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https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#1
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
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
#2
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/28596132/crusade-score-is-superior-to-platelet-function-testing-for-prediction-of-bleeding-in-patients-following-coronary-interventions
#3
Junghee Bang, Sun Young Choi, Moo Hyun Kim, Victor Serebruany
Hypothetically, diminished platelet reactivity (PR) during dual antiplatelet therapy (DAPT) should cause extra major bleeding events (MBE), although definite evidence is lacking. Multiple scores have been proposed to stratify bleeding risk, but their predictive value during DAPT is unclear. We compared the performance of the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) with PR testing to predict MBE in Korean patients with acute coronary syndrome...
June 1, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28584794/correlations-between-high-platelet-reactivity-extent-of-coronary-artery-disease-and-periprocedural-myonecrosis-in-patients-with-acute-coronary-syndrome
#4
Kyeong Ho Yun, Jum Suk Ko, Jeong Mi Lee, Sang Jae Rhee
The purpose of the present study was to evaluate the correlations between high platelet reactivity (HPR) and the extent of coronary atherosclerosis and periprocedural myonecrosis in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). A total of 485 patients who underwent PCI for ACS was studied. HPR was defined as ≥230 platelet reactivity units (PRU) in point-of-care P2Y12 tested by the VerifyNow assay. The incidence of multi-vessel disease (MVD) was higher in patients with HPR than those with no HPR (56...
May 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28583820/impact-of-platelet-inhibition-level-on-subsequent-no-reflow-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#5
Omar Aitmokhtar, Franck Paganelli, Saida Benamara, Adel Azaza, Laurent Bonello, Ouafa Hamza, Saber Seddiki, Tayeb Benathmane, Mourad Saidane, Ahmed Bouzid, Maamar Kara, Arezki Sik, Abdelmalek Azzouz, Faiza Harbi, Jean-Jacques Monsuez, Salim Benkhedda
BACKGROUND: High P2Y12 platelet reactivity (PR) level after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) affects prognosis and may induce the no-reflow phenomenon. AIM: To investigate the role of PR in the genesis of microvascular obstruction. METHODS: Patients with STEMI undergoing PPCI within 12hours of symptoms onset were included prospectively. All patients received a 600mg clopidogrel-loading dose before PPCI and 250mg aspirin...
June 2, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28577681/a-laboratory-association-between-hemoglobin-and-verifynow-p2y12-reaction-unit-a-systematic-review-and-meta-analysis
#6
Yun Gi Kim, Jung-Won Suh, Dirk Sibbing, Adnan Kastrati, Young-Guk Ko, Yangsoo Jang, Young-Seok Cho, Tae-Jin Youn, In-Ho Chae, Dong-Ju Choi, Hyo-Soo Kim
BACKGROUND: VerifyNow P2Y12 assay is used widely to evaluate residual platelet reactivity in patients taking P2Y12 receptor antagonists. However, a laboratory association between VerifyNow P2Y12 reaction unit (PRU) and hemoglobin, which might lead to wrong interpretation of the data, is reported. We performed these systematic review and meta-analysis to clearly define the relationship between PRU and hemoglobin and to elucidate whether the relationship, if any, is a true biological association or is just a laboratory error...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28561235/how-long-does-it-take-for-clopidogrel-and-ticagrelor-to-inhibit-platelets-in-patients-undergoing-primary-percutaneous-coronary-intervention-a-detailed-pharmacodynamic-analysis-time-course-of-platelet-reactivity-in-stemi-tops
#7
Thomas O Bergmeijer, Thea C Godschalk, Paul W A Janssen, Kim van den Berge, Nicoline J Breet, Johannes C Kelder, Christian M Hackeng, Jurriën M Ten Berg
Antiplatelet therapy plays a pivotal role in patients with an ST-segment elevation myocardial infarction (STEMI) to prevent further atherothrombotic events, such as stent thrombosis. Although the risk of stent thrombosis is highest in the first hours after primary percutaneous coronary intervention (pPCI), little is known about when an adequate level of platelet inhibition is achieved following a clopidogrel or ticagrelor loading dose in STEMI patients. Patients presenting with STEMI in whom pPCI was performed and who were loaded with 600 mg clopidogrel or 180 mg ticagrelor were eligible for enrolment in this nonrandomized, open label, single-center study...
June 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28554486/comparison-of-the-antiplatelet-effects-of-once-and-twice-daily-low-dose-ticagrelor-and-clopidogrel-after-percutaneous-coronary-intervention
#8
Kyu-Nam Choi, Han-Young Jin, Ho-Cheol Shin, Young-Ah Park, Jeong-Sook Seo, Jae-Sik Jang, Tae-Hyun Yang, Dae-Kyeong Kim, Dong-Soo Kim
Although Asian people are believed to be more susceptible to bleeding on currently recommended dose of ticagrelor, there is limited evidence supporting low-dose ticagrelor. We prospectively randomized patients receiving dual antiplatelet therapy with aspirin and clopidogrel into 3 groups; aspirin plus clopidogrel 75 mg versus aspirin plus ticagrelor 90 mg once daily versus aspirin plus ticagrelor 45 mg twice daily. Platelet function assessments were conducted using VerifyNow P2Y12 assay at baseline and 28 days after randomization...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28550916/assessment-of-three-point-of-care-platelet-function-assays-in-adult-trauma-patients
#9
Christopher Robert Connelly, John D Yonge, Sean P McCully, Kyle D Hart, Thomas C Hilliard, Diane E Lape, Justin J Watson, Beth Rick, Ben Houser, Thomas G Deloughery, Martin A Schreiber, Laszlo N Kiraly
BACKGROUND: Antiplatelet (AP) medication use is common among trauma patients and is associated with poor outcomes. Management options for platelet dysfunction in trauma patients are controversial, expensive, and potentially harmful. Although light transmission platelet aggregometry is considered the standard test to assess platelet function, it is cumbersome and not generally available. Currently, there are no widely accepted platelet function point-of-care tests for acute trauma. STUDY DESIGN: Prospective observational study from 2014 to 2015...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28495896/percutaneous-coronary-intervention-of-saphenous-vein-graft
#10
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Thomas McAndrew, Jamie Diamond, Xin Huang, Akiko Maehara, Giora Weisz, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) has historically been associated with a high risk of adverse ischemic events, but there is a paucity of contemporary data on the second-generation drug-eluting stent use within SVG, and the relative importance of high platelet reactivity (HPR) in SVG PCI versus native lesion PCI is unknown. We studied ischemic and bleeding events after SVG PCI and their association with HPR. METHODS AND RESULTS: Subjects in the prospective, multicenter ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) were stratified according to whether they had PCI of an SVG or a non-SVG lesion...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28488971/quality-assessment-and-transfusion-efficacy-of-buffy-coat-derived-platelet-concentrates-washed-with-platelet-additive-solution
#11
Hermógenes Fernández-Muñoz, Cristina Castilla-Llorente, Eva M Plaza, Cristina Martínez-Millán, Inmaculada Heras, Pastora Iniesta, María L Amigo, Francisca Ferrer-Marin, María J Candela, María L Lozano, Vicente Vicente, José Rivera
BACKGROUND: Transfusion of washed platelet concentrates (W-PC) is recommended for some patients, such as those who have had previous severe allergic transfusion reactions. However, we still lack a standardised method for preparing these products. Here, we assessed the effect of a manual washing procedure on in vitro platelet quality and on the transfusion efficacy of W-PCs. MATERIALS AND METHODS: Buffy coat-derived W-PC in Composol solution were prepared by onestep centrifugation...
April 13, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28480110/point-of-care-testing-in-the-acute-management-of-traumatic-brain-injury-identifying-the-coagulopathic-patient
#12
Yair M Gozal, Christopher P Carroll, Bryan M Krueger, Jane Khoury, Norberto O Andaluz
BACKGROUND: The use of anticoagulants or antiplatelet medications has become increasingly common and is a well-established risk factor for worsening of hemorrhages in trauma patients. The current study addresses the need to investigate the efficacy of point-of-care tests (POC) as an adjunct to conventional coagulation testing in traumatic brain injury (TBI) patients. METHODS: A retrospective review of 190 TBI patients >18 years of age who underwent both conventional and POC testing as part of their admission coagulopathy workup was conducted...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28454802/association-of-measured-platelet-reactivity-with-changes-in-p2y12-receptor-inhibitor-therapy-and-outcomes-after-myocardial-infarction-insights-into-routine-clinical-practice-from-the-treatment-with-adp-receptor-inhibitors-longitudinal-assessment-of-treatment
#13
Akshay Bagai, Eric D Peterson, Lisa A McCoy, Mark B Effron, Marjorie E Zettler, Gregg W Stone, Timothy D Henry, David J Cohen, Phillip J Schulte, Kevin J Anstrom, Tracy Y Wang
BACKGROUND: Little is known about the use of platelet function testing to guide choice of P2Y12 receptor inhibitor therapy in routine clinical practice. METHODS: We studied 671 myocardial infarction (MI) patients treated with percutaneous coronary intervention in the TRANSLATE-ACS Registry who had VerifyNow platelet function testing performed while on clopidogrel treatment during their index hospitalization (April 2010-October 2012). RESULTS: High platelet reactivity (>208 platelet reactivity units [PRU]) was present in 261 (38...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28444860/aspirin-responsiveness-changes-in-obese-patients-following-bariatric-surgery
#14
Nicholas B Norgard, Scott V Monte, Stanley F Fernandez, Qing Ma
Bariatric surgery has emerged as a promising treatment option for weight loss and to counter the metabolic consequences of obesity. Obesity has been linked to a hyperaggregable state, as well as a blunted response to aspirin. This pilot study assessed the hypothesis that bariatric surgery would lead to an improvement in aspirin-induced platelet inhibition and a reduction in platelet aggregability. METHODS: Fifteen patients scheduled to undergo bariatric surgery were administered two 7-day courses of aspirin 81 mg: the first course administered before surgery and the second was 3 months following surgery...
April 26, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28438734/total-thrombus-formation-analysis-system-predicts-periprocedural-bleeding-events-in-patients-with-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#15
Yu Oimatsu, Koichi Kaikita, Masanobu Ishii, Tatsuro Mitsuse, Miwa Ito, Yuichiro Arima, Daisuke Sueta, Aya Takahashi, Satomi Iwashita, Eiichiro Yamamoto, Sunao Kojima, Seiji Hokimoto, Kenichi Tsujita
BACKGROUND: Periprocedural bleeding events are common after percutaneous coronary intervention. We evaluated the association of periprocedural bleeding events with thrombogenicity, which was measured quantitatively by the Total Thrombus-formation Analysis System equipped with microchips and thrombogenic surfaces (collagen, platelet chip [PL]; collagen plus tissue factor, atheroma chip [AR]). METHODS AND RESULTS: Between August 2013 and March 2016, 313 consecutive patients with coronary artery disease undergoing elective percutaneous coronary intervention were enrolled...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28436258/thrombopoietin-and-platelet-aggregation-in-patients-with-stable-coronary-artery-disease
#16
Sanne Bøjet Larsen, Erik Lerkevang Grove, Søs Neergaard-Petersen, Morten Würtz, Anne-Mette Hvas, Steen Dalby Kristensen
Thrombopoietin (TPO) may facilitate platelet activation and aggregation. However, data on the impact of TPO on platelet aggregation in patients with stable coronary artery disease (CAD) are scarce. We aimed to investigate associations between TPO and platelet aggregation and activation in patients with stable coronary artery disease (CAD). We studied 900 stable CAD patients. Serum TPO was assessed by ELISA. Platelet aggregation was evaluated using the Multiplate Analyzer (agonists: arachidonic acid [AA] and collagen) and the VerifyNow Aspirin Assay...
April 24, 2017: Platelets
https://www.readbyqxmd.com/read/28381198/effect-of-ticagrelor-with-clopidogrel-on-high-on-treatment-platelet-reactivity-in-acute-stroke-or-transient-ischemic-attack-prince-trial-rationale-and-design
#17
Yilong Wang, Yi Lin, Xia Meng, Weiqi Chen, Guohua Chen, Zhimin Wang, Jialing Wu, Dali Wang, Jianhua Li, Yibin Cao, Yuming Xu, Guohua Zhang, Xiaobo Li, Yuesong Pan, Hao Li, Liping Liu, Xingquan Zhao, Yongjun Wang
Rationale and aim Little is known about the safety and efficacy of the combination of ticagrelor and aspirin in acute ischemic stroke. This study aimed to evaluate whether the combination of ticagrelor and aspirin was superior to that of clopidogrel and aspirin in reducing the 90-day high on-treatment platelet reactivity for acute minor stroke or transient ischemic attack, especially for carriers of cytochrome P450 2C19 loss-of-function allele. Sample size and design This study was designed as a prospective, multicenter, randomized, open-label, active-controlled, and blind-endpoint, phase II b trial...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28376544/how-long-does-it-take-clopidogrel-and-ticagrelor-to-inhibit-platelets-in-patients-undergoing-primary-percutaneous-coronary-intervention-a-detailed-pharmacodynamic-analysis-time-course-of-platelet-reactivity-in-stemi-tops
#18
Thomas O Bergmeijer, Thea C Godschalk, Paul W A Janssen, Kim van den Berge, Nicoline J Breet, Johannes C Kelder, Christian M Hackeng, Jurriën M Ten Berg
Antiplatelet therapy plays a pivotal role in patients with an ST-segment elevation myocardial infarction (STEMI) to prevent further atherothrombotic events, such as stent thrombosis. Although the risk of stent thrombosis is highest in the first hours after primary percutaneous coronary intervention (pPCI), little is known about when an adequate level of platelet inhibition is achieved following a clopidogrel or ticagrelor loading dose in STEMI patients. Patients presenting with STEMI in whom pPCI was performed and who were loaded with 600 mg clopidogrel or 180 mg ticagrelor were eligible for enrolment in this nonrandomized, open label, single-center study...
April 4, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28356282/impact-of-diabetes-mellitus-on-the-pharmacodynamic-effects-of-ticagrelor-versus-clopidogrel-in-troponin-negative-acute-coronary-syndrome-patients-undergoing-ad-hoc-percutaneous-coronary-intervention
#19
Joseph M Sweeny, Dominick J Angiolillo, Francesco Franchi, Fabiana Rollini, Ron Waksman, Ganesh Raveendran, George Dangas, Naeem D Khan, Glenn F Carlson, Yonggang Zhao, Renli Teng, Roxana Mehran
BACKGROUND: Diabetes mellitus (DM) is associated with enhanced platelet reactivity and impaired response to oral antiplatelet therapy, including clopidogrel. This post hoc analysis investigated the pharmacodynamic effects of ticagrelor versus clopidogrel loading dose (LD) in troponin-negative acute coronary syndrome patients with or without DM undergoing percutaneous coronary intervention in the Ad Hoc PCI study. METHODS AND RESULTS: Patients randomized (1:1) to receive ticagrelor 180 mg LD or clopidogrel 600 mg LD were assessed by diabetic status...
March 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28342632/the-pharmacodynamics-of-low-and-standard-doses-of-ticagrelor-in-patients-with-end-stage-renal-disease-on-hemodialysis
#20
Jin Sug Kim, Jong Shin Woo, Jin Bae Kim, Woo-Shik Kim, Tae Won Lee, Kwon Sam Kim, Chun Gyoo Ihm, Weon Kim, Kyung Hwan Jeong
BACKGROUND: Patients with end-stage renal disease (ESRD) on maintenance hemodialysis (HD) respond poorly to clopidogrel. We assessed the utility of low-dose ticagrelor in ESRD patients on maintenance HD. METHODS: In this single-center, prospective, randomized pharmacodynamic study, 52 ESRD patients on HD were prescribed clopidogrel (300mg loading dose [LD], then 75mg daily), standard-dose ticagrelor (180mg LD, then 90mg twice daily), or low-dose ticagrelor (90mg LD, then 90mg daily) for 14days...
March 9, 2017: International Journal of Cardiology
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