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https://www.readbyqxmd.com/read/28745582/cyp2c19-guided-antiplatelet-therapy-a-cost-effectiveness-analysis-of-30-day-and-1-year-outcomes-following-percutaneous-coronary-intervention
#1
Mrudula S Borse, Olivia M Dong, Melissa J Polasek, Joel F Farley, George A Stouffer, Craig R Lee
AIM: Determine whether using CYP2C19 genotype to optimize antiplatelet therapy selection is cost-effective over the initial 30 days and 1-year following percutaneous coronary intervention. MATERIALS & METHODS: A cost-effectiveness analysis compared 30-day and 1-year outcomes and cost across three treatment strategies (universal clopidogrel, universal prasugrel, genotype-guided) in a hypothetical cohort. RESULTS: Base-case scenario results at 30 days indicated that the incremental cost per major cardiovascular or bleeding event avoided for genotype-guided treatment was US$8525 and US$42,198 compared with universal clopidogrel and prasugrel, respectively...
July 26, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28745576/association-of-cyp2c19-2-polymorphism-with-clopidogrel-response-and-1-year-major-adverse-cardiovascular-events-in-a-multiethnic-population-with-drug-eluting-stents
#2
Shirley Siang Ning Tan, Alan Yean Yip Fong, Melissa Mejin, Jerry Gerunsin, Khai Liy Kong, Felicia Yien Yin Chin, Lee Len Tiong, Melissa Siaw Han Lim, Asri Said, Ning Zan Khiew, Chi Yen Voon, Nor Hanim Mohd Amin, Yee Ling Cham, Keng Tat Koh, Yen Yee Oon, Tiong Kiam Ong
BACKGROUND: Patients undergoing elective percutaneous coronary intervention (PCI) with drug-eluting stents (DES) who have impaired clopidogrel response, have a higher risk of subsequent major adverse cardiovascular events (MACE). AIM OF THE STUDY: To establish the relationship between CYP2C19 genotype, clopidogrel responsiveness and 1-year MACE. MATERIALS & METHODS: Aspirin/clopidogrel responses were assessed with Multiplate Analyzer and CYP2C19*2 allele by SpartanRx...
July 26, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28744801/a-retrospective-comparison-between-delayed-and-early-hip-fracture-surgery-in-patients-taking-clopidogrel-same-total-bleeding-but-different-timing-of-blood-transfusion
#3
Claire Pailleret, Zakaria Ait Hamou, Nadia Rosencher, Charles-Marc Samama, Violaine Eyraud, François Chilot, Christophe Baillard
PURPOSE: Managing hip fracture surgery in patients taking clopidogrel is challenging. The optimal timing for surgery remains unclear. Early surgery in such patients potentially increases peri-operative bleeding, whereas delayed surgery has been shown to be associated with worse postoperative outcomes. The aim of this study was to investigate whether a delay to surgery affects total blood loss, bleeding kinetics, blood transfusion requirements, or post-operative outcomes. METHODS: A retrospective monocentric study including all hip fracture patients treated with clopidogrel between 2011 and 2016 (39 patients) was carried out...
July 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#4
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740708/staged-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-versus-combined-coronary-artery-bypass-graft-and-mitral-valve-surgery-for-two-vessel-coronary-artery-disease-and-moderate-to-severe-ischemic-mitral-regurgitation
#5
Christos G Mihos, Steve Xydas, Roy F Williams, Andrés M Pineda, Evin Yucel, Hector Davila, Nirat Beohar, Orlando Santana
BACKGROUND: The optimal treatment for concomitant two-vessel coronary artery disease (CAD) and moderate to severe ischemic mitral regurgitation (IMR) remains unclear. We compared the results of a staged percutaneous coronary intervention followed by minimally invasive mitral valve surgery (PCI+MIVS) versus combined coronary artery bypass graft and mitral valve surgery (CABG+MVS) in this population. METHODS: All consecutive patients with two-vessel CAD and moderate to severe IMR, who underwent PCI+MIVS or CABG+MVS at our institution between February 2009 and April 2014, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28737446/quantitative-in-vitro-phenotyping-and-prediction-of-drug-interaction-potential-of-cyp2b6-substrates-as-victims
#6
Raghava Choudary Palacharla, Ramakrishna Nirogi, Venkatesham Uthukam, Arunkumar Manoharan, Ranjith Kumar Ponnamaneni, Ilayaraja Kalaikadhiban
1. Determination of fm, CYP for a compound is critical to assess the potential risk of a drug candidate as a victim of DDI. Several compounds are identified as CYP2B6 substrates but the fm, CYP2B6 values are not determined quantitatively 2. Two methods of reaction phenotyping, the chemical inhibition method, and metabolism in rCYP enzymes, were used to determine the relative contributions of the enzymes. Chemical inhibition method was also conducted in the presence of BSA (0.5% w/v) 3. The results confirm with the earlier studies concerning the identity of the CYP2B6 enzyme...
July 24, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/28736557/the-effect-of-admission-renal-function-on-the-treatment-and-outcome-of-patients-with-acute-coronary-syndrome
#7
Zach Rozenbaum, Sydney Benchetrit, Saar Minha, Yoram Neuman, Meital Shlezinger, Ilan Goldenberg, Morris Mosseri, David Pereg
BACKGROUND: Chronic kidney disease is a frequent comorbidity among patients with acute coronary syndrome (ACS). We aimed to evaluate treatment characteristics in ACS patients according to their renal function and to assess the effect of differences in therapy on clinical outcomes. METHODS: Included were patients with ACS enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) during 2000-2013. Excluded were patients with cardiogenic shock at presentation...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28734623/eight-year-follow-up-of-the-clopidogrel-after-surgery-for-coronary-artery-disease-cascade-trial
#8
Ali Hage, Pierre Voisine, Fernanda Erthal, Éric Larose, David Glineur, Benjamin Chow, Hugo Tremblay, Jacqueline Fortier, Gifferd Ko, Dai Une, Michael Farkouh, Thierry G Mesana, Michel LeMay, Alexander Kulik, Marc Ruel
OBJECTIVE: In this 8 years' follow-up study, we evaluated the long-term outcomes of the addition of clopidogrel to aspirin during the first year after coronary artery bypass grafting, versus aspirin plus placebo, with respect to survival, major adverse cardiac, or major cerebrovascular events, including revascularization, functional status, graft patency, and native coronary artery disease progression. METHODS: In the initial Clopidogrel After Surgery for Coronary Artery Disease trial, 113 patients were randomized to receive either daily clopidogrel (n = 56) or placebo (n = 57), in addition to aspirin, in a double-blind fashion for 1 year after coronary artery bypass grafting...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28734158/interaction-between-platelet-derived-micrornas-and-cyp2c19-2-genotype-on-clopidogrel-antiplatelet-responsiveness-in-patients-with-acs
#9
Li Peng, Jun Liu, Liuan Qin, Jia Liu, Shaozhi Xi, Caiyi Lu, Tong Yin
BACKGROUND: Both platelet-derived microRNAs and the genotype of CYP2C19*2 were implicated for the variability of clopidogrel antiplatelet responsiveness. However, their interaction on the antiplatelet responsiveness of clopidogrel in patients with acute coronary syndrome (ACS) remains unknown. METHODS: Consecutive clopidogrel-treated patients with ACS were recruited, with their antiplatelet responsiveness evaluated by the relative platelet inhibition (RI), as measured by light transmittance aggregometry (LTA) at baseline and 5days' after the maintenance treatment of clopidogrel...
July 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28733910/a-review-study-to-evaluate-holmium-yag-laser-lithotripsy-with-flexible-ureteroscopy-in-patients-on-ongoing-oral-anticoagulant-therapy
#10
Bulent Altay, Bulent Erkurt, Selami Albayrak
The objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified...
July 22, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28730935/effect-of-directly-compressible-excipient-and-treated-agar-on-drug-release-of-clopidogrel-oral-disintegrating-tablets
#11
Kambham Venkateswarlu, Manyam Nirosha, Budideti Kishore Kumar Reddy, Badithala Siva Sai Kiran
AIM: In the present investigation, oral dissolving/dispersible/disintegrating tablets (ODTs) of clopidogrel were designed with a view to enhance the bioavailability and patient compliance by two different methods, namely, direct compression and effervescent methods using directly compressible excipient and treated agar (TAG). MATERIALS & METHODS: In the direct compression method, TAG was used as a disintegrant and another method used a mixture of sodium bicarbonate and tartaric acid along with TAG as disintegrants...
July 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#12
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727358/-antiplatelet-therapy-in-secondary-stroke-prevention
#13
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/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#14
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#15
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28721209/recent-advances-in-preventing-stroke-recurrence
#16
REVIEW
J David Spence
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%...
2017: F1000Research
https://www.readbyqxmd.com/read/28718026/solid-phase-extraction-of-multi-class-pharmaceuticals-from-environmental-water-samples-onto-modified-multi-walled-carbon-nanotubes-followed-by-lc-ms-ms
#17
Bojana Lalović, Tatjana Đurkić, Marija Vukčević, Ivona Janković-Častvan, Ana Kalijadis, Zoran Laušević, Mila Laušević
In this paper, pristine and chemically treated multi-walled carbon nanotubes (MWCNTs) were employed as solid-phase extraction sorbents for the isolation and enrichment of multi-class pharmaceuticals from the surface water and groundwater, prior to liquid chromatography-tandem mass spectrometry analysis. Thirteen pharmaceuticals that belong to different therapeutical classes (erythromycin, azithromycin, sulfamethoxazole, diazepam, lorazepam, carbamazepine, metoprolol, bisoprolol, enalapril, cilazapril, simvastatin, clopidogrel, diclofenac) and two metabolites of metamizole (4-acetylaminoantipyrine and 4-formylaminoantipyrine) were selected for this study...
July 17, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28717586/evaluating-platelet-aggregation-dynamics-from-laser-speckle-fluctuations
#18
Zeinab Hajjarian, Diane M Tshikudi, Seemantini K Nadkarni
Platelets are key to maintaining hemostasis and impaired platelet aggregation could lead to hemorrhage or thrombosis. We report a new approach that exploits laser speckle intensity fluctuations, emanated from a drop of platelet-rich-plasma (PRP), to profile aggregation. Speckle fluctuation rate is quantified by the speckle intensity autocorrelation, g2(t), from which the aggregate size is deduced. We first apply this approach to evaluate polystyrene bead aggregation, triggered by salt. Next, we assess dose-dependent platelet aggregation and inhibition in human PRP spiked with adenosine diphosphate and clopidogrel...
July 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28717113/add-on-antiplatelet-effects-of-eicosapentaenoic-acid-with-tailored-dose-setting-in-patients-on-dual-antiplatelet-therapy
#19
Naoyoshi Hosogoe, Shuichi Ishikawa, Naoyuki Yokoyama, Ken Kozuma, Takaaki Isshiki
The aim of this study was to investigate the antiplatelet effects of eicosapentaenoic acid (EPA) at a sufficient dose following coronary stent implantation. Thirty-one patients on dual antiplatelet therapy with aspirin and clopidogrel were treated with highly purified EPA-E (Epadel(®)) for 12 weeks. Based on our previous study, patients with a high baseline EPA/arachidonic acid (AA) ratio (≥ 0.37; n = 11) were given a standard dose (1800 mg daily) of EPA-E, whereas those with a low EPA/AA ratio (< 0.37; n = 20) were given a high dose (2700 mg daily) to reach the target value of > 0...
July 14, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28715832/aspirin-plus-clopidogrel-was-not-linked-to-risk-for-cancer-compared-with-aspirin-alone-or-no-antiplatelets
#20
Mitchell Levine
No abstract text is available yet for this article.
July 18, 2017: Annals of Internal Medicine
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