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dual antiplatelet therapy

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https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#1
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349596/concomitant-use-of-antiplatelets-and-anticoagulants-in-patients-with-coronary-heart-disease-and-atrial-fibrillation-what-do-recent-clinical-trials-teach-us
#2
REVIEW
David H Lam, Sean M Bell, Ravi S Hira
PURPOSE OF REVIEW: Coronary heart disease (CHD) and atrial fibrillation (AF) are among the most common cardiovascular diseases. A significant proportion of patients have both CHD and AF and are at increased risk for thrombotic complications. Current therapy for CHD and AF includes antiplatelet and anticoagulant medications, respectively. Patients with concurrent CHD and AF may be prescribed dual antiplatelet therapy (DAPT) in addition to anticoagulation, which increases their bleeding risk...
January 19, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29346596/dual-antiplatelet-therapy-how-how-long-and-in-which-patients
#3
Thomas F Lüscher
No abstract text is available yet for this article.
January 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29345593/antithrombotic-therapy-after-tavr
#4
Tobias Geisler, Michal Droppa, Karin Mueller, Oliver Borst
Transvascular aortic valve replacement (TAVR) has emerged as a treatment option in patients with severe aortic stenosis who are inoperable and has recently been evaluated in patients with intermediate surgical risk. The number of procedures is increasing worldwide in parallel with the demographic changes in industrial countries. The risk for cerebral embolism is of main concern and represents a major determinant for prognosis and quality of live after TAVR. The empiric antithrombotic therapy consists of dual antiplatelet therapy (DAPT); however the risk-benefit of this approach is lacking evidence from randomized, placebo-controlled trials regarding choice and duration of antithrombotic treatment...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345590/what-is-the-role-for-glycoprotein-iib-iiia-inhibitor-use-in-the-catheterisation-laboratory-in-the-current-era
#5
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#6
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345586/what-is-the-role-of-cangrelor-in-patients-undergoing-pci
#7
Michal Droppa, Tobias Geisler
Dual antiplatelet therapy with aspirin and oral P2Y12-receptor inhibitors prevents ischemic events in patients undergoing percutaneous coronary intervention (PCI). However oral administration of antiplatelet drugs cause delay of onset of platelet inhibition in P2Y12-inhibitor naïve patients. Cangrelor is a novel P2Y12-receptor inhibitor which is administrated intravenously and thus allows immediate antiplatelet inhibition during PCI. Due to its unique pharmacokinetics with fast onset of platelet inhibition and very short plasma half-life it allows effective and controllable periprocedural platelet inhibition...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29341793/platelet-transfusion-does-not-improve-outcomes-in-patients-with-brain-injury-on-antiplatelet-therapy
#8
Jeremy L Holzmacher, Cassandra Reynolds, Mayur Patel, Patrick Maluso, Seth Holland, Nathaniel Gamsky, Henry Moore, Elizabeth Acquista, Matthew Carrick, Richard Amdur, Heather Hancock, Michael Metzler, Julie Dunn, Babak Sarani
INTRODUCTION: Platelet dysfunction following traumatic brain injury (TBI) is associated with worse outcomes. The efficacy of platelet transfusion to reverse antiplatelet medication (APM) remains unknown. Thrombelastography platelet mapping (TEG-PM) assesses platelet function. We hypothesize that platelet transfusion can reverse the effects of APM but does not improve outcomes following TBI. METHODS: An observational study at six US trauma centres was performed. Adult patients on APM with CT evident TBI after blunt injury were enrolled...
January 17, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29341525/-general-internal-medicine%C3%A2-2017-scientific-breakthroughs-in-ambulatory-care
#9
Alexandre Gouveia, Lionel De Alencastro, Yvonne Fierz, Lionel Koehli, Alexandre Béguelin, Olivier Pasche, Kevin Selby, Patrick Bodenmann
Bariatric surgery improves glycemic control in obese patients with diabetes type 2. Dual antiplatelet therapy can be maintained beyond 12 months after a myocardial infarction. Levothyroxine is not beneficial among patients ≥ 65 years that have subclinical hypothyroidism. Prophylactic anticoagulation in lower limb immobilisation should be reserved only for patients with a high risk of thromboembolism. A diagnosis of asthma should be initially confirmed by a spirometry if clinically suspected. A proton pump inhibitor is indicated for patients ≥ 65 years that are treated with aspirin...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29339684/-2017-esc-focused-update-on-dual-antiplatelet-therapy-in-coronary-artery-disease-developed-in-collaboration-with-eacts-what-is-new
#10
EDITORIAL
Zeki Öngen
No abstract text is available yet for this article.
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29339168/selection-of-p2y12-inhibitor-in-percutaneous-coronary-intervention-and-or-acute-coronary-syndrome
#11
REVIEW
Udaya Tantry, Eliano P Navarese, Aung Myat, Paul Gurbel
The P2Y12 receptor plays a critical role in the amplification of platelet aggregation in response to various agonists and stable thrombus generation at the site of vascular injury leading to deleterious ischemic complications. Therefore, treatment with a P2Y12 receptor blocker is a major effective strategy to prevent ischemic complications in high -risk patients with acute coronary syndrome (ACS) and patients undergoing percutaneous coronary intervention (PCI). The determination of optimal platelet inhibition is based on maximizing antithrombotic properties while minimizing bleeding risk and is critically dependent on individual patient's propensity for thrombotic and bleeding risks...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29338536/p2y12-receptor-inhibitors-an-evolution-in-drug-design-to-prevent-arterial-thrombosis
#12
Danny Kupka, Dirk Sibbing
P2Y12 inhibitors are a critical component of dual antiplatelet therapy (DAPT) - a combination of a P2Y12 receptor inhibitor and aspirin - which is the superior strategy to prevent arterial thrombosis in patients with acute coronary syndromes (ACS) and undergoing stent implantation. Areas covered: Basic science articles, clinical studies, and reviews from 1992-2017 were searched using Pubmed library to collet impactful literature. After an introduction to the purinergic receptor biology, this review summarizes current knowledge on P2Y12 receptor inhibitors including their specific pharmacodynamic as well as pharmacokinetic and drug interaction features...
January 17, 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29336310/2-year-outcomes-of-high-bleeding-risk-patients-with-acute-coronary-syndrome-after-biolimus-a9-polymer-free-drug-coated-stents-a-leaders-free-sub-study
#13
Christoph J Jensen, Christoph K Naber, Philip Urban, Paul J Ong, Mariano Valdes-Chavarri, Alexandre A Abizaid, Stuart J Pocock, Franco Fabbiocchi, Christophe Dubois, Samuel Copt, Hans-Peter Stoll, Marie-Claude Morice
AIMS: The Leaders Free ACS sub-study demonstrated that a Biolimus-A9 drug coated stent (DCS) is more effective and safer than a bare metal stent (BMS) at 12 months follow up in high-bleeding risk (HBR) patients with acute coronary syndrome (ACS). This analysis extends the follow-up to 2 years. METHODS AND RESULTS: A total of 659 ACS patients with HBR were included and received one month of dual antiplatelet therapy only. By 24 months, the primary efficacy endpoint, clinically driven target-lesion revascularization, occurred in 32 (10...
January 16, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29335059/association-of-%C3%AE-2a-adrenergic-receptor-genetic-variants-with-platelet-reactivity-in-chinese-patients-on-dual-antiplatelet-therapy-undergoing-percutaneous-coronary-intervention
#14
Ying Song, Xiao Fang Tang, Yi Yao, Chen He, Jing Jing Xu, Huan Huan Wang, Zhan Gao, Mia Wang, Jin Qing Yuan
OBJECTIVE: The alpha 2A-adrenergic receptor gene (ADRA2A) polymorphism in individuals modifies the antiplatelet response to sympathetic stimulation. The aim of this study was to investigate the effect of ADRA2A variants on platelet reactivity in Chinese patients on dual antiplatelet therapy (DAPT) after undergoing percutaneous coronary intervention (PCI). METHODS: From March 2011 to March 2013, 1,024 patients were enrolled in this prospective, single-center, observational study in China...
December 2017: Biomedical and Environmental Sciences: BES
https://www.readbyqxmd.com/read/29334682/body-mass-index-and-plasma-p-selectin-before-coronary-stenting-predict-high-residual-platelet-reactivity-at-6-months-on-dual-antiplatelet-therapy
#15
Elena Z Golukhova, Marina V Grigoryan, Mariya N Ryabinina, Naida I Bulaeva, Victor L Serebruany
BACKGROUND: High residual platelet reactivity (HRPR) during dual antiplatelet therapy (DAPT) may impact clinical outcomes following percutaneous coronary interventions (PCI). However, whether any biomarkers assessed before PCI at DAPT loading may predict delayed maintenance HRPR is not clear. OBJECTIVE: The aim of this study was to determine whether conventional clinical or laboratory indices at loading before stenting may predict HRPR at 6 months of maintenance DAPT...
January 16, 2018: Cardiology
https://www.readbyqxmd.com/read/29330312/high-sensitive-c-reactive-protein-and-dual-antiplatelet-in-intracranial-arterial-stenosis
#16
Jiejie Li, Anxin Wang, Xingquan Zhao, Liping Liu, Xia Meng, Jinxi Lin, Jing Jing, Xinying Zou, Yilong Wang, Yongjun Wang
OBJECTIVE: To determine the relationship of high-sensitive C-reactive protein (hsCRP) and the efficacy and safety of dual antiplatelet therapy in patients with and without intracranial arterial stenosis (ICAS) in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. METHODS: A subgroup of 807 patients with both magnetic resonance angiography images and hsCRP measurement was analyzed. Cox proportional hazards models were used to assess the interaction of hsCRP levels with the effects of dual and single antiplatelet therapy...
January 12, 2018: Neurology
https://www.readbyqxmd.com/read/29330256/osteoprotegerin-is-associated-with-major-bleeding-but-not-with-cardiovascular-outcomes-in-patients-with-acute-coronary-syndromes-insights-from-the-plato-platelet-inhibition-and-patient-outcomes-trial
#17
Thor Ueland, Axel Åkerblom, Tatevik Ghukasyan, Annika E Michelsen, Pål Aukrust, Richard C Becker, Maria Bertilsson, Anders Himmelmann, Stefan K James, Agneta Siegbahn, Robert F Storey, Frederic Kontny, Lars Wallentin
BACKGROUND: Elevated levels of osteoprotegerin, a secreted tumor necrosis factor-related molecule, might be associated with adverse outcomes in patients with coronary artery disease. We measured plasma osteoprotegerin concentrations on hospital admission, at discharge, and at 1 and 6 months after discharge in a predefined subset (n=5135) of patients with acute coronary syndromes in the PLATO (Platelet Inhibition and Patient Outcomes) trial. METHODS AND RESULTS: The associations between osteoprotegerin and the composite end point of cardiovascular death, nonprocedural spontaneous myocardial infarction or stroke, and non-coronary artery bypass grafting major bleeding during 1 year of follow-up were assessed by Cox proportional hazards models...
January 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29325953/physical-risk-factors-of-hemorrhagic-complications-associated-with-angio-seal-closure-device-use-in-neurointerventional-procedures
#18
Yasuhiro Aida, Kouichi Misaki, Tomoya Kamide, Masanao Mohri, Naoyuki Uchiyama, Mitsutoshi Nakada
BACKGROUND: Few studies have demonstrated detailed physical risk factors of hemorrhagic complications (HC) associated with the Angio-Seal closure device. This retrospective study aimed to identify the risk factors of HC due to Angio-Seal use. METHODS: Data from 143 cases that underwent neurointerventional procedures that involved puncturing the femoral artery and that used an Angio-Seal to close the puncture site were reviewed. We divided these cases into HC and no HC groups and retrospectively compared age, sex, past medical and preference history, body mass index (BMI), femoral artery depth, dual antiplatelet therapy use, activated clotting time, general anesthesia use, sheath size, right femoral artery puncture, and treatment time...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#19
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29317980/a-history-of-kawasaki-disease-from-childhood-and-coronary-artery-ectasia-with-recurrent-st-elevation-myocardial-infarction-a-therapeutic-challenge
#20
Ashraf Abugroun, Daniel Vilchez, Osama Hallak, Anahita Shahrrava
Coronary artery ectasia (CAE) is an uncommon anomaly, usually found in 1.2-2% of patients undergoing coronary angiography, defined as a segment of the coronary artery that has a diameter of more than 1.5 times the normal adjacent segments. Atherosclerosis is considered as the cause of half of the CAE cases. We herein present a 65-year-old Asian male with past medical history of Kawasaki disease (KD) who developed recurrent episodes of inferior wall ST-elevation myocardial infarction (STEMI) despite treatment with dual antiplatelet therapy (DAPT)...
December 2017: Cardiology Research
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