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bleeding in coronary syndroms

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https://www.readbyqxmd.com/read/28228467/gender-differences-in-clinical-presentation-and-1-year-outcomes-in-atrial-fibrillation
#1
Renate B Schnabel, Ladislav Pecen, Francisco M Ojeda, Markus Lucerna, Nargiz Rzayeva, Stefan Blankenberg, Harald Darius, Dipak Kotecha, Raffaele De Caterina, Paulus Kirchhof
OBJECTIVES: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. METHODS: In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. RESULTS: Men with AF were on average younger than women (mean±SD: 70...
February 22, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28213685/prasugrel-for-japanese-patients-with-acute-coronary-syndrome-in-short-term-clinical-practice-prasfit-practice-i-a-postmarketing-observational-study
#2
Masato Nakamura, Tomoko Iizuka, Kei Sagawa, Kenji Abe, Shuichi Chikada, Miyuki Arai
: Data on prasugrel use in Japanese patients are limited to phase II/III clinical trials. This early postmarketing observational study evaluated the safety and efficacy of short-term prasugrel use in patients with acute coronary syndrome (ACS) in real-world clinical settings in Japan. From May 2014 to January 2015, we enrolled consecutive patients with ACS requiring percutaneous coronary intervention in each institution. Each patient started prasugrel treatment ≥1 month before the end of the study period...
February 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28213102/comparison-of-multiplate-and-verifynow-platelet-function-tests-in-predicting-clinical-outcome-in-patients-with-acute-coronary-syndromes
#3
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/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#4
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/28169217/complete-or-incomplete-coronary-revascularization-in-patients-with-myocardial-infarction-and-multivessel-disease-a-propensity-score-analysis-from-the-real-life-bleemacs-bleeding-complications-in-a-multicenter-registry-of-patients-discharged-with-diagnosis-of
#5
Giorgio Quadri, Fabrizio D Ascenzo, Claudio Moretti, Maurizio D'Amico, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose Paulo Simao Henriques, Jorge Saucedo, José Ramón González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, José María García-Acuña, Danielle Southern, Emilio Alfonso, Belén Terol, Alberto Garay, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Pierluigi Omedè, Antonio Montefusco, Francesca Giordana, Silvia Scarano, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahashi, Kenji Sakata, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev, Ferdinando Varbella, Fiorenzo Gaita
AIMS: The benefit of complete or incomplete percutaneous coronary intervention (PCI) in patients with myocardial infarction and multivessel disease remains debated. METHODS AND RESULTS: We conducted a multicenter study including all patients with myocardial infarction and multivessel coronary disease included in the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome) registry. They were divided in two groups: Complete revascularization (CR) and Incomplete Revascularization (IR)...
February 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28150522/dyspnea-in-patients-treated-with-p2y12-receptor-antagonists-insights-from-the-greek-antiplatelet-grape-registry
#6
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/28150284/renal-function-on-admission-affects-both-treatment-strategy-and-long-term-outcomes-of-patients-with-myocardial-infarction-from-polish-registry-of-acute-coronary-syndromes
#7
MIchal Hawranek, Marek Gierlotka, Mariusz Gąsior, Bartosz Hudzik, Piotr Desperak, Aneta Ciślak, Mateusz Tajstra, Tadeusz Osadnik, Piotr Rozentryt, Lech Poloński
BACKGROUND: Impairment of renal function (IRF) is an independent risk factor of myocardial infarction (MI). AIM: The aims of study was to determine if the presence of IRF affects the choice of treatment strategy in patients with MI, and if long-term mortality rates are influenced by the use of invasive strategy in patients with MI according to the grade of IRF. METHODS: Data from the PL-ACS Registry of 22,431 patients hospitalized for MI during 2007-2008 with an available estimated glomerular filtration rate (eGFR) with 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula were included...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28139897/oral-antiplatelet-agents-for-the-management-of-acute-coronary-syndromes-a-review-for-nurses-and-allied-healthcare-professionals
#8
REVIEW
Tania Gesheff, Cescelle Barbour
PURPOSE: We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. DATA SOURCES: Treatment guidelines and clinical articles from PubMed. CONCLUSIONS: Guidelines recommend that dual antiplatelet therapy with a P2Y12 inhibitor and aspirin be initiated for ACS management. The P2Y12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response...
January 31, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28137225/platelet-function-testing-a-role-for-personalised-therapy-in-coronary-disease
#9
Mohamed Farag, Diana A Gorog
Whilst there exist general guidelines regarding administration of antiplatelet therapy to prevent thrombotic events in patients with cardiovascular disease, the optimal therapy for a particular individuals in particular settings remains unclear. For patients with acute coronary syndrome (ACS) or those undergoing percutaneous coronary intervention (PCI), the use of potent antiplatelet agent combinations is recommended. However, some patients continue to have thrombotic events or experience bleeding events, which have been linked to the widely known variability in individual response to antiplatelet therapy, particularly to clopidogrel...
January 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28135897/pharmacokinetic-drug-evaluation-of-vorapaxar-for-secondary-prevention-after-acute-coronary-syndrome
#10
Jose-Angel Perez-Rivera, Jairo Monedero-Campo, Clara Cieza-Borrella, Pablo Ruiz-Perez
Vorapaxar is the first protease-activated receptor-1 inhibitor approved for clinical use. Its main indication is the reduction in thrombotic cardiovascular events in patients with previous myocardial infarction or symptomatic peripheral artery disease. Areas covered: This article reviews the pharmacokinetics of vorapaxar and its potential use in secondary prevention after an acute coronary syndrome. Expert opinion: Vorapaxar inhibits platelet aggregation mediated by thrombin. This effect is carried out without affecting to coagulation parameters and bleeding times...
March 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28127832/does-this-patient-need-telemetry-an-analysis-of-telemetry-ordering-practices-at-an-academic-medical-center
#11
Stephanie Chen, Sonali Palchaudhuri, Amber Johnson, Jeff Trost, Ileana Ponor, Sammy Zakaria
INTRODUCTION: The American Heart Association and Choosing Wisely campaign recommend guideline-based usage of telemetry. Inappropriate use leads to increased costs, alarm fatigue, and inefficient nursing care. This study assesses provider ordering practices for telemetry at a US-based academic hospital. METHODS: This retrospective study includes all telemetry orders in the medicine and progressive care units from April 2014 to March 2015. Indications were grouped into categories per American Heart Association guidelines...
January 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28122793/real-world-insights-on-the-initiation-and-treatment-duration-of-oral-antiplatelets-in-acute-coronary-syndromes-a-retrospective-cohort-study
#12
Marc J Claeys, Christophe Beauloye, Suzanne Pourbaix, Peter R Sinnaeve
AIMS: This study is a real world, observational study evaluating the treatment persistence of oral antiplatelet (OAP) therapy during a one-year follow-up in patients after an acute coronary syndrome (ACS). METHODS AND RESULTS: Data on diagnosis, comorbidities, follow-up, OAP treatment, reasons, and decision maker for treatment discontinuation in patients who were discharged from a hospital in Belgium after an ACS between 1 July 2012 and 1 June 2013 were collected by cardiologists from 18 centres, up to 360 days from discharge...
January 24, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28116778/percutaneous-coronary-intervention-of-complex-calcified-lesions-with-drug-coated-balloon-after-rotational-atherectomy
#13
Tuomas T Rissanen, Sanna Uskela, Antti Siljander, Jussi M Kärkkäinen, Pirjo Mäntylä, Juha Mustonen, Jaakko Eränen
OBJECTIVES: We investigated the safety and efficacy of PCI using drug-coated balloon (DCB) after rotational atherectomy (rotablation) in a retrospective single center study in patients with calcified de novo coronary lesions. The majority of patients had an increased risk for bleeding. BACKGROUND: DCB has been effective in the treatment of in-stent restenosis, small vessels, and bifurcations. DCB enables short one month dual antiplatelet treatment. No published data exist on the use of DCB after rotablation...
January 23, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28110541/validation-of-a-new-elisa-based-vasodilator-associated-stimulated-phosphoprotein-phosphorylation-assay-to-assess-platelet-reactivity-index-in-a-chinese-population
#14
Peng Ding, Yujie Wei, Nana Chen, Huiliang Liu
The level of platelet reactivity during P2Y12-adenosine diphosphate receptor antagonist is associated with ischemic and bleeding risks following percutaneous coronary intervention in acute coronary syndrome. Determining platelet reactivity inhibition may be valuable for confirming effective platelet inhibition for individual patients and identifying patients at risk of bleeding. The enzyme-linked immunosorbent assay (ELISA)-based vasodilator-stimulated phosphoprotein (VASP) assay offers unique advantages over other methods and has not been used in the Chinese population...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28110296/three-six-or-twelve-months-of-dual-antiplatelet-therapy-after-des-implantation-in-patients-with-or-without-acute-coronary-syndromes-an-individual-patient-data-pairwise-and-network-meta-analysis-of-six-randomized-trials-and-11%C3%A2-473-patients
#15
Tullio Palmerini, Diego Della Riva, Umberto Benedetto, Letizia Bacchi Reggiani, Fausto Feres, Alexandre Abizaid, Martine Gilard, Marie-Claude Morice, Marco Valgimigli, Myeong-Ki Hong, Byeong-Keuk Kim, Yangsoo Jang, Hyo-Soo Kim, Kyung Woo Park, Antonio Colombo, Alaide Chieffo, Diego Sangiorgi, Giuseppe Biondi-Zoccai, Philippe Généreux, Gianni D Angelini, Maria Pufulete, Jonathon White, Deepak L Bhatt, Gregg W Stone
AIM: We sought to determine whether the optimal dual antiplatelet therapy (DAPT) duration after drug-eluting stent (DES) placement varies according to clinical presentation. METHODS AND RESULTS: We performed an individual patient data pairwise and network meta-analysis comparing short-term (≤6-months) versus long-term (1-year) DAPT as well as 3-month vs. 6-month vs 1-year DAPT. The primary study outcome was the 1-year composite risk of myocardial infarction (MI) or definite/probable stent thrombosis (ST)...
January 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28102427/prospective-randomised-trial-of-the-time-dependent-antiplatelet-effects-of-500-mg-and-250-mg-acetylsalicylic-acid-i-%C3%A2-v-and-300-mg-p-%C3%A2-o-in-acs-acute
#16
Uwe Zeymer, Thomas Hohlfeld, Jürgen Vom Dahl, Raimund Erbel, Thomas Münzel, Ralf Zahn, Alexander Roitenberg, Stefanie Breitenstein, Ákos Ferenc Pap, Dietmar Trenk
Little is known about the onset of action after intravenous or oral administration of acetylsalicylic acid (ASA) in patients with acute coronary syndromes (ACS). The aim of the study was to compare intravenous 250 or 500 mg acetylsalicylic acid (ASA) with oral 300 mg in ASA naïve patients with ACS concerning the onset of antiplatelet effects measured by time dependent thromboxane inhibition. A total of 270 patients with ACS < 24 hours were randomised into one of three treatment arms comprising administration of a single dose of ASA as soon as possible after admission...
January 19, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#17
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28097639/risk-of-bleeding-and-repeated-bleeding-events-in-prasugrel-treated-patients-a-review-of-data-from-the-japanese-prasfit-studies
#18
REVIEW
Masakatsu Nishikawa, Takaaki Isshiki, Takeshi Kimura, Hisao Ogawa, Hiroyoshi Yokoi, Shunichi Miyazaki, Yasuo Ikeda, Masato Nakamura, Yuko Tanaka, Shigeru Saito
Prasugrel is a third-generation thienopyridine that achieves potent platelet inhibition with less pharmacological variability than other thienopyridines. However, clinical experience suggests that prasugrel may be associated with a higher risk of de novo and recurrent bleeding events compared with clopidogrel in Japanese patients undergoing percutaneous coronary intervention (PCI). In this review, we evaluate the risk of bleeding in Japanese patients treated with prasugrel at the doses (loading/maintenance doses: 20/3...
January 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28091972/-secondary-prevention-with-antiplatelet-therapy-in-cardiac-rehabilitation
#19
Maria M Wanitschek, Hannes F Alber
The long-term increased cardiovascular risk of patients with an acute coronary syndrome (ACS) is a challenging and common clinical problem. Recent evidence demonstrated an ischemic benefit for a prolonged dual antiplatelet therapy beyond the initial 12 months at the cost of an increased bleeding risk. Individual, careful and repeated risk-benefit analyses are essential for an optimized patient management in which cardiovascular rehabilitation providers may play a central role.
January 13, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28089137/a-comparison-of-cangrelor-prasugrel-ticagrelor-and-clopidogrel-in-patients-undergoing-percutaneous-coronary-intervention-a-network-meta-analysis
#20
Peter C Westman, Michael J Lipinski, Rebecca Torguson, Ron Waksman
BACKGROUND: Newer P2Y12 inhibitors have more rapid onset of platelet inhibition compared with clopidogrel, especially the intravenous P2Y12 inhibitor cangrelor. Direct comparisons between cangrelor and oral P2Y12 inhibitors ticagrelor and prasugrel do not exist. Thus, we performed a network meta-analysis to directly and indirectly compare different P2Y12 inhibitors in patients undergoing percutaneous coronary intervention (PCI). METHODS: MEDLINE/PubMed and ClinicalTrials...
October 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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