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https://www.readbyqxmd.com/read/29350995/a-review-of-analytical-methods-for-the-determination-of-clopidogrel-in-pharmaceuticals-and-biological-matrices
#1
Kavitha J, K S Kokilambigai, R Seetharaman, Harini R R, A A Kaaviya, Sowndaravel P, Lakshmi K S
P2Y12 belongs to a group of G protein - coupled (GPCR) purinergic receptors and is a receptor for adenosine diphosphate (ADP). The P2Y12 receptor is involved in platelet aggregation and acts as a biological target for treating thromboembolisms and other clotting disorders. The use of Clopidogrel (CLO) has improved the morbidity and mortality endpoints including cardiovascular death, recurrent myocardial infarction (MI) and stroke at 30 days after percutaneous coronary intervention (PCI). CLO is one such drug that specifically and irreversibly inhibits the P2Y12 subtype of ADP receptor...
January 19, 2018: Critical Reviews in Analytical Chemistry
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/29345594/should-stemi-patients-receive-opiate-analgesia-the-morphine-paradox
#3
Mohamed Farag, Nikolaos Spinthakis, Manivannan Srinivasan, Diana Adrienne Gorog
BACKGROUND: The very significant benefit of P2Y12 receptor inhibitor administration in patients with ST-elevation myocardial infarction (STEMI), in reducing future ischaemic events and stent thrombosis, is undisputed. Morphine analgesia is very frequently co-administered to these patients for pain relief, along with antiplatelet therapy, at the time of presentation, and prior to reperfusion with primary percutaneous coronary intervention. METHODS: Research and online content related to opiates use in STEMI was reviewed...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345592/prolonging-ticagrelor-beyond-a-year-of-acute-coronary-syndrome-worth-or-harmful
#4
Daniel Aradi, Dome Dezsi, Gabor Veress, Bela Merkely
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12-inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345591/should-antithrombotic-treatment-strategies-in-east-asians-differ-from-caucasians-focused-on-acs-or-pci-treated-patients
#5
Jae Seok Bae, Jong-Hwa Ahn, Udaya Tantry, Paul A Gurbel, Young-Hoon Jeong
With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, coronary artery disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials including mostly Caucasians...
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/29343953/impact-of-acute-exacerbations-on-platelet-reactivity-in-chronic-obstructive-pulmonary-disease-patients
#8
Mariana Muñoz-Esquerre, José Luis Ferreiro, Daniel Huertas, Ana Lucrecia Marcano, Marta López-Sánchez, Gerard Roura, Joan Antoni Gómez-Hospital, Jordi Dorca, Angel Cequier, Salud Santos
Background: A higher risk of atherothrombotic cardiovascular events, which are platelet-driven processes, has been described during acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, the relevance of platelet reactivity during AECOPD and whether this is affected by antiplatelet agents are not fully elucidated to date. This study aimed to evaluate whether platelet reactivity is augmented during an exacerbation in COPD patients with and without antiplatelet therapy and its association with systemic inflammatory parameters...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29341465/p2y12-deficiency-in-mouse-impairs-noradrenergic-system-in-brain-and-alters-anxiety-like-neurobehavior-and-memory
#9
Fang Zheng, Qiang Zhou, Yin Cao, Hailian Shi, Hui Wu, Beibei Zhang, Fei Huang, Xiaojun Wu
Purinergic receptor P2Y12 (P2Y12 ), a G protein-coupled (GPCR) purinergic receptor, is widely distributed in nervous system and involved in the progression of neurological diseases such as multiple sclerosis and neuropathic pain. The central noradrenergic system actively participates in a number of neurophysiological processes. Nevertheless, whether there is any direct relevance between P2Y12 and noradrenergic signal transduction remains unknown. In the present study, we tested the hypothesis that lack of P2Y12 impaired noradrenergic signal transduction in mouse brain...
January 17, 2018: Genes, Brain, and Behavior
https://www.readbyqxmd.com/read/29339169/the-timing-of-p2y12-inhibitor-initiation-in-the-treatment-of-acs-does-the-evidence-exist-in-this-era
#10
REVIEW
Harsh Golwala, Deepak L Bhatt
The majority of acute coronary syndromes (ACS) are well characterized as a consequence of plaque rupture and subsequent thrombosis. Antiplatelet agents targeting inhibition of P2Y12 receptors on the platelets have shown to reduce future risk of cardiovascular events in this patient population. However, the timing of initiation of these agents, in particular, in patients managed with invasive strategy with percutaneous coronary interventions (PCI) is debatable. The data supporting pretreatment with antiplatelet agents prior to PCI in ACS patients dates to trials performed >15 years ago, wherein the time to PCI was >5 days, and henceforth, the utility of pretreatment with these agents in the contemporary era remains uncertain...
January 12, 2018: Progress in Cardiovascular Diseases
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/29339166/anticoagulation-in-acute-coronary-syndrome-state-of-the-art
#12
REVIEW
Michel Zeitouni, Mathieu Kerneis, Tarek Nafee, Jean-Philippe Collet, Johanne Silvain, Gilles Montalescot
Early intravenous anticoagulation is the corner stone treatment of patients admitted with an acute coronary syndrome: it antagonizes the ongoing coronary thrombosis and facilitates the percutaneous coronary intervention, hence a reduction of mortality and acute stent thrombosis. Unfractionated heparin, enoxaparin, bivalirudin and fondaparinux have been extensively studied in large randomized control trials and meta-analyses with the same objective: reducing the ischemic burden without hiking hemorrhagic events...
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
#13
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/29336311/comparison-of-the-effects-of-p2y12-receptor-antagonists-on-platelet-function-and-clinical-outcomes-in-patients-undergoing-primary-pci-a-substudy-of-the-heat-ppci-trial
#14
Adeel Shahzad, Vikram Khanna, Ian Kemp, Matthew Shaw, Christine Mars, Robert Cooper, Keith Wilson, Nick Curzen, Rod H Stables
AIMS: The HEAT-PPCI trial compared bivalirudin and unfractionated heparin in patients undergoing Primary PCI. We report pre-specified, secondary analyses comparing the effects of P2Y12 inhibiting agents on platelet reactivity and clinical events. METHODS AND RESULTS: All patients received pre-procedural oral anti-platelet therapy. During the early stages of the trial, the P2Y12 inhibitor of choice was prasugrel with some use of clopidogrel. Later, routine therapy switched to ticagrelor...
January 16, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29329963/switch-to-ticagrelor-in-critical-limb-ischemia-antiplatelet-study-stt-clips
#15
Leonardo C Clavijo, Ashwat Dhillon, Noor Al-Asady, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVE: To investigate platelet reactivity in patients with critical limb ischemia (CLI) after switching from clopidogrel to ticagrelor. BACKGROUND: High on-treatment platelet reactivity (HPR) is highly prevalent in patients with CLI treated with clopidogrel. The effect of ticagrelor in patients with CLI is not known, however. METHODS: We performed P2Y12 platelet receptor inhibition studies (VASP and VerifyNow) in 50 patients with CLI. Tests were performed before and 6±1h after daily 75mg clopidogrel dose...
September 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29322294/ticagrelor-inhibits-platelet-tumor-cell-interactions-and-metastasis-in-human-and-murine-breast-cancer
#16
Alison J Gareau, Colin Brien, Simon Gebremeskel, Robert S Liwski, Brent Johnston, Michael Bezuhly
Activated platelets promote the proliferation and metastatic potential of cancer cells. Platelet activation is largely mediated through ADP engagement of purinergic P2Y12 receptors on platelets. We examined the potential of the reversible P2Y12 inhibitor ticagrelor, an agent used clinically to prevent cardiovascular and cerebrovascular events, to reduce tumor growth and metastasis. In vitro, MCF-7, MDA-MB-468, and MDA-MB-231 human mammary carcinoma cells exhibited decreased interaction with platelets treated with ticagrelor compared to untreated platelets...
January 11, 2018: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29314712/incomplete-reversibility-of-platelet-inhibition-following-prolonged-exposure-to-ticagrelor-comment
#17
M Urooj Zafar, Juan Jose Badimon, Gines Escolar Gines
We read with interest the article by Gerrits et al on the incomplete reversibility of platelet inhibition following prolonged exposure to treatment with ticagrelor [1]. The results are intriguing and somewhat surprising, considering the reversible nature of the binding of ticagrelor with the platelet P2Y12 receptors. The study reported that prolonged exposure (24 hours) to ticagrelor decreased the reversibility of platelet function compared to short exposure (30 minutes) and the degree of this effect varied in the different testing methodologies used in the study...
January 3, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29314641/chronic-total-occlusion-does-anti-platelet-choice-impact-outcomes
#18
EDITORIAL
Wassim Shatila, Zvonimir Krajcer
Chronic total occlusion (CTO) is associated with worse outcomes compared to non CTO percutaneous coronary intervention (PCI). CTO might be associated with vasomotor dysfunction Ticagrelor is a novel P2Y12 inhibitor that increases local adenosine The TIGER-BVS trial plans to assess the impact of using ticagrelor vs. clopidogrel on vasomotor activity and outcomes after successful CTO PCI.
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29313713/ischemic-and-bleeding-outcomes-after-coronary-artery-bypass-grafting-among-patients-initially-treated-with-a-p2y12-receptor-antagonist-for-acute-coronary-syndromes-insights-on-timing-of-discontinuation-of-ticagrelor-and-clopidogrel-prior-to-surgery
#19
Juan J Russo, Tyler E James, Marc Ruel, Jean-Yves Dupuis, Kuljit Singh, Daniel Goubran, Nikita Malhotra, Fraser Rubens, Aun-Yeong Chong, Benjamin Hibbert, Paul Boland, Diem Tt Tran, Jean-Francois Tanguay, Marie Lordkipanidzé, Louis Perrault, George A Wells, Michael Bourke, Vincent Chan, Derek Yf So
BACKGROUND: Clinical outcomes in acute coronary syndrome patients treated with P2Y12 inhibitors who require urgent coronary artery bypass grafting (CABG) have not been well studied. METHODS: We examined clinical outcomes in acute coronary syndrome patients in relation to the timing of CABG following P2Y12 inhibitor discontinuation (<72 h, 72 h to five days, >5 days). The primary ischemic outcome was a composite of death, reinfarction, need for revascularization, or stroke...
January 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29313313/relationship-of-coagulopathy-and-platelet-dysfunction-to-transfusion-needs-after-traumatic-brain-injury
#20
Grace Martin, Dhavan Shah, Nora Elson, Ryan Boudreau, Dennis Hanseman, Timothy A Pritts, Amy T Makley, Brandon Foreman, Michael D Goodman
BACKGROUND: Coagulopathy and platelet dysfunction commonly develop after traumatic brain injury (TBI). Thromboelastography (TEG) and platelet function assays (PFAs) are often performed at the time of admission; however, their roles in assessing post-TBI coagulopathy have not been investigated. We hypothesized that compared to blunt TBI, penetrating TBI would (1) demonstrate greater coagulopathy by TEG, (2) be associated with abnormal PFA results, and (3) require more blood product transfusions...
January 8, 2018: Neurocritical Care
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