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https://www.readbyqxmd.com/read/28342632/the-pharmacodynamics-of-low-and-standard-doses-of-ticagrelor-in-patients-with-end-stage-renal-disease-on-hemodialysis
#1
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
https://www.readbyqxmd.com/read/28316004/effect-of-the-fxa-inhibitors-rivaroxaban-and-apixaban-on-platelet-activation-in-patients-with-atrial-fibrillation
#2
B Steppich, F Dobler, L C Brendel, G Hessling, S L Braun, A L Steinsiek, I Deisenhofer, A Hyseni, M Roest, I Ott
Rivaroxaban and Apixaban, increasingly used for stroke prevention in non-valvular atrial fibrillation (AF), might impact platelet reactivity directly or indirectly. By inhibition of Factor Xa (FXa) they preclude not only generation of relevant thrombin amounts but also block signalling of FXa via protease activated receptors. However, weather FXa-inhibition affects platelet haemostasis remains incompletely known. One hundred and twenty-eight patients with AF on chronic anticoagulation with either Rivaroxaban or Apixaban for at least 4 weeks were included in the study...
March 18, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28301911/the-prevalence-and-clinical-relevance-of-asa-nonresponse-after-cardiac-surgery
#3
Saskia Wand, Elisabeth Hannah Adam, Anna Julienne Wetz, Patrick Meybohm, Nils Kunze-Szikszay, Kai Zacharowski, Aron Frederick Popov, Anton Moritz, Lisa Moldenhauer, Julia Kaiser, Martin Bauer, Christian Friedrich Weber
We aimed to identify the prevalence of acetylsalicylic acid (ASA) nonresponse in patients after coronary artery bypass graft (CABG) surgery and the possible consequences for the rate of major cardiovascular events. This prospective, observational, bicentric cohort study was conducted in two German University hospitals. A total of 400 patients (200 in each study center) undergoing elective CABG surgery were enrolled after written informed consent. Platelet function was analyzed on day 3 (d3) and day 5 (d5) postoperatively following stimulation with arachidonic acid (ASPItest) and with thrombin receptor-activating peptide 6 (TRAPtest) using multiple electrode aggregometry (Multiplate)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28300867/consistent-platelet-inhibition-with-ticagrelor-60-mg-twice-daily-following-myocardial-infarction-regardless-of-diabetes-status
#4
Mark R Thomas, Dominick J Angiolillo, Marc P Bonaca, Ramzi A Ajjan, Heather M Judge, Fabiana Rollini, Francesco Franchi, Arif J Ahsan, Deepak L Bhatt, Julia F Kuder, Philippe Gabriel Steg, Marc Cohen, Rangasamy Muthusamy, Marc S Sabatine, Robert F Storey
Diabetes increases cardiovascular risk and reduces pharmacodynamic response to some oral antiplatelet drugs. This study aimed to determine whether ticagrelor 60 mg twice daily (bid) provided potent and consistent platelet inhibition in patients with vs without diabetes in the PEGASUS-TIMI 54 platelet function substudy. Out of 180 patients studied, 58 patients were randomised to and had received at least four weeks of ticagrelor 60 mg bid, with 20 (34 %) having diabetes, 58 patients received ticagrelor 90 mg bid, with 12 (21 %) having diabetes, and 64 patients received placebo, with 18 (28 %) having diabetes...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28292729/pre-analytical-effects-of-pneumatic-tube-system-transport-on-routine-haematology-and-coagulation-tests-global-coagulation-assays-and-platelet-function-assays
#5
Sandra Le Quellec, Mickaël Paris, Christophe Nougier, Frédéric Sobas, Lucia Rugeri, Sandrine Girard, Jean-Claude Bordet, Claude Négrier, Yesim Dargaud
INTRODUCTION: Pneumatic tube system (PTS) in hospitals is commonly used for the transport of blood samples to clinical laboratories, as it is rapid and cost-effective. The aim was to compare the effects on haematology samples of a newly acquired ~2km-long PTS that links 2 hospitals with usual transport (non-pneumatic tube system, NPTS). METHODS: Complete blood cell count, routine coagulation assays, platelet function tests (PFT) with light-transmission aggregometry and global coagulation assays including ROTEM® and thrombin generation assay (TGA) were performed on blood samples from 30 healthy volunteers and 9 healthy volunteers who agreed to take aspirin prior to blood sampling...
December 28, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28290889/-platelet-metabolism-in-clopidogrel-resistant-and-sensitive-patients-with-ischemic-heart-disease
#6
I Yu Grinshtein, A A Savchenko, Yu I Grinshtein, I V Filonenko, A A Kosinova
OBJECTIVE: to investigate relationship between activity of platelet nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) dependent dehydrogenases in patients with ischemic heart disease (IHD) after coronary artery bypass grafting (CABG) and their sensitivity to clopidogrel. MATERIAL AND METHODS: We studied 51 male patients with chronic IHD before and after CABG. Control group comprised 35 healthy men. In IHD patients spontaneous and induced platelet aggregation was measured by aggregometry before CABG (in 2 weeks after cessation of antiplatelet drugs), after CABG during therapy with clopidogrel (75 mg/day), and in 6 months after surgery...
October 2016: Kardiologiia
https://www.readbyqxmd.com/read/28284561/novel-mutation-in-two-brothers-with-hermansky-pudlak-syndrome-type-3
#7
Kirstin Sandrock-Lang, Ingrid Bartsch, Nina Buechele, Udo Koehler, Carl Philipp Simon-Gabriel, Matthias Eckenweiler, Barbara Zieger
Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder causing oculocutaneous albinism, bleeding disorder and ceroid lipofuscinosis. Platelets from HPS patients are characterized by impaired secretion of dense (δ)-bodies (CD63). Meanwhile, there are ten known human HPS genes, each leading to a particular clinical HPS subtype (HPS1-HPS10). We report on two Turkish brothers showing typical HPS phenotype comprising oculocutaneous albinism and bleeding symptoms. Pathological bleeding time as well as platelet aggregometry analyses revealed impaired platelet function...
March 6, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28281736/optimal-antiplatelet-pharmacotherapy-guided-by-bedside-genetic-or-functional-testing-in-elective-pci-patients-a-pilot-study-onside-test-pilot
#8
Lukasz Koltowski, Mariusz Tomaniak, Daniel Aradi, Zenon Huczek, Krzysztof J Filipiak, Janusz Kochman, Sylwia Gajda, Paweł Balsam, Grzegorz Opolski
BACKGROUND: Dual antiplatelet therapy is recommended after elective percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients; however, still one-third of patients do not obtain adequate platelet inhibition that may result in increased cardiovascular risk. The aim of the ONSIDE TEST study is to evaluate the clinical impact of point-of-care genotyping- and platelet function-based personalized dual antiplatelet strategies in SCAD individuals undergoing PCI...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28279968/newly-formed-reticulated-platelets-undermine-pharmacokinetically-short-lived-antiplatelet-therapies
#9
Paul C Armstrong, Thomas Hoefer, Rebecca B Knowles, Arthur Tucker, Melissa A Hayman, Plinio M Ferreira, Melissa V Chan, Timothy D Warner
OBJECTIVE: Aspirin together with thienopyridine P2Y12 inhibitors, commonly clopidogrel, is a cornerstone of antiplatelet therapy. However, many patients receiving this therapy display high on-treatment platelet reactivity, which is a major therapeutic hurdle to the prevention of recurrent thrombotic events. The emergence of uninhibited platelets after thrombopoiesis has been proposed as a contributing factor to high on-treatment platelet reactivity. Here, we investigate the influences of platelet turnover on platelet aggregation in the face of different dual-antiplatelet therapy strategies...
March 9, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28278197/the-role-of-platelet-and-endothelial-garp-in-thrombosis-and-hemostasis
#10
Elien Vermeersch, Frederik Denorme, Wim Maes, Simon F De Meyer, Karen Vanhoorelbeke, Justin Edwards, Ethan M Shevach, Derya Unutmaz, Hodaka Fujii, Hans Deckmyn, Claudia Tersteeg
BACKGROUND: Glycoprotein-A Repetitions Predominant protein (GARP or LRRC32) is present on among others human platelets and endothelial cells. Evidence for its involvement in thrombus formation was suggested by full knockout of GARP in zebrafish. OBJECTIVES: To evaluate the role of GARP in platelet physiology and in thrombus formation using platelet and endothelial conditional GARP knock out mice. METHODS: Platelet and endothelial specific GARP knockout mice were generated using the Cre-loxP recombination system...
2017: PloS One
https://www.readbyqxmd.com/read/28277062/platelet-function-testing-in-cardiac-surgery-a-comparative-study-of-electrical-impedance-aggregometry-and-thromboelastography
#11
Bilal H Kirmani, Robert Ian Johnson, Seema Agarwal
Point of care platelet function tests are increasingly used to assess drug-related platelet inhibition prior to cardiac surgery. Numerous devices are available including Thromboelastography (TEG(®) PlateletMapping™). The latest generation TEG(®) - the TEG(®) 6 - has recently been released incorporating a cartridge-based system with a PlateletMapping cartridge. In this study, the performance of the TEG(®) 6 PlateletMapping was compared to that of Multiple Electrode Aggregometry (MEA) performed with the Multiplate™...
February 21, 2017: Platelets
https://www.readbyqxmd.com/read/28277060/thrombelastographic-hypercoagulability-and-antiplatelet-therapy-after-coronary-artery-bypass-surgery-teg-cabg-trial-a-randomized-controlled-trial
#12
Sulman Rafiq, Pär I Johansson, Klaus F Kofoed, Jens T Lund, Peter S Olsen, Simon Bentsen, Daniel A Steinbrüchel
A hypercoagulable state has, in observational studies, been associated with increased risk of thromboembolic events. The aim of this trial was to study whether dual antiplatelet therapy (DAPT) with clopidogrel in addition to aspirin could reduce the rate of graft occlusions, thromboembolic events, and death compared to aspirin monotherapy in hypercoagulable patients undergoing coronary artery bypass surgery. A total of 1683 patients were screened for eligibility, among which 165 patients were randomized and 133 patients underwent multislice computed tomography scan to evaluate their grafts...
February 22, 2017: Platelets
https://www.readbyqxmd.com/read/28277058/the-interaction-between-preoperative-platelet-count-and-function-and-its-relationship-with-postoperative-bleeding-in-cardiac-surgery
#13
Marco Ranucci, Ekaterina Baryshnikova
Platelet function tests (PFTs) before cardiac surgery are predictive of postoperative bleeding and can guide a correct timing of surgery in patients under P2Y12 inhibitors. Thrombocytopenia affects PFT and may determine postoperative bleeding. The present study aims to investigate the relationship between platelet count and function, and its role in determining postoperative bleeding in cardiac surgery patients pre-treated with P2Y12 inhibitors. The study includes 589 consecutive cardiac surgery patients, tested before surgery with platelet count and multiple electrode aggregometry (MEA) ADPtest (investigating P2Y12 receptor platelet reactivity) and TRAPtest (investigating the thrombin-dependent platelet reactivity)...
March 2, 2017: Platelets
https://www.readbyqxmd.com/read/28276730/platelet-reactivity-in-thromboelastometry-revision-of-the-fibtem-test-a-basic-study
#14
Grzegorz Biolik, Michał Kokot, Mariola Sznapka, Agnieszka Święszek, Damian Ziaja, Krzysztof Pawlicki, Krzysztof Ziaja
This study aimed to investigate modifications to the FIBTEM test to better assess fibrinogen levels and the quality of fibrin polymerization in citrated blood using Multiplate impedance aggregometry to verify platelet inhibition. Blood samples from 26 healthy volunteers were subjected to thromboelastometry studies (EXTEM/FIBTEM tests) in accordance with the standard study protocol (cytochalasin D) and according to a modified protocol (synthetic IIbIIIa receptor antagonist vs. acetylsalicylic acid [ASA] + synthetic IIbIIIa receptor antagonist instead of cytochalasin D)...
May 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28267389/molecular-requirements-involving-the-human-platelet-protease-activated-receptor-4-mechanism-of-activation-by-peptide-analogues-of-its-tethered-ligand
#15
I C Moschonas, T F Kellici, T Mavromoustakos, P Stathopoulos, V Tsikaris, V Magafa, A G Tzakos, A D Tselepis
Thrombin is the most potent agonist of human platelets and its effects are primarily mediated through the protease-activated receptors (PARs)-1 and -4. Although PAR-1 has higher affinity for thrombin than PAR-4, both receptors contribute to thrombin-mediated actions on platelets. Recently, a potent and selective PAR-1 antagonist (vorapaxar) was approved for clinical use in selected patients. In contrast, despite the fact that several PAR-4 antagonists have been developed, few of them have been tested in clinical trials...
March 7, 2017: Platelets
https://www.readbyqxmd.com/read/28267383/whole-exome-sequencing-identifies-a-mutation-in-thrombomodulin-as-the-genetic-cause-of-a-suspected-platelet-disorder-in-a-family-with-normal-platelet-function
#16
Annabel Maclachlan, Gerry Dolan, Charlotte Grimley, Steve P Watson, Neil V Morgan, On Behalf Of The Uk Gapp Study Group
Here, we describe a mother and son with a lifelong bleeding tendency and posttraumatic bleeding who were recruited to the UK Genotyping and Phenotyping of Platelets (GAPP) study with a suspected platelet function disorder. However, despite a clinically significant bleeding score, both had normal platelet counts and normal platelet function. The patients' blood was analyzed by light transmission aggregometry and genotyping by whole exome sequencing, as outlined by the GAPP study. Approximately 25 000 genetic variants were found for each patient as a result of sequencing and were filtered using a specialized bioinformatics pipeline...
March 7, 2017: Platelets
https://www.readbyqxmd.com/read/28257393/potential-role-of-platelet-leukocyte-aggregation-in-trauma-induced-coagulopathy-ex-vivo-findings
#17
Johannes Zipperle, Katrin Altenburger, Martin Ponschab, Christoph J Schlimp, Andreas Spittler, Soheyl Bahrami, Heinz Redl, Herbert Schöchl
BACKGROUND: Platelet dysfunction has been identified as an important contributor of trauma-induced coagulopathy (TIC) but the underlying mechanism still remains to be elucidated. Trauma-associated pro-inflammatory stimuli strongly activate leukocytes, which in turn bind activated platelets. Therefore, we investigated the role of platelet-leukocyte aggregation (PLA) as a potential feature of trauma-induced platelet dysfunction. METHODS: Whole blood from 10 healthy donors was exposed to selective and collective platelet and leukocyte agonists in order to simulate differential states of activation...
March 2, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28240645/point-of-care-monitoring-for-the-management-of-trauma-induced-bleeding
#18
Alexander A Hanke, Hauke Horstmann, Michaela Wilhelmi
PURPOSE OF REVIEW: Knowledge of trauma-induced coagulopathy has been grown in the past and point-of-care suitable devices for coagulation testing have been introduced. Methodology and clinical application of different systems for point-of-care coagulation monitoring are shown with a focus on thrombelastography as measured by TEG, rotational thromboelastometry as measured by ROTEM and impedance aggregometry as measured by the multiplate analyser and ROTEM platelet. RECENT FINDINGS: Two different methods for point-of-care coagulation assessment are available: viscoelastic tests (ROTEM, TEG) and impedance aggregometry...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28230635/valproic-acid-modulates-platelet-and-coagulation-function-ex-vivo
#19
Ted Bambakidis, Simone E Dekker, Ihab Halaweish, Baoling Liu, Vahagn C Nikolian, Patrick E Georgoff, Patryk Piascik, Yongqing Li, Martin Sillesen, Hasan B Alam
Trauma-induced coagulopathy is associated with adverse patient outcome. Animal models demonstrate that histone deacetylase inhibitors, such as valproic acid (VPA), improve survival following injury. While in-vivo data suggest that improved survival may in part be because of an attenuation of coagulopathy, it remains unknown whether this is a direct effect of the drug, or the establishment of an overall prosurvival phenotype. We thus conducted an ex-vivo experiment to determine if VPA has an effect on coagulation and platelet function...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28229159/platelet-turnover-predicts-outcome-after-coronary-intervention
#20
Matthias K Freynhofer, Liana Iliev, Veronika Bruno, Miklos Rohla, Florian S Egger, Thomas W Weiss, Wolfgang Hübl, Martin Willheim, Johann Wojta, Kurt Huber
Elevated platelet turnover contributes to high platelet reactivity. High platelet reactivity after percutaneous coronary intervention (PCI) is associated with major adverse cardiovascular events (MACE). The purpose of this study was to determine the prognostic value of platelet turnover and function with regard to MACE after PCI with stent implantation. In this prospective observational study, 486 consecutive patients after PCI on aspirin and clopidogrel were included to determine platelet turnover (mean platelet volume (MPV), reticulated platelet fraction (RPF)) and platelet function (multiple electrode aggregometry (MEA), vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P) assay)...
February 23, 2017: Thrombosis and Haemostasis
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