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M Barburoglu, A Arat
BACKGROUND AND PURPOSE: There is very limited data concerning utilization of flow diverters in children. Our aim is to report results for the treatment of complex intracranial aneurysms and carotid cavernous fistulas by using flow diverters in children. MATERIALS AND METHODS: Retrospective review of children (17 years of age or younger) treated with flow diverters between May 2011 and July 2014 was performed. Clinical and laboratory data and angiographic findings were extracted...
October 20, 2016: AJNR. American Journal of Neuroradiology
Min Soo Kim, Kyung Il Jo, Je Young Yeon, Jong Soo Kim, Keon Ha Kim, Pyoung Jeon, Seung Chyul Hong
INTRODUCTION: The purpose of this study was to explore the safety and efficacy of an antiplatelet response assay and drug adjustment to prevent delayed thromboembolic events after stent-assisted coil embolization. METHODS: A total of 370 patients were enrolled in this study between December 2005 and July 2014. Of these, 124 patients were placed into the drug resistance test (DRT) group with drug adjustment according to response to an antiplatelet agent, and 246 patients comprised the control group with a standard antiplatelet regimen...
October 18, 2016: Neuroradiology
J-S Doly, E Lorian, I Desormais, J Constans, A Bura Rivière, P Lacroix
OBJECTIVES: To assess the prevalence and the association between aspirin resistance in critical limb ischemia patients using the VerifyNow(®) bed-side platelet test, and occurrence of cardiovascular morbidity and/or death at one year. MATERIALS AND METHODS: National multicenter prospective observational study related to COPART II centers. From 2010 through 2014, 64 subjects hospitalized for critical limb ischemia and already treated by aspirin before the VerifyNow(®) test were included...
October 13, 2016: Journal des Maladies Vasculaires
Shinya Ichikawa, Kengo Tsukahara, Yugo Minamimoto, Yuichiro Kimura, Yasushi Matsuzawa, Nobuhiko Maejima, Noriaki Iwahashi, Kiyoshi Hibi, Masami Kosuge, Toshiaki Ebina, Kazuo Kimura
BACKGROUND: Few studies have compared the platelet reactivity of prasugrel and clopidogrel in the acute phase of ST-segment elevation myocardial infarction (STEMI).Methods and Results:Primary percutaneous coronary intervention (PCI) was performed in 78 patients with STEMI within 12 h of onset. Patients were randomly assigned to receive a Japanese standard loading dose of prasugrel 20 mg or clopidogrel 300 mg. Platelet reactivity was serially assessed using the VerifyNow-P2Y12 assay, the results of which were expressed as P2Y12-reaction-units (PRU)...
October 6, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Jae-Lim Choi, Bo-Ram Kim, Kwang-Sook Woo, Kyeong-Hee Kim, Jeong-Man Kim, Moo-Hyun Kim, Jin-Yeong Han
BACKGROUND: Clopidogrel is a widely used antiplatelet agent for dual antiplatelet therapy and metabolized by CYP2C19. The polymorphism of CYP2C19 is associated with the therapeutic effect of clopidogrel. METHODS: A total of 119 patients diagnosed with acute coronary syndrome (ACS) and underwent percutaneous coronary intervention (PCI) with drug-eluting stents was enrolled. Polymorphisms of CYP2C19 *2,*3,*17 were determined by the Spartan RX CYP2C19 and confirmed by SNP genotyping assay...
September 2016: Annals of Clinical and Laboratory Science
Yi Yao, Jia-Hui Zhang, Xiao-Fang Tang, Chen He, Yuan-Liang Ma, Jing-Jing Xu, Ying Song, Ru Liu, Xian-Min Meng, Lei Song, Miao Wang, Run-Lin Gao, Jin-Qing Yuan
BACKGROUND: Platelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI)...
2016: Chinese Medical Journal
Marek Koziński, Małgorzata Ostrowska, Piotr Adamski, Joanna Sikora, Adam Sikora, Aleksandra Karczmarska-Wódzka, Michał Piotr Marszałł, Joanna Boinska, Ewa Laskowska, Ewa Obońska, Tomasz Fabiszak, Jacek Kubica
Aim of this study was assessment of the relationship between concentrations of ticagrelor and its active metabolite (AR-C124910XX) and results of selected platelet function tests. In a single-centre, cohort study, patients with myocardial infarction underwent blood sampling following a 180 mg ticagrelor loading dose intake (predose, 1, 2, 3, 4, 6, 12, 24 hours postdose) to perform pharmacokinetic and pharmacodynamic assessments. Platelet reactivity was evaluated using the VASP-assay, the VerifyNow device and the Multiplate analyzer...
September 15, 2016: Thrombosis and Haemostasis
Minka J A Vries, Heleen J Bouman, Renske H Olie, Leo F Veenstra, Suzanne Zwaveling, Paul W M Verhezen, Arina J Ten Cate-Hoek, Hugo Ten Cate, Yvonne M C Henskens, Paola E J van der Meijden
Aims Therapeutic windows for residual platelet reactivity in patients with coronary artery disease on P2Y12 inhibitors were proposed in a consensus document (1). We aimed to explore the level of agreement between windows for different platelet function tests (PFTs) used to classify patients in low, optimal and high on-treatment platelet reactivity categories, and to identify variables contributing to the level of agreement.Methods and results In this explorative clinical study, the VerifyNow P2Y12, Multiplate ADP and light transmission aggregometry (LTA) 20μmol/L ADP were performed simultaneously in 145 consecutive vulnerable patients...
September 7, 2016: European Heart Journal. Cardiovascular Pharmacotherapy
Takeshi Nishi, Noritaka Ariyoshi, Takashi Nakayama, Yoshihide Fujimoto, Kazumasa Sugimoto, Shinichi Wakabayashi, Hideki Hanaoka, Yoshio Kobayashi
BACKGROUND: The impact of chronic kidney disease (CKD) on the antiplatelet effect of clopidogrel and low-dose (3.75mg) prasugrel in Japanese patients is largely unknown. METHODS: A total of 53 consecutive Japanese patients with stable coronary artery disease who received aspirin and clopidogrel were enrolled, and categorized by estimated glomerular filtration rate (eGFR): CKD group (n=15, eGFR<60ml/min/1.73m(2)) and non-CKD group (n=38, eGFR≥60ml/min/1.73m(2))...
August 23, 2016: Journal of Cardiology
Jin-Sin Koh, Yongwhi Park, Udaya S Tantry, Jong-Hwa Ahn, Min Gyu Kang, Kyehwan Kim, Jeong Yoon Jang, Hyun Woong Park, Jeong Rang Park, Seok-Jae Hwang, Choong Hwan Kwak, Jin-Yong Hwang, Paul A Gurbel, Young-Hoon Jeong
Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin is a widely prescribed regimen to prevent ischemic events in patients undergoing percutaneous coronary intervention (PCI). A fixed-dose combination (FDC) capsule (HCP0911) has been developed to provide dosing convenience and improve adherence. We compared the antiplatelet effects of single daily dose HCP0911 with separate treatment with daily 75 mg clopidogrel plus 100 mg aspirin. This was a randomized, open-label, two-period, crossover, non-inferiority study conducted in stented patients who had been treated for at least 6 months with clopidogrel and aspirin...
August 25, 2016: Platelets
Francesco Franchi, Fabiana Rollini, Niti Aggarwal, Jenny Hu, Megha Kureti, Ashwin Durairaj, Valeria E Duarte, Jung Rae Cho, Latonya Been, Martin M Zenni, Theodore A Bass, Dominick J Angiolillo
BACKGROUND: Patients with diabetes mellitus (DM) are at increased risk of atherothrombotic events, underscoring the importance of effective platelet inhibiting therapies. Prasugrel and ticagrelor reduce thrombotic complications to a greater extent than clopidogrel. Subgroup analyses of pivotal clinical trials testing prasugrel and ticagrelor versus clopidogrel showed DM patients to have benefits that were consistent with the overall trial populations, although the magnitude of the ischemic risk reduction appeared to be enhanced with prasugrel...
September 13, 2016: Circulation
Pan Li, Ying Gu, Yawei Yang, Lizhi Chen, Junmei Liu, Lihong Gao, Yongwen Qin, Quancai Cai, Xianxian Zhao, Zhuo Wang, Liping Ma
Ticagrelor has a greater antiplatelet efficacy than clopidogrel but may be accompanied by an increased risk of bleeding. This study evaluated the antiplatelet effect and pharmacokinetic profile of low-dose ticagrelor in healthy Chinese volunteers. Thirty healthy subjects were randomized to receive standard-dose ticagrelor (180-mg loading dose, 90-mg twice daily [bid] [n = 10]), low-dose ticagrelor (90-mg loading dose, 45-mg bid [n = 10]), or clopidogrel (600-mg loading dose, 75-mg once daily [n = 10])...
2016: Scientific Reports
Yun Gi Kim, Jung-Won Suh, Si-Hyuck Kang, Jin Joo Park, Chang-Hwan Yoon, Young-Seok Cho, Tae-Jin Youn, In-Ho Chae, Dong-Ju Choi, Hyo-Soo Kim
OBJECTIVES: The authors performed this analysis to examine whether the enhanced clopidogrel responsiveness in current smokers is maintained after adjusting the influence of hemoglobin on VerifyNow P2Y12 reaction unit (PRU). BACKGROUND: PRU is consistently reported to be lower in current smokers. However, PRU has a significant inverse relationship with hemoglobin level, and smokers have higher hemoglobin levels. Because the association between PRU and hemoglobin is likely to be an in vitro phenomenon, we hypothesized that the observed difference in PRU between nonsmokers and current smokers is the result of confounding effect of hemoglobin rather than true difference in platelet reactivity...
August 22, 2016: JACC. Cardiovascular Interventions
Long Zhe Guo, Moo Hyun Kim, Chang Heon Shim, Sun Young Choi, Victor L Serebruany
AIMS: Clinical utilization of dual antiplatelet therapy (DAPT) in patients with renal impairment (RI) following percutaneous coronary interventions (PCI) represents an urgent, unmet need choosing optimal agents, duration of treatment, and potential dose/regimen adjustment. The lack of any large randomized trials specifically in RI patients, and the absence of the uniformed clinical data reporting policy, clouds the reality. Moreover, triaging RI patients is problematic due to ongoing kidney deterioration, and the fact that RI patients are prone to both vascular occlusions and bleeding...
July 2016: European Heart Journal. Cardiovascular Pharmacotherapy
Long Zhe Guo, Moo Hyun Kim, Eun Seok Shin, Soe Hee Ann, Cai De Jin, Young-Rak Cho, Jong Sung Park, Kyungil Park, Tae-Ho Park, Michael S Lee, Victor L Serebruany
OBJECTIVE: The impact of thienopyridine reloading on clinical outcomes, and residual high platelet reactivity (HPR) is unclear. We sought to compare the HRP-related effect of prasugrel and clopidogrel reloading in the already clopidogrel-loaded patients undergoing percutaneous coronary intervention (PCI). MATERIALS AND METHODS: In this prospective, two-center, randomized, open-label study, patients with HPR who had undergone PCI after a clopidogrel (300-600mg) loading dose (LD) were enrolled...
November 1, 2016: International Journal of Cardiology
Fabiana Rollini, Francesco Franchi, Kamaldeep Singh, Jung Rae Cho, Mona Bhatti, Christopher DeGroat, Jenny Hu, Niti Aggarwal, Zeina Alobaidi, Estela Thano, Elisabetta Ferrante, Martin Zenni, Theodore A Bass, Dominick J Angiolillo
Several platelet function tests (PFT) are available to assess the pharmacodynamic (PD) effects of P2Y12 inhibitors. However, there are technical variances between PFT, and P2Y12 inhibitors differ in pharmacological properties. Manufactures of PFT recommend a time-frame within which assessments needs to be executed. However, if the timing from blood sampling to processing affects PD results is unknown. We conducted a prospective study assessing the impact of timing from blood sampling to processing on PD measures using three different PFT...
August 4, 2016: Thrombosis and Haemostasis
Sandra Le Quellec, Jean-Claude Bordet, Claude Negrier, Yesim Dargaud
The two most widely used antiplatelet drugs in the world are aspirin and clopidogrel. However, some patients on aspirin and/or clopidogrel therapy do not respond appropriately to either aspirin or clopidogrel. This phenomenon is usually called "aspirin/clopidogrel resistance". Several platelet function tests have been used in various studies for the assessment of aspirin and clopidogrel resistance in healthy individuals and patients admitted in cardiology departments. An accurate assessment of platelet response to aspirin/clopidogrel could benefit patients by proposing tailored-antiplatelet therapy based on test results...
September 27, 2016: Thrombosis and Haemostasis
E J Ha, W S Cho, J E Kim, Y D Cho, H H Choi, T Kim, J S Bang, G Hwang, O K Kwon, C W Oh, M H Han, H S Kang
BACKGROUND AND PURPOSE: Prophylactic antiplatelet medication is beneficial in decreasing thromboembolic complications during endovascular treatment of unruptured intracranial aneurysms. The efficacy may be limited by variability of individual response to antiplatelet medication, especially clopidogrel. We compared the efficacy of 2 antiplatelet medications, low-dose prasugrel and clopidogrel, in patients undergoing endovascular treatment of unruptured aneurysms. MATERIALS AND METHODS: From November 2014 to July 2015, 194 patients with a total of 222 unruptured aneurysms underwent endovascular treatment at a single institution...
July 7, 2016: AJNR. American Journal of Neuroradiology
Hong-Zhe Zhang, Moo Hyun Kim, Long-Zhe Guo, Victor Serebruany
Clopidogrel response variability (CRV) is well documented, and may affect clinical outcomes. Impact of genetic polymorphisms is important for assessing and predicting CRV. The extensive evidence indicates the importance of CYP2C19 variants in reducing efficacy of clopidogrel. This study defined the impact of numerous genetic polymorphisms on CRV before and after percutaneous coronary interventions (PCI) exclusively in a Korean cohort assuming less genetic variability noise. One hundred and thirty-six patients of Korean origin undergoing PCI were included...
July 1, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Moo Hyun Kim, Sun Young Choi, Soo Yeon An, Victor Serebruany
BACKGROUND: Although low platelet reactivity (LPR) is commonly detected during bleeding, a validated threshold for reliable DAPT bleeding risk stratification is lacking. We tested the diagnostic utility of 3 conventional platelet-activity assays to define the predictive value (if any) of LPR for bleeding. HYPOTHESIS: We hypothesized whether one of these tests be better than any others for predicting bleeding events. METHODS: Patients (n = 800) following drug-eluting stent implantation received DAPT...
July 2016: Clinical Cardiology
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