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https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#1
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#2
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640324/new-paradigms-in-venous-thromboprophylaxis-of-medically-ill-patients
#3
Alex C Spyropoulos, Alex Spyropoulos, Gary E Raskob
Acutelly-ill hospitalised medical patients are at risk of venous thromboembolism (VTE), both in-hospital and in the immediate post-discharge period, and mortality from VTE is thought to be particularly high in this patient population. However, despite previous mandates from international antithrombotic guidelines such as those of the American College of Chest Physicians (ACCP) for the "universal" use of thromboprophylaxis in hospitalised medical patients, global audits suggest that implementation of thromboprophylaxis continues to be challenging because of the perceived higher risk of bleeding and lower risk of VTE than that reported in clinical trials...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28639987/antithrombotic-strategies-in-the-catheterization-laboratory-for-patients-with-acute-coronary-syndromes-undergoing-percutaneous-coronary-interventions-insights-from-the-employed-antithrombotic-therapies-in-patients-with-acute-coronary-syndromes-hospitalized
#4
Leonardo De Luca, Giuseppe Musumeci, Sergio Leonardi, Lucio Gonzini, Claudio Cavallini, Paolo Calabrò, Ciro Mauro, Luisa Cacciavillani, Stefano Savonitto, Stefano De Servi
AIMS: In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). METHODS: EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy...
July 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28639882/management-of-oral-anticoagulation-therapy-after-gastrointestinal-bleeding-whether-to-when-to-and-how-to-restart-an-anticoagulation-therapy
#5
Kazuhiko Kido, Michael J Scalese
OBJECTIVE: To evaluate current clinical evidence for management of oral anticoagulation therapy after gastrointestinal bleeding (GIB) with an emphasis on whether to, when to, and how to resume an anticoagulation therapy. DATA SOURCES: Relevant articles from MEDLINE, Cochrane Library, and EMBASE databases were identified from 1946 through May 20, 2017, using the keywords: gastrointestinal hemorrhage or gastrointestinal bleeding and antithrombotic therapy or anticoagulation therapy or warfarin or dabigatran or rivaroxaban or apixaban or edoxaban...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28637879/platelets-express-activated-p2y12-receptor-in-patients-with-diabetes
#6
Liang Hu, Lin Chang, Yan Zhang, Lili Zhai, Shenghui Zhang, Zhiyong Qi, Hongmei Yan, Yan Yan, Xinping Luo, Si Zhang, Yiping Wang, Satya P Kunapuli, Hongying Ye, Zhongren Ding
Background -Platelets from patients with diabetes are hyperactive. Hyperactivated platelets may contribute to cardiovascular complications and inadequate responses to antiplatelet agents in the setting of diabetes. However, the underlying mechanism of hyperactivated platelets is not completely understood. Methods -We measured P2Y12 expression on platelets from patients with type 2 diabetes mellitus (T2DM) and on platelets from rats with diabetes. We also assayed platelet P2Y12 activation by measuring cAMP and VASP phosphorylation...
June 21, 2017: Circulation
https://www.readbyqxmd.com/read/28637698/charming-the-snake-venom-derived-peptides-show-surprising-efficacy-as-glycoprotein-vi-targeting-antithrombotic-agents
#7
EDITORIAL
Andrew B Herr
No abstract text is available yet for this article.
July 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28636620/risk-of-ischemic-stroke-after-atrial-fibrillation-diagnosis-a-national-sample-cohort
#8
Mi Kyoung Son, Nam-Kyoo Lim, Hyung Woo Kim, Hyun-Young Park
Atrial fibrillation (AF) is a major risk factor for ischemic stroke and associated with a 5-fold higher risk of stroke. In this retrospective cohort study, the incidence of and risk factors for ischemic stroke in patients with AF were identified. All patients (≥30 years old) without previous stroke who were diagnosed with AF in 2007-2013 were selected from the National Health Insurance Service-National Sample Cohort. To identify factors that influenced ischemic stroke risk, Cox proportional hazard regression analysis was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28634421/the-role-of-von-willebrand-factor-in-vascular-inflammation-from-pathogenesis-to-targeted-therapy
#9
REVIEW
Felice Gragnano, Simona Sperlongano, Enrica Golia, Francesco Natale, Renatomaria Bianchi, Mario Crisci, Fabio Fimiani, Ivana Pariggiano, Vincenzo Diana, Andreina Carbone, Arturo Cesaro, Claudia Concilio, Giuseppe Limongelli, Mariagiovanna Russo, Paolo Calabrò
Beyond its role in hemostasis, von Willebrand factor (VWF) is an emerging mediator of vascular inflammation. Recent studies highlight the involvement of VWF and its regulator, ADAMTS13, in mechanisms that underlie vascular inflammation and immunothrombosis, like leukocyte rolling, adhesion, and extravasation; vascular permeability; ischemia/reperfusion injury; complements activation; and NETosis. The VWF/ADAMTS13 axis is implicated in the pathogenesis of atherosclerosis, promoting plaque formation and inflammation through macrophage and neutrophil recruitment in inflamed lesions...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28634133/acute-severe-gastrointestinal-tract-bleeding-is-associated-with-an-increased-risk-of-thromboembolism-and-death
#10
Naoyoshi Nagata, Toshiyuki Sakurai, Takuro Shimbo, Shiori Moriyasu, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Mikio Yanase, Junichi Akiyama, Naomi Uemura
BACKGROUND & AIMS: We performed a retrospective cohort study of patients with and without gastrointestinal bleeding (GIB) to determine whether GIB increases the risks of thromboembolism and death. METHODS: We collected data from 522 patients with acute severe GIB and 1044 patients without GIB (controls, matched for age, sex, year of diagnosis, history of thromboembolism, and use of antithrombotic drugs) who underwent endoscopy at the National Center for Global Health and Medicine in Japan from January 2009 through December 2014...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28632424/the-progress-in-the-research-of-antiplatelet-agents-1995-2017
#11
Oscar Benimana, Lulu Zhao, Yi Kong, Zhiyu Li, Zhouling Xie
Antiplatelet therapy displays a critical role in the treatment and prevention of antithrombotic disorders. Many new antiplatelet agents have been developed following the emergence of various clinical limitations of classical antiplatelet drugs. This review covers mainly the recent advances in the development of P2Y12 antagonists and GPIIb/IIIa antagonists. Meanwhile, it summarizes promising approaches to new platelet surface receptors such as prostanoid EP3 receptor, thromboxane A2 prostanoid receptor, protease-activated receptors, GPIb-IX-V receptor and P-selectin...
June 20, 2017: Future Medicinal Chemistry
https://www.readbyqxmd.com/read/28632284/benefits-and-risks-of-antithrombotic-therapy-in-essential-thrombocythemia-a-systematic-review
#12
Derek K Chu, Christopher M Hillis, Darryl P Leong, Sonia S Anand, Deborah M Siegal
Background: Patients with essential thrombocythemia (ET) are at high risk for both thrombosis and hemorrhage. Purpose: To evaluate the risks and benefits of antithrombotic therapy in adults with ET. Data Sources: Multiple databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, through 4 March 2017. Study Selection: Randomized and observational studies of antiplatelet or anticoagulant therapy, published in any language and reporting thrombotic or hemorrhagic events...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28631760/-astronauts-asteroids-and-the-universe-of-antithrombotic-therapies-in-primary-percutaneous-coronary-intervention
#13
Leonardo De Luca, Antonino Granatelli
A sensation of self-awareness on the relativity of our certainties comes over looking to the huge amount of data on antithrombotic therapies assessed in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). This sensation can be compared to the so-called "overview effect", a cognitive shift in awareness reported by some astronauts during spaceflight, often while viewing the Earth from orbit. In this review we will mention drugs floated like meteors in the Universe of STEMI treatment and we will discuss the body of evidence on oral and intravenous antithrombotic therapies for patients undergoing pPCI...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28631751/thrombosis-novel-target-with-antithrombotic-potential-and-low-bleeding-risk
#14
Irene Fernández-Ruiz
No abstract text is available yet for this article.
June 15, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28631502/impact-of-acute-infarct-related-artery-patency-before-percutaneous-coronary-intervention-on-30-day-outcomes-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-in-the-euromax-trial
#15
Tomasz Rakowski, Dariusz Dudek, Arnoud van 't Hof, Jurrien Ten Berg, Louis Soulat, Uwe Zeymer, Frederic Lapostolle, Prodromos Anthopoulos, Debra Bernstein, Efthymios N Deliargyris, Philippe Gabriel Steg
AIMS: Early infarct-related artery patency has been associated with improved outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. However, it is unknown whether this relationship persists in contemporary practice with pre-hospital initiation of treatment, use of novel P2Y12 inhibitors and frequent use of drug-eluting stents. The purpose of the study was to determine the impact of early infarct-related artery patency on outcomes in the contemporary EUROMAX trial...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#16
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629432/imaging-of-%C3%AE-v%C3%AE-3-integrin-expression-in-experimental-myocardial-ischemia-with-68-ga-nodaga-rgd-positron-emission-tomography
#17
Maria Grönman, Miikka Tarkia, Tuomas Kiviniemi, Paavo Halonen, Antti Kuivanen, Timo Savunen, Tuula Tolvanen, Jarmo Teuho, Meeri Käkelä, Olli Metsälä, Mikko Pietilä, Pekka Saukko, Seppo Ylä-Herttuala, Juhani Knuuti, Anne Roivainen, Antti Saraste
BACKGROUND: Radiolabeled RGD peptides detect αvβ3 integrin expression associated with angiogenesis and extracellular matrix remodeling after myocardial infarction. We studied whether cardiac positron emission tomography (PET) with [(68)Ga]NODAGA-RGD detects increased αvβ3 integrin expression after induction of flow-limiting coronary stenosis in pigs, and whether αvβ3 integrin is expressed in viable ischemic or injured myocardium. METHODS: We studied 8 Finnish landrace pigs 13 ± 4 days after percutaneous implantation of a bottleneck stent in the proximal left anterior descending coronary artery...
June 19, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28626054/prediction-of-recurrent-stroke-or-transient-ischemic-attack-after-noncardiogenic-posterior-circulation-ischemic-stroke
#18
Changqing Zhang, Yilong Wang, Xingquan Zhao, Liping Liu, ChunXue Wang, Yuehua Pu, Xinying Zou, Yuesong Pan, Ka Sing Wong, Yongjun Wang
BACKGROUND AND PURPOSE: Posterior circulation ischemic stroke (IS) is generally considered an illness with a poor prognosis. However, there are no effective rating scales to predict recurrent stroke following it. Therefore, our aim was to identify clinical or radiological measures that could assist in predicting recurrent cerebral ischemic episodes. METHODS: We prospectively enrolled 723 noncardiogenic posterior circulation IS patients with onset of symptoms <7 days...
June 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28622606/dementia-correlates-with-anticoagulation-underuse-in-older-patients-with-atrial-fibrillation
#19
Giovanni Viscogliosi, Evaristo Ettorre, Iulia Maria Chiriac
OBJECTIVES: Stroke prevention in older atrial fibrillation (AF) patients remains a challenge. This study aimed to investigate whether a dementia diagnosis is an independent correlate of lower prescription rate of oral anticoagulant treatment (OAT) in a sample of older AF patients. METHODS: Cross-sectional retrospective study. Consecutive older community-dwelling AF patients referred for a comprehensive geriatric assessment, were considered. Evaluation of physical, social and mental health, and administration of the Cumulative Illness Rating Scale (CIRS) and Barthel Index were performed...
June 8, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28622439/clinical-effectiveness-of-a-bayesian-algorithm-for-the-diagnosis-and-management-of-heparin-induced-thrombocytopenia
#20
Robert A Raschke, Tyler Gallo, Steven C Curry, Tonya Whiting, Angela Padilla-Jones, Theodore E Warkentin
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a life-threatening drug reaction caused by anti-platelet factor 4/heparin (anti-PF4/H) antibodies. Commercial tests to detect these antibodies have limitations. We previously developed a diagnostic algorithm for HIT that incorporated "four Ts" (4Ts) scoring and a stratified interpretation of an anti-PF4/H enzyme-linked immunosorbent assay (ELISA) and yielded a discriminant accuracy of 0.97 (95% CI: 0.93-1.00). OBJECTIVES: The purpose of this study was to validate the algorithm in an independent patient population and quantitate effects that algorithm adherence could have on clinical care...
June 16, 2017: Journal of Thrombosis and Haemostasis: JTH
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