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dual antiplatelet

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https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#1
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28717113/add-on-antiplatelet-effects-of-eicosapentaenoic-acid-with-tailored-dose-setting-in-patients-on-dual-antiplatelet-therapy
#2
Naoyoshi Hosogoe, Shuichi Ishikawa, Naoyuki Yokoyama, Ken Kozuma, Takaaki Isshiki
The aim of this study was to investigate the antiplatelet effects of eicosapentaenoic acid (EPA) at a sufficient dose following coronary stent implantation. Thirty-one patients on dual antiplatelet therapy with aspirin and clopidogrel were treated with highly purified EPA-E (Epadel(®)) for 12 weeks. Based on our previous study, patients with a high baseline EPA/arachidonic acid (AA) ratio (≥ 0.37; n = 11) were given a standard dose (1800 mg daily) of EPA-E, whereas those with a low EPA/AA ratio (< 0.37; n = 20) were given a high dose (2700 mg daily) to reach the target value of > 0...
July 14, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28707449/individualizing-dual-antiplatelet-therapy-duration-prediction-tools-genomics-and-clinical-judgment
#3
EDITORIAL
Arka Chatterjee, William B Hillegass
Prolonged dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) on average reduces the risk of subsequent myocardial infarction (MI) but increases major bleeds. Individualizing duration of DAPT based on the DAPT trial's net benefit prediction tool would likely optimize outcome beyond population average recommendations. Individualizing agent selection and duration of therapy based on genomic data may further improve outcomes. Clinical judgment remains the most important tool to tailor DAPT duration based on a large array of additional relevant factors not captured by predition rules or genomics...
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28704242/long-term-clinical-outcome-after-implantation-of-the-self-expandable-stentys-stent-in-a-large-multicenter-cohort
#4
Luise Gaede, Christoph Liebetrau, Oliver Dörr, Johannes Blumenstein, Albrecht Elsässer, Christian W Hamm, Helge Möllmann, Christian Schlundt, Holger M Nef, Stephan Achenbach
OBJECTIVE: The objective of the study was to retrospectively evaluate the long-term clinical outcome after implantation of the self-expandable (SE) STENTYS stent in a large multicenter cohort. BACKGROUND: Incomplete stent apposition is known to cause higher rates of myocardial infarction (MI) and stent thrombosis. Because of its self-expanding features, the SE STENTYS stent adapts to the vessel wall and is therefore expected to minimize malapposition and therefore the rates of MI and stent thrombosis...
July 12, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28701676/efficacy-and-safety-of-triple-therapy-and-dual-therapy-with-direct-oral-anticoagulants-compared-to-warfarin
#5
Hideo Amano, Daiga Saito, Takayuki Yabe, Ryo Okubo, Mikihito Toda, Takanori Ikeda
The efficacy and safety of direct oral anticoagulants (DOAC) with antiplatelet therapy compared to warfarin are unclear. The subjects were 280 patients who received antiplatelet therapy with oral anticoagulation (OAC) for the treatment of or protection from thromboembolism between January 2012 and September 2015. Among the 280 subjects, 79 (28.2%) received dual therapy (OAC plus aspirin or P2Y12 inhibitor) with DOAC, 75 (26.8%) dual therapy with warfarin, 46 (16.4%) triple therapy (OAC plus aspirin and P2Y12 inhibitor) with DOAC, and 80 (28...
July 13, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28700669/long-term-health-outcomes-in-patients-with-a-history-of-myocardial-infarction-a-population-based-cohort-study
#6
Navdeep Tangri, Thomas W Ferguson, Reid H Whitlock, Claudio Rigatto, Davinder S Jassal, Malek Kass, Olga Toleva, Paul Komenda
BACKGROUND: Myocardial infarction (MI) is associated with high morbidity and mortality, particularly in the first 12 months post-event. Interventions such as dual antiplatelet therapy can reduce the risk of major adverse cardiovascular events (MACE), but the duration of the high-risk time interval and the optimal prescription time frame for these interventions remains unknown. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We performed a retrospective cohort study using data from medical services and hospitalizations in Manitoba, Canada for patients admitted with a MI between April 2006 and March 2010, and followed until Nov 30, 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28697899/hiv-and-coronary-disease-when-secondary-prevention-is-insufficient
#7
Ana Sofia Carvalho, Rui Osório Valente, Luís Almeida Morais, Pedro Modas Daniel, Ramiro Sá Carvalho, Lurdes Ferreira, Rui Cruz Ferreira
Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal)...
July 8, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28697712/intravenous-administration-of-tirofiban-versus-loading-dose-of-oral-clopidogrel-for-preventing-thromboembolism-in-stent-assisted-coiling-of-intracranial-aneurysms
#8
Wang Zi-Liang, Liang Xiao-Dong, Li Tian-Xiao, Zhu Liang-Fu, Xue Jiang-Yu, Bai Wei-Xing, He Ying-Kun, Xu Gang-Qin, Shao Qiu-Ji, Li Li, Feng Guang, Li Zhao-Shuo
Background Thromboembolic complications after stenting of intracranial aneurysms may be affected by antiplatelet administration. Aims This retrospective study aimed to assess the safety of intravenous tirofiban versus loading dose of oral clopidogrel for preventing thromboembolism in stent-assisted coiling of intracranial aneurysms. Methods From January 2006 to December 2013, 281 patients with cerebral aneurysms were treated with stent-coiling using two antiplatelet strategies in comparison: the initial strategy (a loading dose of ≥300 mg clopidogrel followed by dual antiplatelet, clopidogrel group) and the modified strategy (intravenous administration of tirofiban 8 µg/kg over 3 min followed by a maintenance dose of 0...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28697242/balancing-ischemic-and-bleeding-risks-of-prolonged-dual-antiplatelet-therapy
#9
Glenn N Levine
No abstract text is available yet for this article.
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28691050/evaluation-of-the-bleeding-risk-with-various-antithrombotic-therapies-after-gastric-endoscopic-submucosal-dissection
#10
Tatsuhiro Gotoda, Keisuke Hori, Masaya Iwamuro, Yoshiyasu Kono, Kou Miura, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
BACKGROUND AND STUDY AIMS : Patients receiving antithrombotic drugs have a higher risk of postoperative bleeding and thromboembolic events related to endoscopic procedures. The aim of this study was to evaluate the relationship between various antithrombotic therapies and bleeding after gastric endoscopic submucosal dissection (ESD) (post-ESD bleeding). PATIENTS AND METHODS:  Among 529 consecutive gastric ESD procedures (483 patients with 579 legions), 100 patients with 121 lesions who underwent 108 procedures were on antithrombotic therapy (group A) and 382 patients with 458 lesions who underwent 421 procedures were not on antithrombotic therapy (group B)...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28689481/histological-evaluation-of-a-self-expanding-stent-graft-23-months-after-implantation-in-the-superficial-femoral-artery
#11
Takayuki Ishihara, Osamu Iida, Katsumi Inoue, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura, Akihiro Sunaga, Toshiaki Mano, Masaaki Uematsu
PURPOSE: To report histological examination of a Viabahn stent-graft implanted in the superficial femoral artery (SFA) for nearly 2 years. CASE REPORT: A 78-year-old man with peripheral artery disease was treated successfully with a 6.0×250-mm Viabahn self-expanding stent-graft in the right SFA, relieving his lower limb claudication. The patient died suddenly due to acute myocardial infarction 23 months later. Histological evaluation of the stent-graft implantation site revealed moderate neointimal proliferation at both proximal and distal edges of the device...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28689183/acute-thrombus-formation-on-phosphorilcholine-surface-modified-flow-diverters
#12
Miklos Marosfoi, Frederic Clarencon, Erin T Langan, Robert M King, Olivia W Brooks, Takamisu Tamura, John M Wainwright, Matthew J Gounis, Srinivasan Vedantham, Ajit S Puri
PURPOSE: Thromboembolic complications remain a limitation of flow diverting stents. We hypothesize that phosphorilcholine surface modified flow diverters (Pipeline Flex with Shield Technology, sPED) would have less acute thrombus formation on the device surface compared with the classic Pipeline Embolization device (cPED). METHODS: Elastase-induced aneurysms were created in 40 rabbits and randomly assigned to receive cPED or sPED devices with and without dual antiplatelet therapy (DAPT) (four groups, n=10/group)...
July 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28686352/the-ratio-of-visceral-to-subcutaneous-fat-area-predicts-cardiovascular-events-in-patients-with-type-2-diabetes
#13
Tatsuya Fukuda, Ryotaro Bouchi, Takato Takeuchi, Yujiro Nakano, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa
AIMS/INTRODUCTION: To investigate whether the ratio of visceral fat area (VFA) to subcutaneous fat area (SFA) (V/S ratio) could be predictive of cardiovascular disease (CVD) as compared with VFA or SFA in patients with diabetes. MATERIALS AND METHODS: 682 patients with type 2 diabetes (mean age 64 ± 13 years; 41% female) were enrolled. VFA (cm(2) ) and SFA (cm(2) ) were assessed by dual bioelectrical impedance analyzer (BIA). The patients were divided into four groups according to the quartiles of V/S ratio...
July 7, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28683175/cost-effectiveness-analysis-of-30-month-vs-12-month-dual-antiplatelet-therapy-with-clopidogrel-and-aspirin-after-drug-eluting-stents-in-patients-with-acute-coronary-syndrome
#14
Minghuan Jiang, Joyce H S You
Continuation of dual antiplatelet therapy (DAPT) beyond 1 year reduces late stent thrombosis and ischemic events after drug-eluting stents (DES) but increases risk of bleeding. We hypothesized that extending DAPT from 12 months to 30 months in patients with acute coronary syndrome (ACS) after DES is cost-effective. A lifelong decision-analytic model was designed to simulate 2 antiplatelet strategies in event-free ACS patients who had completed 12-month DAPT after DES: aspirin monotherapy (75-162 mg daily) and continuation of DAPT (clopidogrel 75 mg daily plus aspirin 75-162 mg daily) for 18 months...
July 6, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28680011/bioresorbable-vascular-scaffolds%C3%A3-are-we-facing-a-time-of-crisis-or-one-of-breakthrough
#15
Jeehoon Kang, Jung-Kyu Han, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Hyo-Soo Kim
Current 2nd-generation drug-eluting stents (DES) have dramatically improved clinical outcomes after percutaneous coronary intervention for coronary artery disease. However, DES implantation has major long-term limitations related to the permanent presence of foreign material in the coronary artery. Bioresorbable vascular scaffolds (BVS) were designed to overcome this limitation of permanent metal-based DES. However, because of immature manufacturing technology, BVS have several drawbacks, such as the thicker strut, poor deliverability, poor radio-opacity, poor radial strength, and cumbersome procedure to meet the principle of PSP (Preparation, Sizing, and Post-dilatation)...
July 6, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28679857/challenges-in-the-medical-management-of-symptomatic-intracranial-stenosis-in-an-urban-setting
#16
Rajbeer S Sangha, Andrew M Naidech, Carlos Corado, Sameer A Ansari, Shyam Prabhakaran
BACKGROUND AND PURPOSE: Since the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis), aggressive medical management (AMM), which includes dual antiplatelet therapy (DAPT) and high-dose statin (HDS) therapy, is recommended for patients with symptomatic intracranial atherosclerotic disease. However, limited data on the real-world application of this regimen exist. We hypothesized that recurrent stroke risk among patients treated with AMM is similar to the medical arm of the SAMMPRIS cohort...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28679854/acute-occlusions-of-dual-layer-carotid-stents-after-endovascular-emergency-treatment-of-tandem-lesions
#17
Umut Yilmaz, Heiko Körner, Ruben Mühl-Benninghaus, Andreas Simgen, Catherine Kraus, Silke Walter, Stefanie Behnke, Klaus Faßbender, Wolfgang Reith, Marcus M Unger
BACKGROUND AND PURPOSE: A new generation of carotid artery stents that uses a second micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. The purpose of this study was to compare acute occlusion rates of these new dual-layer stents with those of single-layer stents in the setting of emergency carotid artery stenting with intracranial mechanical thrombectomy in acute ischemic stroke. METHODS: Consecutive patients with acute tandem (intra- and extracranial) lesions of the anterior circulation who were endovascularly treated at our institution were identified from our registry of neuroendovascular interventions...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28679384/transperineal-ultrasound-guided-prostate-biopsy-is-safe-even-when-patients-are-on-combination-antiplatelet-and-or-anticoagulation-therapy
#18
Kimitoshi Saito, Satoshi Washino, Yuhki Nakamura, Tsuzumi Konishi, Masashi Ohshima, Yoshiaki Arai, Tomoaki Miyagawa
BACKGROUND: To assess whether hemorrhagic complications associated with transperineal prostate biopsy increased in patients on antiplatelet and/or anticoagulant therapy. METHODS: In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembolic agents, and the control group comprised those who did not take these agents. No anti-thromboembolic agent was stopped before, during, or after prostate biopsy in the medication group...
July 5, 2017: BMC Urology
https://www.readbyqxmd.com/read/28678044/randomized-clinical-trial-the-impact-of-gastrointestinal-risk-factor-screening-and-prophylactic-proton-pump-inhibitor-therapy-in-patients-receiving-dual-antiplatelet-therapy
#19
Berit E S Jensen, Jane M Hansen, Kasper S Larsen, Anders B Junker, Jens F Lassen, Svend E Jensen, Ove B Schaffalitzky de Muckadell
OBJECTIVE: Dual antiplatelet therapy reduces the risk of ischemic complications after acute coronary syndrome, but increases the risk of bleeding including upper gastrointestinal bleeding (UGIB).The aim of this study was to examine the effect of screening for risk of UGIB and prophylactic proton pump inhibitor (PPI) treatment in dual-antiplatelet-treated patients at risk of UGIB and to assess the significance of dual antiplatelet therapy compliance for cardiovascular events. PATIENTS AND METHODS: In a register-based randomized-controlled trial, 2009 patients were included at the time of first percutaneous coronary intervention and randomized to either screening or control...
July 3, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28677035/symptomatic-carotid-artery-stenosis-surgery-stenting-or-medical-therapy
#20
REVIEW
Ashley M Wabnitz, Tanya N Turan
Symptomatic carotid artery disease is a significant cause of ischemic stroke, and these patients are at high risk for recurrent vascular events. Patients with symptoms of stroke or transient ischemic attack attributable to a significantly stenotic vessel (70-99% luminal narrowing) should be treated with intensive medical therapy. Intensive medical therapy is a combination of pharmacologic and lifestyle interventions consistent with best-known practices as follows: initiation of antiplatelet agent or anticoagulation if medically indicated, high potency statin medication, blood pressure control with goal blood pressure of greater than 140/90, Mediterranean-style diet, exercise, and smoking cessation...
August 2017: Current Treatment Options in Cardiovascular Medicine
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