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Antiplatelets therapy

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https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#1
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28636084/co-morbidities-and-bleeding-in-elderly-patients-with-haemophilia-a-survey-of-the-german-austrian-and-swiss-society-of-thrombosis-and-haemostasis-research-gth
#2
W Miesbach, S-E Reitter-Pfoertner, R Klamroth, F Langer, H-H Wolf, A Tiede, B Siegmund, U Scholz, P R Müller, H Eichler, I Pabinger
BACKGROUND: Nowadays patients with haemophilia survive longer due to improvements in haemophilia care. It has been hypothesized that the bleeding type and frequency may vary with age and are influenced by co-morbidities and co-medication in elderly patients. OBJECTIVES: To investigate a large group of patients older than 60 years of age with haemophilia concerning haemophilia treatment, bleeding pattern changes, co-morbidities, co-medication, bleeding sites and patient mortality...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#3
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28634365/different-levels-of-blood-pressure-different-benefit-from-dual-antiplatelet-therapy-in-minor-stroke-or-tia-patients
#4
Jie Xu, Yongli Tao, Hao Li, Hongqiu Gu, Xuewei Xie, Xia Meng, Yuming Xu, Yilong Wang, Yongjun Wang
The study aimed to evaluate whether the benefits of dual antiplatelet therapy would be influenced by blood pressure (BP) levels, among acute minor stroke or transient ischemic attack (TIA). In CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling cerebrovascular Events) trail, Patients were stratified by systolic BP (SBP) and diastolic BP (DBP) level measured on admission, respectively, using the supine position BP within 24 hours after symptoms onset. The primary efficacy outcome was stroke recurrence, bleeding was the safety outcome...
June 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28632424/the-progress-in-the-research-of-antiplatelet-agents-1995-2017
#5
Oscar Benimana, Lulu Zhao, Yi Kong, Zhiyu Li, Zhouling Xie
Antiplatelet therapy displays a critical role in the treatment and prevention of antithrombotic disorders. Many new antiplatelet agents have been developed following the emergence of various clinical limitations of classical antiplatelet drugs. This review covers mainly the recent advances in the development of P2Y12 antagonists and GPIIb/IIIa antagonists. Meanwhile, it summarizes promising approaches to new platelet surface receptors such as prostanoid EP3 receptor, thromboxane A2 prostanoid receptor, protease-activated receptors, GPIb-IX-V receptor and P-selectin...
June 20, 2017: Future Medicinal Chemistry
https://www.readbyqxmd.com/read/28632284/benefits-and-risks-of-antithrombotic-therapy-in-essential-thrombocythemia-a-systematic-review
#6
Derek K Chu, Christopher M Hillis, Darryl P Leong, Sonia S Anand, Deborah M Siegal
Background: Patients with essential thrombocythemia (ET) are at high risk for both thrombosis and hemorrhage. Purpose: To evaluate the risks and benefits of antithrombotic therapy in adults with ET. Data Sources: Multiple databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, through 4 March 2017. Study Selection: Randomized and observational studies of antiplatelet or anticoagulant therapy, published in any language and reporting thrombotic or hemorrhagic events...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28631703/-association-of-itgb3-p2ry12-and-cyp2c19-gene-polymorphisms-with-platelet-functional-activity-in-patients-with-coronary-heart-disease-during-dual-antiplatelet-therapy
#7
E F Muslimova, S A Afanasiev, T Yu Rebrova, T N Sergienko, A N Repin
AIM: To assess the association of CYP2C19 G681A, P2RY12 H1/H2, and ITGB3 T1565C polymorphisms with the extent of platelet aggregation in patients with coronary heart disease (CHD) during antiplatelet therapy. SUBJECTS AND METHODS: 166 male patients with CHD, living in the Western Siberian Region, were examined. All the patients underwent a test for platelet aggregation induced by ADP (2.5 and 5.0 µm) and epinephrine (0.2 µm). Genotyping was performed using an allele-specific polymerase chain reaction technique...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#8
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28630264/it-is-time-to-end-the-dualistic-short-versus-long-duration-of-dual-antiplatelet-therapy-debates
#9
Glenn N Levine, Eric R Bates
No abstract text is available yet for this article.
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629806/prevalence-of-bleeding-complications-following-ultrasound-guided-botulinum-toxin-injections-in-patiens-on-anticoagulation-or-antiplatelet-therapy
#10
Jeffrey Lavallee, Regan Royer, Geoffrey Smith
BACKGROUND: Patients on anticoagulation or antiplatelet therapy may be at higher risk of bleeding complications following intramuscular chemodenervation injections. Musculoskeletal ultrasound may be able to reduce the risk of bleeding complications by providing real time visualization of vascular structures and post-injection monitoring. Limited data exist addressing risk of bleeding complications following ultrasound-guided botulinum neurotoxin intramuscular chemodenervation procedures in the setting of anticoagulation or antiplatelet therapy...
June 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28629621/differential-effect-of-obesity-on-prevalence-of-cardiac-and-carotid-target-organ-damage-in-hypertension-the-campania-salute-network
#11
Costantino Mancusi, Eva Gerdts, Maria Angela Losi, Andrea D'Amato, Maria Virginia Manzi, Grazia Canciello, Valentina Trimarco, Nicola De Luca, Giovanni de Simone, Raffaele Izzo
BACKGROUND: Whether increasing body mass index (BMI) is independently associated with parallel increased prevalence of hypertensive vascular and cardiac target organ damage (TOD) needs further clarification. METHODS: We analyzed 8815 hypertensive patients without prevalent cardiovascular disease, participating in the Campania Salute Network, grouped into BMI classes (normal 20-24.9kg/m(2), overweight 25-29.9kg/m(2) and obese ≥30kg/m(2)). Vascular and cardiac TOD was defined as ultrasound plaque (intima-media thickness>1...
June 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28629303/dual-antiplatelet-therapy-beyond-one-year-in-patients-after-stent-placement-a-review
#12
Jacob D Sumner, Brianna Zinser, Andrew Smith
PURPOSE: To review the evidence on the safety and efficacy of the continued use of dual antiplatelet therapy (DAPT) beyond 12 months after stent placement in patients following an acute coronary syndrome (ACS) event. SUMMARY: Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a focused update on the duration of DAPT in patients with coronary artery disease (CAD). The update makes new recommendations about the duration of DAPT in light of recently performed studies investigating this topic...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28628711/antiplatelet-therapy-in-patients-with-coronary-stents-undergoing-elective-noncardiac-surgery-continue-stop-or-something-in-between
#13
Christopher P Childers, Melinda Maggard-Gibbons, Paul G Shekelle
No abstract text is available yet for this article.
June 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28628345/personalizing-antiplatelet-therapies-what-have-we-learned-from-recent-trials
#14
Sébastien Landry, Jean-François Tanguay, Marie Lordkipanidzé
Dual antiplatelet therapy with aspirin and a P2Y12 receptor antagonist is currently the standard of care for the prevention of ischemic events in patients with acute coronary syndrome or undergoing percutaneous coronary intervention. Several studies have shown that not all patients benefit from the treatment to the same degree and demonstrated that high on-treatment platelet reactivity may be associated with an increased risk of thrombotic events, while low on-treatment platelet reactivity may be linked to a higher risk of bleeding...
June 19, 2017: Platelets
https://www.readbyqxmd.com/read/28627932/short-term-prognostic-effect-of-prior-cerebrovascular-and-peripheral-artery-disease-in-patients-with-acute-coronary-syndrome-can-we-do-better
#15
Filipa Cordeiro, Pedro S Mateus, Alberto Ferreira, Silvia Leao, Miguel Moz, J Ilidio Moreira
BACKGROUND: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. METHODS: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28626412/congenital-bilateral-c2-transverse-foramina-stenosis-causing-adult-onset-vertebrobasilar-insufficiency-and-posterior-circulation-stroke
#16
Ajeet Gordhan, Catherine Lockhart
Vertebrobasilar insufficiency leading to posterior circulation infarcts caused by congenital hypoplasia of the bilateral transverse foramina at the C2 level, affecting the caliber and flow of the bilateral distal cervical vertebral arteries in an adult, has not been previously reported. A 41-year-old male presented with episodic dizziness for a period of 1 year prior to consultation. Computed tomography angiography of the head and neck demonstrated congenital hypoplasia of the bilateral C2 transverse foramina, with absence of the vertebral arteries in each of the foramina and collateral reconstitution of diminutive intracranial vertebral artery segments...
May 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28625901/the-effect-of-aspirin-in-the-postoperative-management-of-adult-ischemic-moyamoya-disease
#17
Yahui Zhao, Qian Zhang, Dong Zhang, Yuanli Zhao
Aspirin has been implicated in the postoperative management of moyamoya disease (MMD) in order to avoid bypass failure and decrease the incidence of subsequent stroke. However, the effect of it has not been completely determined yet. In this study, we retrospectively reviewed data of 184 adult patients (197 hemispheres) presented with ischemic-onset moyamoya disease that had undergone direct or combined revascularization in our hospital, to clarify the effect of postoperative aspirin therapy in the management of moyamoya disease...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28625670/carotid-occlusion-is-associated-with-more-frequent-neurovascular-events-than-moderately-severe-carotid-stenosis
#18
Matthew Janko, Ryan Moore, Ann H Kim, Andrew J Shevitz, Katherine L Morrow, David J Johnson, Vikram S Kashyap
OBJECTIVE: Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asymptomatic carotid artery stenosis (CS). METHODS: A prospectively maintained database was queried to identify patients with CO and CS with at least >50% carotid stenosis by duplex...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28625534/predictors-of-urinary-and-rectal-toxicity-after-external-conformed-radiation-therapy-in-prostate-cancer-correlation-between-clinical-tumour-and-dosimetric-parameters-and-radical-and-postoperative-radiation-therapy
#19
C M Martínez-Arribas, C González-San Segundo, P Cuesta-Álvaro, F A Calvo-Manuel
OBJECTIVE: To determine rectal and urinary toxicity after external beam radiation therapy (EBRT), assessing the results of patients who undergo radical or postoperative therapy for prostate cancer (pancreatic cancer) and their correlation with potential risk factors. METHOD: A total of 333 patients were treated with EBRT. Of these, 285 underwent radical therapy and 48 underwent postoperative therapy (39 cases of rescue and 9 of adjuvant therapy). We collected clinical, tumour and dosimetric variable to correlate with toxicity parameters...
June 15, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28625383/the-assessment-of-the-watchman-device-in-patients-unsuitable-for-oral-anticoagulation-asap-too-trial
#20
David R Holmes, Vivek Y Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W Bergmann, Boris Schmidt, Jacqueline Saw
BACKGROUND: Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. STUDY OBJECTIVES: The ASAP-TOO study is designed to establish the safety and effectiveness of the Watchman left atrial appendage closure device in patients with nonvalvular AF who are deemed ineligible for OAC...
July 2017: American Heart Journal
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