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antithrombotic drugs

Murtaza Akhter, Tom Qin, Paul Fischer, Homa Sadeghian, Hyung Hwan Kim, Michael J Whalen, Joshua N Goldstein, Cenk Ayata
Rho-associated kinase (ROCK) is an emerging target in acute ischemic stroke. Early pre-hospital treatment with ROCK inhibitors may improve their efficacy, but their antithrombotic effects raise safety concerns in hemorrhagic stroke, precluding use prior to neuroimaging. Therefore, we tested whether ROCK inhibition affects the bleeding times, and worsens hematoma volume in a model of intracerebral hemorrhage (ICH) induced by intrastriatal collagenase injection in mice. Tail bleeding time was measured 1 h after treatment with isoform-nonselective inhibitor fasudil, or ROCK2-selective inhibitor KD025, or their vehicles...
June 2018: Annals of Clinical and Translational Neurology
J J Wei, D Z Kang, R Z Wang
No abstract text is available yet for this article.
June 5, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Lodewijk C S Res, Bart Lubberts, Shivesh H Shah, Christopher W DiGiovanni
BACKGROUND: Little is known about the health-related quality of life (HRQOL) following adverse bleeding events associated with antithrombotic drug therapy. This systematic review assesses the HRQOL of patients who suffered a bleeding event related to antithrombotic drug use. METHODS: Literature search was performed using PubMed, EMBASE, and the Cochrane Library from inception through June 16, 2017. Studies measuring HRQOL after a bleeding event related to antithrombotic drug therapy for primary or secondary prevention of a thromboembolic event were included...
June 14, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Luo-Dan Ouyang, Xiao-Song Hu, Ming Niu, Wen Gao, Yu Cheng, Jia-Bo Wang, Li Ma
The study aims to analyze the mechanisms of Hirudo in promoting blood circulation and removing blood stasis based on network pharmacology. A database of chemical components of Hirudo was established through literature retrieval. The targets were predicted by using the reverse pharmacophore matching method and screened according to the antithrombotic and anticoagulant drug targets approved by FDA in the DrugBank database. Then, the targets were analyzed by KEGG pathway analysis, the protein interactions were analyzed by using BioGrid database, and the active constituents-target-pathway network model of Hirudo was established to study the mechanisms of Hirudo in promoting blood circulation and removing blood stasis...
May 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Jean-Philippe Collet, Sergio Berti, Angel Cequier, Eric Van Belle, Thierry Lefevre, Pascal Leprince, Franz-Josef Neumann, Eric Vicaut, Gilles Montalescot
BACKGROUND: Antithrombotic treatment regimen following transcatheter aortic valve replacement (TAVR) is not evidence-based. Apixaban, a non-vitamin K direct anticoagulant (NOAC) was shown to be superior to VKA and superior to aspirin to prevent cardioembolic stroke in non-valvular atrial fibrillation. It may have the potential to reduce TAVR-related thrombotic complications including subclinical valve thrombosis along with a better safety than the standard of care. DESIGN: ATLANTIS is a multicenter, randomized, phase IIIb, prospective, open-label, superiority study comparing standard of care (SOC Group) versus an apixaban-based strategy (Anti-Xa Group) after successful TAVR (ClinicalTrials...
June 2018: American Heart Journal
Michael T Griffin, Yuanzheng Zhu, Zixiang Liu, Cyrus K Aidun, David N Ku
Platelet accumulation under high shear rates at the site of atherosclerotic plaque rupture leads to myocardial infarction and stroke. Current antiplatelet therapies remain ineffective within a large percentage of the population, while presenting significant risks for bleeding. We explore a novel way to inhibit arterial thrombus formation by biophysical means without the use of platelet inactivating drugs. Our computational multi-scale dynamics model has predicted that charged particles of a specific size may entangle von Willebrand Factor (vWF) polymers and reduce the amount of elongation at high shear rates...
July 2018: Biomicrofluidics
Mehmet Akif Topcuoglu, Liping Liu, Dong-Eog Kim, M Edip Gurol
Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism...
May 2018: Journal of Stroke
Shauna L French, Claudia Thalmann, Paul F Bray, Lynn E Macdonald, Andrew J Murphy, Mark W Sleeman, Justin R Hamilton
Thrombin activates human platelets via 2 protease-activated receptors (PARs), PAR1 and PAR4, both of which are antithrombotic drug targets: a PAR1 inhibitor is approved for clinical use, and a PAR4 inhibitor is in trial. However, a common sequence variant in human PAR4 (rs773902, encoding Thr120 in place of Ala120) renders the receptor more sensitive to agonists and less sensitive to antagonists. Here, we develop the first human monoclonal function-blocking antibody to human PAR4 and show it provides equivalent efficacy against the Ala120 and Thr120 PAR4 variants...
June 12, 2018: Blood Advances
Josef Finsterer, Claudia Stöllberger, Chen-Yu Ho
BACKGROUND: Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy with sudden but transient systolic dysfunction. TTS mimics myocardial infarction clinically, chemically, and electrocardiographically but echocardiography typically shows apical ballooning and coronary angiography is normal. TTS has not been reported in a patient with myasthenia gravis (MG) and polymyositis due to a malignant thymoma. CASE REPORT: Two weeks prior to admission, a 76yo female developed dysarthria, chronic coughing, and disabling myalgias of the entire musculature...
June 8, 2018: International Journal of Neuroscience
Giuseppe Patti, Ludmilla Mantione, Edoardo Bressi, Antonio Bisignani
Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation  (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Xiaoye Li, Ying Xue, Hongyi Wu
Purpose: To report a case of atrioventricular block (AVB) which might be associated with the right coronary artery lesion and the novel oral antithrombotic drug ticagrelor mediated by the increasing adenosine plasma concentration (APC). Case Report: A 65-year-old man was given loading dose of ticagrelor (180 mg) before coronary angiography with total thrombotic occlusion of right coronary artery and one stent was implanted. On second day after successful percutaneous coronary intervention, ECG monitoring showed second-degree (Mobitz type I) AVB with prolonged PR interval (299 ms)...
2018: Case Reports in Vascular Medicine
Makoto Matsubara, Masataka Banshodani, Akira Takahashi, Yusuke Kawai, Tomoki Saiki, Masahiro Yamashita, Nobuaki Shiraki, Sadanori Shintaku, Misaki Moriishi, Takao Masaki, Hideki Kawanishi
Background: Management of vascular access (VA) is essential in hemodialysis (HD) patients. However, VA often fails and percutaneous transluminal angioplasty (PTA) is required. Conventional hemostasis at the puncture site is associated with complications. This study aimed to analyze the efficacy and safety of a hemostatic wound dressing made of calcium alginate at the puncture site of VA after PTA and evaluate other factors affecting hemostasis. Methods: After PTA for VA, 200 HD patients were randomized to a calcium alginate sheet (CA) group (n = 100) or a no drug-eluting sheet (control) group (n = 100)...
May 28, 2018: Nephrology, Dialysis, Transplantation
Koichi Miki, Kenji Yagi, Masani Nonaka, Mitsutoshi Iwaasa, Hiroshi Abe, Takashi Morishita, Hisatomi Arima, Tooru Inoue
OBJECTIVE In patients with spontaneous intracerebral hemorrhage (sICH), postoperative recurrent hemorrhage (PRH) is one of the most severe complications after endoscopic evacuation of hematoma (EEH). However, no predictors of this complication have been identified. In the present study, the authors retrospectively investigated whether PRH can be preoperatively predicted by the presence of the spot sign on CT scans. METHODS In total, 143 patients with sICH were treated by EEH between June 2009 and March 2017, and 127 patients who underwent preoperative CT angiography were included in this study...
May 25, 2018: Journal of Neurosurgery
Roland Tegtmeyer, Oliver Borst, Meinrad Gawaz, Dominik Rath
Recent guidelines suggest dual antiplatelet therapy (DAPT) after 'drug-eluting' stent (DES) implantation for 6 months in stable patients and for 12 months in patients after acute coronary syndrome. Serious complications after stent implantation include stent thrombosis, recurrent myocardial infarction, ischemic stroke, cardiovascular death and bleeding. These complications also occur beyond 1 year after coronary intervention. Thus, it is important to consider whether a prolonged DAPT (>12 months after percutaneous coronary intervention) is of benefit to lower thrombo-ischemic events in high-risk patients...
May 25, 2018: Personalized Medicine
Jia Wei Lim, Siow Xian Chee, Wen Jun Wong, Qiu Ling He, Tang Ching Lau
Traditional Chinese medicine (TCM)-based herbal therapies have gained increasing popularity worldwide, raising concerns of its efficacy, safety profile and potential interactions with Western medications. Antithrombotic agents are among the most common prescription drugs involved in herb-drug interactions, and this article focused on aspirin, one of the most widely used antiplatelet agents worldwide. We discussed herbs that have potential interactions by exploring Western and TCM approaches to thrombotic events...
May 2018: Singapore Medical Journal
Xuyang Liu, Zhan-Guo Gao, Yiran Wu, Raymond C Stevens, Kenneth A Jacobson, Suwen Zhao
Many hemorheologic Traditional Chinese Medicines (TCMs) that are widely-used clinically lack molecular mechanisms of action. We hypothesized that some of the active components of hemorheologic TCMs may function through targeting prothrombotic P2Y1 and/or P2Y12 receptors. The interactions between 253 antithrombotic compounds from TCM and these two G protein-coupled P2Y receptors were evaluated using virtual screening. Eleven highly ranked hits were further tested in radioligand binding and functional assays...
May 24, 2018: Scientific Reports
Laura Mechtouff, Julie Haesebaert, Marie Viprey, Valérie Tainturier, Anne Termoz, Sylvie Porthault-Chatard, Jean-Stéphane David, Laurent Derex, Norbert Nighoghossian, Anne-Marie Schott
BACKGROUND: Secondary prevention is inadequate in the first 2 years after stroke but what happens after that is less documented. The aim of this study was to assess the use and the adherence to preventive drugs 3 and 6 years after experiencing a transient ischemic attack (TIA) or an ischemic stroke (IS). METHODS: The population study was from the AVC69 cohort (IS or TIA admitted in an emergency or stroke unit in the Rhône area, France, for an IS or a TIA during a 7-month period)...
May 14, 2018: European Neurology
Furqan Khattak, Mian B Alam, Timir K Paul, Shasank Rijal, Shoaib Wazir, Carl J Lavie, Samir Saba
Atrial fibrillation (AF) is associated with high risk of systemic thromboembolism leading to significant morbidity and mortality. Warfarin, previously the mainstay for stroke prevention in AF, requires close monitoring because of multiple food and drug interactions. In recent years, food and drug administration has approved several direct oral anticoagulants (DOACs) for use in patients with nonvalvular AF. These agents have not been studied in patients with valvular AF who are at an even higher risk of systemic thromboembolism...
May 2018: American Journal of the Medical Sciences
Pasquale De Bonis, Simone Olei, Lorenzo Mongardi, Michele Alessandro Cavallo, Mariaconsiglia Santantonio, Gianluca Trevisi, Carmelo Anile, Annunziato Mangiola
OBJECTIVE: Chronic subdural hematoma (CSDH) is a common condition in the elderly, and the ageing of population will increase the number of "superaged" patients presenting this pathology for the years to come. Few studies investigating the outcome of superaged patients surgically treated for CSDH are available, and study populations are generally small. The outcome of surgically treated patients and risk factors are not completely clear. Aim of the work is to identify the risk factors which may influence the outcome of patients aged 80 years and older surgically treated for CSDH...
July 2018: Clinical Neurology and Neurosurgery
Kui Kai Lau, Caroline E Lovelock, Linxin Li, Michela Simoni, Sergei Gutnikov, Wilhelm Küker, Henry Ka Fung Mak, Peter M Rothwell
BACKGROUND AND PURPOSE: In patients with transient ischemic attack/ischemic stroke, microbleed burden predicts intracerebral hemorrhage (ICH), and ischemic stroke, but implications for antiplatelet treatment are uncertain. Previous cohort studies have had insufficient follow-up to assess the time course of risks, have not stratified risks by antithrombotic use, and have not reported extracranial bleeds or functional outcome of ICH versus ischemic stroke. METHODS: In 2 independent prospective cohorts with transient ischemic attack/ischemic stroke (Oxford Vascular Study/mainly white; University of Hong Kong/mainly Chinese), antiplatelet treatment was started routinely irrespective of microbleed burden...
May 10, 2018: Stroke; a Journal of Cerebral Circulation
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