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https://www.readbyqxmd.com/read/28528236/-management-of-the-bleeding-risk-associated-with-antiplatelet-agents
#1
A-C Martin, S Houssany-Pissot, D Zlotnik, G Taylor, A Godier
Like all antithrombotic drugs, antiplatelet agents expose to a risk of bleeding complications. Clinical research has extensively focused on the efficacy of these drugs to reduce ischemic events. The bleeding risk associated with them was solely considered as an inevitable and acceptable complication. When two new potent P2Y12-receptor inhibitors, prasugrel and ticagrelor, were marketed, the risk of major bleeding increased. These new agents have modified the balance between the absolute risk reduction in ischemic events and the absolute risk increase in bleeding events...
May 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28524712/p2y12-receptor-gene-mutations-associated-with-bleeding
#2
Mariangela Scavone, Eti A Femia, Marco Cattaneo
No abstract text is available yet for this article.
May 19, 2017: Platelets
https://www.readbyqxmd.com/read/28523947/potentiation-of-trap-6-induced-platelet-dense-granule-release-by-blockade-of-p2y12-signaling-with-mrs2395
#3
Annachiara Mitrugno, Rachel A Rigg, Nicole B Laschober, Anh T P Ngo, Jiaqing Pang, Craig D Williams, Joseph E Aslan, Owen J T McCarty
The release of ADP from platelet dense granules and its binding to platelet P2Y12 receptors is key to amplifying the initial hemostatic response and propagating thrombus formation. P2Y12 has thus emerged as a therapeutic target to safely and effectively prevent secondary thrombotic events in patients with acute coronary syndrome or a history of myocardial infarction. Pharmacological inhibition of P2Y12 receptors represents a useful approach to better understand the signaling mediated by these receptors and to elucidate the role of these receptors in a multitude of platelet hemostatic and thrombotic responses...
May 19, 2017: Platelets
https://www.readbyqxmd.com/read/28521259/von-willebrand-factor-and-its-cleaving-protease-adamts13-balance-in-coronary-artery-vessels-lessons-learned-from-thrombotic-thrombocytopenic-purpura-a-narrative-review
#4
REVIEW
Nuccia Morici, Silvia Cantoni, Francesco Panzeri, Alice Sacco, Chiara Rusconi, Miriam Stucchi, Fabrizio Oliva, Marco Cattaneo
BACKGROUND: Deficiency of the von Willebrand factor-cleaving protease ADAMTS13 is central to the pathophysiology of thrombotic thrombocytopenic purpura (TTP), a microangiopathic syndrome that presents as an acute medical emergency. In this review we will explore the evidence of a two-way relationship between TTP and ACS. Moreover, we will review the evidence emerged from epidemiological studies of an inverse relationship between the plasma levels of ADAMTS13 and the risk of ACS. METHODS AND RESULTS: Pubmed, MEDLINE and EMBASE, CINHAL, COCHRANE and Google Scholar databases were searched from inception to January 2017...
May 12, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28515278/critical-role-of-p2y12-receptor-in-regulation-of-th17-differentiation-and-experimental-autoimmune-encephalomyelitis-pathogenesis
#5
Chaoyan Qin, Jinfeng Zhou, Yuan Gao, Weiming Lai, Cuixia Yang, Yingying Cai, Shuai Chen, Changsheng Du
Adenosine 5'-diphosphate is a key endogenous cell-signaling molecule that can activate P2 purinergic receptor family members. ADP-P2Y signaling is reported to be associated with inflammation, but its function in T cell differentiation and autoimmune diseases pathogenesis is unclear. In this study, we found that the P2Y12 receptor was upregulated in the peripheral immune tissues of experimental autoimmune encephalomyelitis (EAE) mice. Deficiency of P2Y12 led to a reduced peak severity and cumulative disease score in EAE mice, followed by a dramatic reduction of leukocyte infiltration and less extensive demyelination...
May 17, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28511553/whole-blood-platelet-aggregation-test-and-prediction-of-hemostatic-difficulty-after-tooth-extraction-in-patients-receiving-antiplatelet-therapy
#6
Yasushi Nagao, Rikuo Masuda, Akane Ando, Mutsumi Nonaka, Akiko Nishimura, Kinuko Goto, Yasubumi Maruoka, Takehiko Iijima
When patients on antiplatelet therapy (APT) require minor invasive surgery, APT is usually continued to limit the risk of thrombosis. However, the possibility of hemostatic difficulties necessitates the monitoring of platelet aggregation to prevent unexpected bleeding. We examined whether whole blood aggregometry as a point-of-care testing (POCT) could be useful as a tool for predicting hemostatic difficulties. Sixty-five patients receiving APT and 15 patients who were not receiving APT were enrolled in the present study; all patients were scheduled to undergo a tooth extraction...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28510646/benefit-of-switching-dual-antiplatelet-therapy-after-acute-coronary-syndrome-the-topic-timing-of-platelet-inhibition-after-acute-coronary-syndrome-randomized-study
#7
Thomas Cuisset, Pierre Deharo, Jacques Quilici, Thomas W Johnson, Stéphanie Deffarges, Clémence Bassez, Guillaume Bonnet, Laurent Fourcade, Jean Philippe Mouret, Marc Lambert, Valentine Verdier, Pierre Emmanuel Morange, Marie Christine Alessi, Jean Louis Bonnet
Aims: Newer P2Y12 blockers (prasugrel and ticagrelor) demonstrated significant ischaemic benefit over clopidogrel after acute coronary syndrome (ACS). However, both drugs are associated with an increase in bleeding complications. The objective of the present study was to evaluate the benefit of switching dual antiplatelet therapy (DAPT) from aspirin plus a newer P2Y12 blocker to aspirin plus clopidogrel 1 month after ACS. Methods and results: We performed an open-label, monocentric, and randomized trial...
May 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28509568/low-body-weight-and-clinical-outcomes-in-acute-coronary-syndrome-patients-results-of-the-achilles-registry
#8
José Miguel Rivera-Caravaca, Juan M Ruiz-Nodar, Antonio Tello-Montoliu, María Asunción Esteve-Pastor, Andrea Veliz-Martínez, Esteban Orenes-Piñero, Mariano Valdés, Vicente Pernias-Escrig, Miriam Sandin-Rollán, Nuria Vicente-Ibarra, Manuel J Macías-Villanego, Elena Candela-Sánchez, Teresa Lozano, Luna Carrillo-Alemán, Francisco Marín
BACKGROUND: Being overweight increases the risk of cardiovascular diseases and mortality. However, among high-body-weight patients with established acute coronary syndrome (ACS) this evidence is not clear. In this scenario, a low body weight (LBW) has been proposed to confer higher prognostic risk and higher bleeding risk with new P2Y12 inhibitors. AIMS: We aimed to examine differences in mortality, catheterizations/revascularizations, antiplatelet therapy and ischemic/bleeding adverse events between ACS patients with LBW...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28495896/percutaneous-coronary-intervention-of-saphenous-vein-graft
#9
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Thomas McAndrew, Jamie Diamond, Xin Huang, Akiko Maehara, Giora Weisz, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) has historically been associated with a high risk of adverse ischemic events, but there is a paucity of contemporary data on the second-generation drug-eluting stent use within SVG, and the relative importance of high platelet reactivity (HPR) in SVG PCI versus native lesion PCI is unknown. We studied ischemic and bleeding events after SVG PCI and their association with HPR. METHODS AND RESULTS: Subjects in the prospective, multicenter ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) were stratified according to whether they had PCI of an SVG or a non-SVG lesion...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28488971/quality-assessment-and-transfusion-efficacy-of-buffy-coat-derived-platelet-concentrates-washed-with-platelet-additive-solution
#10
Hermógenes Fernández-Muñoz, Cristina Castilla-Llorente, Eva M Plaza, Cristina Martínez-Millán, Inmaculada Heras, Pastora Iniesta, María L Amigo, Francisca Ferrer-Marin, María J Candela, María L Lozano, Vicente Vicente, José Rivera
BACKGROUND: Transfusion of washed platelet concentrates (W-PC) is recommended for some patients, such as those who have had previous severe allergic transfusion reactions. However, we still lack a standardised method for preparing these products. Here, we assessed the effect of a manual washing procedure on in vitro platelet quality and on the transfusion efficacy of W-PCs. MATERIALS AND METHODS: Buffy coat-derived W-PC in Composol solution were prepared by onestep centrifugation...
April 13, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28488405/dollars-and-stents-a-brave-new-world
#11
EDITORIAL
Sandeep K Krishnan, Larry S Dean
Reimbursement in the healthcare system is shifting from pure volume to a mixed volume/value-based metric. Using complex statistical modeling to adjust for unknowns, the study provides real world data that the use of Co-Cr EES is more cost effective than BMS assuming that clinicians select clopidogrel for P2Y12 inhibition. More cost-effectiveness analyses should be conducted to guide the use of ever costlier novel medical devices and drugs.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28487256/lipopolysaccharide-lps-induced-pulmonary-neutrophil-recruitment-and-platelet-activation-is-mediated-via-the-p2y1-and-p2y14-receptors-in-mice
#12
R T Amison, S Arnold, B G O'Shaughnessy, S J Cleary, J Ofoedu, M Idzko, C P Page, S C Pitchford
Platelet activation occurs during host defence and in various inflammatory disorders. In animal models of infection and inflammation, experimental depletion of platelets leads to significantly reduced leukocyte recruitment and impaired clearance of pathogens from the lung. It is now appreciated that purinergic receptor activation is required for leukocyte activation, motility and adhesion, and platelet interactions with leukocytes can be modulated by purinergic stimulation of platelets. Here, we have investigated the role of platelet P2Y1, P2Y12, P2Y14, and P2X1 receptors on leukocyte recruitment and chemotaxis...
May 6, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28487152/effects-of-ticagrelor-on-neointimal-hyperplasia-and-endothelial-function-compared-with-clopidogrel-and-prasugrel-in-a-porcine-coronary-stent-restenosis-model
#13
Hyun Kuk Kim, Myung Ho Jeong, Kyung Seob Lim, Jung Ha Kim, Han Chul Lim, Min Chul Kim, Young Joon Hong, Sung Soo Kim, Keun-Ho Park, Kyoung-Sig Chang
BACKGROUND: Several investigations have been conducted to evaluate the off-target effects of ticagrelor. The aim of the present study was to evaluate the off-target effects of ticagrelor such as neointimal formation and endothelial function after drug-eluting stent implantation in a porcine restenosis model. METHODS: A total of 30 pigs were randomly allocated based on the following P2Y12 inhibitor: (1) clopidogrel 300mg loading plus 75mg maintenance (n=10); (2) prasugrel 60mg loading plus 10mg maintenance (n=10); (3) ticagrelor 180mg loading plus 180mg maintenance (n=10)...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28472364/association-between-polymorphisms-in-the-purinergic-p2y12-receptor-gene-and-severity-of-both-cancer-pain-and-postoperative-pain
#14
Masahiko Sumitani, Daisuke Nishizawa, Makoto Nagashima, Kazutaka Ikeda, Hiroaki Abe, Ryoji Kato, Hiroshi Ueda, Yoshitsugu Yamada
Background.:  Despite the widespread use of opioids for the treatment of cancer pain, results from several surveys consistently show that pain is still prevalent in some patients with malignant diseases. The purinergic P2Y12 receptor is a primary site leading to microglial activation and hyperalgesic pain behaviors and is considered a key regulator in the prevention of the aggravation of clinical pain conditions. Genetic variability in the P2RY12 gene may contribute to individual differences in pain and opioid sensitivity...
May 4, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28465300/randomized-trial-comparing-the-effects-of-ticagrelor-versus-clopidogrel-on-myocardial-perfusion-in-patients-with-coronary-artery-disease
#15
Matthieu Pelletier-Galarneau, Chad R R N Hunter, Kathryn J Ascah, Rob S B Beanlands, Girish Dwivedi, Robert A deKemp, Benjamin J W Chow, Terrence D Ruddy
BACKGROUND: Ticagrelor is a P2Y12 receptor inhibitor used in acute coronary syndromes to reduce platelet activity and to decrease thrombus formation. Ticagrelor is associated with a reduction in mortality incremental to that observed with clopidogrel, potentially related to its non-antiplatelet effects. Evidence from animal models indicates that ticagrelor potentiates adenosine-induced myocardial blood flow (MBF) increases. We investigated MBF at rest and during adenosine-induced hyperemia in patients with stable coronary artery disease treated with ticagrelor versus clopidogrel...
May 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28463894/antiplatelet-treatments-recent-evidence-from-randomized-controlled-trials
#16
Birgit Vogel, Usman Baber
PURPOSE OF REVIEW: To provide an overview of selected randomized studies reported over the last 2 years evaluating antiplatelet therapies in patients with either acute or stable manifestations of atherosclerosis. RECENT FINDINGS: From large outcome trials included evidence for reduced risk of ischemic events associated with use of ticagrelor and aspirin versus aspirin alone, albeit with an increased bleeding risk in patients with stable coronary artery disease and history of myocardial infarction...
April 29, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28459500/gender-related-differences-in-antiplatelet-treatment-patterns-and-outcome-insights-from-the-greekantiplatelet-grape-registry
#17
I Xanthopoulou, P Davlouros, S Deftereos, M Hamilos, G Sitafidis, I Kanakakis, M Vavouranakis, J Goudevenos, J Lekakis, D Alexopoulos
AIMS: Data on the clinical impact of gender in 'real life' acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), receiving clopidogrel, prasugrel or ticagrelor are limited. We aimed to investigate sex-based differences in clinical outcome of those patients. METHODS: In a prospective, observational, multicenter, cohort study 2047 patients were recruited into the GReekAntiPlatElet (GRAPE) Registry and were followed-up until 1 year for major adverse cardiovascular events (MACE, composite of death, non fatal myocardial infarction,urgent revascularization and stroke) and bleeding events [Bleeding Academic Research Consortium (BARC) classification]...
April 29, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28458288/neuropharmacological-study-of-atp-receptors-especially-in-the-relationship-between-glia-and-pain
#18
Kazuhide Inoue
 A growing body of evidence indicates that extracellular ATP released or leaked from nonexcitable cells as well as neurons plays important roles in the regulation of neuronal and glial functions in the entire body through ATP receptors. ATP receptors (ionotropic P2X and metabotropic P2Y receptors) are the most abundant receptor families in living organisms. In the central nervous system, these receptors participate in the synaptic transmission and intercellular communications between neurons and glia. The glia cells are classified into three types: astrocytes; oligodendrocytes; and microglia...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28454802/association-of-measured-platelet-reactivity-with-changes-in-p2y12-receptor-inhibitor-therapy-and-outcomes-after-myocardial-infarction-insights-into-routine-clinical-practice-from-the-treatment-with-adp-receptor-inhibitors-longitudinal-assessment-of-treatment
#19
Akshay Bagai, Eric D Peterson, Lisa A McCoy, Mark B Effron, Marjorie E Zettler, Gregg W Stone, Timothy D Henry, David J Cohen, Phillip J Schulte, Kevin J Anstrom, Tracy Y Wang
BACKGROUND: Little is known about the use of platelet function testing to guide choice of P2Y12 receptor inhibitor therapy in routine clinical practice. METHODS: We studied 671 myocardial infarction (MI) patients treated with percutaneous coronary intervention in the TRANSLATE-ACS Registry who had VerifyNow platelet function testing performed while on clopidogrel treatment during their index hospitalization (April 2010-October 2012). RESULTS: High platelet reactivity (>208 platelet reactivity units [PRU]) was present in 261 (38...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28448773/letter-prudent-formulary-management-or-underutilization-of-the-novel-p2y12-receptor-inhibitors-in-patients-with-acute-coronary-syndrome-who-received-percutaneous-coronary-intervention
#20
Ole Hauch
The author is a former employee of AstraZeneca and owns stock in AstraZeneca. The author reports no conflicts of interest related to the subject of this letter.
May 2017: Journal of Managed Care & Specialty Pharmacy
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