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dual antiplatelet

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https://www.readbyqxmd.com/read/28094166/carotid-stenting-prior-to-coronary-bypass-surgery-an-updated-systematic-review-and-meta-analysis
#1
REVIEW
K I Paraskevas, S Nduwayo, A N Saratzis, A R Naylor
OBJECTIVES: The aim was to determine 30-day outcomes in patients with concurrent carotid and cardiac disease who underwent carotid artery stenting (CAS) followed by coronary artery bypass grafting (CABG). METHODS: This was a systematic review with searches of PubMed/Medline, Embase, and Cochrane databases. "Same-day" procedures involved CAS + CABG being performed on the same day, and "staged" interventions involved at least 1 day's delay between undergoing CAS and then CABG...
January 13, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28092314/novel-technique-for-subretinal-fluid-drainage-with-chandelier-assisted-scleral-buckle-surgery-cannula-controlled-drainage
#2
Abdulelah A Al-Abdullah
PURPOSE: To report a novel technique for subretinal fluid drainage in scleral buckle surgery. METHODS: A 26-gauge intravenous cannula with its needle was used to puncture the sclera; then, the needle (metallic part) was withdrawn to further introduce the cannula into the subretinal space. In addition, we describe using the 25-gauge microcannula of the chandelier light to inject the balanced salt solution to help restore the intraocular pressure and push the subretinal fluid through the intravenous cannula under direct visualization...
January 13, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28091972/-secondary-prevention-with-antiplatelet-therapy-in-cardiac-rehabilitation
#3
Maria M Wanitschek, Hannes F Alber
The long-term increased cardiovascular risk of patients with an acute coronary syndrome (ACS) is a challenging and common clinical problem. Recent evidence demonstrated an ischemic benefit for a prolonged dual antiplatelet therapy beyond the initial 12 months at the cost of an increased bleeding risk. Individual, careful and repeated risk-benefit analyses are essential for an optimized patient management in which cardiovascular rehabilitation providers may play a central role.
January 13, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#4
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28076455/decreased-platelet-responsiveness-to-clopidogrel-correlates-with-cyp2c19-and-pon1-polymorphisms-in-atherosclerotic-patients
#5
J F M Marchini, M R Pinto, G C Novaes, A V Badran, R B Pavão, G L Figueiredo, I M Lago, M O Lima-Filho, D C Lemos, M Tonani, C M Antloga, L Oliveira, J C Lorenzi, J A Marin-Neto
Clopidogrel and aspirin are the most commonly used medications worldwide for dual antiplatelet therapy after percutaneous coronary intervention. However, clopidogrel hyporesponsiveness related to gene polymorphisms is a concern. Populations with higher degrees of genetic admixture may have increased prevalence of clopidogrel hyporesponsiveness. To assess this, we genotyped CYP2C19, ABCB1, and PON1 in 187 patients who underwent percutaneous coronary intervention. Race was self-defined by patients. We also performed light transmission aggregometry with adenosine diphosphate (ADP) and arachidonic acid during dual antiplatelet therapy...
January 9, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#6
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071959/tenfold-risk-increase-of-major-cardiovascular-events-after-high-limb-amputation-with-non-compliance-for-secondary-prevention-measures
#7
Evgeniya V Shalaeva, Hugo Saner, Bakhtiyor B Janabaev, Aleksandra V Shalaeva
Background The aim of the study was to evaluate the impact of compliance with lifestyle recommendations and medication on 1-year prevention of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2D) after trans-femoral amputation (TFA). Methods In this prospective single-center interventional cohort study, 179 consecutive T2D patients with symptomatic coronary artery disease (CAD) underwent 1-year follow-up examination after TFA in 2013. Lower limb and coronary artery CT angiography were provided before surgery; physical examination and laboratory tests were performed at baseline and every month after TFA for 1 year...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28068529/impact-of-high-dose-statins-on-vitamin-d-levels-and-platelet-function-in-patients-with-coronary-artery-disease
#8
Monica Verdoia, Patrizia Pergolini, Roberta Rolla, Matteo Nardin, Alon Schaffer, Lucia Barbieri, Veronica Daffara, Paolo Marino, Giorgio Bellomo, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Statins represent a pivotal treatment in coronary artery disease, offering a reduction in cardiovascular risk even beyond their lipid-lowering action. However, the mechanism of these "pleiotropic" benefits of statins is poorly understood. Vitamin D has been suggested as a potential mediator of the anti-inflammatory, anti-thrombotic and vascular protecting effects of statins. Aim of present study was to assess the impact of a high-intensity statin therapy on vitamin D levels and platelet function in patients with coronary artery disease...
December 28, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28067454/concomitant-use-of-calcium-channel-blockers-with-dual-antiplatelet-therapy-and-re-hospitalization-for-acute-coronary-syndrome
#9
Chen-Yu Wang, Zhen-Fang Lin, Chii-Ming Lee, Yi-Wen Tsai, Ting-Ying Huang, Li-Jiuan Shen, Fei-Yuan Hsiao
BACKGROUND: Existing studies suggested that concomitant use of calcium channel blockers (CCBs) may interfere with the antiplatelet effect of clopidogrel. The objective of this study was to examine the effect of concomitant use of CCBs and clopidogrel on risks of acute coronary syndrome (ACS) re-hospitalization in patients receiving percutaneous coronary intervention. METHODS: Using the Taiwan National Health Insurance Research Database, we identified 51 925 patients who were admitted for newly diagnosed ACS, received percutaneous coronary intervention, and used clopidogrel within 1 year after discharge...
January 9, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28065907/platelet-reactivity-in-human-immunodeficiency-virus-infected-patients-on-dual-antiplatelet-therapy-for-an-acute-coronary-syndrome-the-evere2st-hiv-study
#10
Marie Hauguel-Moreau, Franck Boccara, Anders Boyd, Joe-Elie Salem, Delphine Brugier, Angélique Curjol, Jean-Sébastien Hulot, Mathieu Kerneis, Sophie Galier, Ariel Cohen, Gilles Montalescot, Jean-Philippe Collet, Johanne Silvain
AIM: To explore platelet reactivity on dual antiplatelet therapy (DAPT) of acute coronary syndrome (ACS) patients infected with HIV. METHODS AND RESULTS: Acute coronary syndrome patients infected with HIV (n = 80) were matched to ACS patients without HIV (n = 160) on age, sex, diabetes, and DAPT (aspirin 100%, clopidogrel 68%, prasugrel 31%, ticagrelor 1%). Platelet reactivity was evaluated after ACS (>30 days) by measuring residual platelet aggregation (RPA) to aspirin and to P2Y12 inhibitors with light transmission aggregometry (LTA), VerifyNow aspirin assay (ARU), and P2Y12 assay (PRU) and with the VASP platelet reactivity index (VASP-PRI)...
January 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#11
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28052755/atrial-fibrillation-in-patients-hospitalized-with-acute-myocardial-infarction-analysis-of-the-china-acute-myocardial-infarction-cami-registry
#12
Yan Dai, Jingang Yang, Zhan Gao, Haiyan Xu, Yi Sun, Yuan Wu, Xiaojin Gao, Wei Li, Yang Wang, Runlin Gao, Yuejin Yang
BACKGROUND: The incidence, clinical outcomes and antithrombotic treatment spectrum of atrial fibrillation (AF) in patients hospitalized with acute myocardial infarction (AMI) have not been well studied in Chinese population. METHODS: Twenty-six thousand five hundred ninety-two consecutive patients diagnosed with AMI were enrolled in CAMI registry from January 2013 to September 2014. After excluding 343 patients with uncertain AF status and 1,591 patients transferred out during hospitalization, 24,658 patients were finally included in this study and involved in analysis...
January 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28052578/ticagrelor-increased-adenosine-and-cyclic-adenosine-monophosphate-plasma-concentration-compared-with-clopidogrel-in-acute-coronary-syndromes-patients
#13
Xiao-Ye Li, Qi-Bing Wang, Ying Xue, Jia-Hui Chen, Qian-Zhou Lv
Ticagrelor produces a more potent antiplatelet effect than clopidogrel, and inhibits cellular uptake of adenosine, which is associated with several cardiovascular consequences. We aimed to explore the correlation between adenosine and cyclic adenosine monophosphate (cAMP) plasma concentration and antiplatelet effect by clopidogrel or ticagrelor in acute coronary syndrome (ACS) patients receiving dual antiplatelet therapy (DAPT). We conducted a prospective, observational and single-centre cohort study enrolling 68 patients with non-ST-segment elevation ACS from January 2016 to May 2016...
January 4, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28045759/efficacy-and-safety-of-novel-oral-p2y12-receptor-inhibitors-in-st-segment-elevation-myocardial-infarction-patients-undergoing-pci-a-systematic-review-and-meta-analysis
#14
Jianjun Sun, Qian Xiang, Chao Li, Zining Wang, Kun Hu, Qiufen Xie, Yimin Cui
The efficacy and safety of novel oral P2Y12 receptor inhibitors (prasugrel and ticagrelor) are subjects of contention in ST-segment elevation myocardial infarction (STEMI) patients undergoing PCI, the optimal duration of therapy remains uncertain. We searched PubMed, Embase, Cochrane Library, CNKI, VIP, and WanFang Data to identify randomized controlled trials comparing novel oral P2Y12 receptor inhibitors to clopidogrel in STEMI patients undergoing PCI until February 2016. The primary efficacy and safety endpoint were all-cause mortality and major/minor bleeding...
January 3, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#15
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28044986/ischemic-and-bleeding-outcomes-in-elderly-patients-undergoing-a-prolonged-versus-shortened-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-insights-from-the-prodigy-randomized-trial
#16
Raffaele Piccolo, Giulia Magnani, Sara Ariotti, Giuseppe Gargiulo, Marcello Marino, Andrea Santucci, Anna Franzone, Matteo Tebaldi, Dik Heg, Stephan Windecker, Marco Valgimigli
AIMS: To evaluate the efficacy and safety of 24-month vs. 6-month dual antiplatelet therapy (DAPT) among elderly (≥75 years) and non-elderly patients (<75 years) undergoing percutaneous coronary intervention. METHODS AND RESULTS: The primary efficacy endpoint of the PRODIGY trial was the composite of death, myocardial infarction, or cerebrovascular accident at 24-month follow-up. The key safety endpoint was type 2, 3 or 5 bleeding according to the BARC criteria...
January 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28042389/clinical-problems-with-antithrombotic-therapy-for-endoscopic-submucosal-dissection-for-gastric-neoplasms
#17
REVIEW
Toshiyuki Yoshio, Tsutomu Nishida, Yoshito Hayashi, Hideki Iijima, Masahiko Tsujii, Junko Fujisaki, Tetsuo Takehara
Endoscopic submucosal dissection (ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms, particularly for patients with comorbidities. Antithrombotic agents are used to prevent thrombotic events in patients with comorbidities such as cardio-cerebrovascular diseases and atrial fibrillation. With appropriate cessation, antithrombotic therapy does not increase delayed bleeding in low thrombosis-risk patients. However, high thrombosis-risk patients are often treated with combination therapy with antithrombotic agents and occasionally require the continuation of antithrombotic agents or heparin bridge therapy (HBT) in the perioperative period...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28041858/combining-clinical-and-angiographic-variables-for-estimating-risk-of-target-lesion-revascularization-after-drug-eluting-stent-placement
#18
Joshua M Stolker, David J Cohen, Kevin F Kennedy, Michael J Pencina, Suzanne V Arnold, Neal S Kleiman, John A Spertus
BACKGROUND: Drug-eluting stents (DES) reduce restenosis but require prolonged antiplatelet therapy, when compared with bare metal stents. Ideally, the patient should be involved in this risk:benefit assessment prior to selecting DES, to maximize the benefits and cost-effectiveness of care, and to improve medication adherence. However, accurate estimation of restenosis risk may require angiographic factors identified at cardiac catheterization. METHODS: In a large PCI registry, we used logistic regression to identify clinical and angiographic predictors of clinically-driven target lesion revascularization (TLR) over the first year after stent placement...
December 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28033306/outcomes-of-%C3%A2-6-month-versus-12-month-dual-antiplatelet-therapy-after-drug-eluting-stent-implantation-a-meta-analysis-and-meta-regression
#19
Pedro A Villablanca, Daniele Massera, Verghese Mathew, Sripal Bangalore, Panagiota Christia, Irving Perez, Ningxin Wan, Stefanie Schulz-Schüpke, David F Briceno, Anna E Bortnick, Mario J Garcia, Richard Lucariello, Mark Menegus, Robert Pyo, Jose Wiley, Harish Ramakrishna
BACKGROUND: The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. METHODS: We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28025947/genetics-in-the-clinical-decision-of-antiplatelet-treatment
#20
Gerasimos Siasos, Marina Zaromitidou, Evangelos Oikonomou, Manolis Vavuranakis, Vicky Tsigkou, Nikolaos Papageorgiou, Dimitrios Chaniotis, Dimitrios A Vrachatis, Christodoulos Stefanadis, Athanasios G Papavassiliou, Dimitrios Tousoulis
BACKGROUND: Coronary artery disease remains the leading cause of death globally. Dual antiplatelet treatment with aspirin and aP2Y12 receptor significantly reduces thrombotic events. However, antiplatelet drug response displays considerable interindividual variability. METHODS: Genetic factors account for up to 70% of impaired drug response. A number of genes encoding proteins involved in the pharmacokinetic pathway have been found to alter drug response. RESULTS: According to most studies, CYP2C19 gene is the strongest genetic determinant...
December 26, 2016: Current Pharmaceutical Design
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