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https://www.readbyqxmd.com/read/28921624/pharmacodynamics-and-pharmacokinetics-of-ticagrelor-versus-clopidogrel-in-patients-with-acute-coronary-syndromes-and-chronic-kidney-disease
#1
Heyang Wang, Jing Qi, Yi Li, Yunbiao Tang, Chao Li, Jing Li, Yaling Han
BACKGROUND: Pivotal clinical trials found ticagrelor reduced ischemic complications to a greater extent than clopidogrel and what is more, the benefit gradually increased with the reduction on creatinine clearance. However, the underlying mechanisms remains poorly explored. METHODS: This is a single-center, prospective, randomized clinical trial involving 60 hospitalized P2Y12 inhibitor naïve patients with CKD (eGFR<60ml/min/1.73m(2) ) and NSTE-ACS. Eligible patients were randomly assigned in a 1:1 ratio to receive ticagrelor(180 mg loading dose, then 90 mg twice daily followed) or clopidogrel(600 mg loading dose, then 75 mg qd followed)...
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
#2
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
#3
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
#4
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
#5
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...
August 19, 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
#6
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...
August 18, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28840345/platelet-reactivity-in-sepsis-syndrome-results-from-the-press-study
#7
Karolina Akinosoglou, Spyridoula Theodoraki, Ioanna Xanthopoulou, Angelos Perperis, Theologia Gkavogianni, Aikaterini Pistiki, Evangelos Giamarellos-Bourboulis, Charalambos A Gogos
Platelet activation mediates systemic inflammatory response during infection. However, data on platelet reactivity (PR) varies among different settings. We assessed PR along different stages of sepsis and tried to predict for determinants of its variance. In parallel, we evaluated it as an early bedside diagnostic biomarker. This was an observational prospective cohort study. Incoming patients were assorted to distinct groups of uncomplicated infection, sepsis, and severe sepsis/septic shock. A control group of healthy volunteers was used as comparison...
August 24, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28837213/antithrombotic-potency-of-ticagrelor-versus-clopidogrel-in-type-2-diabetic-patients-with-cardiovascular-disease
#8
M Urooj Zafar, Usman Baber, Donald A Smith, Samantha Sartori, Johanna Contreras, Juan Rey-Mendoza, Carlos A Linares-Koloffon, Gines Escolar, Roxana Mehran, Valentin Fuster, Juan J Badimon
Type-2 Diabetes Mellitus [T2DM] is associated with increased platelet reactivity and hypo-response to antiplatelet drugs. Ticagrelor, with its faster and more potent antiplatelet effects, was shown to reduce adverse events more than clopidogrel in the overall CAD patient population of PLATO trial, but the benefits did not reach statistical significance in the T2DM subgroup. To better understand these findings, we compared the antithrombotic effects of ticagrelor versus with clopidogrel in T2DM patients with cardiovascular disease...
August 24, 2017: Thrombosis and Haemostasis
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
#9
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
#10
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
#11
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
#12
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
#13
MULTICENTER STUDY
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...
September 15, 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
#14
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
#15
MULTICENTER STUDY
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
#16
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
#17
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
#18
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
#19
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
#20
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
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