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https://www.readbyqxmd.com/read/29204116/p2y12-receptor-antagonist-clopidogrel-does-not-contribute-to-risk-of-osteoporotic-fractures-in-stroke-patients
#1
Niklas R Jørgensen, Peter Schwarz, Helle K Iversen, Peter Vestergaard
Background: Stroke is a leading cause of mortality and morbidity. It is associated with excessive bone loss and risk of fracture in stroke patients is high. The P2Y12R antagonist and platelet inhibitor, clopidogrel, is widely used for secondary prevention after a stroke. However, recent studies have shown that clopidogrel has negative effects on bone and that long-term clopidogrel use is associated with increased fracture risk. The purpose of the current study was therefore to investigate the association of clopidogrel treatment with risk of fractures in stroke and TIA patients...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29133611/author-response-risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#2
Yuesong Pan, Yilong Wang, Yongjun Wang
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29133610/letter-re-risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#3
Jose Gutierrez, Tim Lekic
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29084062/antiplatelet-therapy-after-stroke-should-it-differ-in-the-acute-and-chronic-phase-after-stroke
#4
Xinyi Leng, Thomas W Leung, K S Lawrence Wong
PURPOSE OF REVIEW: Reviewing existing evidence regarding well tolerated and effective antiplatelet treatment in patients with acute or chronic, noncardioembolic ischemic stroke and transient ischemic attack (TIA). RECENT FINDINGS: For patients with high-risk stroke or TIA, for instance, minor stroke or high-risk TIA, or stroke of atherosclerotic origin with evidence suggesting risk of artery-to-artery embolism or with high-grade, symptomatic arterial stenosis, early initiated, short-term dual antiplatelet (e...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#5
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28768848/predicting-major-bleeding-in-patients-with-noncardioembolic-stroke-on-antiplatelets-s2top-bleed
#6
Nina A Hilkens, Ale Algra, Hans-Christoph Diener, Johannes B Reitsma, Philip M Bath, Laszlo Csiba, Werner Hacke, L Jaap Kappelle, Peter J Koudstaal, Didier Leys, Jean-Louis Mas, Ralph L Sacco, Pierre Amarenco, Leila Sissani, Jacoba P Greving
OBJECTIVE: To develop and externally validate a prediction model for major bleeding in patients with a TIA or ischemic stroke on antiplatelet agents. METHODS: We combined individual patient data from 6 randomized clinical trials (CAPRIE, ESPS-2, MATCH, CHARISMA, ESPRIT, and PRoFESS) investigating antiplatelet therapy after TIA or ischemic stroke. Cox regression analyses stratified by trial were performed to study the association between predictors and major bleeding...
August 29, 2017: Neurology
https://www.readbyqxmd.com/read/28766499/association-between-platelet-function-and-recurrent-ischemic-vascular-events-after-tia%C3%A2-and-minor-stroke%C3%A2
#7
Jinbiao Zhang, Jiangshan Zhang, Hairong Sun, Tan Ming, Xinwu Liu, Yannan Cong, Fang Li, Zhenguang Li
Platelet activation and aggregation play an important role in the pathological and physiological processes of recurrent ischemic vascular events in stroke patients. The purpose of this study is to determine the association between platelet function measured in the acute period and recurrent ischemic vascular events in patients with transient ischemic attack (TIA) or minor stroke. A total of 417 patients who were within the 24-hour period of clopidogrel-aspirin therapy after onset of a minor stroke or high-risk transient ischemic attack according to the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial were included in this study...
October 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28727358/-antiplatelet-therapy-in-secondary-stroke-prevention
#8
Lorenz Hirt, Emmanuel Carrera
New studies have refined the role of antiplatelet therapy in secondary prevention after noncardioembolic strokes. The first line antiplatelet therapy remains Aspirin. Clopidogrel and the combination aspirine plus dipyridamole are suitable alternatives with a slightly better protection. Ticagrelor, a reversible P2Y12 receptor inhibitor used in cardiology, has not demonstrated its superiority to Aspirin. Early after stroke, a double antiplatelet therapy combining Aspirin and clopidogrel is increasingly administered as a recent study demonstrated a decrease in the incidence of cerebrovascular events after a minor stroke or high-risk TIA...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28672933/a-systematic-review-and-meta-analysis-of-published-randomized-controlled-trials-of-combination-of-clopidogrel-and-aspirin-in-transient-ischemic-attack-or-minor-stroke
#9
Xingjian Zhou, Jing Tian, Ming Zhen Zhu, Colin K He
The use of antiplatelet agents in patients with ischemic stroke is recommended. In this study, we compared the efficacy and safety of the treatment of clopidogrel plus aspirin (ASA) and that of ASA alone in patients with mild stroke/transient ischemic attack (TIA). Randomized controlled trial (RCT) studies of Clop + ASA vs. ASA therapy in the patients with minor stroke/TIA were identified by electronic bibliographic searches. The primary result was recurrent stroke, while myocardial infarction (MI) as well as vascular mortalities were the secondary result, and major hemorrhagic events were the safety result...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28663045/appropriateness-assessment-in-antiplatelet-therapy-apathy-registry-insight-from-current-clinical-practice
#10
Nazario Carrabba, Benedetta Bellandi, Guido Parodi, Emanuele Cecchi, Giorgio Baldereschi, Cristina Giglioli, Angela Migliorini, Renato Valenti, Serafina Valente, Rossella Marcucci, Niccolò Marchionni, David Antoniucci
BACKGROUND: In clinical practice there is a gap between guidelines recommendation and antiplatelet strategies used for acute coronary syndrome (ACS). We sought to evaluate appropriateness of antiplatelet strategies employed in a tertiary center. METHODS AND RESULTS: From January to June 2014, 430 ACS were treated with percutaneous coronary intervention by 3 groups of interventional cardiologists. Aspirin and clopidogrel (52%) were the most commonly used antiplatelet therapies, being prasugrel associated with aspirin in 110 (25...
October 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28634365/different-levels-of-blood-pressure-different-benefit-from-dual-antiplatelet-therapy-in-minor-stroke-or-tia-patients
#11
Jie Xu, Yongli Tao, Hao Li, Hongqiu Gu, Xuewei Xie, Xia Meng, Yuming Xu, Yilong Wang, Yongjun Wang
The study aimed to evaluate whether the benefits of dual antiplatelet therapy would be influenced by blood pressure (BP) levels, among acute minor stroke or transient ischemic attack (TIA). In CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling cerebrovascular Events) trail, Patients were stratified by systolic BP (SBP) and diastolic BP (DBP) level measured on admission, respectively, using the supine position BP within 24 hours after symptoms onset. The primary efficacy outcome was stroke recurrence, bleeding was the safety outcome...
June 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28630782/remote-assessment-of-platelet-function-in-patients-with-acute-stroke-or-transient-ischaemic-attack
#12
Philip M Bath, Jane May, Katie Flaherty, Lisa J Woodhouse, Natalia Dovlatova, Sue C Fox, Timothy J England, Kailash Krishnan, Thompson G Robinson, Nikola Sprigg, Stan Heptinstall, Tardis Investigators
BACKGROUND: The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. METHODS: Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28603135/report-impact-of-drug-combination-of-clopidogrel-and-pantoprazole-in-the-prognosis-of-patients-with-transient-ischemic-attack
#13
RANDOMIZED CONTROLLED TRIAL
Min Lu
The study aimed to investigate the impact of clopidogrel combined with proton pump inhibitors (PPI) pantoprazole treatment on the prognosis of patients with transient ischemic attack (TIA). A total of 478 cases of TIA patients treated with clopidogrel were randomly assigned half to clopidogrel combined with pantoprazole treatment and the control groups (clopidogrel treatment alone) from January 2012 to January 20l4. The platelet aggregation before and after treatment and cerebrovascular events incidence within 90 days were compared and analyzed...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28530518/antiplatelet-therapy-and-clinical-outcomes-following-myocardial-infarction-among-patients-in-a-u-s-employer-based-insurance-database
#14
Mehul D Patel, David Wu, Monica Reed Chase, Panagiotis Mavros, Kim Heithoff, Mary E Hanson, Ross J Simpson
BACKGROUND: Estimates of residual cardiovascular risks among patients who have experienced a recent acute myocardial infarction (MI) are predominantly derived from secondary prevention trial populations, patient registries, and population-based cohorts. OBJECTIVE: To generate real-world evidence of antiplatelet treatment and recurrent events following MI in patients on antiplatelet treatment among commercial, employer-based insured patients in a large administrative database...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28483209/the-population-based-long-term-impact-of-anticoagulant-and-antiplatelet-therapies-in-low-risk-patients-with-atrial-fibrillation
#15
MULTICENTER STUDY
Anjani Golive, Heidi T May, Tami L Bair, Victoria Jacobs, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller, T Jared Bunch
Among patients with atrial fibrillation (AF), the risk of stroke risk is a significant concern. CHADS2 and CHA2DS2-VASc ≤2 scoring have been used to stratify patients into categories of risk. Without randomized, prospective data, the need and type of long-term antithrombotic medications for thromboembolism prevention in lower risk AF patients remains controversial. We sought to define the long-term impact of anticoagulant and antiplatelet therapy use in AF patients at low risk of stroke. A total of 56,764 patients diagnosed with AF and a CHADS2 score of 0 or 1, or CHA2DS2-VASc score of 0, 1, or 2 were studied...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28431593/high-on-treatment-platelet-reactivity-to-aspirin-and-clopidogrel-in-ischemic-stroke-a-systematic-review-and-meta-analysis
#16
Aidonio Fiolaki, Aristeidis H Katsanos, Athanassios P Kyritsis, Styliani Papadaki, Maria Kosmidou, Iraklis C Moschonas, Alexandros D Tselepis, Sotirios Giannopoulos
Emerging studies highlight high on-treatment of platelet reactivity (HTPR) as a major hindrance to the secondary prevention of cardiovascular ischemic events. The aim of this systematic review and meta-analysis is to assess the prevalence of HTPR in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and reveal a possible relation with a higher risk of cerebrovascular event recurrence. Studies were selected if they reported absolute numbers or percentages of HTPR with ASA or clopidogrel in IS/TIA patients at any time point after the cerebrovascular event onset and assessed with any type of platelet function tests...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28424269/risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#17
RANDOMIZED CONTROLLED TRIAL
Yuesong Pan, Jing Jing, Weiqi Chen, Xia Meng, Hao Li, Xingquan Zhao, Liping Liu, David Wang, S Claiborne Johnston, Yilong Wang, Yongjun Wang
OBJECTIVE: To investigate the short-term time course risks and benefits of clopidogrel with aspirin in minor ischemic stroke or TIA. METHODS: Data were derived from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. The primary outcome was a new ischemic stroke. Safety outcomes included any bleeding and moderate to severe bleeding. Time course analyses were performed for the outcomes of both stroke and bleeding. RESULTS: A total of 145 (71...
May 16, 2017: Neurology
https://www.readbyqxmd.com/read/28398139/the-association-between-high-on-treatment-platelet-reactivity-and-early-recurrence-of-ischemic-events-after-minor-stroke-or-tia
#18
Zilong Rao, Huaguang Zheng, Fei Wang, Anxin Wang, Liping Liu, Kehui Dong, Xingquan Zhao, Yilong Wang, Yibin Cao
OBJECTIVES: To evaluate the role of HTPR in predicting early recurrence of ischemic events in patients with minor ischemic stroke or high-risk TIA. METHODS: From January 2014 to September 2014, a single center continuously enrolled patients with minor ischemic stroke or high-risk TIA and gave them antiplatelet therapy consisting of aspirin with clopidogrel. HTPR was assessed by TEG after 7 days of antiplatelet therapy and detected CYP2C19 genotype. The incidence of recurrent ischemic events was assessed 3 months after onset...
April 11, 2017: Neurological Research
https://www.readbyqxmd.com/read/28202699/association-of-multiple-infarctions-and-icas-with-outcomes-of-minor-stroke-and-tia
#19
RANDOMIZED CONTROLLED TRIAL
Yuesong Pan, Xia Meng, Jing Jing, Hao Li, Xingquan Zhao, Liping Liu, David Wang, S Claiborne Johnston, Yilong Wang, Yongjun Wang
OBJECTIVE: To estimate the association of different patterns of infarction and intracranial arterial stenosis (ICAS) with the prognosis of acute minor ischemic stroke and TIA. METHODS: We derived data from the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 1,089 patients from 45 of 114 participating sites of the trial undergoing baseline MRI/angiography were included in this subgroup analysis. Patterns of infarction and ICAS were recorded for each individual...
March 14, 2017: Neurology
https://www.readbyqxmd.com/read/28161565/dual-antiplatelet-therapy-does-not-increase-the-risk-of-bleeding-after-carotid-endarterectomy-results-of-a-prospective-study
#20
Giulio Illuminati, Fabrice Schneider, Giulia Pizzardi, Federica Masci, Francesco G Calio', Jean-Baptiste Ricco
BACKGROUND: The purpose of this study was to evaluate the risk of bleeding and other postoperative complications of carotid endarterectomy (CEA) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From January 2005 to December 2015, 188 consecutive patients undergoing CEA and receiving DAPT (aspirin 100 mg + clopidogrel 75 mg) were enrolled in a prospective study. All of them underwent coronary artery stenting with drug-eluting stents during the 6 months preceding CEA...
April 2017: Annals of Vascular Surgery
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