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https://www.readbyqxmd.com/read/29329963/switch-to-ticagrelor-in-critical-limb-ischemia-antiplatelet-study-stt-clips
#1
Leonardo C Clavijo, Ashwat Dhillon, Noor Al-Asady, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVE: To investigate platelet reactivity in patients with critical limb ischemia (CLI) after switching from clopidogrel to ticagrelor. BACKGROUND: High on-treatment platelet reactivity (HPR) is highly prevalent in patients with CLI treated with clopidogrel. The effect of ticagrelor in patients with CLI is not known, however. METHODS: We performed P2Y12 platelet receptor inhibition studies (VASP and VerifyNow) in 50 patients with CLI. Tests were performed before and 6±1h after daily 75mg clopidogrel dose...
September 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29313313/relationship-of-coagulopathy-and-platelet-dysfunction-to-transfusion-needs-after-traumatic-brain-injury
#2
Grace Martin, Dhavan Shah, Nora Elson, Ryan Boudreau, Dennis Hanseman, Timothy A Pritts, Amy T Makley, Brandon Foreman, Michael D Goodman
BACKGROUND: Coagulopathy and platelet dysfunction commonly develop after traumatic brain injury (TBI). Thromboelastography (TEG) and platelet function assays (PFAs) are often performed at the time of admission; however, their roles in assessing post-TBI coagulopathy have not been investigated. We hypothesized that compared to blunt TBI, penetrating TBI would (1) demonstrate greater coagulopathy by TEG, (2) be associated with abnormal PFA results, and (3) require more blood product transfusions...
January 8, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29310956/medication-history-versus-point-of-care-platelet-activity-testing-in-patients-with-intracerebral-hemorrhage
#3
Matthew B Maas, Andrew M Naidech, Minjee Kim, Ayush Batra, Edward M Manno, Farzaneh A Sorond, Shyam Prabhakaran, Eric M Liotta
OBJECTIVE: We evaluated whether reduced platelet activity detected by point-of-care (POC) testing is a better predictor of hematoma expansion and poor functional outcomes in patients with intracerebral hemorrhage (ICH) than a history of antiplatelet medication exposure. METHODS: Patients presenting with spontaneous ICH were enrolled in a prospective observational cohort study that collected demographic, clinical, laboratory, and radiographic data. We measured platelet activity using the PFA-100 (Siemens AG, Germany) and VerifyNow-ASA (Accumetrics, CA) systems on admission...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29304392/aspirin-non-responsiveness-in-pregnant-women-at-high-risk-of-pre-eclampsia
#4
Kate Navaratnam, Ana Alfirevic, Andrea Jorgensen, Zarko Alfirevic
OBJECTIVES: Low-dose aspirin is recommended for prevention of pre-eclampsia in high-risk pregnant women. Current doses provide a conservative risk reduction and some individuals demonstrate 'aspirin non-responsiveness', with insufficient antiplatelet effects. We aimed to determine if aspirin non-responsiveness could be identified in women at high risk of pre-eclampsia and assess for potential associations with placentally-mediated adverse outcomes. STUDY DESIGN: Prospective cohort study...
January 1, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29221961/prevalence-of-high-on-treatment-aspirin-and-clopidogrel-platelet-reactivity-in-patients-with-critical-limb-ischemia
#5
Leonardo C Clavijo, Noor Al-Asady, Ashwat Dhillon, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVES: The goal of this study is to establish the prevalence of high on-treatment platelet reactivity to aspirin (HPRA) and clopidogrel (HPRC) in patients with critical limb ischemia (CLI). BACKGROUND: CLI is associated with an increased risk of death and cardiovascular events. Unlike other patient populations with atherosclerotic cardiovascular disease, previous studies failed to demonstrate a benefit of antiplatelet therapy in patients with CLI. METHODS: From June 2014 to November 2016, we performed platelet reactivity studies for P2Y12 and thromboxane A2 (TXA2) inhibition in 100 CLI patients receiving daily treatment with aspirin and clopidogrel...
October 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29171876/decreased-platelet-inhibition-by-p2y12-receptor-blockers-in-anemia
#6
Patricia P Wadowski, Christoph W Kopp, Renate Koppensteiner, Irene M Lang, Joseph Pultar, Silvia Lee, Constantin Weikert, Simon Panzer, Thomas Gremmel
BACKGROUND: Anemic patients undergoing angioplasty and stenting are at an increased risk of ischemic events, which may be caused by an inadequate response to antiplatelet therapy with adenosine diphosphate (ADP) P2Y12 inhibitors. In the current study, we investigated the associations between anemia and on-treatment platelet reactivity in clopidogrel- (group 1, n=306) and prasugrel-/ticagrelor-treated (group 2, n=109) patients undergoing elective and acute angioplasty with stent implantation, respectively...
November 24, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29170875/long-term-pharmacodynamic-effects-of-ticagrelor-versus-clopidogrel-in-fibrinolytic-treated-stemi-patients-undergoing-early-pci
#7
Andrew Yang, Quin Pon, Andrea Lavoie, Jennifer J Crawford, Sebastian Harenberg, Rodney H Zimmermann, Jeff Booker, Sheila Kelly, Shahar Lavi, Warren J Cantor, Shamir R Mehta, Akshay Bagai, Shaun G Goodman, Asim N Cheema, Payam Dehghani
The long-term pharmacodynamic effects of Ticagrelor versus Clopidogrel in patients undergoing early percutaneous coronary intervention (PCI) after fibrinolytic therapy is unknown. From May 2014 to August 2016, 212 patients undergoing PCI within 24 h of Tenecteplase (TNK), Aspirin, and Clopidogrel for ST-elevated myocardial infarction (STEMI) were randomized at four Canadian sites to receive additional Clopidogrel or Ticagrelor initiated prior to PCI. The platelet reactivity units (PRU) were measured with the VerifyNow Assay before study drug administration (baseline), at 4 and 24 h post PCI, and follow-up appointment...
November 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29170073/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-design-rationale-and-sample-characteristics-of-the-pacify-randomized-trial
#8
Khalil Ibrahim, Rakesh R Goli, Rohan Shah, Jon R Resar, Steven P Schulman, John W McEvoy
INTRODUCTION: Morphine reduces and delays the absorption of oral P2Y12 platelet inhibitors. Fentanyl is another opiate often administered during percutaneous coronary interventions (PCI). The PACIFY study will test whether intravenous fentanyl also impairs the absorption and action of oral P2Y12 inhibitors. METHODS: PACIFY is a single-center trial randomizing adults undergoing clinically-indicated coronary angiography to have the procedure with or without fentanyl...
January 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29165737/management-of-hemostasis-for-pediatric-patients-on-ventricular-assist-devices
#9
Iki Adachi, Vadim Kostousov, Lisa Hensch, Martin A Chacon-Portillo, Jun Teruya
Ventricular-assist devices (VADs) have seen increased utilization in the pediatric population. Formerly, this therapeutic modality was limited to only the pulsatile VAD, EXCOR (Berlin Heart GmbH). However, the continuous flow VAD devices, HeartMate II (Abbott Inc.) and HeartWare (Medtronic Inc.), are now increasingly used in this population. Postoperatively, VAD patients are acutely anticoagulated using unfractionated heparin, often beginning 24 to 48 hours after VAD placement. Once the patient is stabilized and ready to transition to a lower acuity or outpatient setting, low-molecular-weight heparin or warfarin therapy may be instituted...
November 17, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29131285/favourable-hypotensive-effect-after-standardised-tomato-extract-treatment-in-hypertensive-subjects-at-high-estimated-cardiovascular-risk-a-randomised-controlled-trial
#10
Beata Krasińska, Angelika Osińska, Aleksandra Krasińska, Maciej Osiński, Piotr Rzymski, Andrzej Tykarski, Zbigniew Krasiński
BACKGROUND: Cardiovascular (CV) diseases remain a leading global cause of death. Lowering blood pressure (BP) reduces the risk of CV complications, especially stroke and acute coronary events, and it delays the progression of kidney disease. Adequate non-pharmacological treatment improves the effectiveness of the antihypertensive therapy. A Mediterranean diet with high content of vegetables (rich in tomatoes) is associated with a reduced CV risk. AIM: The main objective of the present study was to assess if the addition of standardised extract of tomato (STE) or acetylsalicylic acid (ASA) to standard antihypertensive therapy can improve blood pressure control in patients with hypertension (HT)...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29126843/the-role-of-platelet-reactivity-assessment-in-dual-antiplatelet-prophylaxis-after-transcatheter-aortic-valve-implantation
#11
Katarzyna Czerwińska-Jelonkiewicz, Adam Witkowski, Maciej Dąbrowski, Walerian Piotrowski, Tomasz Hryniewiecki, Janina Stępińska
BACKGROUND: Dual antiplatelet therapy (DAPT) is recommended prophylaxis after transcatheter aortic valve implantation (TAVI). The usefulness of platelet reactivity (PLTR) tests in predicting the safety of periprocedural DAPT in the TAVI population is unknown. AIM: To analyze the value of aspirin/clopidogrel PLTR testing in predicting the risk of in-hospital TAVI-related bleeding. METHODS: PLTR, expressed as P2Y12/aspirin reaction units (PRU/ARU), was performed using optical aggregometry with the VerifyNow(®) device, in the 24h before and on the sixth day after TAVI...
November 7, 2017: Archives of Cardiovascular Diseases
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
#12
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/28968313/effect-of-ticagrelor-versus-prasugrel-on-platelet-reactivity-a-meta-analysis
#13
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/28938956/effects-of-ticagrelor-versus-clopidogrel-on-platelet-function-in-fibrinolytic-treated-stemi-patients-undergoing-early-pci
#14
RANDOMIZED CONTROLLED TRIAL
Payam Dehghani, Andrea Lavoie, Shahar Lavi, Jennifer J Crawford, Sebastian Harenberg, Rodney H Zimmermann, Jeff Booker, Sheila Kelly, Warren J Cantor, Shamir R Mehta, Akshay Bagai, Shaun G Goodman, Asim N Cheema
OBJECTIVES: Patients undergoing PCI early after fibrinolytic therapy are at high risk for both thrombotic and bleeding complications. We sought to assess the pharmacodynamic effects of ticagrelor versus clopidogrel in the fibrinolytic-treated STEMI patients undergoing early PCI. METHODS AND RESULTS: Patients undergoing PCI within 24 hours of tenecteplase (TNK), aspirin, and clopidogrel for STEMI were randomized to receive additional clopidogrel 300 mg followed by 75 mg daily or ticagrelor 180 mg followed by 90 mg twice daily...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28921624/pharmacodynamics-and-pharmacokinetics-of-ticagrelor-vs-clopidogrel-in-patients-with-acute-coronary-syndromes-and-chronic-kidney-disease
#15
Heyang Wang, Jing Qi, Yi Li, Yunbiao Tang, Chao Li, Jing Li, Yaling Han
BACKGROUND: Pivotal clinical trials found that ticagrelor reduced ischaemic complications to a greater extent than clopidogrel, and also that the benefit gradually increased with the reduction in creatinine clearance. However, the underlying mechanisms remains poorly explored. METHODS: This was a single-centre, prospective, randomized clinical trial involving 60 hospitalized Adenosine Diphosphate (ADP) P2Y12 receptor inhibitor-naïve patients with chronic kidney disease (CKD) (estimated glomerular filtration rate <60 ml min-1 1...
September 15, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28883222/temporal-changes-in-platelet-response-in-acute-coronary-syndrome-patients-with-prasugrel-and-clopidogrel-after-stent-implantation
#16
Antonio Tello-Montoliu, José Rivera, Diana Hernández, Ana Silvente, Eva Jover, Ana I Rodriguez, Miriam Quintana, Ana Romero, Esteban Orenes-Piñero, José Miguel Rivera-Caravaca, Francisco Marín, Andrea Veliz, Mariano Valdés
BACKGROUND: Prasugrel has been shown to provide more potency and less variability than clopidogrel, but its potential temporal variability has not been described.Methods and Results:We conducted a prospective open-label study, evaluating platelet reactivity overtime in acute coronary syndrome (ACS) patients on aspirin and clopidogrel (n=60) or prasugrel (n=61), after a percutaneous coronary intervention (PCI). Blood samples were taken at discharge and at 3 and 6 months. Platelet function tests included VerifyNow (VN-P2Y12), and Multiplate Aggregometry (MEA)...
September 6, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28875481/proteinuria-predicts-resistance-to-antiplatelet-therapy-in-ischemic-stroke
#17
Gemlyn George, Nikul Patel, Cecilia Jang, David Wheeler, Sridhara S Yaddanapudi, Jonathan Dissin, Ramani Balu, Janani Rangaswami
The occurrence of a stroke while on antiplatelet agents presents a therapeutic dilemma. One of the main causes for recurrent strokes is antiplatelet resistance more commonly known as high on treatment platelet reactivity (HTPR). Prior studies have established that proteinuria is associated with HTPR following myocardial infarction. Here, we investigated whether dipstick proteinuria correlates with HTPR in patients presenting with stroke. We performed a retrospective cohort analysis of 102 patients admitted for a recurrent ischemic stroke that had either a VerifyNow aspirin or VerifyNow clopidogrel laboratory test performed to assess platelet reactivity...
September 5, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28875477/effects-of-pon1-gene-promoter-dna-methylation-and-genetic-variations-on-the-clinical-outcomes-of-dual-antiplatelet-therapy-for-patients%C3%A2-undergoing-percutaneous-coronary-intervention
#18
He-Ping Lei, Xi-Yong Yu, Hong Wu, Yan-Hong Kang, Wan-Ping Zhong, Li-Yun Cai, Meng-Zhen Zhang, Ji-Yan Chen, Li-Ping Mai, Qing-Shan Ding, Min Yang, Shi-Long Zhong
INTRODUCTION AND OBJECTIVE: The relationship between either paraoxonase 1 (PON1) gene promoter DNA methylation or genetic variations and bleeding or major adverse cardiac events after dual antiplatelet therapy has been incompletely characterized. We aimed to systematically investigate the role of genetic variations and DNA methylation of the PON1 CpG island promoter on the clinical outcomes of dual antiplatelet therapy for patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI)...
September 5, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28873361/-1-h-nmr-based-pharmacometabolomics-analysis-of-urine-identifies-metabolic-phenotype-of-clopidogrel-high-on-treatment-platelets-reactivity-in-coronary-artery-disease-patients
#19
Arwa M Amin, Lim Sheau Chin, Chin-Hoe Teh, Hamza Mostafa, Dzul Azri Mohamed Noor, Muhamad Ali Sk Abdul Kader, Yuen Kah Hay, Baharudin Ibrahim
Clopidogrel high on treatment platelets reactivity (HTPR) has burdened achieving optimum therapeutic outcome. Although there are known genetic and non-genetic factors associated with clopidogrel HTPR, which explain in part clopidogrel HTPR, yet, great portion remains unknown, often hindering personalizing antiplatelet therapy. Nuclear magnetic resonance ((1)H NMR) pharmacometabolomics analysis is useful technique to phenotype drug response. We investigated using (1)H NMR analysis to phenotype clopidogrel HTPR in urine...
November 30, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28863286/flow-diversion-with-the-pipeline-embolization-device-for-patients-with-intracranial-aneurysms-and-antiplatelet-therapy-a-systematic-literature-review
#20
REVIEW
Pavlos Texakalidis, Kimon Bekelis, Elias Atallah, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
Flow diversion with the Pipeline Embolization Device (PED) is reported as a safe and efficient treatment for patients with intracranial aneurysms; however, literature discussing the antiplatelet (APT) regimen used before and after the PED is limited. Our aim was to systematically review and summarize available data regarding the APT regimen and the platelet function test (PFT) that was used. We also sought to provide an overview of the aneurysm morphologies and adverse event rates associated with the PED use...
October 2017: Clinical Neurology and Neurosurgery
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