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bleeding in coronary syndroms

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https://www.readbyqxmd.com/read/29045308/thirty-days-only-double-antiplatelet-therapy-after-drug-eluting-stenting-could-a-short-term-treatment-be-advantageous
#1
Gianni Casella, Elvira Resciniti, Pamela Gallo
: The duration of dual antiplatelet therapy (DAPT) after coronary stenting has been evaluated in randomized studies with apparently conflicting results. Prolonged DAPT reduces late stent thrombosis and myocardial infarction, but at the expenses of more hemorrhages. On the contrary, bleedings are associated with higher morbidity and mortality. Thus, in patients at high risk of bleeding, the less effective bare-metal stents could be preferred to drug-eluting stents (DES) due to the shortened DAPT needed. However, new DES technology carries a lower risk of stent thrombosis and casts doubts on the recommended prolonged DAPT regimen after DES...
October 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29044298/the-performance-of-crusade-and-acuity-bleeding-risk-scores-in-ticagrelor-treated-acs-patients-who-underwent-pci
#2
Shaozhi Xi, Shanshan Zhou, Xuyun Wang, Jia Liu, Liuan Qin, Jun Liu, Tong Yin, Yundai Chen
The performance of the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) and ACUITY (Acute Catheterization and Urgent Intervention Triage strategy) risk scores for the prediction of major bleeding in ticagrelor-treated acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI) is unknown. The aim of the present study is to validate the performance of both scores in a contemporary Chinese cohort of ACS patients hospitalized for PCI and administrated with ticagrelor...
October 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29043405/-focused-update-on-dual-antiplatelet-treatment-esc-guidelines-2017
#3
A Schäfer, J Bauersachs
Dual antiplatelet treatment (DAPT) is a cornerstone of maintenance medication of patients following elective percutaneous coronary interventions or an acute coronary syndrome (ACS), e. g. ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina. In recent years the inclusion of P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. Following the introduction of the modern generation of drug-eluting stents for elective coronary interventions, the duration of the necessary DAPT has been clearly reduced...
October 17, 2017: Herz
https://www.readbyqxmd.com/read/29033503/the-management-and-prognostic-factors-of-acute-coronary-syndrome-evidence-from-the-taiwan-acute-coronary-syndrome-full-spectrum-registry
#4
REVIEW
Chun-Yuan Chu, Tsung-Hsien Lin, Wen-Ter Lai
Cardiovascular disease (CVD) accounts for approximately one-third of all global deaths, and acute coronary syndrome (ACS) is the most severe form of CVD. It is of notable importance to develop ACS strategies for reducing major adverse cardiac events (MACE) and preventing complications. In the Taiwan ACS Full Spectrum Registry, 1-year mortality among patients with ST-segment elevation myocardial infarction, non ST-segment elevation myocardial infarction and unstable angina was 6.1%, 10.1%, and 6.2%, respectively...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29023996/effect-of-sex-difference-in-clinical-presentation-stable-coronary-artery-disease-vs-unstable-angina-pectoris-or-non-st-elevation-myocardial-infarction-vs-st-elevation-myocardial-infarction-on-2-year-outcomes-in-patients-undergoing-percutaneous-coronary-intervention
#5
Xiao-Fang Tang, Ying Song, Jing-Jing Xu, Yuan-Liang Ma, Jia-Hui Zhang, Yi Yao, Chen He, Huan-Huan Wang, Ping Jiang, Lin Jiang, Ru Liu, Zhan Gao, Xue-Yan Zhao, Shu-Bin Qiao, Bo Xu, Yue-Jin Yang, Run-Lin Gao, Jin-Qing Yuan
OBJECTIVE: To determine whether there is a difference in 2-year prognosis among patients across the spectrum of coronary artery disease undergoing percutaneous coronary intervention (PCI). METHODS: We analyzed all consecutive patients undergoing PCI at a single center from 1/1-12/31/2013. Clinical presentations were compared between sexes according to baseline clinical, angiographic, and procedural characteristics and 2-year (mean 730 ± 30-day) outcomes. RESULTS: We grouped 10 724 consecutive patients based on sex and clinical presentation...
October 11, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28994036/comparison-of-4-different-strategies-of-dapt-after-pci-in-acs-real-world-population-from-a-northern-italy-registry
#6
Marta Rasia, Emilia Solinas, Massimiliano Marino, Paolo Guastaroba, Alberto Menozzi, Maria Alberta Cattabiani, Iacopo Tadonio, Rossana De Palma, Luigi Vignali
Aim of the study was to compare four different strategies of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) treated with PCI. DAPT with Clopidogrel, Ticagrelor and Prasugrel has proved to be effective in patients with ACS treated with percutaneous coronary intervention (PCI) by reducing major adverse cardiovascular outcomes (MACE). However, the effect of the different strategies in a real-world population deserves further verification. A retrospective analysis of 2404 discharged ACS patients treated with PCI was performed, with a median follow-up of 1 year...
October 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28984776/intralesional-versus-intracoronary-administration-of-glycoprotein-iib-iiia-inhibitors-during-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndromes-a-meta-analysis-of-randomized-controlled-trials
#7
REVIEW
Binjie Sun, Zhen Liu, Hongshan Yin, Tao Wang, Tao Chen, Sen Yang, Zhian Jiang
BACKGROUND: Glycoprotein IIb/IIIa inhibitors (GPIs) have been regarded as an adjuvant regimen to deal with no-reflow. However, whether intralesional (IL) administration of GPIs improves myocardial reperfusion without increasing bleeding in patients with acute coronary syndrome (ACS) compared with intracoronary (IC) administration has not been well addressed. Our meta-analysis aimed to evaluate the efficacy and safety of IL versus IC administration of GPIs for patients with ACS during percutaneous coronary intervention...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28982722/differences-in-relative-and-absolute-effectiveness-of-oral-p2y-12-inhibition-in-men-and-women-a-meta-analysis-and-modelling-study
#8
Kuan Ken Lee, Nicky Welton, Anoop S Shah, Philip D Adamson, Sofia Dias, Atul Anand, David E Newby, Nicholas L Mills, David A McAllister
OBJECTIVE: To estimate the absolute treatment effects of newer P2Y12 inhibitors (ticagrelor and prasugrel) compared with clopidogrel in men and women with acute coronary syndrome (ACS). METHODS: We searched Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials of oral P2Y12 inhibitors for acute stroke or ACS. Age-specific and sex-specific mortality was obtained for all patients admitted to hospital with myocardial infarction in Scotland from 2006 to 2010 (prior to introduction of prasugrel or ticagrelor)...
October 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28976875/antiplatelet-therapy-in-a-patient-with-coronary-artery-disease-and-myelodysplastic-syndrome-with-thrombocytopenia
#9
Francisco José Fernández-Fernández, Eugenia Ameneiros-Lago, Cintia Tuñas-Gesto, Inmaculada Gómez-Buela
To date, there are no sufficient data to make firm recommendations on the treatment of patients with severe thrombocytopenia who require antiplatelet therapy after experiencing acute coronary syndrome. Therefore, we think that it is important to communicate the experience with individual cases. We report the case of a patient who presented with pericardial effusion causing cardiac tamponade. He had thrombocytopenia associated with myelodysplastic syndrome, and ten weeks before this admission, percutaneous transluminal coronary angioplasty with implantation of drug-eluting stents was performed for non-ST-segment elevation acute coronary syndrome...
2017: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/28969538/triple-therapy-versus-dual-antiplatelet-therapy-for-patients-with-atrial-fibrillation-and-acute-coronary-syndromes-a-systematic-literature-review
#10
Aimee Louise Fake, Anil Ranchord, Scott Harding, Peter Larsen
BACKGROUND: Patients with acute coronary syndromes (ACS) and a history of atrial fibrillation (AF) have indications for both dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC). Triple therapy (TT), the combination of DAPT and OAC, is recommended in guidelines. We examined studies comparing clinical outcomes on DAPT versus TT for patients with AF and ACS. METHODS: We searched Medline, Medline pending, EMBASE and Evidence-Based Medicine Reviews databases for studies published between January 2000 to December 2016 in AF patients with ACS that compared DAPT and TT that reported ischaemic and/or bleeding outcomes...
September 27, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28960123/assessment-of-platelet-function-on-the-routine-coagulation-analyzer-sysmex-cs-2000i
#11
Corinne Frère, Katsushi Kobayashi, Claire Dunois, Jean Amiral, Pierre-Emmanuel Morange, Marie-Christine Alessi
BACKGROUND: Light transmission aggregometry (LTA) is considered as the gold standard for testing platelet function in the setting of both platelet disorders suspicion and response to antiplatelet therapy evaluation. LTA requires however specialized equipment, substantial blood sample volumes, is technically challenging and time-consuming. AIM: To evaluate an automated platelet aggregation method performed on a routine coagulation analyzer Sysmex CS-2000i. METHODS: 46 patients presenting a bleeding syndrome and 62 patients with acute coronary syndrome receiving dual antiplatelet therapy were studied in total...
September 29, 2017: Platelets
https://www.readbyqxmd.com/read/28956743/transradial-versus-transfemoral-approach-for-percutaneous-coronary-intervention-in-elderly-patients-in-china-a-retrospective-analysis
#12
Chen Jin, Yi Xu, Shu-Bin Qiao, Xin-Ran Tang, Yong-Jian Wu, Hong-Bing Yan, Ke-Fei Dou, Bo Xu, Jin-Gang Yang, Yue-Jin Yang
Objective To compare hospital costs and clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention (PCI) in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control potential biases...
September 27, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28945935/efficacy-and-safety-of-ticagrelor-in-patients-with-acute-coronary-syndrome-a-meta-analysis-of-randomized-controlled-trials
#13
Yunyan Jing, Bin Ni, Donglai Zhou, Xingwei Zhang, Shanxin Liu
Acute coronary syndrome (ACS) is a dangerous and urgent clinical pattern of coronary artery disease. Aspirin and adenosine diphosphate P2Y12 receptor antagonists are the standard dual anti-platelet therapy for patients with ACS. Ticagrelor is a new oral antagonist of the adenosine diphosphate P2Y12 receptor. Randomized controlled trials (RCTs) have evaluated the efficacy and safety of ticagrelor compared to clopidogrel or prasugrel in patients with ACS, obtaining conflicting results. Thus, we conducted a meta-analysis of these RCTs to determine the efficacy and safety of ticagrelor in patients with ACS...
September 25, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28919071/validation-of-the-retrieve-reverse-triage-events-criteria-for-same-day-return-of-non-st-elevation-acute-coronary-syndrome-patients-to-referring-non-pci-centres
#14
Sonya N Burgess, Vu Huynh Nguyen, James Xu, Yoshio Hinde, Anoop Dharmadmajan, Xavier Brennan, Karen Owen, Karen Lintern, Craig Juergens, Sidney Lo, Phong Nguyen, Krishna K Kadappu, John K French, Rohan Rajaratnam
BACKGROUND: There are continuing bed constraints in percutaneous coronary intervention centres (PCI) so efficient patient triage from referral hospitals is pivotal. To evaluate a strategy of PCI centre (PCIC) bed-sparing we examined return of patients to referral hospitals screened by the RETRIEVE (REverse TRIage EVEnts) criteria and validated its use as a tool for screening suitability for same day transfer of non-ST-elevation acute coronary syndrome (NSTEACS) patients post PCI to their referring non-PCI centre (NPCIC)...
August 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28918657/direct-oral-anticoagulant-use-in-atypical-thrombosis-related-conditions
#15
Clement Chang, Mario Hoyos, Yaw Owusu, Hazem Elewa
OBJECTIVE: To review the published literature for evidence of the efficacy and safety of direct oral anticoagulants (DOACs) when used in the management of atypical thrombosis-related conditions. DATA SOURCES: A comprehensive MEDLINE database search (1948 to July 2017) and EMBASE search (1980 to July 2017) were conducted using the search terms direct oral anticoagulant in combination with acute coronary syndrome (ACS), antiphospholipid antibody syndrome (APLAS), and cancer-associated thrombosis (CAT)...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28916239/effect-of-body-mass-index-on-clinical-events-after-acute-coronary-syndromes
#16
Pablo Lamelas, Jon-David Schwalm, Ibrahim Quazi, Shamir Mehta, P J Devereaux, Sanjit Jolly, Salim Yusuf
The association between body mass index (BMI) and major clinical events after acute coronary syndrome (ACS) remains controversial. We investigated the impact of BMI on major clinical events after ACS in a large individual patient data meta-analysis. Data on 81,553 patients from 45 different countries with ACS enrolled in 8 large randomized clinical trials were included, followed up for a median of 171 days. The mean age was 63.4 ± 11.7, 70% were male, and the mean BMI was 27.3 ± 4.7 kg/m(2). Compared with upper-normal-weight participants (BMI 21...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28906404/ticagrelor-induced-life-threatening-bleeding-via-the-cyclosporine-mediated-drug-interaction-a-case-report
#17
Chi Zhang, Long Shen, Min Cui, Xiaoyan Liu, Zhichun Gu
RATIONALE: Ticagrelor has become one of the first-line antiplatelet agents in acute coronary syndrome (ACS) patients recommend by the guideline due to its more potent and predictable antiplatelet effect. However, bleeding is still a severe drug adverse reaction of ticagrelor therapy. We report a first case on ticagrelor-induced life-threatening bleeding via the cyclosporine-mediated drug interaction. PATIENT CONCERNS: A 58-year-old Chinese male who received cyclosporine 200 mg daily 5 years after renal transplantation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28893843/timing-of-angiography-and-outcomes-in-high-risk-patients-with-non-st-segment-elevation-myocardial-infarction-managed-invasively-insights-from-the-tao-trial
#18
Pierre Deharo, Gregory Ducrocq, Christoph Bode, Marc Cohen, Thomas Cuisset, Shamir Mehta, Charles V Pollack, Stephen D Wiviott, Yedid Elbez, Marc Sabatine, P Gabriel Steg
Background -In patients with non ST-elevation myocardial infarction (NSTEMI) and Global Registry of Acute Coronary Events (GRACE) score >140, coronary angiography (CAG) is recommended by European and American guidelines within 24h. We sought to study the association of a "very early" (i.e. ≤12h), early (12-24h) and delayed (>24h) CAG in NSTEMI with GRACE score >140 with ischemic outcomes. Methods -The Treatment of Acute coronary syndrome with Otamixaban (TAO) trial randomized patients with NSTEMI and CAG scheduled within 72h to heparin plus eptifibatide versus otamixaban...
September 11, 2017: Circulation
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#19
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28882733/-risk-of-fatal-non-fatal-events-in-patients-with-previous-coronary-heart-disease-acute-myocardial-infarction-and-treatment-with-non-steroidal-anti-inflammatory-drugs
#20
REVIEW
L Muñoz Olmo, J Juan Armas, J J Gomariz García
BACKGROUND: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk...
September 4, 2017: Semergen
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