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Antiplatelet guidelines

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https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#1
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28806755/acquired-von-willebrand-syndrome-in-cardiogenic-shock-patients-on-mechanical-circulatory-microaxial-pump-support
#2
Ulrike Flierl, Jörn Tongers, Dominik Berliner, Jan-Thorben Sieweke, Florian Zauner, Christoph Wingert, Christian Riehle, Johann Bauersachs, Andreas Schäfer
Early use of mechanical circulatory support, e.g. veno-arterial extracorporeal membrane oxygenation (ECMO) or left ventricular unloading by microaxial pump in refractory cardiogenic shock is recommended in current guidelines. Development of acquired von Willebrand Syndrome (AVWS) in patients with left ventricular assist devices (LVADs) and ECMO has been reported. There is an increasing number of patients treated with the Impella® CP microaxial pump for left ventricular unloading. However, the prevalence of AVWS in these high risk patients is unknown and needs to be determined...
2017: PloS One
https://www.readbyqxmd.com/read/28806011/a-primer-on-bleeding-risk-and-management-strategies-of-newer-oral-anti-platelet-agents-in-cardiovascular-disease
#3
Jimmy Yee, Vishesh Kumar, Amornpol Anuwatworn, Marian Petrasko, Adam Stys
Aspirin, the first antiplatelet agent, has been around since the 19th century, and is one of the most established drugs in history. With the improvement of coronary interventions in the past few decades, there has been more reliance on oral antiplatelet agents to reduce complications of in-stent restenosis/thrombosis. Clopidogrel was initially introduced in 1997, and within the past seven years, two additional oral antiplatelet agents have been approved by the U.S. Food and Drug Administration. With more potent antiplatelet agents comes increased risks of adverse effects...
October 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#4
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28789568/temporal-trends-in-the-use-of-antiplatelet-therapy-in-patients-with-acute-coronary-syndromes
#5
María Asunción Esteve-Pastor, Juan Miguel Ruíz-Nodar, Esteban Orenes-Piñero, José Miguel Rivera-Caravaca, Miriam Quintana-Giner, Andrea Véliz-Martínez, Antonio Tello-Montoliu, Vicente PerniasEscrig, Miriam Sandín Rollán, Nuria Vicente-Ibarra, Manuel Jesús MacíasVillanego, Elena Candela Sánchez, Luna Carrillo Alemán, Teresa Lozano, Mariano Valdés, Francisco Marín
BACKGROUND: Current clinical guidelines of acute coronary syndromes (ACS) recommend the use of potent antiplatelet therapy, prasugrel or ticagrelor, because both drugs consistently reduce cardiovascular events. PURPOSE: The aim of this study was to examine temporal changes in the use of optimal antiplatelet therapy in patients with ACS. METHODS: A total of 1717 consecutive patients admitted for ACS in 3 tertiary hospitals from February 2014 to December 2015 were enrolled...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28781242/outcome-of-percutaneous-coronary-intervention-with-the-absorb-bioresorbable-scaffold-data-from-the-swedish-coronary-angiography-and-angioplasty-registry-scaar
#6
Per Grimfjärd, Stefan James, Jonas Persson, Oskar Angerås, Sasha Koul, Elmir Omerovic, Christoph Varenhorst, Bo Lagerqvist, David Erlinge
AIMS: Randomised trials indicate higher rates of stent thrombosis (ST) and target lesion failure (TLF) after percutaneous coronary intervention (PCI) with the Absorb bioresorbable scaffold (BRS) compared with modern drug eluting stents (DES). We aimed to investigate the outcome of all Swedish patients treated with the Absorb BRS. METHODS AND RESULTS: Absorb BRS (n=810) was compared with commonly used modern DES (n=67,099). Main outcome measure was definite ST, mean follow-up was 2 years...
August 8, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28768756/impact-of-timing-on-the-functional-recovery-achieved-with-platelet-supplementation-after-treatment-with-ticagrelor
#7
M Urooj Zafar, Donald A Smith, Usman Baber, Samantha Sartori, Kevin Chen, David W Lam, Carlos A Linares-Koloffon, Juan Rey-Mendoza, Gustavo Jimenez Britez, Gines Escolar, Valentin Fuster, Juan J Badimon
BACKGROUND: American College of Cardiology/American Heart Association guidelines advise waiting 5 to 7 days before operating on P2Y12 inhibitor-treated acute coronary syndrome patients, to allow dissipation of its antiplatelet effects. Platelet transfusion is often used to restore hemostasis during operations, but its effectiveness and optimal timing are unclear. We investigated the degree of functional gains obtained from platelet supplementation after loading and maintenance of dual antiplatelet therapy with ticagrelor and the influence of timing on this strategy...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28765738/baseline-characteristics-of-a-retrospective-patient-cohort-in-the-korean-vascular-intervention-society-endovascular-therapy-in-lower-limb-artery-diseases-k-vis-ella-registry
#8
Young-Guk Ko, Chul-Min Ahn, Pil-Ki Min, Jae-Hwan Lee, Chang-Hwan Yoon, Cheol Woong Yu, Seung Whan Lee, Sang-Rok Lee, Seung Hyuk Choi, Yoon Seok Koh, In-Ho Chae, Donghoon Choi
BACKGROUND AND OBJECTIVES: The Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry is a multicenter observational study with retrospective and prospective cohorts of patients with lower extremity peripheral artery disease (PAD) undergoing endovascular treatment. In this study, we report the baseline characteristics of this retrospective cohort. SUBJECTS AND METHODS: In the present study we analyzed datasets of 3073 patients with 3972 target limbs from a retrospective cohort treated with endovascular therapy in 31 Korean hospitals...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#9
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28763341/monitoring-platelet-reactivity-during-prasugrel-or-ticagrelor-washout-before-urgent-coronary-artery-bypass-grafting
#10
Katia Orvin, Yaron D Barac, Ran Kornowski, Leor Perl, Yishay Wasserstrum, Victor Rubchevsky, Ram Sharony, Eitan Snir, Dan Aravot, Eli I Lev
OBJECTIVES: Patients with acute myocardial infarction pretreated with prasugrel or ticagrelor may require urgent coronary artery bypass grafting (CABG). However, prasugrel and ticagrelor withdrawal period is recommended for 5-7 days before planned CABG to enable full platelet recovery. We hypothesized that monitoring sequential platelet reactivity (PR) could identify patients with early platelet recovery who may benefit from earlier surgery before the guideline-recommended 5-7 day delay...
September 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28742195/the-use-of-susceptibility-weighted-imaging-to-detect-cerebral-microbleeds-after-lacunar-infarction
#11
L Shao, M Wang, X-H Ge, H-D Huang, L Gao, J-C Qin
OBJECTIVE: To study the value of susceptibility-weighted imaging (SWI) technology to detect cerebral microbleeds (CMBs) in senile cerebral lacunar infarction patients; and to evaluate the complicated cerebral hemorrhage risk after patients with CMBs took aspirin, an antiplatelet medication or received anticoagulant therapy. PATIENTS AND METHODS: MRI scanning, using GRE-T2*WI, SWI and FSE sequences (T1WI, T2WI, and T2FLAIR), was performed on the three groups: (1) a cerebral lacunar infarction group; (2) cerebral lacunar infarction with cerebral microbleeds (CMBs) group; and (3) a healthy elderly group...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28736131/variation-in-organization-of-transient-ischemic-attack-care-in-the-netherlands-a-nationwide-survey-study
#12
Fenna Floortje Muller, Frank de Beer, Marieke Christine Visser
BACKGROUND: Previous research has shown the importance of urgent initiation of antiplatelet therapy after transient ischemic attack (TIA) to reduce the risk of stroke. Many hospitals in the Netherlands have therefore implemented rapid pathways for assessment of patients with TIA. Dutch stroke guidelines lack clear directives for organization of TIA assessment and thus allow for variation. The aim of this study was to investigate variation in organization of TIA assessment in Dutch hospitals...
September 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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
#13
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/28725272/brazilian-guidelines-on-prevention-of-cardiovascular-disease-in-patients-with-diabetes-a-position-statement-from-the-brazilian-diabetes-society-sbd-the-brazilian-cardiology-society-sbc-and-the-brazilian-endocrinology-and-metabolism-society-sbem
#14
REVIEW
Marcello Casaccia Bertoluci, Rodrigo Oliveira Moreira, André Faludi, Maria Cristina Izar, Beatriz D Schaan, Cynthia Melissa Valerio, Marcelo Chiara Bertolami, Ana Paula Chacra, Marcus Vinicius Bolivar Malachias, Sérgio Vencio, José Francisco Kerr Saraiva, Roberto Betti, Luiz Turatti, Francisco Antonio Helfenstein Fonseca, Henrique Tria Bianco, Marta Sulzbach, Adriana Bertolami, João Eduardo Nunes Salles, Alexandre Hohl, Fábio Trujilho, Eduardo Gomes Lima, Marcio Hiroshi Miname, Maria Teresa Zanella, Rodrigo Lamounier, João Roberto Sá, Celso Amodeo, Antonio Carlos Pires, Raul D Santos
BACKGROUND: Since the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28697899/hiv-and-coronary-disease-when-secondary-prevention-is-insufficient
#15
Ana Sofia Carvalho, Rui Osório Valente, Luís Almeida Morais, Pedro Modas Daniel, Ramiro Sá Carvalho, Lurdes Ferreira, Rui Cruz Ferreira
Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal)...
July 8, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28694393/turkish-assessment-of-surf-survey-of-risk-factor-management-study-control-rates-of-cardiovascular-risk-factors-derived-from-databases-of-15-different-levels-of-health-centers-in-turkey
#16
Lale Tokgözoğlu, Aytekin Oğuz, Mustafa Kemal Balcı, Ahmet Temizhan, Esma Güldal Altunoğlu, Osman Bektaş, Güler Aslan, Özgün Iyigün, Ahmet Kara, Handan Tanrıverdi Pınar, Saffet Yavuz, Murat Tekin, Saffet Ercan, Selda Çelik, Özlem Sezgin Meriçliler, İrem Bozkurt Çakır
OBJECTIVE: The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. METHODS: According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28685623/cardiovascular-disease-prevention-strategies-for-type-2-diabetes-mellitus
#17
Niki Katsiki, Francesco Purrello, Costas Tsioufis, Dimitri P Mikhailidis
Type 2 diabetes mellitus (T2DM) is associated with several cardiovascular (CV) risk factors such as insulin resistance, obesity, hypertension, dyslipidaemia, non-alcoholic fatty liver disease as well as platelet and haemostatic abnormalities increasing the risk of thrombosis. Therefore, T2DM patients are at an increased risk for CV disease (CVD). Areas covered: This narrative review discusses the treatment of T2DM. This includes lifestyle measures (diet, exercise and smoking cessation) as well as hypolipidaemic, antihypertensive, weight reducing, antiplatelet and glucose lowering drugs...
July 14, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28673245/takotsubo-cardiomyopathy-complicated-with-apical-thrombus-formation-on-first-day-of-the-illness-a-case-report-and-literature-review
#18
H M M T B Herath, S P Pahalagamage, Laura C Lindsay, S Vinothan, Sampath Withanawasam, Vajira Senarathne, Milinda Withana
BACKGROUND: Takotsubo cardiomyopathy is characterized by transient systolic dysfunction of the apical and mid segments of the left ventricle in the absence of obstructive coronary artery disease. Intraventricular thrombus formation is a rare complication of Takotsubo cardiomyopathy and current data almost exclusively consists of isolated case reports and a few case series. Here we describe a case of Takotsubo cardiomyopathy with formation of an apical thrombus within 24 h of symptom onset, which has been reported in the literature only once previously, to the best of our knowledge...
July 3, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28665919/medical-compliance-to-evidence-based-clinical-guidelines-on-secondary-prevention-of-coronary-heart-disease-in-a-hospital-from-lima-peru-a-retrospective-study
#19
Zaira Castañeda-Amado, Lesly Calixto-Aguilar, César Loza Munarriz, Félix A Medina Palomino
INTRODUCTION: Cardiovascular disease is the leading cause of mortality worldwide. When an acute myocardial infarction occurs, it is necessary to establish secondary prevention measures, which can reduce mortality by 50%. Clinical guidelines state that the optimal medical treatment is based upon four groups of drugs: antiplatelet drugs, statins, beta-blockers and angiotensin-converting-enzyme inhibitor or angiotensin II receptor antagonist. OBJECTIVE: To determine physician compliance to evidence-based clinical practice guidelines on secondary prevention of coronary heart disease...
June 29, 2017: Medwave
https://www.readbyqxmd.com/read/28663045/appropriateness-assessment-in-antiplatelet-therapy-apathy-registry-insight-from-current-clinical-practice
#20
Nazario Carrabba, Benedetta Bellandi, Guido Parodi, Emanuele Cecchi, Giorgio Baldereschi, Cristina Giglioli, Angela Migliorini, Renato Valenti, Serafina Valente, Rossella Marcucci, Niccolò Marchionni, David Antoniucci
BACKGROUND: In clinical practice there is a gap between guidelines recommendation and antiplatelet strategies used for acute coronary syndrome (ACS). We sought to evaluate appropriateness of antiplatelet strategies employed in a tertiary center. METHODS AND RESULTS: From January to June 2014, 430 ACS were treated with percutaneous coronary intervention by 3 groups of interventional cardiologists. Aspirin and clopidogrel (52%) were the most commonly used antiplatelet therapies, being prasugrel associated with aspirin in 110 (25...
October 1, 2017: International Journal of Cardiology
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