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https://www.readbyqxmd.com/read/28642210/rationale-and-design-for-a-randomized-comparison-of-efficacy-and-safety-between-aspirin-and-clopidogrel-in-atrial-fibrillation-patients-with-low-stroke-risk-cesac-af-trial
#1
Sang Min Park, Haemin Jeong, Mi-Hyang Jung, Kyung Soon Hong, Myeong-Ki Hong, Chang Seok Bang, Christopher Y Kim
BACKGROUND: Atrial fibrillation (AF) increases the risk of thromboembolic stroke. An oral anticoagulant should be administrated to prevent stroke in patients with moderate stroke risk (ie, CHA2DS2-VASc score>2). If the stroke risk is low (i.e. the score=1), however, antiplatelet agent such as aspirin is widely used. Aspirin can cause peptic ulcer disease (PUD) while its alternative, clopidogrel, theoretically does not. OBJECTIVE: To elucidate the efficacy and safety between aspirin and clopidogrel, a multicenter randomized controlled trial was designed in AF patients with low stroke risk...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28641840/6-versus-24-month-dual-antiplatelet-therapy-after-implantation-of-drug-eluting%C3%A2-stents-in-patients-nonresistant-to-aspirin-final-results-of-the-italic-trial-is-there-a-life-for-des-after-discontinuation-of-clopidogrel
#2
Romain Didier, Marie Claude Morice, Paul Barragan, Arif A L Noryani, Hussam A Noor, Talib Majwal, Thomas Hovasse, Philippe Castellant, Michel Schneeberger, Luc Maillard, Erwan Bressolette, Jaroslaw Wojcik, Nicolas Delarche, Didier Blanchard, Bernard Jouve, Olivier Ormezzano, Franck Paganelli, Gilles Levy, Joël Sainsous, Didier Carrie, Alain Furber, Jacques Berlan, Olivier Darremont, Hervé Le Breton, Anne Lyuycx-Bore, Antoine Gommeaux, Claude Cassat, Alain Kermarrec, Pierre Cazaux, Philippe Druelles, Raphael Dauphin, Jean Armengaud, Patrick Dupouy, Didier Champagnac, Patrick Ohlmann, Hakim Ben Amer, Robert G Kiss, Irme Ungi, Martine Gilard
OBJECTIVES: The aim of this study was to test the hypothesis that 6-month dual antiplatelet therapy (DAPT) is noninferior to 24-month DAPT in aspirin-sensitive patients. BACKGROUND: The ITALIC (Is There a Life for DES After Discontinuation of Clopidogrel) trial showed that rates of bleeding and thrombotic events at 1 year were much the same with 6 versus 12 months of DAPT after percutaneous coronary intervention with second-generation drug-eluting stents. In this report, 2-year follow-up is presented...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28637375/anticoagulant-therapy-for-recurrent-in-stent-thrombosis-following-carotid-artery-stenting-a-case-report
#3
Akinori Miyakoshi, Hiroki Toda, Makoto Hayase, Takeshi Kawauchi, Yuki Oichi, Etsuko Hattori
We report a case in which strict anticoagulant therapy management was useful for a recurrent in-stent thrombosis after carotid artery stenting (CAS). An 84-year-old man presented with cognitive decline that progressed rapidly over two months. Head magnetic resonance imaging showed an acute-stage infarct occurring frequently in the right cerebral hemisphere, and he underwent hospitalization and treatment. On neck magnetic resonance angiography (MRA), severe stenosis was found at the origin of the right internal carotid artery...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#4
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28634365/different-levels-of-blood-pressure-different-benefit-from-dual-antiplatelet-therapy-in-minor-stroke-or-tia-patients
#5
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/28632784/contemporary-use-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-austria-a-prospective-multi-centre-registry
#6
Maximilian Tscharre, Florian Egger, Matthias Machata, Miklos Rohla, Nadia Michael, Manuel Neumayr, Robert Zweiker, Johannes Hajos, Christopher Adlbrecht, Markus Suppan, Wolfgang Helmreich, Bernd Eber, Kurt Huber, Thomas W Weiss
BACKGROUND: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. METHODS: In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres...
2017: PloS One
https://www.readbyqxmd.com/read/28631703/-association-of-itgb3-p2ry12-and-cyp2c19-gene-polymorphisms-with-platelet-functional-activity-in-patients-with-coronary-heart-disease-during-dual-antiplatelet-therapy
#7
E F Muslimova, S A Afanasiev, T Yu Rebrova, T N Sergienko, A N Repin
AIM: To assess the association of CYP2C19 G681A, P2RY12 H1/H2, and ITGB3 T1565C polymorphisms with the extent of platelet aggregation in patients with coronary heart disease (CHD) during antiplatelet therapy. SUBJECTS AND METHODS: 166 male patients with CHD, living in the Western Siberian Region, were examined. All the patients underwent a test for platelet aggregation induced by ADP (2.5 and 5.0 µm) and epinephrine (0.2 µm). Genotyping was performed using an allele-specific polymerase chain reaction technique...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28630782/remote-assessment-of-platelet-function-in-patients-with-acute-stroke-or-transient-ischaemic-attack
#8
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/28625369/rationale-and-design-of-the-hunting-for-the-off-target-properties-of-ticagrelor-on-endothelial-function-and-other-circulating-biomarkers-in-humans-hi-tech-trial
#9
Sara Ariotti, Maarten van Leeuwen, Salvatore Brugaletta, Sergio Leonardi, Kristiaan Martijn Akkerhuis, Emrush Rexhaj, Gladys Janssens, Luis Ortega-Paz, Diego Rizzotti, Jan C van den Berge, Dierik Heg, Gloria Francolini, Stephan Windecker, Marco Valgimigli
BACKGROUND: Among the 3 approved oral P2Y12 inhibitors for the treatment for patients with acute coronary syndrome (ACS), ticagrelor, but not prasugrel or clopidogrel, has been associated with off-target properties, such as improved endothelial-dependent vasomotion and increased adenosine plasma levels. METHODS: The HI-TECH study (NCT02587260) is a multinational, randomized, open-label, crossover study with a Latin squares design, conducted at 5 European sites, in which patients free from recurrent ischemic or bleeding events ≥30 days after a qualifying ACS were allocated to sequentially receive a 30 ± 5-day treatment with prasugrel, clopidogrel, and ticagrelor in random order...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28623527/updating-the-evidence-of-the-interaction-between-clopidogrel-and-cyp2c19-inhibiting-selective-serotonin-reuptake-inhibitors-a-cohort-study-and-meta-analysis
#10
Katsiaryna Bykov, Sebastian Schneeweiss, Robert J Glynn, Murray A Mittleman, David W Bates, Joshua J Gagne
INTRODUCTION: We previously found that patients who initiate clopidogrel while treated with a cytochrome P450 (CYP) 2C19-inhibiting selective serotonin reuptake inhibitor (SSRI) have a higher risk of subsequent ischemic events than patients treated with other SSRIs. It is not known whether initiating an inhibiting SSRI while treated with clopidogrel will also increase risk of ischemic events. OBJECTIVE: The aim of this study was to assess clinical outcomes following initiation of a CYP2C19-inhibiting SSRI versus initiation of other SSRIs among patients treated with clopidogrel and to update existing evidence on the clinical impact of clopidogrel-SSRI interaction...
June 16, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28619235/morphological-and-pharmacological-determinants-of-peri-procedural-myocardial-infarction-following-elective-stent-implantation-optical-coherence-tomography-sub-analysis-of-the-prasfit-elective-study
#11
Kenzo Uzu, Toshiro Shinke, Hiromasa Otake, Tomofumi Takaya, Tsuyoshi Osue, Masamichi Iwasaki, Hiroto Kinutani, Akihide Konishi, Masaru Kuroda, Hachidai Takahashi, Daisuke Terashita, Ken-Ichi Hirata, Shigeru Saito, Masato Nakamura, Junya Shite, Takashi Akasaka
BACKGROUND: Previous studies have suggested that peri-procedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) is associated with adverse short- and long-term outcomes, and several morphological predictors of PMI have been studied. However, the determinants of PMI under novel anti-platelet therapy are not fully elucidated. METHODS AND RESULTS: PRASFIT-Elective is a multicenter, parallel-group study of PCI patients in non-acute settings receiving either prasugrel or clopidogrel in addition to aspirin...
June 12, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28619104/individualized-dual-antiplatelet-therapy-based-on-platelet-function-testing-in-patients-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-controlled-trials
#12
Yijiang Zhou, Yanwei Wang, Yutao Wu, Chaoyang Huang, Hui Yan, Weiguo Zhu, Weiwei Xu, Li Zhang, Jianhua Zhu
BACKGROUND: High on-treatment platelet reactivity (HPR) represents a strong risk factor for thrombotic events after PCI. We aim to evaluate the efficacy and safety of individualizing intensified dual antiplatelet therapy (DAPT) in PCI-treated patients with HPR based on platelet function testing (PFT). METHODS: Electronic databases were searched for randomized control trials that reported the clinical outcomes of using an intensified antiplatelet protocol with P2Y12 receptor inhibitor comparing with standard maintenance dose of clopidogrel on the basis of platelet function testing...
June 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28618904/antiplatelet-and-antithrombotic-treatment-for-secondary-prevention-in-ischaemic-heart-disease
#13
Maddalena Lettino, Sergio Leonardi, Elia De Maria, Sigrun Halvorsen
Platelets play a key role in the pathogenesis of acute coronary syndromes and this is why antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in preventing recurrent myocardial infarction, stroke and cardiovascular death. Aspirin is the most used agent and still remains the first choice drug for lifelong administration in secondary prevention after myocardial infarction. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has significantly improved the outcome of patients with acute coronary syndromes despite an increased risk of bleeding complications...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28617992/antiplatelet-therapy-and-the-risk-of-hepatocellular-carcinoma-in-chronic-hepatitis-b-patients-on-antiviral-treatment
#14
Minjong Lee, Goh Eun Chung, Jeong-Hoon Lee, Sohee Oh, Joon Yeul Nam, Young Chang, Hyeki Cho, Hongkeun Ahn, Young Youn Cho, Jeong-Ju Yoo, Yuri Cho, Dong Hyeon Lee, Eun Ju Cho, Su Jong Yu, Dong Ho Lee, Jeong Min Lee, Yoon Jun Kim, Jung-Hwan Yoon
Antiplatelet therapy has shown protective effects against hepatocellular carcinoma (HCC) in preclinical studies. However, it is unclear whether antiplatelet therapy lowers the risk of HCC in patients with chronic hepatitis B (CHB). A retrospective analysis was conducted of data from 1,674 CHB patients, enrolled between January 2002 and May 2015, whose serum hepatitis B virus (HBV) DNA levels were suppressed by antivirals to <2,000 IU/mL. The primary and secondary outcomes were development of HCC and bleeding events, respectively...
June 15, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28616861/medical-therapy-and-recurrent-ischemic-events-in-high-risk-patients-surviving-their-myocardial-infarction-for-at-least-12%C3%A2-months-comparison-of-patients-with-st-elevation-versus-non-st-elevation-myocardial-infarction
#15
Uwe Zeymer, Katrin Riedel, Michael Hahn
INTRODUCTION: Data about treatments and recurrent ischemic events in patients surviving their most recent myocardial infarction event-free for at least 12 months are scarce. METHODS: In a retrospective data analysis, charts of patients who had a myocardial infarction 1-3 years ago with an event-free period of at least 12 months after the index event and at least one high risk factor were centrally collected and analyzed. Here we compare patients with ST elevation myocardial infarction (STEMI) versus non-ST elevation myocardial infarction (NSTEMI)...
June 14, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28616432/effect-of-pretreatment-with-omega-3-supplement-on-cardiac-necrosis-markers-in-chronic-kidney-disease-patients-undergoing-elective-percutaneous-coronary-intervention
#16
Farzaneh Foroughinia, Maryam Foroozmehr
OBJECTIVE: Studies have demonstrated the direct relation between elevation in cardiac necrosis markers and increased risk of cardiovascular complications after percutaneous coronary intervention (PCI) in chronic kidney disease (CKD) patients. In this study, we sought to evaluate the effect of omega-3 on creatine kinase-MB (CK-MB) and troponin-I in CKD patients undergoing elective PCI. METHODS: Eighty CKD patients, candidate for elective PCI, were randomly assigned into two groups: Group A - receiving omega-3 (2...
April 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28612911/short-term-efficacy-and-safety-of-three-different-antiplatelet-regimens-in-diabetic-patients-treated-with-primary-percutaneous-coronary-intervention-a-randomized-study
#17
Yang Liu, Hengliang Liu, Yibin Hao, Zhenxuan Hao, Guoying Geng, Wenjie Han, Qi Chen, Danli Wang, Lingzhi Liu, Kailong Jia, Yuxin Zhou
BACKGROUND: This study aimed to investigate the efficacy and safety of dual and triple antiplatelet therapy (DAPT and TAPT) in patients with diabetes and acute ST segment elevation myocardial infarction (D-STEMI), who had undergone primary percutaneous coronary intervention (PCI). METHODS: We designed a phase IV, single-center, randomized, double-blind, placebo-controlled study. The D-STEMI patients (N=258) were randomly divided into three groups. Control group A (85 patients), was treated with aspirin and clopidogrel; group B (87 patients) received aspirin, clopidogrel, and tirofiban; and group C (86 patients) was treated with aspirin, ticagrelor, and tirofiban...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28612420/bivalirudin-or-heparin-for-radial-access
#18
EDITORIAL
John A Bittl
Bivalirudin is a reasonable choice during transradial PCI for acute MI when bleeding risk is high and clopidogrel or cangrelor is used Heparin is reasonable during transradial PCI when bleeding risk is low and high-intensity antiplatelet therapy is used Future studies are required to define the utility of post-PCI bivalirudin infusions.
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28611833/open-label-phase-i-clinical-study-to-assess-the-safety-and-efficacy-of-cilostazol-in-patients-undergoing-internal-carotid-artery-stent-placement
#19
Ameer E Hassan, Haralabos Zacharatos, Mikayel Grigoryan, Wondwossen G Tekle, Amir Khan, Farhan Siddiq, Gustavo J Rodriguez, Ramachandra Tummala, Bharathi Jagadeesan, M Fareed K Suri, Adnan I Qureshi
BACKGROUND: One-month dual antiplatelet treatment, with aspirin and clopidogrel, following internal carotid artery stent placement is the current standard of care to prevent in-stent thrombosis. Cilostazol, an antiplatelet drug, has been demonstrated to have a safety profile comparable to aspirin and clopidogrel. OBJECTIVE: To evaluate the safety and clinical efficacy of cilostazol and aspirin therapy following internal carotid artery stent placement up to 1 month postprocedure...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28608310/platelet-inhibition-after-loading-dose-of-prasugrel-in-patients-with-st-elevation-and-non-st-elevation-acute-coronary-syndrome
#20
Shinichi Wakabayashi, Hideki Kitahara, Takeshi Nishi, Kazumasa Sugimoto, Takashi Nakayama, Yoshihide Fujimoto, Noritaka Ariyoshi, Yoshio Kobayashi
The PRASFIT-ACS study showed the antiplatelet effect 2-4 h after prasugrel loading. However, there is little information about the antiplatelet effect <2 h after prasugrel loading dose, especially in patients with acute coronary syndrome (ACS). There had not been any comparison between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). Fifty patients with ACS (15 with STEMI and 35 with NSTE-ACS) were enrolled. They received a 20-mg prasugrel loading dose followed by a maintenance dose of 3...
June 12, 2017: Cardiovascular Intervention and Therapeutics
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