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https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#1
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28780510/reduced-antiplatelet-effect-of-aspirin-does-not-predict-cardiovascular-events-in-patients-with-stable-coronary-artery-disease
#2
Sanne Bøjet Larsen, Erik Lerkevang Grove, Søs Neergaard-Petersen, Morten Würtz, Anne-Mette Hvas, Steen Dalby Kristensen
BACKGROUND: Increased platelet aggregation during antiplatelet therapy may predict cardiovascular events in patients with coronary artery disease. The majority of these patients receive aspirin monotherapy. We aimed to investigate whether high platelet-aggregation levels predict cardiovascular events in stable coronary artery disease patients treated with aspirin. METHODS AND RESULTS: We included 900 stable coronary artery disease patients with either previous myocardial infarction, type 2 diabetes mellitus, or both...
August 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28768756/impact-of-timing-on-the-functional-recovery-achieved-with-platelet-supplementation-after-treatment-with-ticagrelor
#3
M Urooj Zafar, Donald A Smith, Usman Baber, Samantha Sartori, Kevin Chen, David W Lam, Carlos A Linares-Koloffon, Juan Rey-Mendoza, Gustavo Jimenez Britez, Gines Escolar, Valentin Fuster, Juan J Badimon
BACKGROUND: American College of Cardiology/American Heart Association guidelines advise waiting 5 to 7 days before operating on P2Y12 inhibitor-treated acute coronary syndrome patients, to allow dissipation of its antiplatelet effects. Platelet transfusion is often used to restore hemostasis during operations, but its effectiveness and optimal timing are unclear. We investigated the degree of functional gains obtained from platelet supplementation after loading and maintenance of dual antiplatelet therapy with ticagrelor and the influence of timing on this strategy...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28763341/monitoring-platelet-reactivity-during-prasugrel-or-ticagrelor-washout-before-urgent-coronary-artery-bypass-grafting
#4
Katia Orvin, Yaron D Barac, Ran Kornowski, Leor Perl, Yishay Wasserstrum, Victor Rubchevsky, Ram Sharony, Eitan Snir, Dan Aravot, Eli I Lev
OBJECTIVES: Patients with acute myocardial infarction pretreated with prasugrel or ticagrelor may require urgent coronary artery bypass grafting (CABG). However, prasugrel and ticagrelor withdrawal period is recommended for 5-7 days before planned CABG to enable full platelet recovery. We hypothesized that monitoring sequential platelet reactivity (PR) could identify patients with early platelet recovery who may benefit from earlier surgery before the guideline-recommended 5-7 day delay...
September 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28754568/quantifying-ischemic-risk-after-percutaneous-coronary-intervention-attributable-to-high-platelet-reactivity-on-clopidogrel-from-the-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents-study
#5
Björn Redfors, Ori Ben-Yehuda, Sheng-Hsuan Lin, Ariel Furer, Ajay J Kirtane, Bernhard Witzenbichler, Giora Weisz, Thomas D Stuckey, Akiko Maehara, Philippe Généreux, Gennaro Giustino, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Girma Minalu Ayele, Roxana Mehran, Gary S Mintz, Gregg W Stone
Patients at high risk of thrombotic events after percutaneous coronary intervention (PCI) may potentially benefit from intensified antiplatelet therapy. However, more potent antiplatelet therapy would be expected to only overcome risk that is mediated by high platelet reactivity (PR). We used mediation analysis to determine the contribution of residual PR to the 2-year risk of major adverse cardiac events (MACE; the composite of cardiac death, myocardial infarction, or stent thrombosis) associated with clinical risk factors after PCI with drug-eluting stents (DES) in 8,374 patients from the prospective, multicenter Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents (ADAPT-DES) registry...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28717113/add-on-antiplatelet-effects-of-eicosapentaenoic-acid-with-tailored-dose-setting-in-patients-on-dual-antiplatelet-therapy
#6
Naoyoshi Hosogoe, Shuichi Ishikawa, Naoyuki Yokoyama, Ken Kozuma, Takaaki Isshiki
The aim of this study was to investigate the antiplatelet effects of eicosapentaenoic acid (EPA) at a sufficient dose following coronary stent implantation. Thirty-one patients on dual antiplatelet therapy with aspirin and clopidogrel were treated with highly purified EPA-E (Epadel(®)) for 12 weeks. Based on our previous study, patients with a high baseline EPA/arachidonic acid (AA) ratio (≥ 0.37; n = 11) were given a standard dose (1800 mg daily) of EPA-E, whereas those with a low EPA/AA ratio (< 0.37; n = 20) were given a high dose (2700 mg daily) to reach the target value of > 0...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28675986/clinical-determinants-of-clopidogrel-responsiveness-in-a-heterogeneous-cohort-of-puerto-rican-hispanics
#7
Dagmar F Hernandez-Suarez, Stuart A Scott, Matthew I Tomey, Kyle Melin, Angel Lopez-Candales, Charlotte E Buckley, Jorge Duconge
BACKGROUND: Clopidogrel is by far the most prescribed platelet adenosine diphosphate (ADP) antagonist in Puerto Rico despite the advent of newer agents (prasugrel and ticagrelor). Given the paucity of data on clopidogrel responsiveness in Hispanics, we sought to determine the association between clinical characteristics and platelet reactivity in Puerto Rican patients on clopidogrel therapy. STUDY POPULATION: A total of 100 Puerto Rican patients on clopidogrel therapy were enrolled and allocated into two groups: Group I, without high on-treatment platelet reactivity (HTPR); and Group II, with HTPR...
September 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#8
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
#9
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
#10
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...
July 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
#11
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
#12
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
#13
REVIEW
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
MULTICENTER STUDY
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
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