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Antiplatelets therapy

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https://www.readbyqxmd.com/read/28213047/the-effect-of-combined-aspirin-and-clopidogrel-treatment-on-cancer-incidence
#1
Avi Leader, Ravit Zelikson-Saporta, David Pereg, Galia Spectre, Uri Rozovski, Pia Raanani, Doron Hermoni, Michael Lishner
BACKGROUND: Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data regarding the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared to aspirin alone and no antiplatelet therapy...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28211603/impact-of-six-versus-12-months-of-dual-antiplatelet-therapy-in-patients-with-drug-eluting-stent-implantation-after-risk-stratification-with-the-residual-syntax-score-results-from-a-secondary-analysis-of-the-i-love-it-2-trial
#2
Miaohan Qiu, Yi Li, Jing Li, Kai Xu, Quanmin Jing, Shaohong Dong, Zhe Jin, Pitian Zhao, Bo Xu, Yaling Han
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. OBJECTIVES: This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). METHODS: A total of 2737 patients in the I-LOVE-IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28211030/antithrombotic-therapy-after-transcatheter-aortic-valve-implantation
#3
Raul Moreno
Current guidelines for patients who are undergoing transcatheter aortic valve implantation but who do not require anticoagulation recommend double antiplatelet therapy for 3-6 months after the procedure, followed by aspirin indefinitely. However, these guidelines are based on expert consensus rather than clinical trials. Several randomized trials are currently evaluating alternative antithrombotic strategies, and recommendations will likely change when their results become available.
February 16, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28210867/management-and-outcome-of-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-or-antiplatelet-drugs
#4
Sven Pannach, Julia Goetze, Sandra Marten, Thomas Schreier, Luise Tittl, Jan Beyer-Westendorf
BACKGROUND: Non-vitamin K dependent oral anticoagulants (NOACs) significantly decrease overall major bleeding rates compared with vitamin K antagonists (VKAs) but there is conflicting evidence regarding the relative risk of gastrointestinal bleeding. Since data regarding the types, the management, and the outcome of NOAC-associated gastrointestinal bleeding are scarce, we aimed to fill this gap by comparing cases of gastrointestinal bleeding associated with NOAC, VKA, or antiplatelet therapy...
February 16, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#5
Menno V Huisman, Kenneth J Rothman, Miney Paquette, Christine Teutsch, Hans-Christoph Diener, Sergio J Dubner, Jonathan L Halperin, Chang Sheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B Bartels, Gregory Y H Lip
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28207573/genome-wide-analysis-of-clopidogrel-active-metabolite-levels-identifies-novel-variants-that-influence-antiplatelet-response
#6
Joshua D Backman, Jeffrey R O'Connell, Keith Tanner, Cody J Peer, William D Figg, Shawn D Spencer, Braxton D Mitchell, Alan R Shuldiner, Laura M Yerges-Armstrong, Richard B Horenstein, Joshua P Lewis
Clopidogrel is one of the most commonly used therapeutics for the secondary prevention of cardiovascular events in patients with acute coronary syndromes. However, considerable interindividual variation in clopidogrel response has been documented, resulting in suboptimal therapy and an increased risk of recurrent events for some patients. In this investigation, we carried out the first genome-wide association study of circulating clopidogrel active metabolite levels in 513 healthy participants to directly measure clopidogrel pharmacokinetics...
February 15, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28198091/impact-of-chronic-kidney-disease-on-2-year-clinical-outcomes-in-patients-treated-with-6-month-or-24-month-dapt-duration-an-analysis-from-the-prodigy-trial
#7
Giuseppe Gargiulo, Andrea Santucci, Raffaele Piccolo, Anna Franzone, Sara Ariotti, Andrea Baldo, Giovanni Esposito, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
OBJECTIVES: To assess whether moderate-to-severe CKD is a treatment modifier for benefit or harm in patients randomly allocated to 24-month versus 6-month DAPT. BACKGROUND: It is still unclear whether chronic kidney disease CKD should impact on the decision-making on optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). METHODS AND RESULTS: PRODIGY trial randomized 1970 all-comer patients at 24-month versus 6-month DAPT after PCI...
February 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28198064/real-life-practices-for-preventing-venous-thromboembolism-in-multiple-myeloma-patients-a-cohort-study-from-the-french-health-insurance-database
#8
Aurore Palmaro, Marie-Eve Rougé-Bugat, Martin Gauthier, Fabien Despas, Guillaume Moulis, Maryse Lapeyre-Mestre
PURPOSE: The risk of venous thromboembolic event (VTE) in multiple myeloma is particularly increased. Current guidelines recommend systematic VTE prophylaxis with vitamin K antagonists (VKA) or low weight molecular heparin (LWMH) or unfractionated heparin (UFH) in high-risk patients, based on treatment received [e.g. use of IMiDs (thalidomide, lenalidomide and pomalidomide), alkylating agents or erythropoietin] and individual risk factors (e.g. history of VTE). The aim of this study was to describe strategy of VTE prophylaxis and prescribing of other antithrombotic agents during the first 6 months of multiple myeloma therapy, with stratification on IMiD-based regimens and drug and disease-related risk factors...
February 15, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28197295/spontaneous-coronary-artery-dissection-the-phantom-menace
#9
Nikolaos Spinthakis, Nada Abdulkareem, Mohamed Farag, Diana A Gorog
We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography...
December 2016: Cardiology Research
https://www.readbyqxmd.com/read/28195937/an-updated-protocol-for-evaluating-chest-pain-and-managing-acute-coronary-syndromes
#10
Christopher R Kelly, Ajay J Kirtane, Jennifer Stant, Gregg W Stone, Robert M Minutello, S Chiu Wong, Honeyleen Manuzon, Roxanne Gerow-Smith, Nancy Kelley, LeRoy E Rabbani
Clinical pathways can optimize care both across and within institutions, but regular updates to these pathways based on new clinical trials, professional guidelines, and Food and Drug Administration approvals are essential. Herein we describe the most recent revisions to the New York-Presbyterian Hospital (Columbia University Medical Center and Weill Cornell Medical Center) clinical pathway for acute coronary syndromes and chest pain, which incorporates novel data regarding the timing and administration of P2Y12 inhibition (including the intravenous P2Y12 inhibitor cangrelor) and the appropriateness of prolonged (>1 year) dual antiplatelet therapy for the secondary prevention of ischemic events...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28194663/cilostazol-use-is-associated-with-reduced-risk-of-dementia-a-nationwide-cohort-study
#11
Shu-Yu Tai, Chen-Yu Chien, Yu-Han Chang, Yuan-Han Yang
Whether antiplatelet agents have a preventive effect on cognitive function remains unknown. We examined the potential association between the use of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, and the risk of dementia in an Asian population. Patients initiating cilostazol therapy between 1 January 2004 and 31 December 2009 without a prior history of dementia were identified from Taiwan's National Health Insurance database. Participants were stratified by age, sex, comorbidities, and comedication...
February 13, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28193677/sex-differences-in-the-clinical-impact-of-high-platelet-reactivity-after-percutaneous-coronary-intervention-with-drug-eluting-stents-results-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#12
Jennifer Yu, Roxana Mehran, Usman Baber, Sze-Yuan Ooi, Bernhard Witzenbichler, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Akiko Maehara, Ke Xu, Ori Ben-Yehuda, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown. METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208)...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28190712/effect-of-antiplatelet-therapy-on-aneurysmal-sac-expansion-associated-with-type-ii-endoleaks-after-endovascular-aneurysm-repair
#13
Francisco Álvarez Marcos, José Manuel Llaneza Coto, Francisco José Franco Meijide, Ahmad Amer Zanabili Al-Sibbai, Jorge Vilariño Rico, Manuel Alonso Pérez, Santiago Caeiro Quinteiro
OBJECTIVE: Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) has gained widespread use through a solid reputation of safety and effectiveness. However, some issues, such as endoleaks and sac growth over time, still arise as important concerns. Antiplatelet therapy, mandatory as secondary prevention of cardiovascular disease, may play a role in both phenomena by interfering with blood clotting properties and the inflammatory process associated with AAA. We analyzed whether different antiplatelet therapies were independent risk factors for type II endoleak (T2E) persistence and midterm sac growth after EVAR...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28188927/xanthohumol-isolated-from-humulus-lupulus-prevents-thrombosis-without-increased-bleeding-risk-by-inhibiting-platelet-activation-and-mtdna-release
#14
Guang Xin, Zeliang Wei, Chengjie Ji, Huajie Zheng, Jun Gu, Limei Ma, Wenfang Huang, Susan L Morris-Natschke, Jwu-Lai Yeh, Rui Zhang, Chaoyi Qin, Li Wen, Zhihua Xing, Yu Cao, Qing Xia, Ke Li, Hai Niu, Kuo-Hsiung Lee, Wen Huang
AIM: As the global population has reached 7 billion and the baby boom generation reaches old age, thrombosis has become the major contributor to the global disease burden. It has been reported that, in moderate doses, beer may protect against thrombosis. Xanthohumol (XN), an antioxidant, is found at high concentrations in hop cones (Humulus lupulus L.) and is a common ingredient of beer. Here, the aim of the present work was to investigate the effects of XN on antithrombotic and antiplatelet activities, and study its mechanism...
February 7, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28188508/potentially-inappropriate-prescribing-and-associated-factors-in-elderly-patients-at-hospital-discharge-in-brazil-a-cross-sectional-study
#15
Ana Luiza Pereira Moreira Mori, Renata Cunha Carvalho, Patricia Melo Aguiar, Maria Goretti Farias de Lima, Magali da Silva Pacheco Nobre Rossi, José Fernando Salvador Carrillo, Egídio Lima Dórea, Sílvia Storpirtis
Background The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria is used to identify instances of potentially inappropriate prescribing in a patient's medication regimen. Objective To determine the prevalence and predictors of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients at hospital discharge. Setting A university hospital medical clinic in Brazil. Method Discharge prescriptions were examined using the STOPP/START criteria...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28186273/coronary-surgery-in-the-contest-of-new-and-old-antiplatelet-therapies-is-it-only-a-matter-of-suspension-timing
#16
Filippo Prestipino, Antonio Nenna, Cristiano Spadaccio, Massimo Chello
No abstract text is available yet for this article.
February 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28185650/usefulness-of-a-systematic-screening-of-carotid-atherosclerosis-in-asymptomatic-people-with-type%C3%A2-2-diabetes-for-cardiovascular-risk-reclassification
#17
Marjorie Helfre, Claire Grange, Benjamin Riche, Delphine Maucort-Boulch, Charles Thivolet, Julien Vouillarmet
AIMS: Routine screening of carotid atherosclerosis lesions is frequently suggested for people with type 2 diabetes, the presence of a carotid lesion being associated with a significant increase risk for vascular events. However, the impact of this strategy on medical management is not validated. We herein question the usefulness of such screening. METHODS: We assessed the prevalence and severity of carotid lesions in 337 consecutive people with type 2 diabetes without known cardiovascular disease who underwent a systematic carotid duplex ultrasonography...
February 6, 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/28185392/thrombotic-valvular-dysfunction-with-transcatheter-mitral-interventions-for-postsurgical-failures
#18
Marvin H Eng, Adam Greenbaum, Dee Dee Wang, Janet Wyman, Dnp, Heider Arjomand, Pradeep Yadav, Hassan Nemeh, Gaetano Paone, Mayra Guerrero, William O'Neill
BACKGROUND: Degenerated surgical mitral valve repairs or surgical prostheses are currently being treated with transcatheter mitral valve replacement (TMVR). We report the procedural and mid-term assessment of thirteen cases. METHODS: From 12/2013 to 12/2015, 13 consecutive patients with degenerated mitral valve repair or valve replacement were treated. Patients were assessed for mitral valve academic valve consortium (MVARC) defined outcomes. RESULTS: Immediate procedural MVARC defined technical success was 92%...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28185168/polymer-free-drug-coated-coronary-stents-in-patients-with-stable-coronary-artery-disease-at-high-bleeding-risk
#19
REVIEW
Hemang B Panchal, Ramesh Daggubati, David Zhao, Sunil V Rao, Timir Paul
PURPOSE OF REVIEW: Patients with stable coronary artery disease (CAD) and a high risk of bleeding are not ideal candidates for a polymer-based drug-eluting stent (DES) because it requires 6-12 months of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). The purpose of this review is to assess the angiographic and clinical outcomes of polymer-free drug-coated stents (PF-DCS) in stable CAD patients with a high bleeding risk. RECENT FINDINGS: Several randomized controlled trials (RCTs) have compared angiographic and clinical outcomes of PF-DCS with bare-metal stents (BMS), permanent polymer (PP)-DES, or biodegradable polymer (BP)-DES...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#20
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
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