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https://www.readbyqxmd.com/read/29134853/real-world-clopidogrel-utilization-in-acute-coronary-syndromes-patients-selection-and-outcomes-in-a-single-center-experience
#1
Diego Castini, Simone Persampieri, Sara Cazzaniga, Giulia Ferrante, Marco Centola, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: With this study, we sought to identify patient characteristics associated with clopidogrel prescription and its relationship with in-hospital adverse events in an unselected cohort of ACSs patients. MATERIALS AND METHODS: We studied all consecutive patients admitted at our institution for ACSs from 2012 to 2014. Patients were divided into two groups based on clopidogrel or novel P2Y12 inhibitors (prasugrel or ticagrelor) prescription and the relationship between clopidogrel use and patient clinical characteristics and in-hospital adverse events was evaluated using logistic regression analysis...
December 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#2
M Spartalis, E Tzatzaki, E Spartalis, C Damaskos, A Athanasiou, D Moris, M Politou
OBJECTIVE: Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29121762/ticagrelor-versus-prasugrel-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-an-unresolved-issue
#3
EDITORIAL
Gianluigi Savarese, Lars H Lund
No abstract text is available yet for this article.
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29121759/comparison-of-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-and-non-randomized-studies
#4
Hussam Watti, Khagendra Dahal, Henock G Zabher, Pavan Katikaneni, Kalgi Modi, Abdulrahman Abdulbaki
BACKGROUND: The newer oral P2Y12 receptor antagonists (i.e. prasugrel and ticagrelor) are recommended over clopidogrel for patients with acute coronary syndrome (ACS) going for percutaneous coronary intervention (PCI). As the superiority of one agent over the other remains unclear, we designed a systematic review and meta-analysis of these agents in patients with ACS undergoing PCI. METHODS: PUBMED, EMBASE, Cochrane CENTRAL, CINAHL and manual search were performed through 11/02/2016...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29118712/comparative-long-term-effect-of-three-anti-p2y12-drugs-after-percutaneous-angioplasty-an-observational-study-based-on-electronic-drug-adherence-monitoring
#5
Valentina Forni Ogna, Isabelle Bassi, Isabelle Menetrey, Olivier Muller, Eric Tousset, Pierre Fontana, Eric Eeckhout, Chin B Eap, Bernard Vrijens, Michel Burnier, Grégoire Wuerzner
Aims: Dual platelet inhibition using anti-P2Y12 drugs and aspirin is the standard of care in patients after percutaneous coronary interventions (PCI). Prasugrel and ticagrelor have been shown to be more potent than clopidogrel with less high on-treatment platelet reactivity. Whether differences in long-term adherence to these drugs can partly explain different antiplatelet efficacy has not been studied so far. The objective was to compare the long-term P2Y12 receptor inhibition and drug adherence to different anti-P2Y12 drugs, and to assess the impact of adherence on the pharmacodynamic effect...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29104118/clinical-trial-conduct-in-special-populations-and-developing-regions-an-overview-of-the-dove-study-in-pediatric-patients-with-sickle-cell-disease
#6
Stephen G Reams, Linda Messana, Patricia B Brown, Kevin Nanry, Alexandria E Gunnell
Clinical trials conducted in unique patient populations or individuals with rare diseases are typically hampered by limitations in availability of qualified patients, requiring sponsors to broaden their global outreach to achieve enrollment. Engaging clinical study centers in developing regions may offer access to a substantially larger patient pool. However, they provide a unique set of challenges based on local cultures and requirements. The DOVE study (Determining effects Of platelet inhibition on Vaso-occlusive Events) was a clinical trial of prasugrel hydrochloride (prasugrel) in pediatric patients (aged 2 to <18years) with sickle cell anemia...
November 2, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29103068/antiplatelet-therapy-for-secondary-prevention-of-vascular-disease-complications
#7
REVIEW
Rahul R Goli, Mayur M Contractor, Ashwin Nathan, Sony Tuteja, Taisei Kobayashi, Jay Giri
PURPOSE OF REVIEW: Platelets are activated upon interaction with injured vascular endothelium to form a primary hemostatic plug. Pathogenic thrombosis driven by platelet aggregation can occur in the setting of vascular disease leading to ischemic events. The use of antiplatelet agents has become a mainstay for prevention of the secondary complications of vascular disease. This review summarizes seminal and recent literature related to this area. RECENT FINDINGS: Aspirin is a cornerstone of antiplatelet therapy for coronary artery disease and cerebrovascular disease for prevention of myocardial infarction, stroke, and vascular death...
November 4, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29102571/multisite-investigation-of-outcomes-with%C3%A2-implementation-of-cyp2c19-genotype-guided-antiplatelet-therapy-after-percutaneous-coronary-intervention
#8
Larisa H Cavallari, Craig R Lee, Amber L Beitelshees, Rhonda M Cooper-DeHoff, Julio D Duarte, Deepak Voora, Stephen E Kimmel, Caitrin W McDonough, Yan Gong, Chintan V Dave, Victoria M Pratt, Tameka D Alestock, R David Anderson, Jorge Alsip, Amer K Ardati, Brigitta C Brott, Lawrence Brown, Supatat Chumnumwat, Michael J Clare-Salzler, James C Coons, Joshua C Denny, Chrisly Dillon, Amanda R Elsey, Issam S Hamadeh, Shuko Harada, William B Hillegass, Lindsay Hines, Richard B Horenstein, Lucius A Howell, Linda J B Jeng, Mark D Kelemen, Y M Lee, Oyunbileg Magvanjav, May Montasser, David R Nelson, Edith A Nutescu, Devon C Nwaba, Ruth E Pakyz, Kathleen Palmer, Josh F Peterson, Toni I Pollin, Alison H Quinn, Shawn W Robinson, Jamie Schub, Todd C Skaar, D Max Smith, Vindhya B Sriramoju, Petr Starostik, Tomasz P Stys, James M Stevenson, Nicholas Varunok, Mark R Vesely, Dyson T Wake, Karen E Weck, Kristin W Weitzel, Russell A Wilke, James Willig, Richard Y Zhao, Rolf P Kreutz, George A Stouffer, Philip E Empey, Nita A Limdi, Alan R Shuldiner, Almut G Winterstein, Julie A Johnson
OBJECTIVES: This multicenter pragmatic investigation assessed outcomes following clinical implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention (PCI). BACKGROUND: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after PCI. METHODS: After clinical genotyping, each institution recommended alternative antiplatelet therapy (prasugrel, ticagrelor) in PCI patients with a loss-of-function allele...
October 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29075924/contemporary-use-of-p2y12-inhibitors-in-patients-with-st-segment-elevation-myocardial-infarction-referred-to-primary-percutaneous-coronary-interventions-in-poland-data-from-orpki-national-registry
#9
Tomasz Rakowski, Zbigniew Siudak, Artur Dziewierz, Krzysztof Plens, Paweł Kleczyński, Dariusz Dudek
According to guidelines, it is recommended to give P2Y12 inhibitors (preferably ticagrelor or prasugrel) at the time of first medical contact in patients with STEMI. However, in real life antiplatelet treatment strategies are different among countries. We analyzed data on antiplatelet treatment in STEMI patients included into Polish ORPKI national registry. A total of 23,139 STEMI patients from 153 invasive cardiology centers were reported in ORPKI registry between September 2015 and August 2016. Finally 19,437 patients from 122 centers (immediate PCI in 94%) were included into the analysis (lack of ticagrelor or prasugrel usage reported in 31 centers)...
October 26, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29071332/effect-of-chewing-vs-swallowing-ticagrelor-on-platelet-inhibition-in-patients-with-st-segment-elevation-myocardial-infarction-a-randomized-clinical-trial
#10
Elad Asher, Shir Tal, Israel Mazin, Arsalan Abu-Much, Avi Sabbag, Moshe Katz, Ehud Regev, Fernando Chernomordik, Victor Guetta, Amit Segev, Dan Elian, Israel Barbash, Paul Fefer, Michael Narodistky, Roy Beigel, Shlomi Matetzky
Importance: Dual anti-platelet therapy represents standard care for treating patients with ST-segment elevation myocardial infarction (STEMI). Ticagrelor is a direct-acting P2Y12 inhibitor and, unlike clopidogrel and prasugrel, does not require metabolic activation. Objective: To evaluate whether chewing a loading dose (LD) of ticagrelor, 180 mg, vs traditional oral administration of an equal dose enhances platelet inhibition at 30 minutes and 1 hour after LD administration in patients with STEMI...
October 25, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29043405/-focused-update-on-dual-antiplatelet-treatment-esc-guidelines-2017
#11
A Schäfer, J Bauersachs
Dual antiplatelet treatment (DAPT) is a cornerstone of maintenance medication of patients following elective percutaneous coronary interventions or an acute coronary syndrome (ACS), e. g. ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina. In recent years the inclusion of P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. Following the introduction of the modern generation of drug-eluting stents for elective coronary interventions, the duration of the necessary DAPT has been clearly reduced...
October 17, 2017: Herz
https://www.readbyqxmd.com/read/29035430/the-use-pattern-and-clinical-impact-of-new-antiplatelet-agents-including-prasugrel-and-ticagrelor-on-30-day-outcomes-after-acute-myocardial-infarction-in-korea-korean-health-insurance-review-and-assessment-data
#12
Choongki Kim, Dong Ho Shin, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Juhee Park, Hyeyeong Lee, Yoon Jung Choi, Youn Song Choi, Sang Kwon Oh, Yangsoo Jang
BACKGROUND AND OBJECTIVES: Despite the favorable efficacy of new antiplatelet agents demonstrated in randomized controlled trials, their clinical implications in Korea are unclear. The purpose of this study was to investigate trends in antiplatelet agent use for acute myocardial infarction (AMI) and their impact on 30-day clinical outcomes. METHODS: AMI patients undergoing percutaneous coronary intervention between 2010 and 2015 were assessed using claim data from the Health Insurance Review and Assessment Service...
September 12, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29032872/assessing-bleeding-risk-in-patients-with-intentional-overdoses-of-novel-antiplatelet-and-anticoagulant-medications
#13
Michael Levine, Michael C Beuhler, Anthony Pizon, F Lee Cantrel, Meghan B Spyres, Frank LoVecchio, Aaron B Skolnik, Daniel E Brooks
STUDY OBJECTIVE: In recent years, the use of novel anticoagulants and antiplatelet agents has become widespread. Little is known about the toxicity and bleeding risk of these agents after acute overdose. The primary objective of this study is to evaluate the relative risk of all bleeding and major bleeding in patients with acute overdose of novel antiplatelet and anticoagulant medications. METHODS: This study is a retrospective study of acute ingestion of apixaban, clopidogrel, ticlopidine, dabigatran, edoxaban, prasugrel, rivaroxaban, and ticagrelor reported to 7 poison control centers in 4 states during a 10-year span...
October 9, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29025684/ninety-day-readmission-and-long-term-mortality-in-medicare-patients-%C3%A2-65-years-treated-with-ticagrelor-versus-prasugrel-after-percutaneous-coronary-intervention-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium
#14
Chris Song, Devraj Sukul, Milan Seth, James M Dupree, Akshay Khandelwal, Simon R Dixon, David Wohns, Thomas LaLonde, Hitinder S Gurm
Ticagrelor and prasugrel were found to be superior to clopidogrel for the treatment of acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI); however, the comparative effectiveness of these 2 drugs remains unknown. We compared postdischarge outcomes among older patients treated with ticagrelor versus prasugrel after PCI for ACS. We linked clinical data from PCIs performed in older patients (age ≥65) for ACS at 47 Michigan hospitals to Medicare fee-for-service claims from January 1, 2013, to December 31, 2014, to ascertain rates of 90-day readmission and long-term mortality...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29022423/combination-antiplatelet-treatment-in-coronary-artery-disease-patients-a-necessary-evil-or-an-overzealous-practice
#15
Dimitrios Alexopoulos, Konstantinos Katogiannis, Danai Sfantou, John Lekakis
In seeking to improve care in coronary artery disease patients, further platelet inhibition has been occasionally applied beyond that provided by aspirin and a P2Y12 receptor antagonist. This review aims to offer insights about the rationale, the efficacy and safety of combination antiplatelet therapy, involving three or more agents. Overall, the use of glycoprotein (GP) IIb/IIIa inhibitors did not significantly modify the treatment effect of different antiplatelet strategies, including double vs standard clopidogrel, prasugrel vs clopidogrel, ticagrelor vs clopidogrel, cangrelor vs clopidogrel, and vorapaxar vs placebo...
October 12, 2017: Platelets
https://www.readbyqxmd.com/read/28994036/comparison-of-4-different-strategies-of-dapt-after-pci-in-acs-real-world-population-from-a-northern-italy-registry
#16
Marta Rasia, Emilia Solinas, Massimiliano Marino, Paolo Guastaroba, Alberto Menozzi, Maria Alberta Cattabiani, Iacopo Tadonio, Rossana De Palma, Luigi Vignali
Aim of the study was to compare four different strategies of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) treated with PCI. DAPT with Clopidogrel, Ticagrelor and Prasugrel has proved to be effective in patients with ACS treated with percutaneous coronary intervention (PCI) by reducing major adverse cardiovascular outcomes (MACE). However, the effect of the different strategies in a real-world population deserves further verification. A retrospective analysis of 2404 discharged ACS patients treated with PCI was performed, with a median follow-up of 1 year...
November 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28988425/the-safety-and-effectiveness-of-adenosine-diphosphate-receptor-inhibitor-pretreatment-among-acute-myocardial-infarction-patients-treated-with-percutaneous-coronary-intervention-in-community-practice-insights-from-the-translate-acs-study
#17
Mark B Effron, Tracy Y Wang, Gregg C Fonarow, Timothy D Henry, Marjorie E Zettler, Brian A Baker, Lisa A McCoy, Eric D Peterson
OBJECTIVES: To understand the optimal timing of adenosine diphosphate (ADP) receptor inhibitor pretreatment prior to percutaneous coronary intervention (PCI) among acute myocardial infarction (MI) patients. BACKGROUND: The role of ADP receptor inhibitor pretreatment in this population is unclear. METHODS: A total of 9,251 ADP receptor inhibitor-naïve MI patients undergoing PCI at 229 TRANSLATE-ACS sites were evaluated. Adjusted risks of in-hospital major adverse cardiovascular events (MACE) and major bleeding were compared among patients with and without pretreatment using inverse probability-weighted propensity adjustment...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28982722/differences-in-relative-and-absolute-effectiveness-of-oral-p2y-12-inhibition-in-men-and-women-a-meta-analysis-and-modelling-study
#18
Kuan Ken Lee, Nicky Welton, Anoop S Shah, Philip D Adamson, Sofia Dias, Atul Anand, David E Newby, Nicholas L Mills, David A McAllister
OBJECTIVE: To estimate the absolute treatment effects of newer P2Y12 inhibitors (ticagrelor and prasugrel) compared with clopidogrel in men and women with acute coronary syndrome (ACS). METHODS: We searched Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials of oral P2Y12 inhibitors for acute stroke or ACS. Age-specific and sex-specific mortality was obtained for all patients admitted to hospital with myocardial infarction in Scotland from 2006 to 2010 (prior to introduction of prasugrel or ticagrelor)...
October 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28968313/effect-of-ticagrelor-versus-prasugrel-on-platelet-reactivity-a-meta-analysis
#19
Hengliang Zhang, Pei Zhang, Pingshuan Dong, Xvming Yang, Yanyu Wang, Huifeng Zhang, Junqiang Yan, Yaheng Zhang, Tiantian Zhang, Yanyun Li
BACKGROUND AND OBJECTIVE: Whether ticagrelor is superior to prasugrel in inhibiting platelet reactivity (PR) has remained unclear, possibly because different test methods have been used to determine this. Therefore, using a different test method, we performed a meta-analysis comparing the effects of ticagrelor and prasugrel on PR. METHODS AND RESULTS: PubMed, Embase, Web of Science, and Google Scholar were searched - without language restrictions (last updated on 26 February 2017) - for randomized trials comparing the effects of prasugrel with those of ticagrelor in patients with coronary artery disease...
November 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28948299/-cardiogenic-shock-current-evidence
#20
H Thiele
This CME article addresses the pathophysiology, incidence, current survival outcome and treatment options for patients with cardiogenic shock as a complication of acute myocardial infarction. The shock spiral of left heart failure due to cardiac infarction, subsequent vasoconstriction and paradoxical vasodilation due to the systemic inflammation response syndrome (SIRS) is a vicious circle which must be interrupted. Treatment focuses on the evidence from randomized clinical trials and the current guideline recommendations...
September 25, 2017: Herz
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