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https://www.readbyqxmd.com/read/29901608/efficacy-and-safety-of-cyp2c19-genotype-in-stroke-or-transient-ischemic-attack-patients-treated-with-clopidogrel-monotherapy-or-clopidogrel-plus-aspirin-protocol-for-a-systemic-review-and-meta-analysis
#1
Jia-Chen Yao, Min Cui, Mang-Mang Pan, Zhi-Chun Gu, Wen-Yan Li
BACKGROUND: The relationship of CYP2C19 genotype and clinical efficacy in stroke or transient ischemic attack (TIA) patients treated with clopidogrel monotherapy or clopidogrel plus aspirin remains unknown. We thus aim to conduct a meta-analysis to appraise evidence on the association of CYP2C19 genotype and clinical efficacy for stroke or TIA. METHODS: An electronic search will be performed for clinical trials that reported the interested efficacy data (stroke, myocardial infarction, or vascular death) and safety data (any bleeding) in clopigogrel-treated patients with stroke or TIA...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29773949/effect-of-dual-antiplatelet-on-recurrent-stroke-in-minor-stroke-or-tia-depends-on-bodyweight
#2
Yan Ma, Ying Liu, Jie Xu, Yilong Wang, Yongjun Wang, Fenghe Du
Objective: To assess whether bodyweight influences the efficacy and safety of dual antiplatelet therapy (DAT) in male patients with minor stroke or transient ischemic attack patients. Materials and methods: All 3,420 male participants coming from the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events trial were divided into 3 groups based on bodyweight (<65 kg, 65-75 kg, and ≥75 kg). The stroke outcomes included stroke recurrence, combined vascular events, and bleeding events during 90 days of follow-up...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29766750/clopidogrel-and-aspirin-in-acute-ischemic-stroke-and-high-risk-tia
#3
S Claiborne Johnston, J Donald Easton, Mary Farrant, William Barsan, Robin A Conwit, Jordan J Elm, Anthony S Kim, Anne S Lindblad, Yuko Y Palesch
Background Combination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population. Methods In a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29747016/carotid-endarterectomy-and-concurrent-clopidogrel-use-us-national-practice-patterns
#4
Eva A Mistry, Jane C Khoury, Dawn Kleindorfer
BACKGROUND: Patients diagnosed with high-grade carotid stenosis often receive a carotid endarterectomy (CEA) during their hospital stay and most receive antiplatelet medication. There is inter-surgeon variability in performing CEA in patients receiving clopidogrel given the potent antiplatelet effect. METHODS: Utilizing the PREMIER database, adults with principal discharge diagnosis of stroke, transient ischemic attack (TIA) or carotid artery stenosis or occlusion without stroke/TIA(CAS), who had a CEA during the same hospital stay, in 2014 were analyzed...
May 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29707143/the-secondary-prevention-of-stroke-according-to-cytochrome-p450-2c19-genotype-in-patients-with-acute-large-artery-atherosclerosis-stroke
#5
Xingyang Yi, Jing Lin, Ju Zhou, Yanfeng Wang, Ruyue Huang, Chun Wang
Purpose: To investigated the effectiveness of antiplatelet agents for the secondary prevention of stroke according to CYP2C19 genotype in patients with ischemic stroke (IS). Methods: Between August 2009 and December 2011, 570 acute IS patients with acute large-artery atherosclerosis were randomly assigned to receive either combined clopidogrel and aspirin for the first 30 day, and clopidogrel thereafter (clopidogrel group, n=284) or aspirin monotherapy (aspirin group, n=286)...
April 3, 2018: Oncotarget
https://www.readbyqxmd.com/read/29691157/transcatheter-aortic-valve-replacement-and-atrial-fibrillation-impact-of-antithrombotic-strategy-on-clinical-outcomes
#6
Samuel Hui, Robert Gooley, Hashrul N Rashid, Sarah Zaman
BACKGROUND: Antithrombotic recommendations following transcatheter aortic valve replacement (TAVR) are largely based on previous trial protocols. The efficacy and risk of anticoagulation has not been systematically assessed. The aim of this study was to determine the efficacy and safety of oral anticoagulation in patients with atrial fibrillation (AF) following TAVR with the Lotus Valve System (Boston Scientific, Malborough, MA, USA). METHODS: Consecutive patients with severe aortic stenosis who underwent Lotus valve implantation were prospectively recruited (n=164)...
April 4, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29678934/neutrophil-counts-neutrophil-ratio-and-new-stroke-in-minor-ischemic-stroke-or-tia
#7
Bihong Zhu, Yuesong Pan, Jing Jing, Xia Meng, Xingquan Zhao, Liping Liu, David Wang, S Claiborne Johnston, Hao Li, Yilong Wang, Zhimin Wang, Yongjun Wang
OBJECTIVE: Evidence about whether neutrophil counts or neutrophil ratio is associated with new stroke is scant. The aim of this study is to assess the association of neutrophil counts or neutrophil ratio with a new stroke in patients with minor stroke or TIA. METHODS: We derived data from the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 4 groups according to the quartile of neutrophil counts or neutrophil ratio...
May 22, 2018: Neurology
https://www.readbyqxmd.com/read/29600887/prognosis-of-dolichoectasia-in-non-cardioembolic-transient-ischemic-attack-and-minor-stroke
#8
Xinmiao Zhang, Jing Jing, Xingquan Zhao, Liping Liu, Xia Meng, Anxin Wang, Yuesong Pan, David Wang, Yilong Wang, Yongjun Wang
Objectives This study aimed to estimate the prognosis of dolichoectasia in non-cardioembolic transient ischemic attack (TIA) and minor stroke patients. Methods Data were derived from the imaging subgroup of patients in the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Dolichoectasia was defined as ectasia (basilar artery diameter >4.5 mm) and dolichosis (either basilar artery bifurcation above the suprasellar cistern or lateral to the margin of the clivus or dorsum sellae)...
March 30, 2018: Neurological Research
https://www.readbyqxmd.com/read/29582084/dual-antiplatelet-therapy-in-transient-ischemic-attack-and-minor-stroke-with-different-infarction-patterns-subgroup-analysis-of-chance-randomized-clinical-trial
#9
Jing Jing, Xia Meng, Xingquan Zhao, Liping Liu, Anxin Wang, Yuesong Pan, Hao Li, David Wang, S Claiborne Johnston, Yongjun Wang, Yilong Wang
Importance: Infarction patterns may serve as important imaging markers to assess the probability of stroke recurrence in transient ischemic attack (TIA) and minor stroke. However, it is unclear whether patients with different infarction patterns benefit differently from dual antiplatelet therapy. Objectives: To investigate whether infarction patterns can stratify the risk of recurrent stroke and whether the efficacy and safety of clopidogrel plus aspirin vs aspirin alone are consistent in different infarction patterns after TIA or minor stroke...
March 26, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29581711/dual-versus-single-antiplatelet-therapy-for-patients-with-long-term-oral-anticoagulation-undergoing-coronary-intervention-a-systematic-review-and-meta-analysis
#10
Jing-Jing Yu, Chan Zou, Wen-Yu Liu, Guo-Ping Yang
Objective: The main aim of this meta-analysis is to compare the efficacy and safety of dual versus single antiplatelet therapy for patients taking oral anticoagulation (OAC) after coronary intervention. Background: The optimal regimen remains controversial for patients taking OAC after coronary intervention. Methods: PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for eligible studies including data of triple therapy (TT) versus OAC plus single antiplatelet therapy for patients requiring OAC after coronary intervention...
December 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29520080/impact-of-cyp2c19-polymorphism-in-prognosis-of-minor-stroke-or-tia-patients-with-declined-egfr-on-dual-antiplatelet-therapy-chance-substudy
#11
Yu Wu, Yilun Zhou, Yuesong Pan, Xingquan Zhao, Liping Liu, David Wang, Chunxue Wang, Hao Li, S Claiborne Johnston, Xia Meng, Yilong Wang, Yongjun Wang
Clopidogrel resistance is prevalent in chronic kidney disease (CKD) patients. Genetic polymorphism is considered to be the most important factor that influences clopidogrel resistance. Limited data exist as to the role of pharmacogenetics in prognosis of stroke patients with impaired renal function on clopidogrel. We sought to explore whether decreased kidney function alters the association between CYP2C19 genetic variants and clinical outcome in patients with minor stroke or transient ischemic attack (TIA) receiving clopidogrel therapy...
March 8, 2018: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/29507777/risk-factors-associated-with-90-day-recurrent-stroke-in-patients-on-dual-antiplatelet-therapy-for-minor-stroke-or-high-risk-tia-a-subgroup-analysis-of-the-chance-trial
#12
Runqi Wangqin, Xianwei Wang, Yilong Wang, Ying Xian, Xingquan Zhao, Liping Liu, Hao Li, Xia Meng, Yongjun Wang
Objective: Many patients receiving dual antiplatelet therapy still had recurrent strokes. We aimed to identify factors associated with recurrent stroke at 90 days in patients receiving dual antiplatelet therapy in Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. Methods: Patients with transient ischaemic attack or minor stroke receiving clopidogrel and aspirin in the trial were analysed in the study. The primary outcome was recurrent stroke within 90 days after the index event...
December 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/29374102/early-time-course-of-major-bleeding-on-antiplatelet-therapy-after-tia-or-ischemic-stroke
#13
Nina A Hilkens, Ale Algra, L Jaap Kappelle, Philip M Bath, László Csiba, Peter M Rothwell, Jacoba P Greving
OBJECTIVE: To study the early time course of major bleeding and its subtypes in patients with cerebral ischemia on dual and single antiplatelet therapy. METHODS: We performed a post hoc analysis on individual patient data from 6 randomized clinical trials (Clopidogrel Versus Aspirin in Patients at Risk of Ischaemic Events [CAPRIE], Second European Stroke Prevention Study [ESPS-2], Management of Atherothrombosis With Clopidogrel in High-Risk Patients [MATCH], Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance [CHARISMA], European/Australasian Stroke Prevention in Reversible Ischaemia Trial [ESPRIT], and Prevention Regimen for Effectively Avoiding Second Strokes [PRoFESS]) including 45,195 patients with a TIA or noncardioembolic ischemic stroke...
February 20, 2018: Neurology
https://www.readbyqxmd.com/read/29363651/rationale-and-study-design-for-a-single-arm-phase-iia-study-investigating-feasibility-of-preventing-ischemic-cerebrovascular-events-in-high-risk-patients-with-acute-non-disabling-ischemic-cerebrovascular-events-using-remote-ischemic-conditioning
#14
Shi-Meng Liu, Wen-Le Zhao, Hai-Qing Song, Ran Meng, Si-Jie Li, Chang-Hong Ren, Bruce Ovbiagele, Xun-Ming Ji, Wu-Wei Feng
BACKGROUND: Acute minor ischemic stroke (AMIS) or transient ischemic attack (TIA) is a common cerebrovascular event with a considerable high recurrence. Prior research demonstrated the effectiveness of regular long-term remote ischemic conditioning (RIC) in secondary stroke prevention in patients with intracranial stenosis. We hypothesized that RIC can serve as an effective adjunctive therapy to pharmacotherapy in preventing ischemic events in patients with AMIS/TIA. This study aimed to investigate the feasibility, safety, and preliminary efficacy of daily RIC in inhibiting cerebrovascular/cardiovascular events after AMIS/TIA...
February 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#15
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite results of the PROTECT AF trial, many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: Forty-four consecutive patients (22 males, mean age 74 ± 7.8 years) with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using a Watchman device followed by DAPT (75 mg/d aspirin and 75 mg/d clopidogrel)...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#16
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29330312/high-sensitive-c-reactive-protein-and-dual-antiplatelet-in-intracranial-arterial-stenosis
#17
Jiejie Li, Anxin Wang, Xingquan Zhao, Liping Liu, Xia Meng, Jinxi Lin, Jing Jing, Xinying Zou, Yilong Wang, Yongjun Wang
OBJECTIVE: To determine the relationship of high-sensitive C-reactive protein (hsCRP) and the efficacy and safety of dual antiplatelet therapy in patients with and without intracranial arterial stenosis (ICAS) in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. METHODS: A subgroup of 807 patients with both magnetic resonance angiography images and hsCRP measurement was analyzed. Cox proportional hazards models were used to assess the interaction of hsCRP levels with the effects of dual and single antiplatelet therapy...
February 6, 2018: Neurology
https://www.readbyqxmd.com/read/29274727/antiplatelet-therapy-with-aspirin-clopidogrel-and-dipyridamole-versus-clopidogrel-alone-or-aspirin-and-dipyridamole-in-patients-with-acute-cerebral-ischaemia-tardis-a-randomised-open-label-phase-3-superiority-trial
#18
Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg
BACKGROUND: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset...
March 3, 2018: Lancet
https://www.readbyqxmd.com/read/29204116/p2y12-receptor-antagonist-clopidogrel-does-not-contribute-to-risk-of-osteoporotic-fractures-in-stroke-patients
#19
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
#20
Yuesong Pan, Yilong Wang, Yongjun Wang
No abstract text is available yet for this article.
November 14, 2017: Neurology
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