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https://www.readbyqxmd.com/read/29150850/comparison-of-pharmacodynamic-effects-of-ticagrelor-vs-prasugrel-in-type-2-diabetes-mellitus-patients-with-coronary-heart-disease
#1
L-L Shang, D-D Guo, H-Y Zhao, A-J Quan, P-G Cao
WHAT IS KNOWN AND OBJECTIVE: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of thrombotic complications. Studies have indicated that patients with T2DM have impaired clopidogrel-induced antiplatelet effect. Ticagrelor and prasugrel are two latest generation P2Y12 inhibitors with advantageous platelet inhibitory profiles. However, the pharmacodynamic differences between the two drugs in patients with T2DM remain poorly explored. METHODS: This study, involving 140 patients with T2DM following percutaneous coronary intervention (PCI), evaluated the efficacy of aspirin upon concomitant use of prasugrel (10 mg/d) or ticagrelor (90 mg/d)...
November 17, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29146484/association-between-ischemic-and-bleeding-risk-scores-and-the-use-of-new-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome
#2
Pedro J Flores-Blanco, Francisco Cambronero-Sánchez, Sergio Raposeiras-Roubin, Emad Abu-Assi, Gunnar Leithold, Rafael Cobas-Paz, Ana I Rodríguez Serrano, Francisco Calvo-Iglesias, Mariano Valdés, James L Januzzi, Andrés Iñiguez-Romo, Sergio Manzano-Fernández
INTRODUCTION AND OBJECTIVES: Acute coronary syndrome (ACS) guidelines recommend the use of newer P2Y12 inhibitors (prasugrel and ticagrelor) over clopidogrel in patients with moderate-to-high ischemic risk, unless they have an increased bleeding risk. The aim of our study was to assess the GRACE risk score and the CRUSADE bleeding risk score relative to prescription of newer P2Y12 inhibitors at discharge in ACS patients. METHODS: Retrospective analysis of a multicenter ACS registry; 3515 consecutive patients were included...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29142364/bone-scan-in-evaluation-of-bone-viability-in-severe-frostbite-of-the-hand
#3
Ishan Garg, Maria J Baladron Zanetti, Ayse T Kendi
A 39-year-old male presented to the emergency department (ED) with frostbite to the fingers of both hands. In the ED, he received warm baths, acetylsalicylic acid, clopidogrel, and heparin. A three-phase bone scintigraphy with technetium-99m-methylene diphosphonate revealed absent radiotracer uptake in distal phalanges of both hands. The patient received acetylsalicylic acid, clopidogrel and wound care for the next 5 days and made an excellent recovery with satisfactory wound healing in both hands. Early rapid rewarming and reperfusion can improve the prognosis significantly and therefore bone scan done within first 1-2 days may give spurious results...
October 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29138287/clopidogrel-carboxylic-acid-glucuronidation-is-mediated-mainly-by-ugt2b7-ugt2b4-and-ugt2b17-implications-for-pharmacogenetics-and-drug-drug-interactions
#4
Helina Kahma, Anne M Filppula, Mikko Neuvonen, E Katriina Tarkiainen, Aleksi Tornio, Mikko T Holmberg, Matti K Itkonen, Moshe Finel, Pertti J Neuvonen, Mikko Niemi, Janne T Backman
The antiplatelet drug clopidogrel is metabolized to an acyl-β-D-glucuronide, which causes time-dependent inactivation of CYP2C8. Our aim was to characterize the UDP-glucuronosyltransferase (UGT) enzymes that are responsible for the formation of clopidogrel acyl-β-D-glucuronide. Kinetic analyses and targeted inhibition experiments were performed using pooled human liver and intestine microsomes (HLM and HIM, respectively) and selected human recombinant UGTs based on preliminary screening. The effects of relevant UGT polymorphisms on the pharmacokinetics of clopidogrel were evaluated in 106 healthy volunteers...
November 14, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/29137043/portal-vein-thrombosis-before-and-after-transjugular-intrahepatic-portosystemic-shunt-placement-an-observational-study-strobe-compliant
#5
Yue-Meng Wan, Yu-Hua Li, Hua-Mei Wu, Zhi-Yuan Xu, Ying Xu, Li-Hong Yang, Xi-Nan Wu, Jin-Hui Yang
Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Enrolled patients were screened for PVT before TIPS and at 3, 6, 12, and 24 months post-TIPS...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29134853/real-world-clopidogrel-utilization-in-acute-coronary-syndromes-patients-selection-and-outcomes-in-a-single-center-experience
#6
Diego Castini, Simone Persampieri, Sara Cazzaniga, Giulia Ferrante, Marco Centola, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: With this study, we sought to identify patient characteristics associated with clopidogrel prescription and its relationship with in-hospital adverse events in an unselected cohort of ACSs patients. MATERIALS AND METHODS: We studied all consecutive patients admitted at our institution for ACSs from 2012 to 2014. Patients were divided into two groups based on clopidogrel or novel P2Y12 inhibitors (prasugrel or ticagrelor) prescription and the relationship between clopidogrel use and patient clinical characteristics and in-hospital adverse events was evaluated using logistic regression analysis...
December 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29133611/author-response-risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#7
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
#8
Jose Gutierrez, Tim Lekic
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29132090/the-potential-use-of-transdermal-drug-delivery-for-the-prophylaxis-and-management-of-stroke-and-coronary-artery-disease
#9
REVIEW
Kevin Ita
In 2013, cardiovascular disease was responsible for 30.8% (800,937) of all 2,596,993 deaths, or approximately 1 of every 3 deaths while stroke caused about 1 of every 20 deaths in the United States [1]. To put it in context, about 795,000 people continue to have a new or recurrent stroke (ischemic or hemorrhagic) [1] in the USA. Mechanical vascular recanalization and thrombolysis with tissue plasminogen activator are the only clinically useful approaches available now for the management of ischemic stroke [2]...
June 4, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#10
M Spartalis, E Tzatzaki, E Spartalis, C Damaskos, A Athanasiou, D Moris, M Politou
OBJECTIVE: Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#11
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29129512/thieno-2-3-b-pyridine-derivatives-are-potent-anti-platelet-drugs-inhibiting-platelet-activation-aggregation-and-showing-synergy-with-aspirin
#12
Naif K Binsaleh, Catherine A Wigley, Kathryn A Whitehead, Michelle van Rensburg, Johannes Reynisson, Lisa I Pilkington, David Barker, Sarah Jones, Nina C Dempsey-Hibbert
Drugs which inhibit platelet function are commonly used to prevent blood clot formation in patients with Acute Coronary Syndromes (ACS) or those at risk of stroke. The thieno[3,2-c]pyridine class of therapeutic agents, of which clopidogrel is the most commonly used, target the P2Y12 receptor, and are often used in combination with acetylsalicylic acid (ASA). Six thieno[2,3-b]pyridine were assessed for in vitro anti-platelet activity; all derivatives showed effects on both platelet activation and aggregation, and showed synergy with ASA...
November 7, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29127901/cerium-dioxide-doped-carboxyl-fullerene-as-novel-nanoprobe-and-catalyst-in-electrochemical-biosensor-for-amperometric-detection-of-the-cyp2c19-2-allele-in-human-serum
#13
Chengli Zhang, Junlin He, Yuchan Zhang, Jun Chen, Yilin Zhao, Yazhen Niu, Chao Yu
The disposition dose of clopidogrel is different in CYP2C19*2 gene carriers and non-carriers. High-dose clopidogrel has been recommended to overcome a low-responsiveness to clopidogrel in patients with the CYP2C19*2 gene. To guide the choice of clopidogrel dosage and catalyse a development in the field of personalized therapy, we developed an ultrasensitive electrochemical biosensor to detect CYP2C19*2 gene. We constructed a novel assay based on cerium dioxide (CeO2)-functionalized carboxyl fullerene (c-C60) supported by Pt nanoparticles (c-C60/CeO2/PtNPs) for signal amplification...
November 8, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29126843/the-role-of-platelet-reactivity-assessment-in-dual-antiplatelet-prophylaxis-after-transcatheter-aortic-valve-implantation
#14
Katarzyna Czerwińska-Jelonkiewicz, Adam Witkowski, Maciej Dąbrowski, Walerian Piotrowski, Tomasz Hryniewiecki, Janina Stępińska
BACKGROUND: Dual antiplatelet therapy (DAPT) is recommended prophylaxis after transcatheter aortic valve implantation (TAVI). The usefulness of platelet reactivity (PLTR) tests in predicting the safety of periprocedural DAPT in the TAVI population is unknown. AIM: To analyze the value of aspirin/clopidogrel PLTR testing in predicting the risk of in-hospital TAVI-related bleeding. METHODS: PLTR, expressed as P2Y12/aspirin reaction units (PRU/ARU), was performed using optical aggregometry with the VerifyNow(®) device, in the 24h before and on the sixth day after TAVI...
November 7, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29126156/antithrombotic-therapy-after-myocardial-infarction-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#15
Gorav Batra, Leif Friberg, David Erlinge, Stefan James, Tomas Jernberg, Bodil Svennblad, Lars Wallentin, Jonas Oldgren
Aims: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with myocardial infarction and atrial fibrillation is uncertain. In this study, we compared antithrombotic regimes with regard to a composite cardiovascular outcome of all-cause mortality, myocardial infarction or ischaemic stroke and major bleeds. Methods and results: Patients between October 2005 and December 2012 were identified in Swedish registries, n = 7,116...
November 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29126112/risk-scoring-to-guide-anti-platelet-therapy-post-percutaneous-coronary-intervention-pci-for-acute-coronary-syndrome-acs-results-in-improved-clinical-outcomes
#16
S Antoniou, M Colicchia, O Guttmann, K Rathod, P Wright, S Fhadil, C Knight, A K Jain, E J Smith, A Mathur, R Weerackody, A Wragg, D A Jones
Objective: To use the GRACE and CRUSADE scores to risk stratify anti-platelet treatment post Acute Coronary Syndrome (ACS). Methods: This was a prospective registry of 3374 patients undergoing PCI for ACS between 2013-2015 at a UK cardiac centre. Patients with either low GRACE or high CRUSADE risk scores were stratified to clopidogrel therapy otherwise ticagrelor was used. The primary end-point was major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction, stroke, or target vessel revascularization with bleeding rates as a secondary outcome, assessed at a median follow-up of 1...
November 8, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#17
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29121979/platelet-inhibition-during-ticagrelor-monotherapy-versus-ticagrelor-plus-aspirin-in-patients-with-coronary-artery-disease-template-study-study-protocol-for-a-randomised-controlled-trial
#18
Sarah Baos, Wendy Underwood, Lucy Culliford, Barnaby C Reeves, Chris A Rogers, Ruth Bowles, Tom Johnson, Andreas Baumbach, Andrew Mumford
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin (ASP) and a P2Y12 blocker is currently standard care after percutaneous coronary intervention (PCI) with stent insertion, and aims to inhibit platelet function in order to prevent stent thrombosis. The P2Y12 blocker ticagrelor (TIC) has greater antiplatelet effect than the previously used members of this class, such as clopidogrel. In healthy volunteers, TIC is sufficient to cause strong platelet inhibition, with little additional effect from ASP...
November 9, 2017: Trials
https://www.readbyqxmd.com/read/29121759/comparison-of-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-and-non-randomized-studies
#19
Hussam Watti, Khagendra Dahal, Henock G Zabher, Pavan Katikaneni, Kalgi Modi, Abdulrahman Abdulbaki
BACKGROUND: The newer oral P2Y12 receptor antagonists (i.e. prasugrel and ticagrelor) are recommended over clopidogrel for patients with acute coronary syndrome (ACS) going for percutaneous coronary intervention (PCI). As the superiority of one agent over the other remains unclear, we designed a systematic review and meta-analysis of these agents in patients with ACS undergoing PCI. METHODS: PUBMED, EMBASE, Cochrane CENTRAL, CINAHL and manual search were performed through 11/02/2016...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29118712/comparative-long-term-effect-of-three-anti-p2y12-drugs-after-percutaneous-angioplasty-an-observational-study-based-on-electronic-drug-adherence-monitoring
#20
Valentina Forni Ogna, Isabelle Bassi, Isabelle Menetrey, Olivier Muller, Eric Tousset, Pierre Fontana, Eric Eeckhout, Chin B Eap, Bernard Vrijens, Michel Burnier, Grégoire Wuerzner
Aims: Dual platelet inhibition using anti-P2Y12 drugs and aspirin is the standard of care in patients after percutaneous coronary interventions (PCI). Prasugrel and ticagrelor have been shown to be more potent than clopidogrel with less high on-treatment platelet reactivity. Whether differences in long-term adherence to these drugs can partly explain different antiplatelet efficacy has not been studied so far. The objective was to compare the long-term P2Y12 receptor inhibition and drug adherence to different anti-P2Y12 drugs, and to assess the impact of adherence on the pharmacodynamic effect...
2017: Frontiers in Pharmacology
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