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Aspirin primary prevention

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https://www.readbyqxmd.com/read/28642210/rationale-and-design-for-a-randomized-comparison-of-efficacy-and-safety-between-aspirin-and-clopidogrel-in-atrial-fibrillation-patients-with-low-stroke-risk-cesac-af-trial
#1
Sang Min Park, Haemin Jeong, Mi-Hyang Jung, Kyung Soon Hong, Myeong-Ki Hong, Chang Seok Bang, Christopher Y Kim
BACKGROUND: Atrial fibrillation (AF) increases the risk of thromboembolic stroke. An oral anticoagulant should be administrated to prevent stroke in patients with moderate stroke risk (ie, CHA2DS2-VASc score>2). If the stroke risk is low (i.e. the score=1), however, antiplatelet agent such as aspirin is widely used. Aspirin can cause peptic ulcer disease (PUD) while its alternative, clopidogrel, theoretically does not. OBJECTIVE: To elucidate the efficacy and safety between aspirin and clopidogrel, a multicenter randomized controlled trial was designed in AF patients with low stroke risk...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28641383/neuroprotection-in-stroke-the-importance-of-collaboration-and-reproducibility
#2
Ain A Neuhaus, Yvonne Couch, Gina Hadley, Alastair M Buchan
Acute ischaemic stroke accounts for 6.5 million deaths per year, and by 2030 will result in the annual loss of over 200 million disability-adjusted life years globally. There have been considerable recent advances in the gold standard of acute ischaemic stroke treatment, some aspects of which-aspirin to prevent recurrence, and treating patients in specialized stroke wards-are widely applicable. Recanalization of the occluded artery through thrombolysis and/or endovascular thrombectomy is restricted to only a small proportion of patients, due to contra-indications and the costs associated with establishing the infrastructure to deliver these treatments...
June 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#3
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28619690/metformin-the-aspirin-of-the-21-st-century-its-role-in-gestational-diabetes-prevention-of-preeclampsia-and-cancer-and-the-promotion-of-longevity
#4
REVIEW
Roberto Romero, Offer Erez, Maik Hüttemann, Eli Maymon, Bogdan Panaitescu, Agustin Conde-Agudelo, Percy Pacora, Bo Hyun Yoon, Lawrence I Grossman
Metformin is everywhere. Originally introduced in clinical practice as an anti-diabetic agent, its role as a therapeutic agent is expanding to include treatment of pre-diabetes, gestational diabetes, polycystic ovarian disease, and more recently, experimental studies, as well as observations in randomized clinical trials, suggest that metformin could have a place in the treatment or prevention of preeclampsia. This article provides a brief overview of the history of metformin in the treatment of diabetes, reviews the results of meta-analyses of metformin in gestational diabetes, and the treatment of obese non-diabetic pregnant women to prevent macrosomia...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28611833/open-label-phase-i-clinical-study-to-assess-the-safety-and-efficacy-of-cilostazol-in-patients-undergoing-internal-carotid-artery-stent-placement
#5
Ameer E Hassan, Haralabos Zacharatos, Mikayel Grigoryan, Wondwossen G Tekle, Amir Khan, Farhan Siddiq, Gustavo J Rodriguez, Ramachandra Tummala, Bharathi Jagadeesan, M Fareed K Suri, Adnan I Qureshi
BACKGROUND: One-month dual antiplatelet treatment, with aspirin and clopidogrel, following internal carotid artery stent placement is the current standard of care to prevent in-stent thrombosis. Cilostazol, an antiplatelet drug, has been demonstrated to have a safety profile comparable to aspirin and clopidogrel. OBJECTIVE: To evaluate the safety and clinical efficacy of cilostazol and aspirin therapy following internal carotid artery stent placement up to 1 month postprocedure...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28606584/impact-of-a-modified-anti-thrombotic-guideline-on-stroke-in-children-supported-with-a-pediatric-ventricular-assist-device
#6
David N Rosenthal, Chacy A Lancaster, Doff B McElhinney, Sharon Chen, MaryLyn Stein, Aileen Lin, Lan Doan, Jenna M Murray, Mary Alice Gowan, Katsuhide Maeda, Olaf Reinhartz, Christopher S Almond
BACKGROUND: Stroke is the most feared complication associated with the Berlin Heart EXCOR pediatric ventricular assist device (VAD), the most commonly used VAD in children, and affects 1 in 3 children. We sought to determine whether a modified anti-thrombotic guideline, involving more intense platelet inhibition and less reliance on platelet function testing, is associated with a lower incidence of stroke. METHODS: All children supported with the EXCOR at Stanford from 2009 to 2014 were divided into 2 cohorts based on the primary anti-thrombotic guideline used to prevent pump thrombosis: (1) the Edmonton Anti-thrombotic Guideline (EG) cohort, which included children implanted before September 2012 when dual anti-platelet therapy was used with doses titrated to Thromboelastrography/PlateletMapping (TEG/PM); and (2) the Stanford Modified Anti-thrombotic Guideline (SG) cohort, which included children implanted on or after September 2012 when triple anti-platelet therapy was used routinely and where doses were uptitrated to high, weight-based dosing targets, with low-dose steroids administered as needed for inflammation...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28585903/dabigatran-following-acute-transient-ischemic-attack-and-minor-stroke-ii-datas-ii
#7
Kuan H Ng, Mukul Sharma, Oscar Benavente, Laura Gioia, Thalia S Field, Michael D Hill, Shelagh B Coutts, Kenneth Butcher
Rationale Patients with transient ischemic attack or minor stroke are at high risk of early recurrent cerebrovascular events. Anticoagulation with heparin or warfarin acutely after ischemic stroke is at least as efficacious as aspirin for preventing recurrent events but is associated with an increased risk of clinical worsening due to hemorrhagic transformation. Aim and hypothesis We aim to demonstrate the safety of early anticoagulation with dabigatran, an oral direct thrombin inhibitor, in acute cerebrovascular syndrome patients...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28580631/kawasaki-disease-medical-therapies
#8
Jane W Newburger
Medical therapies in patients with Kawasaki disease (KD) are administered to reduce the prevalence of coronary aneurysms, reduce systemic inflammation, and prevent coronary thrombosis. All patients with acute KD should be treated with intravenous immunoglobulin (IVIG) 2 g/kg, generally administered over 10-12 hours. Aspirin has never been shown to prevent aneurysms, but is given for its anti-inflammatory and antipyretic effects until the patient has been afebrile for ∼2 days, then lowered to an antiplatelet dose...
June 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28577622/aspirin-for-primary-prevention
#9
REVIEW
Ilana B Richman, Douglas K Owens
Aspirin reduces the risk of nonfatal myocardial infarction and stroke, and the risk of colorectal cancer. Aspirin increases the risk of gastrointestinal and intracranial bleeding. The best available evidence supports initiating aspirin in select populations. In 2016, the US Preventive Services Task Force recommended initiating aspirin for the primary prevention of both cardiovascular disease and colorectal cancer among adults ages 50 to 59 who are at increased risk for cardiovascular disease. Adults 60 to 69 who are at increased cardiovascular disease risk may also benefit...
July 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28573479/aspirin-and-the-primary-prevention-of-cardiovascular-diseases-an-approach-based-on-individualized-integrated-estimation-of-risk
#10
Massimo Volpe, Allegra Battistoni, Giovanna Gallo, Roberta Coluccia, Raffaele De Caterina
While the use of aspirin in the secondary prevention of cardiovascular (CVD) is well established, aspirin in primary prevention is not systematically recommended because the absolute CV event reduction is similar to the absolute excess in major bleedings. Recently, emerging evidence suggests the possibility that the assumption of aspirin, may also be effective in the prevention of cancer. By adding to the CV prevention benefits the potential beneficial effect of aspirin in reducing the incidence of mortality and cancer could tip the balance between risks and benefits of aspirin therapy in the primary prevention in favour of the latter and broaden the indication for treatment with in populations at average risk...
June 1, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28527771/aspirin-versus-aspirin-plus-clopidogrel-as-antithrombotic-treatment-following-transcatheter-aortic-valve-replacement-with-a-balloon-expandable-valve-the-arte-aspirin-versus-aspirin%C3%A2-clopidogrel-following%C3%A2-transcatheter-aortic-valve-implantation-randomized%C3%A2
#11
Josep Rodés-Cabau, Jean-Bernard Masson, Robert C Welsh, Bruno Garcia Del Blanco, Marc Pelletier, John G Webb, Faisal Al-Qoofi, Philippe Généreux, Gabriel Maluenda, Martin Thoenes, Jean-Michel Paradis, Chekrallah Chamandi, Vicenç Serra, Eric Dumont, Mélanie Côté
OBJECTIVE: The aim of this study was to compare aspirin plus clopidogrel with aspirin alone as antithrombotic treatment following transcatheter aortic valve replacement (TAVR) for the prevention of ischemic events, bleeding events, and death. BACKGROUND: Few data exist on the optimal antithrombotic therapy following TAVR. METHODS: This was a randomized controlled trial comparing aspirin (80 to 100 mg/day) plus clopidogrel (75 mg/day) (dual-antiplatelet therapy [DAPT]) versus aspirin alone (single-antiplatelet therapy [SAPT]) in patients undergoing TAVR with a balloon-expandable valve...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28515767/cost-effectiveness-evaluation-of-aspirin-in-primary-prevention-of-myocardial-infarction-amongst-males-with-average-cardiovascular-risk-in-iran
#12
Mohammadreza Amirsadri, Mohammad Javad Sedighi
Aspirin is one of the certified medicines commonly used for the secondary prevention of myocardial infarction (MI). Aspirin side effects and gastrointestinal bleeding, in particular, have arisen debates on its use for the primary prevention of MI. The present research evaluates the cost-effectiveness of the use of aspirin in the primary prevention of MI among Iranian men with average cardiovascular disease (CVD) risk, using Markov modeling technique. The incremental cost-effectiveness ratios (ICERs) estimated to be 864 USA dollars (USD) per quality-adjusted life years (QALY) gained and 782 USD per life years gained (LYG) for each patient in the base-case scenario (public tariffs and no discounting)...
April 2017: Research in Pharmaceutical Sciences
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
#13
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/28507597/low-adherence-to-national-guidelines-for-proton-pump-inhibitor-prescription-in-patients-receiving-combination-aspirin-and-anticoagulation
#14
Rajani Sharma, Abhik Roy, Christopher Ramos, Richard Rosenberg, Reuben Garcia-Carrasquillo, Benjamin Lebwohl
BACKGROUND: Aspirin, when used with concurrent anticoagulation, increases the risk of gastrointestinal bleeding (GIB). Therefore, multisociety guidelines recommend prophylactic proton-pump inhibitors (PPIs) for patients receiving aspirin and anticoagulation. We aimed to determine rates and predictors of adherence to these recommendations. METHODS: All adult inpatients discharged from the hospital on aspirin and anticoagulation from July 2009 to June 2014 were retrospectively evaluated for PPI prescription on discharge instructions...
May 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28507183/longterm-hydroxychloroquine-therapy-and-low-dose-aspirin-may-have-an-additive-effectiveness-in-the-primary-prevention-of-cardiovascular-events-in-patients-with-systemic-lupus-erythematosus
#15
Serena Fasano, Luciana Pierro, Ilenia Pantano, Michele Iudici, Gabriele Valentini
OBJECTIVE: Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease (CVD). Thromboprophylaxis with low-dose aspirin (ASA) and hydroxychloroquine (HCQ) seems promising in SLE. We investigated the effects of HCQ cumulative dosages (c-HCQ) and the possible synergistic efficacy of ASA and HCQ in preventing a first CV event (CVE) in patients with SLE. METHODS: Patients consecutively admitted to our center who, at admission, satisfied the 1997 American College of Rheumatology and/or 2012 Systemic Lupus Collaborating Clinics classification criteria for SLE, and had not experienced any CVE, were enrolled...
May 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28469496/use-and-misuse-of-aspirin-in-primary-cardiovascular-prevention
#16
REVIEW
Sergio Coccheri
The use of low-dose aspirin in primary prevention of cardiovascular (CV) events in healthy or apparently healthy people is a widely debated topic. Many arguments indicate that "primary prevention" is only a conventional definition and that the transition from primary to secondary prevention represents a continuum of increasing levels of CV risk. Although there are no direct proofs of a different efficacy of aspirin at different CV risk levels, in low-risk populations aspirin will appear to be less efficient...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28455079/impact-of-uspstf-recommendations-for-aspirin-for%C3%A2-prevention-of-recurrent-preeclampsia
#17
Mary Catherine Tolcher, Derrick M Chu, Lisa M Hollier, Joan M Mastrobattista, Diana A Racusin, Susan M Ramin, Haleh Sangi-Haghpeykar, Kjersti M Aagaard
BACKGROUND: The US Preventive Services Task Force recommends low-dose aspirin for the prevention of preeclampsia among women at high risk for primary occurrence or recurrence of disease. Recommendations for the use of aspirin for preeclampsia prevention were issued by the US Preventive Services Task Force in September 2014. OBJECTIVES: The objective of the study was to evaluate the incidence of recurrent preeclampsia in our cohort before and after the US Preventive Services Task Force recommendation for aspirin for preeclampsia prevention...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28435446/cardiovascular-risk-assessment-in-patients-with-diabetes
#18
REVIEW
Marcello Casaccia Bertoluci, Viviane Zorzanelli Rocha
Although patients with diabetes have 2 to 4 times increased risk of cardiovascular morbidity and mortality than individuals without diabetes, recent studies indicate that a significant part of patients are in a lower cardiovascular risk category. Men younger than 35 years, women younger than 45 years, patients with diabetes duration of less than 10 years without other risk factors have a much lower risk than patients who have traditional cardiovascular risk factors, and subclinical or established coronary artery disease (CAD)...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28413512/long-term-statin-use-before-primary-percutaneous-coronary-intervention-improves-treatment-outcomes-of-acute-myocardial-infarction
#19
Ruiwei Guo, Lixia Yang, Lihua Mu, Xianfeng Pan, Feng Qi
Numerous studies have reported that high-dose statin loading therapy prior to primary percutaneous coronary intervention (PPCI) improves the clinical outcomes of patients following acute myocardial infarction (AMI). However, little is known about the effects of long-term statin use prior to PPCI on such outcomes. Therefore, the aim of the present analysis was to clarify the effects of long-term statin use before PPCI on the treatment outcomes of patients following AMI. The records of 213 patients who had AMI and met the inclusion criteria were retrospectively reviewed...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28410791/gastrointestinal-safety-of-celecoxib-versus-naproxen-in-patients-with-cardiothrombotic-diseases-and-arthritis-after-upper-gastrointestinal-bleeding-concern-an-industry-independent-double-blind-double-dummy-randomised-trial
#20
Francis K L Chan, Jessica Y L Ching, Yee Kit Tse, Kelvin Lam, Grace L H Wong, Siew C Ng, Vivian Lee, Kim W L Au, Pui Kuan Cheong, Bing Y Suen, Heyson Chan, Ka Man Kee, Angeline Lo, Vincent W S Wong, Justin C Y Wu, Moe H Kyaw
BACKGROUND: Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. METHODS: For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin...
June 17, 2017: Lancet
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