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bleeding in coronary syndroms

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https://www.readbyqxmd.com/read/29666900/polymer-free-biolimus-a9-coated-stent-for-primary-percutaneous-coronary-intervention
#1
D J H Lee, J K K Loh, F H Jafary, H H Ho, T Watson, H-P Stoll, P J L Ong
BACKGROUND: The polymer-free biolimus-A9 drug-coated stent (DCS) was reported to have superior safety and efficacy outcomes compared with a bare metal stent in the LEADERS FREE trial of high-bleeding-risk patients with acute coronary syndrome and on dual antiplatelet treatment (DAPT) for 1 month. The aim of this investigation was to evaluate the DCS in a consecutive cohort of patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI)...
April 17, 2018: Herz
https://www.readbyqxmd.com/read/29664423/long-term-follow-up-of-antithrombotic-management-patterns-in-acute-coronary-syndrome-patients
#2
Fatih Sinan Ertaş, Lale Tokgozoglu
OBJECTIVE: The aim of this study was to evaluate the longterm, post-discharge follow-up of antithrombotic management patterns (AMPs), clinical outcomes, and real-life health status of patients hospitalized acute coronary syndrome (ACS). METHODS: A total of 1034 patients hospitalized for ACS within 24 hours of symptom onset who survived to discharge were included. Of those, 514 had ST-segment elevation myocardial infarction (STEMI) and 520 had unstable angina (UA)/non-STEMI (NSTEMI)...
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29659846/is-administration-of-dual-antiplatelet-therapy-beneficial-for-patients-following-off-pump-coronary-artery-bypass-grafting
#3
Maciej Peksa, Sleiman Sebastian Aboul-Hassan, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether administration of dual-antiplatelet therapy (DAPT) following off-pump coronary artery bypass grafting (OPCAB) would improve postoperative clinical outcomes or minimize the incidence of postoperative graft failure. In total, 101 papers were found using the reported search, 14 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
April 5, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29656987/differential-prognostic-impact-on-mortality-of-myocardial-infarction-compared-with-bleeding-severity-in-contemporary-acute-coronary-syndrome-patients
#4
Berenice Caneiro-Queija, Emad Abu-Assi, Sergio Raposeiras-Roubín, Sergio Manzano-Fernández, Pedro Flores Blanco, Ángel López-Cuenca, Rafael Cobas-Paz, Miriam Gómez-Molina, José Manuel Rodríguez-Rodríguez, Francisco Calvo-Iglesias, Mariano Valdés-Chávarri, Andrés Íñiguez-Romo
INTRODUCTION AND OBJECTIVES: The impact on mortality of myocardial infarction (MI) compared with the specific degree of bleeding severity occurring after discharge in acute coronary syndrome is poorly characterized. Defining this relationship may help to achieve a favorable therapeutic risk-benefit balance. METHODS: Using Cox-based shared frailty models, we assessed the relationship between mortality and postdischarge MI and bleeding severity-graded according to Bleeding Academic Research Consortium (BARC)-in 4229 acute coronary syndrome patients undergoing in-hospital coronary arteriography between January 2012 and December 2015...
April 12, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#5
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29617503/postoperative-bleeding-following-preoperative-clopidogrel-administration-in-patients-with-haemoglobin-level-above-110-g-l-undergoing-urgent-cabg
#6
Sasa Milan Kacar, Aleksandar Mikic, Mirjana Božidar Kačar
INTRODUCTION: Patients with acute coronary syndrome usually receive dual antiplatelet therapy (DAPT) (usually clopidogrel + aspirin) prior to coronary catheterization, and approximately 10% of these patients require coronary artery bypass grafting (CABG). DAPT has favorable effects on prevention of thrombus formation, but it can have deleterious effects on surgical hemostasis. Anaemia, if present, gives additional risk to such patients. The aim of this study was to examine if DAPT affects postoperative bleeding in patients with haemoglobin levels above 110 g/L, who underwent urgent or emergent CABG, less than five days after stopping DAPT therapy...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29614534/-current-concepts-of-cardiologic-therapies-in-the-elderly
#7
Ursula Müller-Werdan, Kristina Norman
MYOCARDIAL INFARCTION IN THE OLD PATIENT: Even old patients may crucially benefit from reopening the occluded coronary artery by percutaneous coronary intervention with stent implantation. Bleeding complications can be reduced by choosing the radial instead of the femoral vascular approach for cardiac catheterization. STATINS FOR THE ELDERLY: WHEN TO START UND WHEN TO STOP?: Elderly benefit no less than the younger from statins. "Goal-oriented statin therapy" is preferable to the "statin strategy of fixed dose"...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29614517/prediction-of-post-discharge-bleeding-in-elderly-patients-with-acute-coronary-syndromes-insights-from-the-bleemacs-registry
#8
Alberto Garay, Albert Ariza-Solé, Francesc Formiga, Sergio Raposeiras-Roubín, Emad Abu-Assi, José C Sánchez-Salado, Victòria Lorente, Oriol Alegre, Jose Paulo Simao Henriques, Fabrizio D'Ascenzo, Jorge Saucedo, José Ramón González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Claudio Moretti, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, José María García-Acuña, Danielle Southern, Emilio Alfonso, Belén Terol, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Francesca Giordana, Fiorenzo Gaita, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahashi, Kenji Sakata, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev, Angel Cequier
BACKGROUND:  A poor ability of recommended risk scores for predicting in-hospital bleeding has been reported in elderly patients with acute coronary syndromes (ACS). No study assessed the prediction of post-discharge bleeding in the elderly. The new BleeMACS score (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome), was designed to predict post-discharge bleeding in ACS patients. We aimed to assess the predictive ability of the BleeMACS score in elderly patients...
April 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29611427/impact-of-known-or-new-onset-atrial-fibrillation-on-2-year-cardiovascular-event-rate-in-patients-with-acute-coronary-syndromes-results-from-the-prospective-epicor-registry
#9
Uwe Zeymer, Lieven Annemans, Nicolas Danchin, Stuart Pocock, Simon Newsome, Frans Van de Werf, Jesús Medina, Héctor Bueno
BACKGROUND: Atrial fibrillation (AF) is associated with increased morbidity in acute coronary syndrome patients, but impact on outcomes beyond 1 year is unclear. METHODS: This was a post-hoc analysis from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) registry (NCT01171404), a prospective, observational study conducted in Europe and Latin America, which enrolled acute coronary syndrome survivors at discharge...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29606324/comparison-of-outcomes-and-intervention-among-patients-with-non-st-segment-elevation-acute-myocardial-infarction-of-those-with-a-left-circumflex-versus-those-with-a-non-left-circumflex-related-coronary-artery-from-the-elisa-3-trial
#10
Erik A Badings, Renicus S Hermanides, Salem H K The, Jan-Henk E Dambrink, Saman Rasoul, Jan Van Wijngaarden, Esther Van 't Riet, Evelien Kolkman, Wouter S Remkes, Geert Tjeerdsma, Marloes L J Van Der Wielen, Dirk J A Lok, Harry Suryapranata, Arnoud W J Van 't Hof
Previous studies found that patients with an acute coronary syndrome (ACS) due to occlusion of the left circumflex (LC) coronary artery often present without ST-elevation, leading to a delay in diagnosis and revascularization, a larger infarct size, and a worse prognosis. In this subgroup analysis of the ELISA-3 study (early or late intervention in high-risk non-ST-segment elevation acute coronary syndromes [NSTE-ACS]) incidence, characteristics and prognosis of LC-related NSTE-ACS was investigated, and the outcome of early versus late invasive strategy was compared...
February 21, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29602767/in-hospital-outcomes-of-dual-loading-antiplatelet-therapy-in-patients-75-years-and-older-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-findings-from-the-ccc-acs-improving-care-for-cardiovascular-disease-in-china-acute-coronary-syndrome
#11
Guanqi Zhao, Mengge Zhou, Changsheng Ma, Yong Huo, Sidney C Smith, Gregg C Fonarow, Junbo Ge, Yaling Han, Jing Liu, Yongchen Hao, Jun Liu, Xiao Wang, Kathryn A Taubert, Louise Morgan, Dong Zhao, Shaoping Nie
BACKGROUND: Elderly patients with acute coronary syndrome (ACS) are at high risk for ischemic and bleeding events. This study aimed to evaluate the clinical effectiveness and safety of dual loading antiplatelet therapy for patients 75 years and older undergoing percutaneous coronary intervention for ACS. METHODS AND RESULTS: The Improving Care for Cardiovascular Disease in China-ACS project was a collaborative study of the American Heart Association and Chinese Society of Cardiology...
March 30, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29602462/dual-antithrombotic-plus-adjunctive-antiinflammatory-therapy-to-improve-cardiovascular-outcome-in-atrial-fibrillation-patients-with-concurrent-acute-coronary-syndrome-a-triple-pathway-strategy
#12
Gerald Chi, Adeel Jamil, Miroslav Radulovic, Umer Jamil, Muhammad A Balouch, Jolanta Marszalek, Zahra Karimi, Seyedmahdi Pahlavani, Mehrian Jafarizade, Husnain Shaukat, Sunny Kumar, Arzu Kalayci
The concurrence of atrial fibrillation and acute coronary syndrome poses a conundrum in the antithrombotic management as intensification of anticoagulation or antiplatelet therapy inevitably comes at the price of an increased bleeding risk. Various antithrombotic combinations have been attempted to prevent the recurrent cardiovascular events, however, there has been limited success in effective risk reduction for this high risk population. Given the overarching effect of interleukin 1β-driven inflammation on the arrhythmogenesis, thrombogenesis, and hypercoagulability, we hypothesize that the triple-pathway strategy (i...
May 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29596078/reduction-in-postpercutaneous-coronary-intervention-angina-in-addition-to-gastrointestinal-events-in-patients-on-combined-proton-pump-inhibitors-and-dual-antiplatelet-therapy-a-systematic-review-and-meta-analysis
#13
Muhammad Y Khan, Waqas J Siddiqui, Chikezie Alvarez, Sandeep Aggarwal, Syed F Hasni, Asyia Ahmad, Howard Eisen
BACKGROUND: Primary percutaneous coronary intervention (PCI) is a standard treatment in patients with acute coronary syndrome. Studies have shown that proton pump inhibitors (PPIs) can potentially attenuate the antiplatelet effects of P2Y12 inhibitors with associated adverse cardiovascular outcomes. MATERIALS AND METHODS: Medline was searched using Pubmed from inception to 8 November 2017 for randomized control trials studying the effect of PPIs on coronary artery disease with concomitant use of dual antiplatelet therapy (DAPT)...
March 28, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29595186/evaluation-of-the-patterns-of-non-adherence-to-anti-platelet-regimens-in-stented-patients-bleeding-score-for-predicting-the-long-term-out-of-hospital-bleeding-risk-in-chinese-patients-after-percutaneous-coronary-intervention
#14
Xue-Yan Zhao, Jian-Xin Li, Xiao-Fang Tang, Jing-Jing Xu, Ying Song, Lin Jiang, Jue Chen, Lei Song, Li-Jian Gao, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan
Background: The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients (PARIS) bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention (PCI). However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score's predictive value of bleeding in patients after PCI in the Chinese population. Methods: We performed a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China...
March 27, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29588304/inhibitory-mechanisms-of-very-low-dose-rivaroxaban-in-non-st-elevation-myocardial-infarction
#15
Oliver Borst, Patrick Münzer, Nada Alnaggar, Sascha Geue, Roland Tegtmeyer, Dominik Rath, Michal Droppa, Peter Seizer, Stefan Heitmeier, Johan W M Heemskerk, Lisa K Jennings, Robert F Storey, Dominick J Angiolillo, Bianca Rocca, Henri Spronk, Hugo Ten Cate, Meinrad Gawaz, Tobias Geisler
Very low-dose (VLD) factor Xa (FXa) inhibition, in combination with acetylsalicylic acid (ASA) and clopidogrel, is associated with improved outcomes in patients with acute coronary syndrome (ACS) with a tolerable bleeding risk profile. To date, there are no data documenting platelet inhibition and the anticoagulatory effects of VLD FXa inhibition on top of guideline-adherent dual-antiplatelet therapy (DAPT) in patients with ACS. Patients with non-ST-elevation myocardial infarction (NSTEMI) receiving oral DAPT (ASA + clopidogrel, n = 20; or ASA + ticagrelor, n = 20) were prospectively enrolled in a nonrandomized study...
March 27, 2018: Blood Advances
https://www.readbyqxmd.com/read/29579602/high-on-treatment-platelet-reactivity-and-outcome-in-elderly-with-non-st-segment-elevation-acute-coronary-syndrome-insight-from-the-gepress-study
#16
Roberta De Rosa, Tullio Palmerini, Stefano De Servi, Marta Belmonte, Gabriele Crimi, Stefano Cornara, Paolo Calabrò, Marco Cattaneo, Diego Maffeo, Anna Toso, Antonio Bartorelli, Cataldo Palmieri, Marco De Carlo, Davide Capodanno, Philippe Genereux, Dominick Angiolillo, Federico Piscione, Gennaro Galasso
BACKGROUND: Elderly treated with dual antiplatelet therapy after percutaneous coronary intervention (PCI) represent a challenging population because of increased risk of both ischemic and bleeding events. We aimed to investigate the association between high on-treatment platelet reactivity (HPR) and long-term outcome in elderly with non-ST-elevated acute coronary syndromes (NSTE-ACS) undergoing PCI. METHODS: Platelet reactivity was measured by vasodilator-stimulated phosphoprotein (VASP) assay at three time-points (baseline, discharge, 1 month after PCI) in 1053 NSTE-ACS patients (311 elderly) treated with clopidogrel...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29577768/antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-where-are-we-now
#17
Ryan G D'Angelo, Thaddeus McGiness, Laura H White
OBJECTIVE: To synthesize the literature and provide guidance to practitioners regarding double therapy (DT) and triple therapy (TT) in patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI). DATA SOURCES: PubMed and MEDLINE (January 2000 to February 2018) were searched using the following terms: atrial fibrillation, myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, anticoagulation, dual-antiplatelet therapy, clopidogrel, aspirin, ticagrelor, prasugrel, and triple therapy...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29564693/clinical-effects-with-inhibition-of-multiple-coagulative-pathways-in-patients-admitted-for-acute-coronary-syndrome
#18
REVIEW
Ilaria Cavallari, Giuseppe Patti
Platelets and the coagulation cascade play key roles in initiation, amplification, and perpetuation of acute coronary syndromes (ACS). In the past few years, there has been great progress in ACS antithrombotic treatment with the introduction of novel anticoagulants (fondaparinux and bivalirudin), more potent P2Y12 inhibitors (prasugrel and ticagrelor) and protease-activated receptor antagonists (vorapaxar). Nonetheless, patients with ACS frequently have recurrent ischemic events despite the use of currently recommended dual antiplatelet therapy, revascularization procedures as appropriate, and other evidence-based secondary preventive measures...
March 21, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29563393/accelerated-atherogenicity-in-tangier-disease
#19
Jun Muratsu, Masahiro Koseki, Daisaku Masuda, Yuji Yasuga, Satoki Tomoyama, Keiji Ataka, Yoshiki Yagi, Atsushi Nakagawa, Hidehumi Hamada, Shigeki Fujita, Hiroaki Hattori, Tohru Ohama, Makoto Nishida, Hisatoyo Hiraoka, Yuji Matsuzawa, Shizuya Yamashita
We report a case of Tangier disease with Leriche syndrome and bleeding tendency. In this male patient, nasal hemorrhage had been observed frequently throughout childhood. At 46 years old, he experienced effort angina, and coronary angiography demonstrated 75% stenosis in the right coronary artery. Orange-colored tonsils, mild hepatosplenomegaly and very low levels of serum high-density lipoprotein cholesterol (HDL-C) were observed, and the patient was diagnosed with Tangier disease. At 52 years old, effort angina recurred...
March 20, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29562422/-predictive-value-of-the-grace-discharge-score-on-the-long-term-out-of-hospital-coronary-thrombotic-events-after-implantation-of-drug-eluting-stents
#20
X Y Zhao, J X Li, X F Tang, Y Xian, J J Xu, Y Song, L Jiang, L J Xu, J Chen, Y Zhang, L Song, L J Gao, Z Gao, J Zhang, Y Wu, S B Qiao, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To evaluate the predictive value of GRACE discharge score on the long-term out-of-hospital coronary thrombotic events (CTE) after percutaneous coronary intervention (PCI) with drug-eluting stents. Methods: Present study was a prospective, observational, single center study. 10 724 consecutive patients underwent PCI in Fuwai Hospital between January and December 2013 were included, stents were implanted with conventional method. After PCI, patients were prescribed aspirin 100 mg once daily indefinitely, and either clopidogrel 75 mg once daily or ticagrelor 90 mg twice daily for at least 1 year...
March 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
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