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https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#1
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28224924/left-bundle-branch-block-in-patients-with-acute-myocardial-infarction-presentation-treatment-and-trends-in-outcome-from-1997-to-2016-in-routine-clinical-practice
#2
Paul Erne, Juan F Iglesias, Philip Urban, Franz R Eberli, Hans Rickli, René Simon, Thomas A Fischer, Dragana Radovanovic
BACKGROUND: Whether patients with acute myocardial infarction presenting with new or presumed new left bundle-branch block (LBBB) should be treated in the same way as those presenting with ST-elevation (STE) is still a matter of debate. METHODS: Data from 28,358 patients enrolled in AMIS Plus from 1997 to 2016 were analyzed to evaluate differences in treatment and outcome of patients presenting with LBBB (n=2295) or STE (n=26,090) on their initial electrocardiogram using descriptive statistics and multivariate logistic regression...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28222641/genotyping-guided-approach-versus-the-conventional-approach-in-selection-of-oral-p2y12-receptor-blockers-in-chinese-patients-suffering-from-acute-coronary-syndrome
#3
Chor Cheung Tam, Janette Kwok, Anthony Wong, Arthur Yung, Catherine Shea, Shun Ling Kong, Wing Hong Tang, David Siu, Raymond Chan, Stephen Lee
Objective The CYP2C19 loss-of-function (LoF) allele is present in half of the East Asian population and is associated with high on-treatment platelet reactivity (HTPR). This study aimed to investigate whether a rapid genotyping-guided approach is feasible and efficacious for selecting P2Y12 receptor blockers in Chinese patients suffering from acute coronary syndrome (ACS). Methods This was a single-centre, prospective, randomized, open-label study. A total of 132 patients with ACS were randomized to the rapid genotyping-guided treatment group (GG, N = 65) or the standard treatment group (SG, N = 67)...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28213881/poor-adherence-to-p2y12-antagonists-increased-cardiovascular-risks-in-chinese-pci-treated-patients
#4
Yang Sun, Chenze Li, Lina Zhang, Dong Hu, Xudong Zhang, Ting Yu, Min Tao, Dao Wen Wang, Xiaoqing Shen
Low adherence to secondary prevention medications (ATM) of patients after acute coronary syndrome (ACS) is associated with poor clinical outcomes. However, literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS. In the current work, ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5, 2013 to December 31, 2014. A total of 2126 patients were classified under low adherence (proportion of days covered (PDC) C< 50%) and high adherence (PDC>50%) groups based on their performance after discharge...
February 17, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28213102/comparison-of-multiplate-and-verifynow-platelet-function-tests-in-predicting-clinical-outcome-in-patients-with-acute-coronary-syndromes
#5
Peter D Larsen, Ana S Holley, Alexander Sasse, Ali Al-Sinan, Sarah Fairley, Scott A Harding
INTRODUCTION: This study examined the ability of two widely used "point of care" platelet function assays, VerifyNow and Multiplate, to predict adverse outcomes in patients with acute coronary syndromes (ACS). METHODS: We examined platelet reactivity using VerifyNow and Multiplate P2Y12 assays in patients with ACS and the relationship between platelet reactivity and both MACE (defined as a composite of death, myocardial infarction, stroke, stent thrombosis and unplanned revascularisation) and TIMI major bleeding at 1year...
February 10, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28212842/pathophysiological-consequences-of-receptor-mistraffic-tales-from-the-platelet-p2y12-receptor
#6
Margaret R Cunningham, Riyaad Aungraheeta, Stuart J Mundell
Genetic variations in G protein-coupled receptor (GPCR) genes can disrupt receptor function in a wide variety of human genetic diseases, including platelet bleeding disorders. Platelets are critical for haemostasis with inappropriate platelet activation leading to the development of arterial thrombosis, which can result in heart attack and stroke whilst decreased platelet activity is associated with an increased risk of bleeding. GPCRs expressed on the surface of platelets play key roles in regulating platelet activity and therefore function...
February 14, 2017: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/28207524/in-stent-stenosis-in-the-patient-with-internal-carotid-aneurysm-after-treated-by-the-willis-covered-stent-two-case-reports-and-literature-review
#7
Lun-Xin Liu, Meng-Yuan Song, Xiao-Dong Xie
: In-stent stenosis after treated by Willis covered stent-case reports. BACKGROUND: Advancements in minimally invasive technology have allowed endovascular reconstruction of internal carotid aneurysm. However, in-stent stenosis is an important and well-characterized complication of stenting after the treatment of internal carotid aneurysm. CASE DESCRIPTION: We would present 2 patients who were diagnosed with in-stent stenosis after the treatment of Willis covered stent...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28204303/advocating-cardiovascular-precision-medicine-with-p2y12-receptor-inhibitors
#8
Max-Paul Winter, Erik L Grove, Raffaele De Caterina, Diana A Gorog, Ingo Ahrens, Tobias Geisler, Paul A Gurbel, Udaya Tantry, Eliano P Navarese, Jolanta M Siller-Matula
No abstract text is available yet for this article.
February 15, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28203684/crushed-sublingual-versus-oral-ticagrelor-administration-strategies-in-patients-with-unstable-angina-a-pharmacokinetic-pharmacodynamic-study
#9
Piotr Niezgoda, Joanna Sikora, Malwina Barańska, Adam Sikora, Katarzyna Buszko, Emilia Siemińska, Michał Piotr Marszałł, Jolanta M Siller-Matula, Bernd Jilma, Dimitrios Alexopoulos, Tomasz Fabiszak, Jacek Kubica
Oral administration of crushed ticagrelor tablets turned out to be an efficacious method that improves its pharmacokinetics and pharmacodynamics. This strategy, however, is unlikely to eliminate the drug-drug interaction in patients receiving intravenous morphine, as the impairment of the P2Y12 inhibitor absorption related to decreased propulsive motility of the gastro-intestinal tract is the most likely mechanism of interaction. Thus, we designed a pharmacokinetic and pharmacodynamic study setting the feasibility of platelet inhibition with a loading dose of ticagrelor given as crushed tablets sublingually compared with two other ticagrelor loading dose administration strategies: integral tablet given orally and crushed tablet given orally in patients with unstable angina...
February 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28202132/comparison-of-platelet-reactivity-in-black-versus-white-patients-with-acute-coronary-syndromes-after-treatment-with-ticagrelor
#10
Michael A Gaglia, Michael J Lipinski, Thibault Lhermusier, Arie Steinvil, Sarkis Kiramijyan, Shreejana Pokharel, Rebecca Torguson, Dominick J Angiolillo, Lars Wallentin, Robert F Storey, Ron Waksman
Ticagrelor, a potent platelet inhibitor, has primarily been studied in white patients. Platelet reactivity among black patients with acute coronary syndrome (ACS) on ticagrelor, however, is unknown. Our objective was to compare platelet reactivity in black versus white patients with ACS treated with ticagrelor. We conducted a prospective, pharmacodynamic study of 29 black patients with ACS treated with ticagrelor. Platelet reactivity was assessed at 1, 4, and 8 hours after a loading dose of ticagrelor 180 mg and at 30 days on a maintenance dose of ticagrelor 90 mg twice daily...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28195937/an-updated-protocol-for-evaluating-chest-pain-and-managing-acute-coronary-syndromes
#11
Christopher R Kelly, Ajay J Kirtane, Jennifer Stant, Gregg W Stone, Robert M Minutello, S Chiu Wong, Honeyleen Manuzon, Roxanne Gerow-Smith, Nancy Kelley, LeRoy E Rabbani
Clinical pathways can optimize care both across and within institutions, but regular updates to these pathways based on new clinical trials, professional guidelines, and Food and Drug Administration approvals are essential. Herein we describe the most recent revisions to the New York-Presbyterian Hospital (Columbia University Medical Center and Weill Cornell Medical Center) clinical pathway for acute coronary syndromes and chest pain, which incorporates novel data regarding the timing and administration of P2Y12 inhibition (including the intravenous P2Y12 inhibitor cangrelor) and the appropriateness of prolonged (>1 year) dual antiplatelet therapy for the secondary prevention of ischemic events...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28193677/sex-differences-in-the-clinical-impact-of-high-platelet-reactivity-after-percutaneous-coronary-intervention-with-drug-eluting-stents-results-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#12
Jennifer Yu, Roxana Mehran, Usman Baber, Sze-Yuan Ooi, Bernhard Witzenbichler, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Akiko Maehara, Ke Xu, Ori Ben-Yehuda, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown. METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208)...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#13
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28159194/optimal-same-day-platelet-inhibition-in-patients-receiving-drug-eluting-stents-with-or-without-previous-maintenance-thienopyridine-therapy-from-the-evaluation-of-platelet-inhibition-in-patients-having-a-verifynow-assay-epiphany-trial
#14
Michael S Lee, Evan Shlofmitz, Elizabeth Haag, Lyn Santiago, Simcha Pollack, Nathaniel Reichek, Richard A Shlofmitz
We determined if high on-treatment platelet reactivity (HTPR) can be overcome on the day of percutaneous coronary intervention (PCI) in patients with or without previous maintenance thienopyridine therapy. Patients with HTPR, as defined as P2Y12 reaction units (PRU) >230, were switched to an alternate thienopyridine. Patients with HTPR undergoing PCI are at increased risk for ischemic complications. A total of 429 patients undergoing PCI with drug-eluting stents were enrolled. Patients on maintenance thienopyridine (n = 249) with PRU >230 were loaded with the alternative thienopyridine...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28150852/novel-role-of-platelet-reactivity-in-adverse-left-ventricular-remodelling-after-st-segment-elevation-myocardial-infarction-the-remodeling-trial
#15
Yongwhi Park, Udaya S Tantry, Jin-Sin Koh, Jong-Hwa Ahn, Min Gyu Kang, Kye Hwan Kim, Jeong Yoon Jang, Hyun Woong Park, Jeong-Rang Park, Seok-Jae Hwang, Ki-Soo Park, Choong Hwan Kwak, Jin-Yong Hwang, Paul A Gurbel, Young-Hoon Jeong
The role of platelet-leukocyte interaction in the infarct myocardium still remains unveiled. We aimed to determine the linkage of platelet activation to post-infarct left ventricular remodelling (LVR) process. REMODELING was a prospective, observational, cohort trial including patients (n = 150) with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Patients were given aspirin plus clopidogrel therapy (600 mg loading and 75 mg daily). Platelet reactivity (PRU: P2Y12 Reaction Units) was assessed with VerifyNow P2Y12 assay on admission...
February 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28150850/chewing-versus-swallowing-ticagrelor-to-accelerate-platelet-inhibitionin-acute-coronary-syndrome-the-cheers-study-for-the-platis-platelets-and-thrombosis-in-sheba-study-group
#16
Elad Asher, Shir Frydman, Moshe Katz, Ehud Regev, Avi Sabbag, Israel Mazin, Arsalan Abu-Much, Andrew Kukuy, Anna Mazo, Aharon Erez, Anat Berkovitch, Michael Narodistky, Israel Barbash, Amit Segev, Roy Beigel, Shlomi Matetzky
It was the study objective to evaluate whether chewing a 180 mg loading dose of ticagrelor versus an equal dose of traditional oral administration, enhances inhibition of platelet aggregation 1 hour (h) after administering a ticagrelor loading dose in non-ST elevation myocardial infarction (NSTEMI) patients. Dual anti-platelet therapy represents standard care for treating NSTEMI patients. Ticagrelor is a direct acting P2Y12 inhibitor and, unlike clopidogrel and prasugrel, does not require metabolic activation...
February 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28150522/dyspnea-in-patients-treated-with-p2y12-receptor-antagonists-insights-from-the-greek-antiplatelet-grape-registry
#17
Dimitrios Alexopoulos, Ioanna Xanthopoulou, Angelos Perperis, John Goudevenos, Michalis Hamilos, George Sitafidis, Ioannis Kanakakis, Manolis Vavouranakis, George Giannopoulos, Nikolaos Barampoutis, Spyridon Deftereos, John Lekakis
In 'real life' acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and receiving contemporary antiplatelet treatment, data on dyspnea occurrence and impact on persistence with treatment are scarce. In a prospective, multicenter, cohort study, ACS patients undergoing PCI were recruited into the GReekAntiPlatElet (GRAPE) registry. During 1-year follow up, overall, 249/1989 (12.5%) patients reported dyspnea, more frequently at 1-month and decreasing thereafter. Multivariate analysis showed that ticagrelor administration (n = 738) at discharge was associated with the occurrence of dyspnea: Odds ratio 2...
February 2, 2017: Platelets
https://www.readbyqxmd.com/read/28150441/characterization-of-the-binding-of-a-glycosylated-serine-protease-from-euphorbia-cf-lactea-latex-to-human-fibrinogen
#18
Jaruwan Siritapetawee, Chutima Talabnin, Jarunee Vanichtanankul, Chomphunuch Songsiriritthigul, Kanjana Thumanu, Chun-Jung Chen, Nantarat Komanasin
In this study, the binding of a glycosylated serine protease (EuP-82) with human fibrinogen was investigated by the isothermal titration calorimetry (ITC). The ITC analysis indicated that the binding of EuP-82 to fibrinogen in the conditions with or without the activator (Ca(2+) ) was an exothermic reaction (dominant negative enthalpy), which tended to be driven by hydrogen bonding and van der Waals interactions. In contrast, the binding of fibrinogen-EuP-82 in the condition with the inhibitor (Zn(2+) ) was an unfavorable endothermic reaction...
February 1, 2017: Biotechnology and Applied Biochemistry
https://www.readbyqxmd.com/read/28146050/uridine-triphosphate-thio-analogues-inhibit-platelet-p2y12-receptor-and-aggregation
#19
Dursun Gündüz, Christian Tanislav, Daniel Sedding, Mariana Parahuleva, Sentot Santoso, Christian Troidl, Christian W Hamm, Muhammad Aslam
Platelet P2Y12 is an important adenosine diphosphate (ADP) receptor that is involved in agonist-induced platelet aggregation and is a valuable target for the development of anti-platelet drugs. Here we characterise the effects of thio analogues of uridine triphosphate (UTP) on ADP-induced platelet aggregation. Using human platelet-rich plasma, we demonstrate that UTP inhibits P2Y12 but not P2Y₁ receptors and antagonises 10 µM ADP-induced platelet aggregation in a concentration-dependent manner with an IC50 value of ~250 °µM...
January 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28144998/p2y12-receptors-in-primary-microglia-activate-nuclear-factor-of-activated-t-cell-signaling-to-induce-c-c-chemokine-3-expression
#20
Hidetoshi Tozaki-Saitoh, Hiroyuki Miyata, Tomohiro Yamashita, Katsuyuki Matsushita, Makoto Tsuda, Kazuhide Inoue
Microglia are widely accepted as surveillants in the central nervous system that are continually searching the local environment for signs of injury. Following an inflammatory situation, microglia alter their morphology, extend ramified processes, and undergo cell body hypertrophy. Extracellular nucleotides are recognized as a danger signal by microglia. ADP acting on P2Y12 receptors induce process extension of microglia thereby attracting microglia to the site of adenosine tri-phosphate/ADP leaking or release...
January 31, 2017: Journal of Neurochemistry
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