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dual antiplatelet

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https://www.readbyqxmd.com/read/29138929/safety-and-feasibility-study-of-holmium-laser-enucleation-of-the-prostate-holep-on-patients-receiving-dual-antiplatelet-therapy-dapt
#1
Jie Sun, An Shi, Zhen Tong, Wei Xue
OBJECTIVE: To evaluate the safety and feasibility of Holmium laser enucleation of the prostate (HoLEP) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From March 2013 to August 2016, we retrospectively analyzed 1124 benign prostatic hyperplasia (BPH) patients undergoing HoLEP and divided into four groups: 56 cases receiving DAPT therapy (group A); 72 patients treated with continuous single antiplatelet (AP) therapy (group B); 41 patients treated with single AP therapy but intermittent during preoperative time (group C) and 955 cases had no AP therapy (group D)...
November 14, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29131804/assessing-the-performance-of-the-precise-dapt-and-paris-risk-scores-for-predicting-1-year-out-of-hospital-bleeding-in-acute-coronary-syndrome-patients
#2
Emad Abu-Assi, Sergio Raposeiras-Roubin, Rafael Cobas-Paz, Berenice Caneiro-Queija, Cristina Martínez-Reglero, José Manuel Rodríguez-Rodríguez, Antonio Baz, Andrés Íñiguez-Romo
AIMS: PRECISE-DAPT and PARIS risk scores (RSs) were recently developed to bleeding risk assessment in percutaneous coronary intervention (PCI) patients treated with dual antiplatelet therapy (DAPT). We aimed to assess the performance of these RSs at predicting out-of-hospital bleeding in patients with acute coronary syndrome (ACS). METHODS AND RESULTS:  Retrospectively, we studied 1926 consecutive ACS patients treated with PCI and DAPT. The performance of RSs for predicting one-year BARC type 2, 3 or 5 bleeding and BARC type 3 or 5 bleeding was assessed and compared...
November 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#3
M Spartalis, E Tzatzaki, E Spartalis, C Damaskos, A Athanasiou, D Moris, M Politou
OBJECTIVE: Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29126843/the-role-of-platelet-reactivity-assessment-in-dual-antiplatelet-prophylaxis-after-transcatheter-aortic-valve-implantation
#4
Katarzyna Czerwińska-Jelonkiewicz, Adam Witkowski, Maciej Dąbrowski, Walerian Piotrowski, Tomasz Hryniewiecki, Janina Stępińska
BACKGROUND: Dual antiplatelet therapy (DAPT) is recommended prophylaxis after transcatheter aortic valve implantation (TAVI). The usefulness of platelet reactivity (PLTR) tests in predicting the safety of periprocedural DAPT in the TAVI population is unknown. AIM: To analyze the value of aspirin/clopidogrel PLTR testing in predicting the risk of in-hospital TAVI-related bleeding. METHODS: PLTR, expressed as P2Y12/aspirin reaction units (PRU/ARU), was performed using optical aggregometry with the VerifyNow(®) device, in the 24h before and on the sixth day after TAVI...
November 7, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29126156/antithrombotic-therapy-after-myocardial-infarction-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#5
Gorav Batra, Leif Friberg, David Erlinge, Stefan James, Tomas Jernberg, Bodil Svennblad, Lars Wallentin, Jonas Oldgren
Aims: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with myocardial infarction and atrial fibrillation is uncertain. In this study, we compared antithrombotic regimes with regard to a composite cardiovascular outcome of all-cause mortality, myocardial infarction or ischaemic stroke and major bleeds. Methods and results: Patients between October 2005 and December 2012 were identified in Swedish registries, n = 7,116...
November 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#6
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29122278/meta-analysis-of-aspirin-versus-dual-antiplatelet-therapy-following-coronary-artery-bypass-grafting
#7
Nayan Agarwal, Ahmed N Mahmoud, Nimesh Kirit Patel, Ankur Jain, Jalaj Garg, Mohammad Khalid Mojadidi, Sahil Agrawal, Arman Qamar, Harsh Golwala, Tanush Gupta, Nirmanmoh Bhatia, R David Anderson, Deepak L Bhatt
Although aspirin monotherapy is considered the standard of care after coronary artery bypass grafting (CABG), more recent evidence has suggested a benefit with dual antiplatelet therapy (DAPT) after CABG. We performed a meta-analysis of observational studies and randomized controlled trials comparing outcomes of aspirin monotherapy with DAPT in patients after CABG. Subgroup analyses were conducted according to surgical technique (i.e., on vs off pump) and clinical presentation (acute coronary syndrome vs no acute coronary syndrome)...
October 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29121979/platelet-inhibition-during-ticagrelor-monotherapy-versus-ticagrelor-plus-aspirin-in-patients-with-coronary-artery-disease-template-study-study-protocol-for-a-randomised-controlled-trial
#8
Sarah Baos, Wendy Underwood, Lucy Culliford, Barnaby C Reeves, Chris A Rogers, Ruth Bowles, Tom Johnson, Andreas Baumbach, Andrew Mumford
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin (ASP) and a P2Y12 blocker is currently standard care after percutaneous coronary intervention (PCI) with stent insertion, and aims to inhibit platelet function in order to prevent stent thrombosis. The P2Y12 blocker ticagrelor (TIC) has greater antiplatelet effect than the previously used members of this class, such as clopidogrel. In healthy volunteers, TIC is sufficient to cause strong platelet inhibition, with little additional effect from ASP...
November 9, 2017: Trials
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#9
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29118712/comparative-long-term-effect-of-three-anti-p2y12-drugs-after-percutaneous-angioplasty-an-observational-study-based-on-electronic-drug-adherence-monitoring
#10
Valentina Forni Ogna, Isabelle Bassi, Isabelle Menetrey, Olivier Muller, Eric Tousset, Pierre Fontana, Eric Eeckhout, Chin B Eap, Bernard Vrijens, Michel Burnier, Grégoire Wuerzner
Aims: Dual platelet inhibition using anti-P2Y12 drugs and aspirin is the standard of care in patients after percutaneous coronary interventions (PCI). Prasugrel and ticagrelor have been shown to be more potent than clopidogrel with less high on-treatment platelet reactivity. Whether differences in long-term adherence to these drugs can partly explain different antiplatelet efficacy has not been studied so far. The objective was to compare the long-term P2Y12 receptor inhibition and drug adherence to different anti-P2Y12 drugs, and to assess the impact of adherence on the pharmacodynamic effect...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29118299/the-effect-of-cilostazol-on-the-angiographic-outcome-of-drug-eluting-coronary-stents-angiographic-analysis-of-the-cilon-t-influence-of-cilostazol-based-triple-antiplatelet-therapy-on-ischemi-complication-after-drug-eluting-stent-implantation-trial
#11
Jung-Won Suh, Seung-Pyo Lee, KyungWoo Park, Hyun-Jae Kang, Bon-Kwon Koo, Young-Seok Cho, Tae-Jin Youn, In-Ho Chae, Dong-Ju Choi, Seung-Woon Rha, Jang-Ho Bae, Taek-Geun Kwon, Jang-Whan Bae, Myeong-Chan Cho, Hyo-Soo Kim
It is not clear if anti-restonotic effect of cilostazol is consistent for different types of drug-eluting stents (DES).The purpose of this study was to compare the anti-proliferative effect of cilostazol between DAT and TAT with consideration of confounding influences of DES type.Nine hundred and fifteen patients were randomized to either dual antiplatelet therapy (DAT; aspirin and clopidogrel) or triple antiplatelet therapy (TAT; aspirin, clopidogrel, and cilostazol) in the previous CILON-T trial. After excluding 70 patients who received both or neither stents, we analyzed 845 patients who received exclusively PES or ZES, and compared in-stent late loss at 6 months between both antiplatelet regimens (DAT versus TAT)...
November 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29113375/efficacy-and-safety-of-triple-versus-dual-antithrombotic-therapy-in-atrial-fibrillation-and-ischemic-heart-disease-a-systematic-review-and-meta-analysis
#12
Wengen Zhu, Linjuan Guo, Fadi Liu, Rong Wan, Yang Shen, Gregory Y H Lip, Kui Hong
The optimal antithrombotic regimen for patients with atrial fibrillation and ischemic heart disease remains unclear. Therefore, we aimed to compare the efficacy and safety of triple therapy (TT [an anticoagulant and 2 antiplatelet drugs]) with dual therapy (DAPT [2 antiplatelet drugs] or DT [an anticoagulant and a single antiplatelet drug]) in patients with atrial fibrillation and ischemic heart disease. We systematically searched the Cochrane Library, PubMed and Embase databases for all relevant studies up to August 2017...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29112547/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-chronic-treatments-with-antiplatelet-agents
#13
Juan V Llau, Pieter Kamphuisen, Pierre Albaladejo
: Antiplatelet agents (APA) are considered first-line therapy in preventing cardiovascular thrombotic events, but they are of limited value in the prophylaxis of venous thromboembolism (VTE) during the perioperative period. Consequently, many patients should receive both an APA and an anticoagulant. This combination can increase the bleeding risk and it is necessary to make some recommendations to minimise that risk. In patients receiving APA chronically, if the risk of VTE outweighs the risk of bleeding, we suggest pharmacological prophylaxis (grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29110813/duration-of-dual-antiplatelet-therapy-following-drug-eluting-stent-implantation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Abhishek Sharma, Ofek Hai, Akash Garg, Ajay Vallakati, Carl J Lavie, Jonathan D Marmur
To evaluate the efficacy and safety of long-duration dual antiplatelet therapy (L-DAPT) compared to short-duration dual antiplatelet therapy (S-DAPT) after drug-eluting stent implantation. We searched Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials assessing the clinical effect of L-DAPT vs S-DAPT after drug-eluting stent. Efficacy end points were all-cause mortality, cardiac mortality, myocardial infarction (MI), stent thrombosis (ST), and target vessel revascularization (TVR)...
December 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29106831/-transcatheter-aortic-valve-thrombosis
#15
D Leguay, S Duval, M Leroux, A Monnier, Y Davienne, C Brasselet
GOALS: Transcatheter aortic valve or leaflets thrombosis are mainly misapprehended. It negatively impacts the long-term efficiency of such prosthesis. Moreover, its incidence is presumably higher than previously described. EPIDEMIOLOGY: Recently reported subclinical leaflet thrombosis, occurring between first to third months after implantation, is about 10to 15%. All prosthesis are concerned by potential thrombosis. DIAGNOSIS: Transcatheter aortic valve thrombosis is usually detected on the basis of increased transvalvular pressure gradients or symptoms at routine follow-up...
October 26, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29104841/a-unique-case-of-drug-interaction-between-ticagrelor-and-statin-leading-to-acute-renal-failure
#16
Gbeminiyi Samuel, Adebayo C Atanda, Alex Onyemeh, Ahmad Awan, Oyintayo Ajiboye
Dual antiplatelet agents and high-intensity statins are frequently used in combination after myocardial infarction. Ticagrelor has the potential of causing acute kidney injury. Rosuvastatin is excreted through the kidneys and dose adjustment is needed in patients with kidney disease. When used in combination, they can potentiate the toxic effects of each other. We report a case of drug interaction between rosuvastatin and ticagrelor resulting in rhabdomyolysis and acute renal failure necessitating dialysis...
August 31, 2017: Curēus
https://www.readbyqxmd.com/read/29104179/safety-of-6-month-dual-antiplatelet-therapy-after-second-generation-drug-eluting-stent-implantation-optima-c-randomized-clinical-trial-and-oct-substudy
#17
Byoung-Kwon Lee, Jung-Sun Kim, Oh-Huyn Lee, Pil-Ki Min, Young-Won Yoon, Bum-Kee Hong, Dong-Ho Shin, Tae-Soo Kang, Byung Ok Kim, Duk-Kyu Cho, Dong Woon Jeon, Sung-Ill Woo, Seonghoon Choi, Byung-Ryul Cho, Woong-Chol Kang, Seunghwan Kim, Byeong-Keuk Kim, Myeong-Ki Hong, Yangsoo Jang, Hyuck Moon Kwon
AIMS: There are few randomized studies of the optimal duration of dual antiplatelet therapy (DAPT) for patients who receive a second-generation drug-eluting stent (DES). METHODS AND RESULTS: A prospective, randomized, multicenter trial was performed at 10 medical centers. The 1,368 patients included in the study received a biolimus-eluting stent (BES) or zotarolimus-eluting stent (ZES). The primary outcome measured was the composite of major adverse cardiac events (MACEs), including cardiac death, myocardial infarction (MI), or ischemia-driven target lesion revascularization at the 12-month follow-up...
November 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29103068/antiplatelet-therapy-for-secondary-prevention-of-vascular-disease-complications
#18
REVIEW
Rahul R Goli, Mayur M Contractor, Ashwin Nathan, Sony Tuteja, Taisei Kobayashi, Jay Giri
PURPOSE OF REVIEW: Platelets are activated upon interaction with injured vascular endothelium to form a primary hemostatic plug. Pathogenic thrombosis driven by platelet aggregation can occur in the setting of vascular disease leading to ischemic events. The use of antiplatelet agents has become a mainstay for prevention of the secondary complications of vascular disease. This review summarizes seminal and recent literature related to this area. RECENT FINDINGS: Aspirin is a cornerstone of antiplatelet therapy for coronary artery disease and cerebrovascular disease for prevention of myocardial infarction, stroke, and vascular death...
November 4, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29102968/delayed-ischemic-stroke-due-to-stent-marker-band-occlusion-after-stent-assisted-coiling
#19
Shuhei Kawabata, Hirotoshi Imamura, Keita Suzuki, Shoichi Tani, Hidemitsu Adachi, Nobuyuki Sakai
A middle-aged patient with an internal carotid-posterior communicating artery aneurysm and basilar artery tip aneurysm was treated by stent-assisted coiling. One ischemic infarction and two transient ischemic attacks occurred with the same symptoms (inability to walk unassisted and tendency to fall to the left) during the first 2 years post-treatment. The ischemic infarction was found in the right side of the pons, consistent with the vascular territory of the stent-containing vessel. The cause of the delayed ischemic stroke was investigated on DSA and cone beam CT, which revealed that the proximal end of the stent, one marker band, was just covering a small perforating artery of the basilar artery trunk...
November 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29101508/a-sticky-situation-myocardial-infarction-in-a-young-woman-with-immune-thrombocytopenia-on-eltrombopag-and-a-history-of-mediastinal-radiation
#20
Jennifer Teichman, Ahmed Taher, Abdulaziz Hashi, Akshay Bagai, Michelle Sholzberg
More recent immune thrombocytopenia (ITP) treatment strategies enhance platelet production with the use of thrombopoietin receptor agonists (TPO-RA) such as eltrombopag. Patients receiving TPO-RA agents may be at an increased risk of thromboembolism, however the pathophysiology and common underlying risk factors are not well understood. We present the case of a young asplenic woman on eltrombopag for chronic ITP with acute myocardial infarction involving the right coronary artery. Past medical history was significant for remote mediastinal radiation for lymphoma and splenectomy for ITP...
November 3, 2017: Journal of Thrombosis and Thrombolysis
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