals in Michigan from January 2013 through June 2015...
April 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28417436/evaluation-of-the-pharmacokinetics-and-pharmacodynamics-of-prasugrel-in-japanese-elderly-subjects
#4
Tomoko Hasunuma, Hiroyuki Fukase, Atsuhiro Miyazaki, Yasuhiro Nishikawa
BACKGROUND AND OBJECTIVE: An increased incidence in bleeding events has been reported in Western elderly patients receiving prasugrel. Therefore, doses in Japanese elderly subjects need to be carefully determined. We assessed the pharmacokinetic and pharmacodynamic effects of prasugrel at the clinical dose used in Japan in healthy Japanese elderly subjects compared with non-elderly subjects. METHODS: In an open-label parallel-group study conducted in Japan, two groups (elderly, aged >75 years; non-elderly, aged 45-65 years) received a 20-mg loading dose and a 3...
April 17, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28403576/no-pharmacokinetic-drug-drug-interaction-between-prasugrel-and-vorapaxar-following-multiple-dose-administration-in-healthy-volunteers
#5
Matt S Anderson, Teddy Kosoglou, Paul Statkevich, Jing Li, Jennifer Rotonda, Alan G Meehan, David L Cutler
Vorapaxar is a first-in-class antagonist of the protease-activated receptor-1, the primary thrombin receptor on human platelets, which mediates the downstream effects of thrombin in hemostasis and thrombosis. Prasugrel is a platelet inhibitor that acts as a P2Y12 receptor antagonist through an active metabolite, R-138727. This study investigated the interaction of these 2 platelet antagonists when coadministered. This was a randomized, open-label, multiple-dose study in 54 healthy volunteers consisting of a fixed-sequence crossover and a parallel group design...
April 12, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28400368/relationship-between-peak-troponin-values-and-long-term-ischemic-events-among-medically-managed-patients-with-acute-coronary-syndromes
#6
Sarah A Goldstein, L Kristin Newby, Derek D Cyr, Megan Neely, Thomas F Lüscher, Eileen B Brown, Harvey D White, E Magnus Ohman, Matthew T Roe, Christian W Hamm
BACKGROUND: The relationship between troponin level and outcomes among patients with non-ST-segment elevation ACS is established, but the relationship of troponin level with long-term outcomes among medically managed non-ST-segment elevation ACS patients receiving contemporary antiplatelet therapy is inadequately defined. METHODS AND RESULTS: In 6763 medically managed non-ST-segment elevation ACS patients randomized in TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) (prasugrel versus clopidogrel), we examined relationships between categories of peak troponin/upper limit of normal (ULN) ratio within 48 hours of the index ACS event (≈4...
April 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28385176/meta-analysis-of-the-relative-efficacy-and-safety-of-oral%C3%A2-p2y12-inhibitors-in-patients-with-acute-coronary%C3%A2-syndrome
#7
Rahman Shah, Abdul Rashid, Inyong Hwang, Tai-Hwang M Fan, Rami N Khouzam, Guy L Reed
A cornerstone of medical therapy for patients with acute coronary syndrome (ACS) is dual antiplatelet therapy, which includes aspirin and a P2Y12 inhibitor. Randomized controlled trials (RCTs) have shown that prasugrel and ticagrelor are superior to clopidogrel, but none directly compared these 3 commonly used oral P2Y12 inhibitors for safety and efficacy. Therefore, we performed a Bayesian network meta-analysis of RCTs to compare the efficacies and safeties of 3 commonly used oral P2Y12 inhibitors in patients with ACS...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28335837/potent-p2y12-inhibitors-in-men%C3%A2-versus%C3%A2-women-a%C3%A2-collaborative%C3%A2-meta-analysis%C3%A2-of%C3%A2-randomized%C3%A2-trials
#8
Emily S Lau, Eugene Braunwald, Sabina A Murphy, Stephen D Wiviott, Marc P Bonaca, Steen Husted, Stefan K James, Lars Wallentin, Peter Clemmensen, Matthew T Roe, E Magnus Ohman, Robert A Harrington, Jessica L Mega, Deepak L Bhatt, Marc S Sabatine, Michelle L O'Donoghue
BACKGROUND: Sex-specific differences in response to antiplatelet therapies have been described. Whether women and men derive comparable benefit from intensification of antiplatelet therapy remains uncertain. OBJECTIVES: The study investigated the efficacy and safety of the potent P2Y12 inhibitors in patients with coronary artery disease. METHODS: A collaborative sex-specific meta-analysis was conducted of phase III or IV randomized trials of potent P2Y12 inhibitors, including prasugrel, ticagrelor, and intravenous cangrelor...
March 28, 2017: Journal of the American College 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
#9
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
#10
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
No abstract text is available yet for this article.
June 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28281736/optimal-antiplatelet-pharmacotherapy-guided-by-bedside-genetic-or-functional-testing-in-elective-pci-patients-a-pilot-study-onside-test-pilot
#11
Lukasz Koltowski, Mariusz Tomaniak, Daniel Aradi, Zenon Huczek, Krzysztof J Filipiak, Janusz Kochman, Sylwia Gajda, Paweł Balsam, Grzegorz Opolski
BACKGROUND: Dual antiplatelet therapy is recommended after elective percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients; however, still one-third of patients do not obtain adequate platelet inhibition that may result in increased cardiovascular risk. The aim of the ONSIDE TEST study is to evaluate the clinical impact of point-of-care genotyping- and platelet function-based personalized dual antiplatelet strategies in SCAD individuals undergoing PCI...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28279076/triple-antithrombotic-therapy-with-aspirin-p2y12-inhibitor-and-warfarin-after-percutaneous-coronary-intervention
#12
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/28267384/comparison-of-p2y12-inhibitors-for-mortality-and-stent-thrombosis-in-patients-with-acute-coronary-syndromes-single-center-study-of-10-793-consecutive-real-world-patients
#13
Rebecca Gosling, Momina Yazdani, Yasir Parviz, Ian R Hall, Ever D Grech, Julian P Gunn, Robert F Storey, Javaid Iqbal
Three oral platelet P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are available for reducing the risk of cardiovascular death and stent thrombosis in patients with acute coronary syndromes (ACS). We sought to compare the efficacy of these antiplatelet drugs in contemporary practice. Data were collected for 10 793 consecutive ACS patients undergoing coronary angiography at Sheffield, UK (2009-2015). Since prasugrel use was mostly restricted to the STEMI subgroup, clopidogrel and ticagrelor were compared for all ACS patients, and all three agents were compared in the STEMI subgroup...
March 7, 2017: Platelets
https://www.readbyqxmd.com/read/28262344/clopidogrel-prasugrel-or-ticagrelor-use-and-clinical-outcome-in-patients-with-acute-coronary-syndrome-a-nationwide-long-term-registry-analysis-from-2009-to-2014
#14
Safoura Sheikh Rezaei, Angelika Geroldinger, Georg Heinze, Berthold Reichardt, Michael Wolzt
BACKGROUND: The beneficial use of dual antiplatelet therapy (DAPT) with acetylsalicylic acid (ASA) and P2Y12 õinhibitors has been established for patients after acute coronary syndrome (ACS). However, the optimal duration of DAPT is under debate. The aim of the present study was to investigate the long-term utilization and clinical outcome of clopidogrel, prasugrel, and ticagrelor in patients with ACS from 2009 to 2014 in Austria. METHODS: We analysed data from 13 Austrian health insurance funds for the years 2009 to 2014, on 72,676 patients with a hospital discharge diagnosis of ACS...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28261826/a-literature-review-of-antithrombotic-and-anticoagulating-agents-on-sexual-function
#15
L W-H Chen, H-L Yin
Although millions of people receive antithrombotic agents (ATAs) or anticoagulating agents (ACAs) for vascular prophylaxis daily, the negative impact of these agents on sexual function has not been systematically studied. Therefore, a literature search was conducted to determine the effects of the marketed ATAs and ACAs on sexual function. In regard to men, the results show that thienopyridine derivatives increase the risk of erectile dysfunction (ED) and decrease libido and sexual function. The relationship between aspirin use and ED is inconsistent, ranging from a moderate risk to beneficial effects...
March 6, 2017: Andrologia
https://www.readbyqxmd.com/read/28238074/atorvastatin-induced-dermatomyositis
#16
Mert Oztas, Serdal Ugurlu, Ovgu Aydin
A 49-year-old man with no previous history of musculoskeletal or cutaneous problems who had a myocardial infarction (MI) was treated with atorvastatin, prasugrel, enoxaparine, and diltiazem following percutaneous coronary intervention. He was referred to our rheumatology outpatient clinic for rash and papules on the knuckles, face, and neck, as well as proximal muscle weakness. In the physical examination, a reddish rash on the face and Gottron's papules on the knuckles were detected. The skin biopsy performed indicated interface dermatitis with hydropic degeneration of basal keratinocytes, supporting the clinical impression of dermatomyositis...
February 25, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#17
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28228427/myocardial-infarction-risk-after-discontinuation-of-thienopyridine-therapy-in-the-randomized-dapt-study
#18
Ada C Stefanescu Schmidt, Dean J Kereiakes, Donald E Cutlip, Robert W Yeh, Ralph B D'Agostino, Joseph M Massaro, Wen-Hua Hsieh, Laura Mauri
Background -Thienopyridine plus aspirin beyond one year after coronary stenting (PCI) reduces myocardial infarction (MI) risk and increases bleeding risk compared with aspirin alone. The hazard associated with late thienopyridine discontinuation and risk factors for MI after discontinuation are poorly defined. Methods -In the Dual Antiplatelet Therapy (DAPT) Study, after PCI and 12 months of thienopyridine (clopidogrel or prasugrel) plus aspirin, eligible patients remained on aspirin and were randomized to continued thienopyridine vs...
February 22, 2017: Circulation
https://www.readbyqxmd.com/read/28213685/prasugrel-for-japanese-patients-with-acute-coronary-syndrome-in-short-term-clinical-practice-prasfit-practice-i-a-postmarketing-observational-study
#19
Masato Nakamura, Tomoko Iizuka, Kei Sagawa, Kenji Abe, Shuichi Chikada, Miyuki Arai
Data on prasugrel use in Japanese patients are limited to phase II/III clinical trials. This early postmarketing observational study evaluated the safety and efficacy of short-term prasugrel use in patients with acute coronary syndrome (ACS) in real-world clinical settings in Japan. From May 2014 to January 2015, we enrolled consecutive patients with ACS requiring percutaneous coronary intervention in each institution. Each patient started prasugrel treatment ≥1 month before the end of the study period...
February 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28213047/the-effect-of-combined-aspirin-and-clopidogrel-treatment-on-cancer-incidence
#20
Avi Leader, Ravit Zelikson-Saporta, David Pereg, Galia Spectre, Uri Rozovski, Pia Raanani, Doron Hermoni, Michael Lishner
BACKGROUND: Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data regarding the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared to aspirin alone and no antiplatelet therapy...
February 14, 2017: American Journal of Medicine
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