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Chang-Zheng Gao, Qian-Qian Ma, Jing Wu, Rui Liu, Fen Wang, Jie Bai, Xiang-Jun Yang, Qiang Fu, Peng Wei
BACKGROUND/AIMS: Acute ST-segment elevation of myocardial infarction (STEMI) is the most severe type of acute coronary syndrome (ACS). Particular attention has been focused on studying the pathogenesis of STEMI, and how to prevent thrombosis, reduce inflammatory reaction, stabilize plaques and improve vascular endothelial functions to preserve the survived myocardium. This study aimed to compare the anti-inflammatory endothelium-protective effects, clinical prognosis, and relevant bleeding risks of ticagrelor versus clopidogrel in patients with STEMI who underwent urgent percutaneous coronary intervention (PCI) and provide certain experimental evidence and a theoretical basis for the selection of safe and effective drugs and their proper dosage, thereby further guiding clinical medication...
July 17, 2018: Cellular Physiology and Biochemistry
Weiran Dai, Ziliang Ye, Lang Li, Qiang Su
Background: Previous studies have shown that ticagrelor is more effective than clopidogrel in platelet inhibition. However, this conclusion remains controversial. Therefore, we performed this meta-analysis to assess the effect of preoperative loading dose ticagrelor and clopidogrel on no-reflow (NRF) during intervention in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI). Materials and methods: Randomized controlled trials and observational studies were reviewed...
2018: Drug Design, Development and Therapy
Christopher R Ellis, Mohamed Metawee, Robert N Piana, Jeremy M Bennett, Mias Pretorius, Robert J Deegan
BACKGROUND: Incomplete surgical left atrial appendage occlusion (S-LAAO) with a narrow neck has been shown to predict an increased rate of embolic stroke. Patients with a previously attempted S-LAAO were systematically excluded from all clinical trials of LAA closure devices. OBJECTIVE: Evaluate the feasibility of Watchman LAA device closure for patients referred with chronically incomplete S-LAAO. METHODS: Prospective single arm feasibility cohort of Watchman LAA closure following incomplete S-LAAO...
July 13, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Young Hee Nam, Colleen M Brensinger, Warren B Bilker, Charles E Leonard, Scott E Kasner, Tilo Grosser, Xuanwen Li, Sean Hennessy
[This corrects the article DOI: 10.1371/journal.pone.0193800.].
2018: PloS One
Ieva Briede, Inga Narbute, Indulis Kumsars, Dace Sondore, Karlis Trushinskis, Sanda Jegere, Gustavs Latkovskis, Karlis Strenge, Ainars Rudzitis, Andrejs Erglis
Aim: The aim of this long-term registry data was to evaluate 2-year clinical and angiographic outcomes after implantation of everolimus-eluting bioresorbable scaffolds (Absorb) from the Latvian Centre of Cardiology Real-life Registry. Material and methods: Between November 2012 and December 2014 in the Centre of Cardiology Real-life Bioresorbable Vascular Scaffold Registry, 187 patients with stable angina or acute coronary syndrome and available 2-year follow-up were selected...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Richard Myles Turner, Vanessa Fontana, Mark Bayliss, Sarah Whalley, Anahi Santoyo Castelazo, Munir Pirmohamed
Cardiovascular disease is a leading cause of morbidity, mortality, and healthcare expenditure worldwide. Importantly, there is interindividual variation in response to cardiovascular medications, leading to variable efficacy and adverse events. Therefore a rapid, selective, sensitive and reproducible multi-analyte HPLC-MS/MS assay for the quantification in human plasma of atorvastatin, its major metabolites 2-hydroxyatorvastatin, atorvastatin lactone and 2-hydroxyatorvastatin lactone, plus bisoprolol and clopidogrel-carboxylic acid has been developed, fully validated, and applied to a large patient study...
July 3, 2018: Journal of Pharmaceutical and Biomedical Analysis
Dorota Danielak, Marta Karaźniewicz-Łada, Franciszek Główka
The introduction of ticagrelor, one of the first directly-acting oral antiplatelet drugs, provided new possibilities in the prevention of thrombotic events in patients with acute coronary syndromes (ACS). Current guidelines recommend ticagrelor in dual antiplatelet therapy with aspirin over clopidogrel for prevention of stent thrombosis in patients with ACS. Moreover, in the management of ACS, lipid-lowering treatment with high-intensity statin therapy is advised for secondary prevention of cardiovascular events over the long term...
July 12, 2018: Drugs
Mikko T Holmberg, Aleksi Tornio, Maria Paile-Hyvärinen, E Katriina Tarkiainen, Mikko Neuvonen, Pertti J Neuvonen, Janne T Backman, Mikko Niemi
CYP3A enzymes participate in the elimination of ticagrelor and the bioactivation of clopidogrel and prasugrel. We studied the effects of functional CYP3A genetic variants (CYP3A4*22; rs35599367 and CYP3A5*3; rs776746) on the pharmacokinetics and pharmacodynamics of ticagrelor, clopidogrel, and prasugrel. Six healthy volunteers with the CYP3A4*1/*22 and CYP3A5*3/*3 genotype (CYP3A4*22 carriers), eight with the CYP3A4*1/*1 and CYP3A5*1/*3 genotype (CYP3A5 expressors), and 11 to 13 with the CYP3A4*1/*1 and CYP3A5*3/*3 genotypes (controls) ingested single doses of ticagrelor, clopidogrel, and prasugrel on separate occasions...
July 11, 2018: Clinical Pharmacology and Therapeutics
Jeffrey S Berger, Beth L Abramson, Renato D Lopes, Gretchen Heizer, Frank W Rockhold, Iris Baumgartner, F Gerry R Fowkes, Peter Held, Brian G Katona, Lars Norgren, W Schuyler Jones, Marcus Millegård, Juuso Blomster, Craig Reist, William R Hiatt, Manesh R Patel, Kenneth W Mahaffey
Patients with peripheral artery disease (PAD) are at heightened risk of cardiovascular morbidity and mortality. We sought to evaluate the risk of concomitant coronary artery disease (CAD) in patients with symptomatic PAD versus PAD without diagnosed CAD, and whether ticagrelor was superior to clopidogrel in reducing that risk. The EUCLID trial randomized 13,885 patients with PAD to antithrombotic monotherapy with ticagrelor or clopidogrel. CAD was defined as prior myocardial infarction (MI), percutaneous coronary intervention (PCI), or coronary artery bypass graft (CABG) surgery...
July 1, 2018: Vascular Medicine
Giuseppe Tarantini, Plinio Cirillo, Stefano De Servi, Guido Parodi, Davide Capodanno, Gianpiero D'Amico, Alessandro Boccanelli, Marco Cattaneo, Leonardo Bolognese, Claudio Cavallini, Giuseppe Musumeci, Niccolò Marchionni
The appropriate use of dual antiplatelet therapy (DAPT) in elderly patients with acute coronary syndrome (ACS) remains a highly debated subject. In fact, achieving the correct balance between the reduction of ischemic risk and the increase in hemorrhagic events is more difficult in this population than in younger subjects, especially in the case of very potent drug therapy. As a consequence of this, despite guideline recommendations, antiplatelet therapy is currently underutilized in elderly patients with ACS...
July 2018: Giornale Italiano di Cardiologia
Jeffrey S Berger
Patients surviving an acute coronary syndrome (ACS) remain at increased risk of ischemic events long term. This paper reviews current evidence and guidelines for oral antiplatelet therapy for secondary prevention following ACS, with respect to decreased risk of ischemic events versus bleeding risk according to individual patient characteristics and risk factors. Specifically, data are reviewed from clinical studies of clopidogrel, prasugrel, ticagrelor and vorapaxar, as well as the results of systematic reviews and meta-analyses looking at the benefits and risks of oral antiplatelet therapy, and the relative merits of shorter versus longer duration of dual antiplatelet therapy, in different patient groups...
July 10, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Dimitrios Dimitroulis, Milad Golabkesh, David Naguib, Betül Knoop, Lisa Dannenberg, Carolin Helten, Martin Pöhl, Christian Jung, Malte Kelm, Tobias Zeus, Amin Polzin
Prasugrel and ticagrelor are recommended over clopidogrel in patients with ST-elevation myocardial infarction (STEMI). In this registry analysis, we compared efficacy and safety of ticagrelor and prasugrel P2Y12 inhibition in STEMI patients. We included 318 patients in this single-center analysis. 12 months follow-up was conducted during ambulatory care at our department. Patients were on dual antiplatelet therapy with aspirin and ticagrelor or prasugrel during the follow-up period. Prescription of prasugrel or ticagrelor respectively was according to the preference of the treating physician...
June 27, 2018: Journal of Cardiovascular Pharmacology
Ana Alastruey-Izquierdo, Jacques Cadranel, Holger Flick, Cendrine Godet, Christophe Hennequin, Martin Hoenigl, Chris Kosmidis, Christoph Lange, Oxana Munteanu, Iain Page, Helmut J F Salzer
Chronic pulmonary aspergillosis (CPA) complicates conditions including tuberculosis, chronic obstructive pulmonary disease and sarcoidosis, and is associated with high morbidity and mortality. Surgical cure should be considered where feasible; however, many patients are unsuitable for surgery due to extensive disease or poor respiratory function. Azoles are the only oral drug with anti-Aspergillus activity and itraconazole and voriconazole are considered as first-line drugs. A randomized controlled trial demonstrated improvement or stability in three-quarters of patients given 6 months of itraconazole, but a quarter relapsed on stopping therapy...
July 6, 2018: Respiration; International Review of Thoracic Diseases
Jing Chen, Ling Ding, Cui He, Dan Chen, Su-Rong Deng, Fang Gong, Yuan Li
Objective To explore the inhibitory effect of aspirin and clopidogrel on platelet adhesion and aggregation behaviors under the physiological flow condition using microfluidic chip technology for health volunteers. Methods Peripheral venous blood samples collected from twelve randomly recruited health volunteers were treated with 20 μmol/L acetylsalicylic acid,50 μmol/L 2-methlthioadenosine-5'-monophosphate triethylammonium salt,and their combination,respectively,with untreated blood samples being control group...
June 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
C Michael Gibson, Bennett Levitan, William J Gibson, Megan K Yee, Sabina A Murphy, Zhong Yuan, Anjan K Chakrabarti, Michael Lee, Eugene Braunwald
BACKGROUND: Net clinical outcome analyses of acute coronary syndrome (ACS) mingle fatal or irreversible events with survivable or reversible events that vary significantly in clinical impact. OBJECTIVES: A comparison of efficacy and safety limited to fatal or irreversible ischemic and adverse or seriously harmful events is one way to assess net clinical outcome and risk-benefit overall, given the fact that these events have a similar clinical impact. METHODS: In the ATLAS ACS 2-TIMI 51 (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome-Thrombolysis In Myocardial Infarction) trial of rivaroxaban in the secondary prevention of events among patients with ACS treated with aspirin plus clopidogrel or ticlopidine (clopidogrel/ticlopidine) or aspirin alone, fatal and irreversible efficacy events including nonbleeding cardiovascular death, myocardial infarction, and ischemic stroke were compared to fatal or irreversible safety events, including fatal and intracranial bleeding...
July 10, 2018: Journal of the American College of Cardiology
Xiaojiao Li, Cai Liu, Xiaoxue Zhu, Haijing Wei, Hong Zhang, Hong Chen, Guiling Chen, Deming Yang, Hongbin Sun, Zhenwei Shen, Yifan Zhang, Wei Li, Jin Yang, Yongqiang Liu, Xiaojuan Lai, Yanchun Gong, Xuefang Liu, Yongguo Li, Dafang Zhong, Junqi Niu, Bin Liu, Yanhua Ding
Background: Vicagrel is a novel anti-platelet drug and hydrolyzed to the same intermediate as clopidogrel via esterase, instead of CYP2C19. Here we report the first clinical trial on the tolerability, pharmacokinetics and pharmacodynamics of different doses of vicagrel, and comparison with clopidogrel in healthy Chinese volunteers. Methods: This study was conducted in two parts. Study I was a dose-escalating (5-15 mg) study. For each dose, 15 participants were randomized into three groups (total n = 45); nine participants were given vicagrel, three were given clopidogrel, and three were given a placebo...
2018: Frontiers in Pharmacology
Plinio Cirillo, Luigi Di Serafino, Giuseppe Patti, Emilia Antonucci, Paolo Calabrò, Paolo Gresele, Gualtiero Palareti, Vittorio Pengo, Pasquale Pignatelli, Rossella Marcucci
We investigated whether gender influences antiplatelet treatment in patients with acute coronary syndrome (ACS). The primary end point was major adverse cardiac and cerebrovascular events (MACCEs), a composite of death, myocardial infarction (MI), stroke, or target vessel revascularization. The coprimary end point was net adverse cardiac and cerebrovascular events (NACEs), based on MACCE plus major bleeding. From January 2014 to December 2016, 840 consecutive patients with ACS who completed 1-year follow-up were enrolled, 625 (74%) males and 215 (26%) females...
January 1, 2018: Angiology
Akihide Konishi, Masamichi Iwasaki, Toshiro Shinke, Hiromasa Otake, Masayuki Nakagawa, Hirotoshi Hariki, Tsuyoshi Osue, Takumi Inoue, Yu Taniguchi, Ryo Nishio, Hiroto Kinutani, Noritoshi Hiranuma, Masaru Kuroda, Ken-Ichi Hirata, Shigeru Saito, Masato Nakamura, Junya Shite, Takashi Akasaka
Intra-stent thrombus (IS-Th) formed immediately after percutaneous coronary intervention (PCI) is associated with subsequent adverse coronary events. However, the impact of on-treatment platelet reactivity on IS-Th is unknown. PRASFIT-Elective is a multicenter study of PCI patients receiving prasugrel (20/3.75 mg, loading/maintenance dose) or clopidogrel (300/75 mg), with aspirin (100 mg). Among the 742 study patients, 111 were pre-specified for the OCT sub-study. Of these, 82 underwent OCT immediately after PCI to assess IS-Th and at an 8-month follow-up to evaluate the fate of the IS-Th...
July 2, 2018: Heart and Vessels
Jessie Scaglione, Sandra F Diaz, John D Bonagura, Rebecca A Kohnken, Timothy H Helms, Rachel E Cianciolo
CASE DESCRIPTION A 2.5-year-old 12-kg (26.4-lb) castrated male Miniature American Shepherd was referred because of a 3-week history of a localized crusted skin lesion on the digital pad of digit 3 of the right hind limb. CLINICAL FINDINGS Skin lesions were noted on the digital pads of the right hind limb. Serum biochemical analyses indicated severe hypercholesterolemia and hypertriglyceridemia. Ultrasonography of the terminal portion of the aorta and other major arterial vessels revealed substantial arteriosclerotic change...
July 15, 2018: Journal of the American Veterinary Medical Association
Shinichi Wakabayashi, Noritaka Ariyoshi, Hideki Kitahara, Kenichi Fujii, Yoshihide Fujimoto, Yoshio Kobayashi
BACKGROUND: Due to concern about bleeding complications, a maintenance dose of prasugrel 2.5 mg may be used in elderly or low-body-weight patients in Japan. There is little information, however, on the efficacy and safety of a 2.5-mg maintenance dose of prasugrel.Methods and Results:In this single-center, prospective, open-label, cross-over study, a total of 44 elderly (≥75 years old) or low body-weight (<50 kg) Japanese patients >1 month after percutaneous coronary intervention who were treated with aspirin 81-100 mg and clopidogrel 75 mg were randomized to either prasugrel 2...
June 29, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
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