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https://www.readbyqxmd.com/read/29600887/prognosis-of-dolichoectasia-in-non-cardioembolic-transient-ischemic-attack-and-minor-stroke
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
February 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#16
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-s-2-top-bleed
#17
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-and-minor-stroke
#18
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
#19
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
#20
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
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