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https://www.readbyqxmd.com/read/29150850/comparison-of-pharmacodynamic-effects-of-ticagrelor-vs-prasugrel-in-type-2-diabetes-mellitus-patients-with-coronary-heart-disease
#1
L-L Shang, D-D Guo, H-Y Zhao, A-J Quan, P-G Cao
WHAT IS KNOWN AND OBJECTIVE: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of thrombotic complications. Studies have indicated that patients with T2DM have impaired clopidogrel-induced antiplatelet effect. Ticagrelor and prasugrel are two latest generation P2Y12 inhibitors with advantageous platelet inhibitory profiles. However, the pharmacodynamic differences between the two drugs in patients with T2DM remain poorly explored. METHODS: This study, involving 140 patients with T2DM following percutaneous coronary intervention (PCI), evaluated the efficacy of aspirin upon concomitant use of prasugrel (10 mg/d) or ticagrelor (90 mg/d)...
November 17, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29150806/ticagrelor-a-review-in-long-term-secondary-prevention-of-cardiovascular-events
#2
Zaina T Al-Salama, Gillian M Keating, Susan J Keam
Ticagrelor (Brilique(®)) is an orally administered P2Y12 inhibitor. A long-term (maintenance) regimen of ticagrelor 60 mg twice daily is indicated in the EU for coadministration with low-dose aspirin 75-150 mg/day for the secondary prevention of atherothrombotic events in high-risk patients with a history of myocardial infarction (MI) of at least 1 year. Approval is based on the results of the PEGASUS-TIMI 54 trial that compared ticagrelor with placebo (in conjunction with low-dose aspirin) in stable patients who had had a spontaneous MI 1-3 years prior to enrolment and were at high risk of atherothrombotic events...
November 18, 2017: Drugs
https://www.readbyqxmd.com/read/29146484/association-between-ischemic-and-bleeding-risk-scores-and-the-use-of-new-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome
#3
Pedro J Flores-Blanco, Francisco Cambronero-Sánchez, Sergio Raposeiras-Roubin, Emad Abu-Assi, Gunnar Leithold, Rafael Cobas-Paz, Ana I Rodríguez Serrano, Francisco Calvo-Iglesias, Mariano Valdés, James L Januzzi, Andrés Iñiguez-Romo, Sergio Manzano-Fernández
INTRODUCTION AND OBJECTIVES: Acute coronary syndrome (ACS) guidelines recommend the use of newer P2Y12 inhibitors (prasugrel and ticagrelor) over clopidogrel in patients with moderate-to-high ischemic risk, unless they have an increased bleeding risk. The aim of our study was to assess the GRACE risk score and the CRUSADE bleeding risk score relative to prescription of newer P2Y12 inhibitors at discharge in ACS patients. METHODS: Retrospective analysis of a multicenter ACS registry; 3515 consecutive patients were included...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29134853/real-world-clopidogrel-utilization-in-acute-coronary-syndromes-patients-selection-and-outcomes-in-a-single-center-experience
#4
Diego Castini, Simone Persampieri, Sara Cazzaniga, Giulia Ferrante, Marco Centola, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: With this study, we sought to identify patient characteristics associated with clopidogrel prescription and its relationship with in-hospital adverse events in an unselected cohort of ACSs patients. MATERIALS AND METHODS: We studied all consecutive patients admitted at our institution for ACSs from 2012 to 2014. Patients were divided into two groups based on clopidogrel or novel P2Y12 inhibitors (prasugrel or ticagrelor) prescription and the relationship between clopidogrel use and patient clinical characteristics and in-hospital adverse events was evaluated using logistic regression analysis...
December 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#5
M Spartalis, E Tzatzaki, E Spartalis, C Damaskos, A Athanasiou, D Moris, M Politou
OBJECTIVE: Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29129512/thieno-2-3-b-pyridine-derivatives-are-potent-anti-platelet-drugs-inhibiting-platelet-activation-aggregation-and-showing-synergy-with-aspirin
#6
Naif K Binsaleh, Catherine A Wigley, Kathryn A Whitehead, Michelle van Rensburg, Johannes Reynisson, Lisa I Pilkington, David Barker, Sarah Jones, Nina C Dempsey-Hibbert
Drugs which inhibit platelet function are commonly used to prevent blood clot formation in patients with Acute Coronary Syndromes (ACS) or those at risk of stroke. The thieno[3,2-c]pyridine class of therapeutic agents, of which clopidogrel is the most commonly used, target the P2Y12 receptor, and are often used in combination with acetylsalicylic acid (ASA). Six thieno[2,3-b]pyridine were assessed for in vitro anti-platelet activity; all derivatives showed effects on both platelet activation and aggregation, and showed synergy with ASA...
November 7, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29126843/the-role-of-platelet-reactivity-assessment-in-dual-antiplatelet-prophylaxis-after-transcatheter-aortic-valve-implantation
#7
Katarzyna Czerwińska-Jelonkiewicz, Adam Witkowski, Maciej Dąbrowski, Walerian Piotrowski, Tomasz Hryniewiecki, Janina Stępińska
BACKGROUND: Dual antiplatelet therapy (DAPT) is recommended prophylaxis after transcatheter aortic valve implantation (TAVI). The usefulness of platelet reactivity (PLTR) tests in predicting the safety of periprocedural DAPT in the TAVI population is unknown. AIM: To analyze the value of aspirin/clopidogrel PLTR testing in predicting the risk of in-hospital TAVI-related bleeding. METHODS: PLTR, expressed as P2Y12/aspirin reaction units (PRU/ARU), was performed using optical aggregometry with the VerifyNow(®) device, in the 24h before and on the sixth day after TAVI...
November 7, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29121979/platelet-inhibition-during-ticagrelor-monotherapy-versus-ticagrelor-plus-aspirin-in-patients-with-coronary-artery-disease-template-study-study-protocol-for-a-randomised-controlled-trial
#8
Sarah Baos, Wendy Underwood, Lucy Culliford, Barnaby C Reeves, Chris A Rogers, Ruth Bowles, Tom Johnson, Andreas Baumbach, Andrew Mumford
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin (ASP) and a P2Y12 blocker is currently standard care after percutaneous coronary intervention (PCI) with stent insertion, and aims to inhibit platelet function in order to prevent stent thrombosis. The P2Y12 blocker ticagrelor (TIC) has greater antiplatelet effect than the previously used members of this class, such as clopidogrel. In healthy volunteers, TIC is sufficient to cause strong platelet inhibition, with little additional effect from ASP...
November 9, 2017: Trials
https://www.readbyqxmd.com/read/29121759/comparison-of-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-and-non-randomized-studies
#9
Hussam Watti, Khagendra Dahal, Henock G Zabher, Pavan Katikaneni, Kalgi Modi, Abdulrahman Abdulbaki
BACKGROUND: The newer oral P2Y12 receptor antagonists (i.e. prasugrel and ticagrelor) are recommended over clopidogrel for patients with acute coronary syndrome (ACS) going for percutaneous coronary intervention (PCI). As the superiority of one agent over the other remains unclear, we designed a systematic review and meta-analysis of these agents in patients with ACS undergoing PCI. METHODS: PUBMED, EMBASE, Cochrane CENTRAL, CINAHL and manual search were performed through 11/02/2016...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29119544/nationwide-claims-data-validated-for-quality-assessments-in-acute-myocardial-infarction-in-the-netherlands
#10
D C Eindhoven, L N van Staveren, J A van Erkelens, D E Ikkersheim, S C Cannegieter, V A W M Umans, A Mosterd, J van Wijngaarden, M J Schalij, C J W Borleffs
INTRODUCTION: Since health insurance is compulsory in the Netherlands, the centrally registered medical claims data might pose a unique opportunity to evaluate quality of (cardiac) care on a national level without additional collection of data. However, validation of these claims data has not yet been assessed. DESIGN: Retrospective cohort study. METHODS: National claims data ('national registry') were compared with data collected by patient records reviews in four representative hospitals ('validation registry')...
November 8, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29118712/comparative-long-term-effect-of-three-anti-p2y12-drugs-after-percutaneous-angioplasty-an-observational-study-based-on-electronic-drug-adherence-monitoring
#11
Valentina Forni Ogna, Isabelle Bassi, Isabelle Menetrey, Olivier Muller, Eric Tousset, Pierre Fontana, Eric Eeckhout, Chin B Eap, Bernard Vrijens, Michel Burnier, Grégoire Wuerzner
Aims: Dual platelet inhibition using anti-P2Y12 drugs and aspirin is the standard of care in patients after percutaneous coronary interventions (PCI). Prasugrel and ticagrelor have been shown to be more potent than clopidogrel with less high on-treatment platelet reactivity. Whether differences in long-term adherence to these drugs can partly explain different antiplatelet efficacy has not been studied so far. The objective was to compare the long-term P2Y12 receptor inhibition and drug adherence to different anti-P2Y12 drugs, and to assess the impact of adherence on the pharmacodynamic effect...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#12
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29096904/-stent-thrombosis-what-s-up-in-2017
#13
R Kallel, R Hakim, G Rangé
Stent thrombosis (ST) is still a dreadful and threatening complication of percutaneous coronary intervention (PCI) with a high risk of morbi-mortality. Nevertheless, it becomes exceptional (0.6% at 1 year and 0.15%/year later) thanks to improvement of stents and use of new P2Y12 inhibitors. Endo-coronary imaging and especially Optical Coherence Tomography (OCT) change radically its understanding with revealing quiet systematic morphologic endoluminal abnormalities (97% of the cases). OCT becomes an essential tool in practice (ESC recommendation class IIa) and allows a therapeutic strategy optimization...
October 30, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29092730/bioequivalence-and-pharmacokinetic-pharmacodynamic-correlation-of-clopidogrel-in%C3%A2-healthy-thai-subjects%C3%A2
#14
Malinee Chunsangchan, Pajaree Chariyavilaskul, Wannarasmi Ketchart, Nantaporn Prompila, Supeecha Wittayalertpanya
Clopidogrel is an antiplatelet drug, selectively binding to the platelet P2Y12 receptor of adenosine diphosphate. Clopidogrel is a prodrug modified through active metabolite in the liver by two steps of CYP enzyme. The active metabolite is responsible for inhibiting platelet aggregation. OBJECTIVE: The study aimed to assess the bioequivalence of clopidogrel 75 mg generic and reference drugs and to investigate the correlation between pharmacokinetics of active metabolites and its antiplatelet activities...
October 26, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29091481/the-quest-for-safer-antithrombotic-treatment-regimens-in-patients-with-coronary-artery-disease-new-strategies-and-paradigm-shifts
#15
Jae Youn Moon, Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Despite the undeniable benefits on reducing ischemic adverse events, antiplatelet regimens including dual antiplatelet therapy (DAPT) with aspirin and P2Y12 receptor inhibitors are associated with an increased risk of bleeding. The awareness of the unfavorable prognostic implications associated with bleeding complications have somewhat hampered the enthusiasm towards the use of more potent antiplatelet treatment regimens or prolonged use of DAPT. This awareness also has prompted a series of investigations geared towards the identification of antithrombotic treatment regimens which are efficacious at reducing ischemic recurrences while also safe in terms of bleeding risk profile...
November 14, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/29081979/dual-antiplatelet-therapy-for-secondary-prevention-of-coronary-artery-disease
#16
REVIEW
Sophie Degrauwe, Thomas Pilgrim, Adel Aminian, Stephane Noble, Pascal Meier, Juan F Iglesias
Dual antiplatelet therapy (DAPT) combining aspirin and a P2Y12 receptor inhibitor has been consistently shown to reduce recurrent major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) compared with aspirin monotherapy, but at the expense of an increased risk of major bleeding. Nevertheless, the optimal duration of DAPT for secondary prevention of CAD remains uncertain, owing to the conflicting results of several large randomised trials...
2017: Open Heart
https://www.readbyqxmd.com/read/29078099/neuromedin-u-potentiates-adp-and-epinephrine-induced-human-platelet-activation
#17
C Grippi, B Izzi, F Gianfagna, F Noro, E Falcinelli, A Di Pardo, E Amico, M B Donati, G de Gaetano, L Iacoviello, M F Hoylaerts, C Cerletti
Neuromedin U (NmU) is a pleiotropic hypothalamic neuropeptide involved in the gut-brain axis. It acts via both a Gαq/11-coupled receptor (NMUR1) and a Gαi-coupled receptor (NMUR2) in different cell types. Expression of both receptors was reported in platelets, but their significance for NmU signaling remains elusive. We studied the potential effects of NmU on human platelet activation. In platelet-rich plasma (PRP), NmU alone (up to 10μM) did not induce any measurable aggregation, but at nanomolar concentrations, it potentiated platelet aggregation by low (mean 0...
September 29, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29075924/contemporary-use-of-p2y12-inhibitors-in-patients-with-st-segment-elevation-myocardial-infarction-referred-to-primary-percutaneous-coronary-interventions-in-poland-data-from-orpki-national-registry
#18
Tomasz Rakowski, Zbigniew Siudak, Artur Dziewierz, Krzysztof Plens, Paweł Kleczyński, Dariusz Dudek
According to guidelines, it is recommended to give P2Y12 inhibitors (preferably ticagrelor or prasugrel) at the time of first medical contact in patients with STEMI. However, in real life antiplatelet treatment strategies are different among countries. We analyzed data on antiplatelet treatment in STEMI patients included into Polish ORPKI national registry. A total of 23,139 STEMI patients from 153 invasive cardiology centers were reported in ORPKI registry between September 2015 and August 2016. Finally 19,437 patients from 122 centers (immediate PCI in 94%) were included into the analysis (lack of ticagrelor or prasugrel usage reported in 31 centers)...
October 26, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29071332/effect-of-chewing-vs-swallowing-ticagrelor-on-platelet-inhibition-in-patients-with-st-segment-elevation-myocardial-infarction-a-randomized-clinical-trial
#19
Elad Asher, Shir Tal, Israel Mazin, Arsalan Abu-Much, Avi Sabbag, Moshe Katz, Ehud Regev, Fernando Chernomordik, Victor Guetta, Amit Segev, Dan Elian, Israel Barbash, Paul Fefer, Michael Narodistky, Roy Beigel, Shlomi Matetzky
Importance: Dual anti-platelet therapy represents standard care for treating patients with ST-segment elevation myocardial infarction (STEMI). Ticagrelor is a direct-acting P2Y12 inhibitor and, unlike clopidogrel and prasugrel, does not require metabolic activation. Objective: To evaluate whether chewing a loading dose (LD) of ticagrelor, 180 mg, vs traditional oral administration of an equal dose enhances platelet inhibition at 30 minutes and 1 hour after LD administration in patients with STEMI...
October 25, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29064388/the-role-of-platelet-derived-adp-and-atp-in-promoting-pancreatic-cancer-cell-survival-and-gemcitabine-resistance
#20
Omar Elaskalani, Marco Falasca, Niamh Moran, Michael C Berndt, Pat Metharom
Platelets have been demonstrated to be vital in cancer epithelial-mesenchymal transition (EMT), an important step in metastasis. Markers of EMT are associated with chemotherapy resistance. However, the association between the development of chemoresistance, EMT, and the contribution of platelets to the process, is still unclear. Here we report that platelets regulate the expression of (1) human equilibrative nucleoside transporter 1 (hENT1) and (2) cytidine deaminase (CDD), markers of gemcitabine resistance in pancreatic cancer...
October 24, 2017: Cancers
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