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https://www.readbyqxmd.com/read/28318511/effect-of-tailored-antiplatelet-therapy-to-reduce-recurrent-stent-thrombosis-and-cardiac-death-after-a-first-episode-of-stent-thrombosis
#1
Thea C Godschalk, Laura M Willemsen, Bastiaan Zwart, Thomas O Bergmeijer, Paul Willem A Janssen, Johannes C Kelder, Christian M Hackeng, Jurriën M Ten Berg
The recurrence rate of coronary stent thrombosis (ST) is high. Patients with ST often demonstrate high on-treatment platelet reactivity (HPR). It is suggested that patients at high risk of atherothrombotic events, that is patients with ST, could benefit from tailored antiplatelet therapy (APT). This study evaluated whether tailored APT, based on platelet function testing, reduced the rate of cardiac death and/or recurrent ST at 1 year after ST, compared with a historical cohort of patients with ST without tailored APT...
February 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28317790/clinical-events-beyond-one-year-after-an-acute-coronary-syndrome-insights-from-the-reclose-2-acs-study
#2
Guido Parodi, Benedetta Bellandi, Giuseppe Tarantini, Fernando Scudiero, Renato Valenti, Rossella Marcucci, Angela Migliorini, Niccolò Marchionni, Anna Maria Gori, Chiara Zocchi, David Antoniucci
AIMS: The optimal duration of dual antiplatelet therapy after an acute coronary syndrome (ACS) is still unknown and debated. We sought to assess the incidence of adverse clinical events beyond 12 months after an ACS in patients treated by percutaneous coronary intervention (PCI) and clopidogrel. METHODS AND RESULTS: Among 1,592 consecutive ACS patients treated by PCI enrolled in the RECLOSE 2-ACS study and without event within one year, 1,310 (82%) patients presented at least one risk factor such as age ≥65 years, diabetes, prior myocardial infarction (MI), chronic kidney disease and multivessel coronary disease...
March 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#3
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28302342/does-percutaneous-coronary-stent-implantation-increase-platelet-reactivity
#4
REVIEW
P W A Janssen, E A Mol, S M C Geene, E Barbato, J M Ten Berg
High platelet reactivity (PR) values on treatment with clopidogrel are associated with an increased rate of thrombotic events after a percutaneous coronary intervention (PCI). However, we do not know the optimal timing of the performance of the PR measurements. Platelets might be activated during a PCI, which means that the timing of PR measurements, before or after PCI, could influence the outcome. In turn, this could lead to misinterpretation of the patient's response to antiplatelet therapy and a less accurate prediction of the patient's risk of thrombotic events during follow-up...
March 8, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28298800/a-case-of-subclavian-artery-aneurysm-with-history-of-ischemic-heart-disease-operated-under-cervical-epidural-anesthesia
#5
Amrita Rath, J Abhinay, Sandeep Loha, Atul Kumar Singh
Subclavian artery aneurysm is usually operated under general anesthesia (GA), but in specific situations, it can also be conducted under regional anesthesia (RA) such as cervical epidural anesthesia (CEA). A 48-year-old male presented with chief complaint of progressive swelling in the right side of the neck for the past 3 months following trauma. He was diagnosed as subclavian artery aneurysm, and surgical intervention was advised. He had previous history of angina 4 months back for which tablet aspirin 75 mg and tablet clopidogrel 75 mg once daily was prescribed...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298798/regional-anesthesia-in-patients-of-aged-99-years-in-clopidogrel-use
#6
Bruno Brasileiro, Luiz Eduardo Imbelloni
The risk of neuraxial block in patients treated with antiplatelet drugs are uncertain. Elderly patients often have low physiological reserve, delaying surgery can lead to a high rate of morbidity and mortality. The aim of this paper is to present a case of a patient with 99 years using clopidogrel undergoing regional anesthesia for surgical treatment of hip fracture without complications.
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296036/targeting-of-c-type-lectin-like-receptor-2-or-p2y12-for-the-prevention-of-platelet-activation-by-immunotherapeutic-cpg-oligodeoxynucleotides
#7
C Delierneux, N Donis, L Servais, O Wéra, C Lecut, M Vandereyken, L Musumeci, S Rahmouni, J Schneider, J A Eble, P Lancellotti, C Oury
BACKGROUND: Synthetic phosphorothioate-modified CpG oligodeoxynucleotides (CpG ODNs) display potent immunostimulatory properties that are widely exploited in clinical trials of anticancer treatment. Unexpectedly, a recent study indicates that CpG ODNs activate human platelets via the immunoreceptor tyrosine-based activation motif (ITAM)-coupled receptor glycoprotein VI. OBJECTIVE: To further analyze the mechanisms of CpG ODN-induced platelet activation and identify potential inhibitory strategies...
March 11, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28294864/-thromboxane-a2-mechanisms-of-synthesis-and-intracellular-signaling-system-of-realization
#8
E F Barinov
One of major complications of ischemic heart disease is myocardial infarction, which develops as a result of thrombosis at the site of ruptured atherosclerotic plaque. Platelets activation and aggregation are the key events of this process. The efficiency of aspirin and/or clopidogrel use is limited by residual platelet reactivity what indicates the need to explore its mechanisms. This review covers intracellular signaling systems involved in realization of effects of the main platelet agonists in order to specify new molecules for the target therapy in case of aspirin resistance...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28294854/-registry-of-acute-coronary-syndromes-record-3-characteristics-of-patients-and-treatment-during-initial-hospitalization
#9
A D Erlikh, N A Gratsiansky On Behalf Of Record-Participants
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month. RESULTS: Number of included pts was 2370 (39% women, mean age 64...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290994/derivation-and-validation-of-the-predicting-bleeding-complications-in-patients-undergoing-stent-implantation-and-subsequent-dual-antiplatelet-therapy-precise-dapt-score-a-pooled-analysis-of-individual-patient-datasets-from-clinical-trials
#10
Francesco Costa, David van Klaveren, Stefan James, Dik Heg, Lorenz Räber, Fausto Feres, Thomas Pilgrim, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Philippe Gabriel Steg, Thomas Zanchin, Tullio Palmerini, Lars Wallentin, Deepak L Bhatt, Gregg W Stone, Stephan Windecker, Ewout W Steyerberg, Marco Valgimigli
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor prevents ischaemic events after coronary stenting, but increases bleeding. Guidelines support weighting bleeding risk before the selection of treatment duration, but no standardised tool exists for this purpose. METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290889/-platelet-metabolism-in-clopidogrel-resistant-and-sensitive-patients-with-ischemic-heart-disease
#11
I Yu Grinshtein, A A Savchenko, Yu I Grinshtein, I V Filonenko, A A Kosinova
OBJECTIVE: to investigate relationship between activity of platelet nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) dependent dehydrogenases in patients with ischemic heart disease (IHD) after coronary artery bypass grafting (CABG) and their sensitivity to clopidogrel. MATERIAL AND METHODS: We studied 51 male patients with chronic IHD before and after CABG. Control group comprised 35 healthy men. In IHD patients spontaneous and induced platelet aggregation was measured by aggregometry before CABG (in 2 weeks after cessation of antiplatelet drugs), after CABG during therapy with clopidogrel (75 mg/day), and in 6 months after surgery...
October 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290236/efficacy-of-cilostazol-based-dual-antiplatelet-treatment-in-patients-undergoing-carotid-artery-stenting
#12
Ichiro Nakagawa, Hun Soo Park, Takeshi Wada, Shohei Yokoyama, Syuichi Yamada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: It is essential that patients undergoing carotid artery stenting (CAS) receive optimal antiplatelet inhibition. Although a reduction in platelet reactivity and improved clinical outcomes occur when using adjunctive cilostazol with dual antiplatelet therapy, this can lead to an increased risk of hemorrhagic complications. Therefore, our current study examined patients undergoing CAS and evaluated the impact of cilostazol-based dual antiplatelet treatment on the outcomes. METHODS: Between 2010 and 2015, 137 consecutive patients underwent CAS...
March 14, 2017: Neurological Research
https://www.readbyqxmd.com/read/28289237/impact-of-glycemic-control-on-efficacy-of-clopidogrel-in-transient-ischemic-attack-or-minor-stroke-patients-with-cyp2c19-genetic-variants
#13
Yi Lin, Anxin Wang, Jiejie Li, Jinxi Lin, David Wang, Xia Meng, Lixian Ou, Weiqi Chen, Xingquan Zhao, Liping Liu, Yilong Wang, Yongjun Wang
BACKGROUND AND PURPOSE: Dysglycemia may influence the predictive value of CYP2C19 loss-of-function allele for clinical efficacy of antiplatelet drug, but the role of glycated albumin (GA) remains unclear in patients with stroke on antiplatelet drugs. METHODS: The CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) included 2933 patients who had GA levels and CYP2C19 genotyping. Cox proportional hazards model was used to assess the interaction between CYP2C19 loss-of-function allele (*2, *3) carrier status and the effect of antiplatelet therapy based on their GA levels...
March 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28284524/evaluation-of-atrial-fibrillation-management-and-cardiovascular-risk-profile-in-atrial-fibrillation-patients-a-cross-sectional-survey
#14
Gediminas Račkauskas, Vytautas Zabiela, Germanas Marinskis, Arvydas Baranauskas, Deimilė Balkutė, Justina Alunderytė, Aras Puodžiūkynas, Tomas Kazakevičius, Vilius Kviesulaitis, Audrius Aidietis
OBJECTIVE: The aim of this study to investigate the most frequent risk factors of atrial fibrillation (AF), co-morbidities, complications associated with AF and the use of anticoagulants and other medications in patients who were referred to university hospitals in Lithuania. MATERIALS AND METHODS: This cross-sectional study enrolled consecutive inpatients and outpatients with AF presenting to cardiologists in the two biggest Lithuanian university hospitals from November 2013 to May 2014...
February 20, 2017: Medicina
https://www.readbyqxmd.com/read/28283218/long-term-performance-evaluation-of-small-diameter-vascular-grafts-based-on-polyvinyl-alcohol-hydrogel-and-dextran-and-mscs-based-therapies-using-the-ovine-pre-clinical-animal-model
#15
Nuno Alexandre, Irina Amorim, Ana Rita Caseiro, Tiago Pereira, Rui Alvites, Alexandra Rêma, Ana Gonçalves, Guilherme Valadares, Elísio Costa, Alice Santos-Silva, Miguel Rodrigues, Maria Ascensão Lopes, André Almeida, José Domingos Santos, Ana Colette Maurício, Ana Lúcia Luís
The functional and structural performance of a 5cm synthetic small diameter vascular graft (SDVG) produced by the copolymerization of polyvinyl alcohol hydrogel with low molecular weight dextran (PVA/Dx graft) associated to mesenchymal stem cells (MSCs)-based therapies and anticoagulant treatment with heparin, clopidogrel and warfarin was tested using the ovine model during the healing period of 24 weeks. The results were compared to the ones obtained with standard expanded polyetetrafluoroethylene grafts (ePTFE graft)...
March 7, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28281736/optimal-antiplatelet-pharmacotherapy-guided-by-bedside-genetic-or-functional-testing-in-elective-pci-patients-a-pilot-study-onside-test-pilot
#16
Lukasz Koltowski, Mariusz Tomaniak, Daniel Aradi, Zenon Huczek, Krzysztof J Filipiak, Janusz Kochman, Sylwia Gajda, Paweł Balsam, Grzegorz Opolski
BACKGROUND: Dual antiplatelet therapy is recommended after elective percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients; however, still one-third of patients do not obtain adequate platelet inhibition that may result in increased cardiovascular risk. The aim of the ONSIDE TEST study is to evaluate the clinical impact of point-of-care genotyping- and platelet function-based personalized dual antiplatelet strategies in SCAD individuals undergoing PCI...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28281731/current-patterns-of-antithrombotic-and-revascularization-therapy-in-patients-hospitalised-for-acute-coronary-syndromes-data-from-the-polish-subset-of-the-epicor-study
#17
Izabela Wojtkowska, Janina Stępińska, Małgorzata Stępień-Wojno, Mateusz Sobota, Jerzy Kopaczewski, Zygfryd Reszka, Michał Kurzelewski, Jesus Medina
BACKGROUND: Cardiovascular disease is the leading cause of mortality and morbidity in developed countries, including Poland. Antithrombotic drugs play a crucial role in the management of acute coronary syndromes (ACS). Recent clinical trials have demonstrated the efficacy and safety profiles of new antiplatelet and anticoagulant agents, which may be used as add-on therapy or replacements for older drugs. The EPICOR: (long-t E: rm follow-u P: of antithrombotic management patterns I: n acute COR: onary syndrome patients) is a prospective international observational study (NCT01171404) designed to describe the use of antithrombotic management strategies for the treatment of ACS during the acute phase and over a follow-up period of up to 2 years from the index event...
March 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28280103/association-of-genetic-variant-and-platelet-function-in-patients-undergoing-neuroendovascular-stenting
#18
Xin-Gang Li, Ning Ma, Shu-Sen Sun, Zhe Xu, Wei Li, Yong-Jun Wang, Xin Yang, Zhong-Rong Miao, Zhi-Gang Zhao
INTRODUCTION: The risk of recurrent ischaemic events is related to platelet function, which is often assessed by thromboelastography (TEG). TEG has high interindividual variability. OBJECTIVE: To identify causal variants associated with TEG parameters in patients who receive aspirin and clopidogrel after intra- or extracranial stenting. METHODS: Patients who underwent stenting for extracranial or intracranial stenosis (70-99%) were recruited into the study...
March 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28279968/newly-formed-reticulated-platelets-undermine-pharmacokinetically-short-lived-antiplatelet-therapies
#19
Paul C Armstrong, Thomas Hoefer, Rebecca B Knowles, Arthur Tucker, Melissa A Hayman, Plinio M Ferreira, Melissa V Chan, Timothy D Warner
OBJECTIVE: Aspirin together with thienopyridine P2Y12 inhibitors, commonly clopidogrel, is a cornerstone of antiplatelet therapy. However, many patients receiving this therapy display high on-treatment platelet reactivity, which is a major therapeutic hurdle to the prevention of recurrent thrombotic events. The emergence of uninhibited platelets after thrombopoiesis has been proposed as a contributing factor to high on-treatment platelet reactivity. Here, we investigate the influences of platelet turnover on platelet aggregation in the face of different dual-antiplatelet therapy strategies...
March 9, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28279076/triple-antithrombotic-therapy-with-aspirin-p2y12-inhibitor-and-warfarin-after-percutaneous-coronary-intervention
#20
Nathan J Verlinden, James C Coons, Carlo J Iasella, Sandra L Kane-Gill
BACKGROUND: Triple antithrombotic therapy is used in patients who require systemic anticoagulation and undergo percutaneous coronary intervention (PCI) requiring dual antiplatelet therapy. Bleeding with this combination is significant; however, few studies have described outcomes with the use of newer oral P2Y12 inhibitors in this setting. OBJECTIVES: We aimed to compare outcomes among patients prescribed triple therapy with prasugrel or ticagrelor compared to triple therapy with clopidogrel in patients who underwent PCI and required warfarin...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
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