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clopidogrel

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https://www.readbyqxmd.com/read/28213047/the-effect-of-combined-aspirin-and-clopidogrel-treatment-on-cancer-incidence
#1
Avi Leader, Ravit Zelikson-Saporta, David Pereg, Galia Spectre, Uri Rozovski, Pia Raanani, Doron Hermoni, Michael Lishner
BACKGROUND: Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data regarding the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared to aspirin alone and no antiplatelet therapy...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28207573/genome-wide-analysis-of-clopidogrel-active-metabolite-levels-identifies-novel-variants-that-influence-antiplatelet-response
#2
Joshua D Backman, Jeffrey R O'Connell, Keith Tanner, Cody J Peer, William D Figg, Shawn D Spencer, Braxton D Mitchell, Alan R Shuldiner, Laura M Yerges-Armstrong, Richard B Horenstein, Joshua P Lewis
Clopidogrel is one of the most commonly used therapeutics for the secondary prevention of cardiovascular events in patients with acute coronary syndromes. However, considerable interindividual variation in clopidogrel response has been documented, resulting in suboptimal therapy and an increased risk of recurrent events for some patients. In this investigation, we carried out the first genome-wide association study of circulating clopidogrel active metabolite levels in 513 healthy participants to directly measure clopidogrel pharmacokinetics...
February 15, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28203101/prevalence-of-clinically-actionable-genotypes-and-medication-exposure-of-older-adults-in-the-community
#3
Nilofar Daneshi, Elizabeth Holliday, Stephen Hancock, Jennifer J Schneider, Rodney J Scott, John Attia, Elizabeth A Milward
This study analyzed clinically actionable pharmacogenotypes for clopidogrel, warfarin, statins, thiopurines, and tacrolimus using microarray data for 2121 participants (55-85 years) from the Australian Hunter Community Study (HCS). At least 74% of participants (95% confidence interval [CI]: 72%-76%) had strong level evidence for at least one medium- or high-risk actionable genotype that would trigger a change in standard therapy under current international recommendations. About 14% of these participants (95% CI: 12%-16%) were taking medication potentially affected by the genotype in question...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28202699/association-of-multiple-infarctions-and-icas-with-outcomes-of-minor-stroke-and-tia
#4
Yuesong Pan, Xia Meng, Jing Jing, Hao Li, Xingquan Zhao, Liping Liu, David Wang, S Claiborne Johnston, Yilong Wang, Yongjun Wang
OBJECTIVE: To estimate the association of different patterns of infarction and intracranial arterial stenosis (ICAS) with the prognosis of acute minor ischemic stroke and TIA. METHODS: We derived data from the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 1,089 patients from 45 of 114 participating sites of the trial undergoing baseline MRI/angiography were included in this subgroup analysis. Patterns of infarction and ICAS were recorded for each individual...
February 15, 2017: Neurology
https://www.readbyqxmd.com/read/28202132/comparison-of-platelet-reactivity-in-black-versus-white-patients-with-acute-coronary-syndromes-after-treatment-with-ticagrelor
#5
Michael A Gaglia, Michael J Lipinski, Thibault Lhermusier, Arie Steinvil, Sarkis Kiramijyan, Shreejana Pokharel, Rebecca Torguson, Dominick J Angiolillo, Lars Wallentin, Robert F Storey, Ron Waksman
Ticagrelor, a potent platelet inhibitor, has primarily been studied in white patients. Platelet reactivity among black patients with acute coronary syndrome (ACS) on ticagrelor, however, is unknown. Our objective was to compare platelet reactivity in black versus white patients with ACS treated with ticagrelor. We conducted a prospective, pharmacodynamic study of 29 black patients with ACS treated with ticagrelor. Platelet reactivity was assessed at 1, 4, and 8 hours after a loading dose of ticagrelor 180 mg and at 30 days on a maintenance dose of ticagrelor 90 mg twice daily...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28193677/sex-differences-in-the-clinical-impact-of-high-platelet-reactivity-after-percutaneous-coronary-intervention-with-drug-eluting-stents-results-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#6
Jennifer Yu, Roxana Mehran, Usman Baber, Sze-Yuan Ooi, Bernhard Witzenbichler, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Akiko Maehara, Ke Xu, Ori Ben-Yehuda, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown. METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208)...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28190712/effect-of-antiplatelet-therapy-on-aneurysmal-sac-expansion-associated-with-type-ii-endoleaks-after-endovascular-aneurysm-repair
#7
Francisco Álvarez Marcos, José Manuel Llaneza Coto, Francisco José Franco Meijide, Ahmad Amer Zanabili Al-Sibbai, Jorge Vilariño Rico, Manuel Alonso Pérez, Santiago Caeiro Quinteiro
OBJECTIVE: Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) has gained widespread use through a solid reputation of safety and effectiveness. However, some issues, such as endoleaks and sac growth over time, still arise as important concerns. Antiplatelet therapy, mandatory as secondary prevention of cardiovascular disease, may play a role in both phenomena by interfering with blood clotting properties and the inflammatory process associated with AAA. We analyzed whether different antiplatelet therapies were independent risk factors for type II endoleak (T2E) persistence and midterm sac growth after EVAR...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#8
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28181944/management-of-a-patient-requiring-intrathecal-drain-insertion-and-removal-in-the-setting-of-concomitant-dual-antiplatelet-therapy-with-clopidogrel-and-aspirin-a-case-report
#9
Christopher W Connors, Janie D Nguyen
We report a case of deliberate intrathecal catheter insertion and removal in the setting of continuous dual-antiplatelet therapy with clopidogrel and aspirin. A patient with recently sited bare metal intracerebral stents developed severe symptomatic hydrocephalus and required temporary cerebrospinal fluid diversion. The risks of intracerebral in-stent thrombosis or delayed intervention precluded following guidelines for the management of clopidogrel in neuraxial procedures. Options to mitigate the risk of and facilitate the early detection of epidural hematoma are discussed when neuraxial instrumentation is indicated in the setting of clopidogrel and aspirin therapy...
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28181585/single-or-dual-antiplatelet-therapy-after-pci
#10
REVIEW
Yosuke Miyazaki, Pannipa Suwannasom, Yohei Sotomi, Mohammad Abdelghani, Karthik Tummala, Yuki Katagiri, Taku Asano, Erhan Tenekecioglu, Yaping Zeng, Rafael Cavalcante, Carlos Collet, Yoshinobu Onuma, Patrick W Serruys
The optimal duration and type of antiplatelet therapy after implantation of a drug-eluting stent (DES) remains uncertain. At the time of the first-in-man implantation of the sirolimus DES in 1999, the protocol-defined dual antiplatelet therapy (DAPT) duration was only 2 months. Subsequently, DAPT duration was extended to 1 year on the basis of anecdotal historical data, and this practice was then incorporated into clinical guidelines. For >1 decade, trialists have sought to compare the safety and efficacy of abbreviated (<6 months) and prolonged (>12 months) DAPT regimens...
February 9, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28180001/assessment-of-platelet-function-in-patients-receiving-tirofiban-early-after-primary-coronary-intervention
#11
REVIEW
Péter Kupó, Dániel Aradi, Adrienn Tornyos, Margit Tőkés-Füzesi, András Komócsi
BACKGROUND: Following percutaneous coronary intervention, combined antiplatelet therapy is necessary. Platelet function testing (PFT) has prognostic value and may be applied in the risk assessment of acute coronary syndrome. In case of combined antiplatelet therapy, PFT may require special laboratory methods, as different antiplatelet agents may influence test results. MATERIALS AND METHODS: Platelet functions were measured in stent thrombosis-segment elevation myocardial infarction patients receiving aspirin, clopidogrel, and tirofiban...
December 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28179614/genotyping-of-six-clopidogrel-metabolizing-enzyme-polymorphisms-has-a-minor-role-in-the-assessment-of-platelet-reactivity-in-patients-with-acute-coronary-syndrome
#12
María Henar García-Lagunar, Luciano Consuegra-Sánchez, Pablo Conesa-Zamora, Javier Ruiz-Cosano, Federico Soria-Arcos, Luis García de Guadiana, Pedro Cano Vivar, Juan Antonio Castillo-Moreno, Antonio Melgarejo-Moreno
OBJECTIVE: To evaluate the contribution of six polymorphisms to the platelet reactivity in patients with acute coronary syndrome (ACS) treated with clopidogrel. METHODS: Cross-sectional study of 278 consecutive patients with ACS. Detailed clinical information for each patient was collected and genotypes (CYP2C9*2, CYP2C9*3, CYP2C19*2, CYP2C19*17, CYP3A4*1B, and PON1-Q192R) were evaluated with TaqMan® and KASPar® assays. Platelet reactivity was measured with VerifyNow®...
February 1, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28167470/effect-of-shexiang-baoxin-pills-on-clopidogrel-resistance-in-patients-with-acute-coronary-syndrome
#13
Li Zhang, Na Liu, Jinying Zhang, Hui Zhang
To explore the effect of Shexiang baoxin pills on clopidogrel resistance in patients with acute coronary syndrome (ACS). 131 cases with ACS combining with clopidogrel resistance admitted to our hospital during March 2013 to November 2015 were recruited in this study and were divided into observation group (66 cases) and control group (65 cases) according to the random number table method. And the patients in observation group were given clopidogrel with Shexiang baoxin pills therapy while the control group clopidogrel therapy to observe the platelet aggregation rate, heart rate variability (HRV), and serum level of matrix metalloproteinase-2 (MMP-2)...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28166651/dipeptidyl-peptidase-4-inhibitor-associated-risk-of-bleeding
#14
Md Motiur Rahman, Michael J Scalese, Richard A Hansen
BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) inhibitors improve glycemic control, and sitagliptin has been associated with a reduction in cardiovascular events. In vivo data suggest reduced platelet activation, and aggregation may play a role, and therefore, increased bleeding risk is possible. OBJECTIVE: Comparatively assess bleeding risks associated with DPP-4 inhibitors against standard treatment. METHODS: Exploratory analyses of adverse event reports (AERs) from the US Food and Drug Administration Adverse Event Reporting System (FAERS) database (2004-2012 periods) were conducted...
February 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28164572/impact-of-the-cyp2c19-gene-polymorphism-on-clopidogrel-personalized-drug-regimen-and-the-clinical-outcomes
#15
Keguang Chen, Rui Zhang, Huanjun Liu, Xi Guo, Pingli Li, Xuehong Liu
BACKGROUND: Although the relationship between CYP2C19 genotype and clopidogrel metabolism has been studied clearly, we have not seen the report that clopidogrel was administered at a dose adjusted based on genotyping. The two main polymorphism loci of CYP2C19 gene were detected by the CYP2C19 genetic testing. ADP platelet aggregation technology was used to investigate the correlation between clinical effect and the clopidogrel dose, genetic metabolic type, physiological, pathological and other factors, to provide new ideas for clopidogrel therapy for percutaneous coronary intervention postoperation patients...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164519/angiotensin-converting-enzyme-inhibitors-influence-on-antiplatelet-therapy-of-clopidogrel-in-acs
#16
Shuo Yang, Chanjuan Cui, Jie Zhang, Rui Qiao
BACKGROUND: Clopidogrel is a prodrug, the minority of which is converted to an active metabolite by hepatic cytochrome P450 (CYP2C19), however, most of it is metabolized to inactive substance by hepatic carboxylesterase1 (CES1). Meanwhile angiotensin-converting enzyme inhibitors (ACEIs) are mostly metabolized by CES1. We aimed to assess the impact of ACEIs on platelet inhibition by clopidogrel. METHODS: We genotyped variants CES1, CYP2C19*2 and *3 in 502 patients with acute coronary syndrome (ACS) receiving clopidogrel therapy, and analyzed the effects of ACEIs on responsiveness to clopidogrel by the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay and ADP-stimulated impedance whole blood platelet aggregation assay...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28161565/dual-antiplatelet-therapy-does-not-increase-the-risk-of-bleeding-after-carotid-endarterectomy-results-of-a-prospective-study
#17
Giulio Illuminati, Fabrice Schneider, Giulia Pizzardi, Federica Masci, Francesco G Calio, Jean-Baptiste Ricco
BACKGROUND: The purpose of this study was to evaluate the risk of bleeding and other postoperative complications of carotid endarterectomy (CEA) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From January 2005 to December 2015, 188 consecutive patients undergoing CEA and receiving DAPT (aspirin 100 mg + clopidogrel 75 mg) were enrolled in a prospective study. All of them underwent coronary artery stenting with drug-eluting stents during the 6 months preceding CEA...
February 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28159194/optimal-same-day-platelet-inhibition-in-patients-receiving-drug-eluting-stents-with-or-without-previous-maintenance-thienopyridine-therapy-from-the-evaluation-of-platelet-inhibition-in-patients-having-a-verifynow-assay-epiphany-trial
#18
Michael S Lee, Evan Shlofmitz, Elizabeth Haag, Lyn Santiago, Simcha Pollack, Nathaniel Reichek, Richard A Shlofmitz
We determined if high on-treatment platelet reactivity (HTPR) can be overcome on the day of percutaneous coronary intervention (PCI) in patients with or without previous maintenance thienopyridine therapy. Patients with HTPR, as defined as P2Y12 reaction units (PRU) >230, were switched to an alternate thienopyridine. Patients with HTPR undergoing PCI are at increased risk for ischemic complications. A total of 429 patients undergoing PCI with drug-eluting stents were enrolled. Patients on maintenance thienopyridine (n = 249) with PRU >230 were loaded with the alternative thienopyridine...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28154807/hypersensitivity-to-ticagrelor-and-low-response-to-clopidogrel-a-case-report
#19
Jing Dai, Shuzheng Lyu, Changjiang Ge
Ticagrelor is widely used to treat acute coronary syndrome. Hypersensitivity reaction of ticagrelor is rarely recognized. A low response to clopidogrel, which occurs in up to 23% of patients, is an independent risk factor for stent thrombosis. Management of patients with a low response to clopidogrel and ticagrelor hypersensitivity who are undergoing antithrombotic therapy remains to be a challenge. Herein, we report a patient with low response to clopidogrel and ticagrelor hypersensitivity, who was successfully managed using aspirin and warfarin...
January 2017: Asia Pacific Allergy
https://www.readbyqxmd.com/read/28150852/novel-role-of-platelet-reactivity-in-adverse-left-ventricular-remodelling-after-st-segment-elevation-myocardial-infarction-the-remodeling-trial
#20
Yongwhi Park, Udaya S Tantry, Jin-Sin Koh, Jong-Hwa Ahn, Min Gyu Kang, Kye Hwan Kim, Jeong Yoon Jang, Hyun Woong Park, Jeong-Rang Park, Seok-Jae Hwang, Ki-Soo Park, Choong Hwan Kwak, Jin-Yong Hwang, Paul A Gurbel, Young-Hoon Jeong
The role of platelet-leukocyte interaction in the infarct myocardium still remains unveiled. We aimed to determine the linkage of platelet activation to post-infarct left ventricular remodelling (LVR) process. REMODELING was a prospective, observational, cohort trial including patients (n = 150) with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Patients were given aspirin plus clopidogrel therapy (600 mg loading and 75 mg daily). Platelet reactivity (PRU: P2Y12 Reaction Units) was assessed with VerifyNow P2Y12 assay on admission...
February 2, 2017: Thrombosis and Haemostasis
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