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https://www.readbyqxmd.com/read/28645644/-antiplatelet-agents-and-transfusion
#1
P Gaussem, A-C Martin, T Belleville-Rolland, D Helley, C Bachelot-Loza, A Godier
Antiplatelet agents are at risk for bleeding complications, the management of which differs depending on the clinical situation and on the antiplatelet agent itself. Neutralization of antiplatelets is sometimes necessary, most often leading to platelet transfusion, although the benefit of this strategy is poorly documented. In addition, if platelet transfusion corrects the platelet inhibition induced by aspirin and probably by clopidogrel and prasugrel, it does not neutralize ticagrelor, as a consequence of its pharmacological properties...
June 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28632784/contemporary-use-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-austria-a-prospective-multi-centre-registry
#2
Maximilian Tscharre, Florian Egger, Matthias Machata, Miklos Rohla, Nadia Michael, Manuel Neumayr, Robert Zweiker, Johannes Hajos, Christopher Adlbrecht, Markus Suppan, Wolfgang Helmreich, Bernd Eber, Kurt Huber, Thomas W Weiss
BACKGROUND: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. METHODS: In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres...
2017: PloS One
https://www.readbyqxmd.com/read/28625369/rationale-and-design-of-the-hunting-for-the-off-target-properties-of-ticagrelor-on-endothelial-function-and-other-circulating-biomarkers-in-humans-hi-tech-trial
#3
Sara Ariotti, Maarten van Leeuwen, Salvatore Brugaletta, Sergio Leonardi, Kristiaan Martijn Akkerhuis, Emrush Rexhaj, Gladys Janssens, Luis Ortega-Paz, Diego Rizzotti, Jan C van den Berge, Dierik Heg, Gloria Francolini, Stephan Windecker, Marco Valgimigli
BACKGROUND: Among the 3 approved oral P2Y12 inhibitors for the treatment for patients with acute coronary syndrome (ACS), ticagrelor, but not prasugrel or clopidogrel, has been associated with off-target properties, such as improved endothelial-dependent vasomotion and increased adenosine plasma levels. METHODS: The HI-TECH study (NCT02587260) is a multinational, randomized, open-label, crossover study with a Latin squares design, conducted at 5 European sites, in which patients free from recurrent ischemic or bleeding events ≥30 days after a qualifying ACS were allocated to sequentially receive a 30 ± 5-day treatment with prasugrel, clopidogrel, and ticagrelor in random order...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28619235/morphological-and-pharmacological-determinants-of-peri-procedural-myocardial-infarction-following-elective-stent-implantation-optical-coherence-tomography-sub-analysis-of-the-prasfit-elective-study
#4
Kenzo Uzu, Toshiro Shinke, Hiromasa Otake, Tomofumi Takaya, Tsuyoshi Osue, Masamichi Iwasaki, Hiroto Kinutani, Akihide Konishi, Masaru Kuroda, Hachidai Takahashi, Daisuke Terashita, Ken-Ichi Hirata, Shigeru Saito, Masato Nakamura, Junya Shite, Takashi Akasaka
BACKGROUND: Previous studies have suggested that peri-procedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) is associated with adverse short- and long-term outcomes, and several morphological predictors of PMI have been studied. However, the determinants of PMI under novel anti-platelet therapy are not fully elucidated. METHODS AND RESULTS: PRASFIT-Elective is a multicenter, parallel-group study of PCI patients in non-acute settings receiving either prasugrel or clopidogrel in addition to aspirin...
June 12, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28618904/antiplatelet-and-antithrombotic-treatment-for-secondary-prevention-in-ischaemic-heart-disease
#5
Maddalena Lettino, Sergio Leonardi, Elia De Maria, Sigrun Halvorsen
Platelets play a key role in the pathogenesis of acute coronary syndromes and this is why antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in preventing recurrent myocardial infarction, stroke and cardiovascular death. Aspirin is the most used agent and still remains the first choice drug for lifelong administration in secondary prevention after myocardial infarction. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has significantly improved the outcome of patients with acute coronary syndromes despite an increased risk of bleeding complications...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28608310/platelet-inhibition-after-loading-dose-of-prasugrel-in-patients-with-st-elevation-and-non-st-elevation-acute-coronary-syndrome
#6
Shinichi Wakabayashi, Hideki Kitahara, Takeshi Nishi, Kazumasa Sugimoto, Takashi Nakayama, Yoshihide Fujimoto, Noritaka Ariyoshi, Yoshio Kobayashi
The PRASFIT-ACS study showed the antiplatelet effect 2-4 h after prasugrel loading. However, there is little information about the antiplatelet effect <2 h after prasugrel loading dose, especially in patients with acute coronary syndrome (ACS). There had not been any comparison between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). Fifty patients with ACS (15 with STEMI and 35 with NSTE-ACS) were enrolled. They received a 20-mg prasugrel loading dose followed by a maintenance dose of 3...
June 12, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28590305/management-of-diabetic-patients-hospitalized-for-acute-coronary-syndromes-a-prospective-multicenter-registry
#7
Marco Ferlini, Giuseppe Musumeci, Andrea Demarchi, Niccolò Grieco, Antonio Mafrici, Stefano De Servi, Roberta Rossini, Carlo Sponzilli, Paola Bognetti, Antonino Cardile, Silvia Frattini, Alfonso Ielasi, Alessandra Russo, Claudia Vecchiato, Corrado Lettieri, Luigi O Visconti
BACKGROUND: Patients with diabetes mellitus and acute coronary syndrome (ACS) present an increased risk of adverse cardiovascular events. An Italian Consensus Document indicated 'three specific must' to obtain in this subgroup of patients: optimal oral antiplatelet therapy, early invasive approach and a tailored strategy of revascularization for unstable angina/non-ST-elevation-myocardial infarction (UA/NSTEMI); furthermore, glycemia at admission should be managed with dedicated protocols...
June 5, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28587584/strategies-to-optimize-dual-antiplatelet-therapy-after-coronary-artery-stenting-in-acute-coronary-syndrome
#8
Bridget Paravattil, Hazem Elewa
The use of aspirin and a P2Y12 receptor antagonist as dual antiplatelet therapy (DAPT) has become the treatment of choice in patients with acute coronary syndrome (ACS) and percutaneous coronary intervention to prevent recurrent thrombotic events. Although DAPT is beneficial for most patients, few patients still experience recurrent thrombotic events and increased bleeding episodes. This article reviews current literature to identify various approaches that may enhance the DAPT benefit-risk ratio in patients with ACS...
July 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28578536/population-pharmacokinetic-and-exposure-response-analyses-of-prasugrel-in-pediatric-patients-with-sickle-cell-anemia
#9
Brian A Moser, Elizabeth S LaBell, Emmanuel Chigutsa, Joseph A Jakubowski, David S Small
BACKGROUND AND OBJECTIVE: Prasugrel, a P2Y12 adenosine diphosphate (ADP) receptor antagonist, inhibits ADP-mediated platelet activation and aggregation in patients with sickle cell anemia (SCA). We developed a population pharmacokinetic (popPK) model in pediatric patients from 2 to <18 years of age with SCA, and performed exposure-response evaluations to characterize the effects of prasugrel in a subset of these patients who weighed 19 kg or more and experienced at least two episodes of vaso-occlusive crises (VOC) in the past year...
June 3, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28577683/use-of-prasugrel-vs-clopidogrel-and-outcomes-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-contemporary-clinical-practice-results-from-the-prometheus-study
#10
Usman Baber, Samantha Sartori, Melissa Aquino, Annapoorna Kini, Samir Kapadia, Sandra Weiss, Craig Strauss, J Brent Muhlestein, Catalin Toma, Sunil V Rao, Anthony DeFranco, Kanhaiya L Poddar, Jaya Chandrasekhar, William Weintraub, Timothy D Henry, Sameer Bansilal, Brian A Baker, Elizabeth Marrett, Stuart Keller, Mark Effron, Stuart Pocock, Roxana Mehran
BACKGROUND AND OBJECTIVES: We sought to determine the frequency of use and association between prasugrel and outcomes in acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI) in clinical practice. METHODS: PROMETHEUS was a multicenter observational registry of acute coronary syndrome patients undergoing PCI from 8 centers in the United States that maintained a prospective PCI registry for patient outcomes. The primary end points were major adverse cardiovascular events at 90days, a composite of all-cause death, nonfatal myocardial infarction, stroke, or unplanned revascularization...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28577671/dual-antiplatelet-therapy-in-patients-with-diabetes-and-acute-coronary-syndromes-managed-without-revascularization
#11
Anthony J Dalby, Shmuel Gottlieb, Derek D Cyr, Erik Magnus Ohman, Darren K McGuire, Witold Ruzyllo, Deepak L Bhatt, Stephen D Wiviott, Kenneth J Winters, Keith A A Fox, Paul W Armstrong, Harvey D White, Dorairaj Prabhakaran, Matthew T Roe
OBJECTIVE: Patients with diabetes mellitus (DM) presenting with acute coronary syndrome (ACS) and undergoing percutaneous coronary intervention (PCI) derived enhanced benefit with dual antiplatelet therapy (DAPT) with prasugrel vs. clopidogrel. The risk profile and treatment response to DAPT for medically managed ACS patients with DM remains uncertain. METHODS: The TRILOGY ACS trial compared aspirin + prasugrel vs. aspirin + clopidogrel for up to 30months in non-ST-segment elevation (NSTE) ACS patients managed medically without revascularization...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28576388/safety-and-efficacy-of-prasugrel-and-ticagrelor-in-acute-coronary-syndrome-results-of-a-real-world-multicenter-registry
#12
Manuel Almendro-Delia, Ángel García-Alcántara, M Victoria de la Torre-Prados, Antonio Reina-Toral, José Andrés Arboleda-Sánchez, Michel Butrón-Calderón, Alberto García-Guerrero, Rafael de la Chica-Ruiz Ruano, Rafael Hidalgo-Urbano, Juan C García-Rubira
INTRODUCTION AND OBJECTIVES: The incorporation of the new antiplatelet agents (NAA) prasugrel and ticagrelor into routine clinical practice is irregular and data from the "real world" remain scarce. We aimed to assess the time trend of NAA use and the clinical safety and efficacy of these drugs compared with those of clopidogrel in a contemporary cohort of patients with acute coronary syndromes (ACS). METHODS: A multicenter retrospective observational study was conducted in patients with ACS admitted to coronary care units and prospectively included in the ARIAM-Andalusia registry between 2013 and 2015...
May 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28571507/the-genetic-basis-of-antiplatelet-and-anticoagulant-therapy-a-pharmacogenetic-review-of-newer-antiplatelets-clopidogrel-prasugrel-and-ticagrelor-and-anticoagulants-dabigatran-rivaroxaban-apixaban-and-edoxaban
#13
Cormac T O'connor, Thomas J Kiernan, Bryan P Yan
The study of pharmacogenomics presents the possibility of individualised optimisation of drug therapy tailored to each patients' unique physiological traits. Both antiplatelet and anticoagulant drugs play a key role in the management of cardiovascular disease. Despite their importance, there is a substantial volume of literature to suggest marked person-to-person variability in their effect. Areas covered: This article reviews the data available for the genetic cause for this inter-patient variability of antiplatelet and anticoagulant drugs...
June 13, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28562105/prasugrel-hydrochloride-for-the-treatment-of-sickle-cell-disease
#14
Nicola Conran, David C Rees
Therapeutic options for sickle cell disease (SCD) are limited and, currently, only one drug (hydroxyurea) has FDA approval for the treatment of adult SCD. While this genetic disease is caused by hemoglobin polymerization, subsequent downstream events trigger platelet activation, vaso-occlusion and the disease's complex pathophysiology. Areas covered: The oral thienopyridine, prasugrel hydrochloride, irreversibly inhibits the P2Y12 receptors, inhibiting ADP-dependent platelet activation. We discuss recent clinical trials evaluating the pharmokinetics of prasugrel and its potential for use in SCD...
June 12, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28560760/oral-antiplatelet-therapy-impact-for-transfusion-medicine
#15
REVIEW
T Gremmel, S Panzer
Patients on antiplatelet therapy, be it aspirin only, or aspirin in combination with oral adenosine diphosphate (ADP) receptor inhibitors like clopidogrel, prasugrel and ticagrelor, or the protease-activated receptor-1 inhibitor vorapaxar, may develop bleeding or need transient reversal of platelet blockade for acute interventions. In this review, we summarize reports on patients with antiplatelet therapy receiving platelet concentrates due to bleeding, and in vitro experiments estimating the feasibility to restore platelet function by spiking blood from healthy individuals or patients on antiplatelet treatment with noninhibited platelets...
May 30, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28555946/comparative-effectiveness-of-oral-antiplatelet-agents-in-patients-with-acute-coronary-syndrome
#16
Kibum Kim, Todd A Lee, Amer K Ardati, Robert J DiDomenico, Daniel R Touchette, Surrey M Walton
OBJECTIVE: In randomized controlled trials, prasugrel and ticagrelor reduced cardiovascular complications in patients with acute coronary syndrome (ACS) compared to clopidogrel. However, there have been limited head-to-head comparisons across the three anti-platelet agents using real-world data. The aim of this study was to compare clinical outcomes of three strategies during a 1-year post percutaneous coronary intervention (PCI) period. METHODS: Rates of all-cause and acute myocardial infarction (AMI) related hospitalizations were retrospectively compared using an insurance claims database...
May 27, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28545073/the-clinical-efficacy-and-safety-evaluation-of-ticagrelor-for-acute-coronary-syndrome-in-general-acs-patients-and-diabetic-patients-a-systematic-review-and-meta-analysis
#17
Qiutong Tan, Xin Jiang, Sichao Huang, Tiantian Zhang, Lin Chen, Siwen Xie, Enpan Mo, Jun Xu, Shaohui Cai
OBJECTIVE: In this study, a systematic evaluation was conducted to estimate the efficacy and safety of ticagrelor for treating acute coronary syndrome (ACS) in general ACS patients and a diabetes mellitus (DM) group. METHODS: A search of PubMed, Cochrane Central Register of Controlled Trials, Web of Science, CNKI databases was conducted to analyze relevant randomized controlled trails (RCTs) of ticagrelor treating ACS during 2007 to 2015. Article screening, quality accessing and data extracting was independently undertaken by two reviewers...
2017: PloS One
https://www.readbyqxmd.com/read/28528236/-management-of-the-bleeding-risk-associated-with-antiplatelet-agents
#18
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/28510709/clopidogrel-instead-of-prasugrel-or-ticagrelor-after-1%C3%A2-month-in-stabilized-acs-patients-back-to-square-one-for-dapt
#19
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
#20
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
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