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bleeding in coronary syndroms

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https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#1
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#2
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#3
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28809046/platelet-transfusion-to-reverse-antiplatelet-therapy-before-decompressive-surgery-in-patients-with-intracranial-haemorrhage
#4
M Baschin, S Selleng, J-P Zeden, A Westphal, T Kohlmann, H W Schroeder, A Greinacher, T Thiele
BACKGROUND: Platelet concentrates (PC) are transfused to improve primary haemostasis before urgent neurosurgery in patients with intracranial haemorrhage (ICH) receiving antiplatelet therapy (APT). It is unresolved, whether PCs increase the risk for major cardio- and cerebrovascular adverse events. We evaluated a standardized transfusion regimen to reverse APT in patients with ICH who required decompressive neurosurgery. METHODS: Analysed were consecutive patients between 2012 and 2014...
August 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#5
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28802810/early-invasive-versus-initially-conservative-strategy-in-elderly-patients-older-than-75-years-with-non-st-elevation-acute-coronary-syndrome-a-meta-analysis
#6
Wenfang Ma, Yan Liang, Jun Zhu
BACKGROUND: Fear of complications related to the procedure and unclear benefits in elderly patients are common reasons for invasive angiography being withheld. METHODS: We searched PubMed and Embase from inception until February 2016 for studies that enrolled individuals older than 75 years with non-ST-elevation acute coronary syndrome (NSTE-ACS) and allocated patients to either an invasive or conservative strategy. RESULTS: Thirteen studies (four randomised controlled trials (RCTs) and nine observational studies) enrolling 832,007 elderly NSTE-ACS patients were analysed...
July 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28797584/long-term-outcomes-of-frozen-elephant-trunk-for-type-a-aortic-dissection-in-patients-with-marfan-syndrome
#7
Wei-Guo Ma, Wei Zhang, Jun-Ming Zhu, Bulat A Ziganshin, Ai-Hua Zhi, Jun Zheng, Yong-Min Liu, John A Elefteriades, Li-Zhong Sun
OBJECTIVE: The use of the frozen elephant trunk (FET) technique for repair of type A aortic dissection (TAAD) in Marfan syndrome (MFS) is controversial. We seek to evaluate the efficacy of FET and total arch replacement (TAR) for TAAD in patients with MFS. METHODS: The early and long-term outcomes were analyzed for 106 patients with MFS (mean age, 34.5 ± 9.7 years) undergoing FET + TAR for TAAD. RESULTS: Operative mortality was 6.6% (7 of 106)...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28789846/additive-value-of-the-crusade-score-to-the-grace-score-for-mortality-risk-prediction-in-patients-with-acute-coronary-syndromes
#8
Alberto Cordero, Moisés Rodriguez-Manero, Jose M García-Acuña, Ramón López-Palop, Belen Cid, Pilar Carrillo, Rosa Agra-Bermejo, Violeta González-Salvado, Diego Iglesias-Alvarez, Vicente Bertomeu-Martínez, Jose R González-Juanatey
INTRODUCTION: Acute coronary syndrome (ACS) treatments increase bleeding complications that also impair prognosis. Bleeding risk scores reclassification of actual mortality risk estimated by the GRACE score might improve overall estimation. METHODS: Observational and prospective study of all ACS patients admitted in two hospitals. Mortality risk was assessed by the GRACE score and bleeding risk by the CRUSADE score. We analyzed the net reclassification improvement (NRI) of adding the CRUSADE score to the GRACE score...
August 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28780028/associations-between-chronic-kidney-disease-and-outcomes-with-use-of-prasugrel-versus-clopidogrel-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-a-report-from-the-prometheus-study
#9
Usman Baber, Jaya Chandrasekhar, Samantha Sartori, Melissa Aquino, Annapoorna S Kini, Samir Kapadia, William Weintraub, Joseph B Muhlestein, Birgit Vogel, Michela Faggioni, Serdar Farhan, Sandra Weiss, Craig Strauss, Catalin Toma, Anthony DeFranco, Brian A Baker, Stuart Keller, Mark B Effron, Timothy D Henry, Sunil Rao, Stuart Pocock, George Dangas, Roxana Mehran
OBJECTIVES: The study sought to compare clinical outcomes in a contemporary acute coronary syndrome (ACS) percutaneous coronary intervention (PCI) cohort stratified by chronic kidney disease (CKD) status. BACKGROUND: Patients with CKD exhibit high risks for both thrombotic and bleeding events, thus complicating decision making regarding antiplatelet therapy in the setting of ACS. METHODS: The PROMETHEUS study was a multicenter observational study comparing outcomes with prasugrel versus clopidogrel in ACS PCI patients...
July 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28763308/revascularization-strategies-and-in-hospital-management-in-acute-coronary-syndromes-complicated-by-hemophilia-a-or-hemophilia-b
#10
Matthew J Reilley, Anne Blair, William H Matthai, Rolando Vega, Meghan Buckley, Phyllis A Gimotty, Patrick F Fogarty
: Among adult patients with hemophilia A and hemophilia B the emergent management of acute coronary syndromes (ACSs) is challenging, and exposure to antithrombotic agents and/or revascularization procedures may confer an enhanced risk of bleeding. We sought to identify clinical characteristics and in-hospital outcomes among ACS patients with hemophilia A/hemophilia B, compared with matched noncoagulopathic ACS controls. Case discharges from the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (1998-2011) had International Classification of Diseases, 9th Revision codes for hemophilia A/hemophilia B and ACS...
July 29, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28762912/-the-experience-of-use-triple-antithrombotic-therapy-in-patients-with-acute-coronary-syndrome-and-atrial-fibrillation
#11
N G Lozhkina, M H Hasanova, E A Glebchenko, E A Naidena, V A Kozik, A D Kuimov
AIM: In real life to evaluate the effectiveness and safety of apixaban with double antiplatelet therapy for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and the recent episode of acute coronary syndrome without ST segment elevation. MATERIALS AND METHODS: 8 patients with atrial fibrillation and the recent (8-14 days after the onset of symptoms of ACS) episode of acute coronary syndrome without ST segment elevation were involved into the research...
April 2017: Kardiologiia
https://www.readbyqxmd.com/read/28759944/impact-of-health-utility-after-thrombotic-complications-following-total-hip-and-knee-arthroplasty
#12
Bikram Karmakar
BACKGROUND: Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life-threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient. METHODS: The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data...
July 31, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28751841/consensus-document-of-the-italian-association-of-hospital-cardiologists-anmco-italian-society-of-cardiology-sic-italian-association-of-interventional-cardiology-sici-gise-and-italian-society-of-cardiac-surgery-sicch-clinical-approach-to-pharmacologic-pre-treatment
#13
Roberto Caporale, Giovanna Geraci, Michele Massimo Gulizia, Mauro Borzi, Furio Colivicchi, A Menozzi, Giuseppe Musumeci, Marino Scherillo, Antonietta Ledda, Giuseppe Tarantini, Piersilvio Gerometta, Giancarlo Casolo, Dario Formigli, Francesco Romeo, Roberto Di Bartolomeo
The wide availability of effective drugs in reducing cardiovascular events together with the use of myocardial revascularization has greatly improved the prognosis of patients with coronary artery disease. The combination of antithrombotic drugs to be administered before the knowledge of the coronary anatomy and before the consequent therapeutic strategies, can allow to anticipate optimal treatment, but can also expose the patients at risk of bleeding that, especially in acute coronary syndromes, can significantly weigh on their prognosis, even more than the expected theoretical benefit...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28750372/contemporary-antiplatelet-treatment-in-acute-coronary-syndrome-patients-with-impaired-renal-function-undergoing-percutaneous-coronary-intervention
#14
Periklis Davlouros, Ioanna Xanthopoulou, John Goudevenos, Michalis Hamilos, Emmanouil Vavuranakis, George Sitafidis, Ioannis Kanakakis, Spyridon Deftereos, Dimitrios Alexopoulos
OBJECTIVES: To assess the clinical impact of impaired renal function (IRF), in "real-world" acute coronary syndrome (ACS) patients, receiving clopidogrel, prasugrel, or ticagrelor. METHODS: This was a prospective, observational, multicenter, cohort study of ACS patients undergoing percutaneous coronary interventions (PCI) with IRF (creatinine clearance <60 mL/min by Cockroft-Gault equation), who were recruited into the Greek Antiplatelet Registry (GRAPE). Patients were followed-up until 1 year for major adverse cardiovascular events (MACE; a composite of death, nonfatal myocardial infarction, urgent revascularization, and stroke) and BARC (Bleeding Academic Research Consortium) bleeding...
July 28, 2017: Cardiology
https://www.readbyqxmd.com/read/28744215/safety-and-effectiveness-of-bivalirudin-in-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#15
REVIEW
Abdul Hafeez Ahmad Hamdi, Ahmad Fauzi Dali, Thimarul Huda Mat Nuri, Muhammad Syafiq Saleh, Noor Nabila Ajmi, Chin Fen Neoh, Long Chiau Ming, Amir Heberd Abdullah, Tahir Mehmood Khan
Recent clinical trials have shown that while bivalirudin exhibits similar efficacy with heparin, it offers several advantages over heparin, such as a better safety profile. We aimed to evaluate the efficacy and safety of bivalirudin use during Percutaneous Coronary Intervention (PCI) in the treatment of angina and acute coronary syndrome (ACS). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, PubMed, EMBASE, and Science Direct from January 1980 to January 2016...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28740709/outcomes-of-a-hybrid-approach-of-percutaneous-coronary-intervention-followed-by-minimally-invasive-aortic-valve-replacement
#16
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Gerald P Rosen, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients requiring coronary revascularization and aortic valve replacement, a combined approach of percutaneous coronary intervention followed by minimally invasive aortic valve replacement may be a viable treatment strategy. METHODS: The outcomes of 123 consecutive patients with significant coronary artery and aortic valve disease, who underwent percutaneous coronary intervention followed by elective minimally invasive aortic valve replacement between February 2009 and April 2014, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28736558/evaluation-of-the-crusade-risk-score-for-predicting-major-bleeding-in-patients-with-concomitant-kidney-dysfunction-and-acute-coronary-syndromes
#17
Marianela Sánchez-Martínez, Pedro J Flores-Blanco, Ángel A López-Cuenca, María J Sánchez-Galián, Miriam Gómez-Molina, Francisco Cambronero-Sánchez, Esther Guerrero-Pérez, Mariano Valdés, James L Januzzi, Sergio Manzano-Fernández
BACKGROUND: Kidney dysfunction (KD) has been associated with increased risk for major bleeding (MB) in patients with acute coronary syndromes (ACS) and may be in part related to an underuse of evidence-based therapies. Our aim was to assess the predictive ability of the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) risk score in patients with concomitant ACS and chronic kidney disease. METHODS: We conducted a retrospective analysis of a prospective registry including 1,587 ACS patients...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28732349/intracoronary-administration-of-tirofiban-during-percutaneous-coronary-intervention-facilitates-patients-with-acute-coronary-syndrome
#18
Helei Jia, Changqing Lu, Panli Sun
We assessed the efficacy and safety of tirofiban intracoronary versus intravenous administration during percutaneous coronary intervention for patients with acute coronary syndrome. The databases of PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang Database were retrieved. A total of 437 articles were found, according to inclusive and exclusive criteria, 13 of which were finally included. Compared with subjects with intravenous administration, those with intracoronary administration were more likely to reach thrombolysis in myocardial infarction trial grade 3 flow (relative risk = 1...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28730895/incidence-treatment-strategies-and-outcomes-of-acute-coronary-syndrome-with-and-without-ongoing-myocardial-ischaemia-results-from-the-czech-3-registry
#19
Petr Tousek, Klara Staskova, Anna Mala, Martin Sluka, Alexandra Vodzinska, Radek Jancar, Denisa Maluskova, Jiri Jarkovsky, Petr Widimsky
BACKGROUND: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28730406/benefits-and-risks-of-p2y12-inhibitor-preloading-in-patients-with-acute-coronary-syndrome-and-stable-angina
#20
REVIEW
Taylor C Bazemore, Michael G Nanna, Sunil V Rao
Treatment with P2Y12 inhibitors is an integral part of the standard of care for patients undergoing percutaneous coronary intervention. However, the most appropriate timing for P2Y12 inhibitor administration remains unclear, and the value of "preloading" with P2Y12 inhibitors prior to cardiac catheterization is controversial. While pre-catheterization treatment with P2Y12 inhibitors is performed with the goal of decreasing adverse cardiovascular events, this potential benefit must be weighed against the increased risk of bleeding complications and operative delay if coronary artery bypass graft surgery is indicated...
July 20, 2017: Journal of Thrombosis and Thrombolysis
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