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Antiplatelet guidelines

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https://www.readbyqxmd.com/read/28540489/endoscopy-in-patients-on-antiplatelet-agents-and-anticoagulants
#1
REVIEW
Andrew M Veitch
Management of patients on anticoagulant or antiplatelet therapy undergoing endoscopy presents a balance of risks between haemorrhage due to the procedure, and thrombosis due to discontinuation of antithrombotic therapy. Haemorrhage is usually controllable endoscopically, but thrombosis could, on occasion, result in myocardial infarction or stroke, with permanent disability or death. For elective procedures, there is adequate time to plan best management of antithrombotic therapy. International guidelines have been published, but recommendations are based on limited evidence and consultation with appropriate medical specialists, and the patient is important...
May 25, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28540395/management-of-atherosclerosis-risk-factors-for-patients-at-high-cardiovascular-risk-in-the-real-world-practice-a-multicentre-study
#2
Arintaya Phrommintikul, Rungroj Krittayaphong, Wanwarang Wongcharoen, Sukit Yamwong, Smonporn Boonyaratavej, Rapeephon Kunjara-Na-Ayudhya, Pyatat Tatsanavivat, Piyamitr Sritara
INTRODUCTION: Atherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions regarding the risk factors and clinical manifestations of atherosclerotic diseases as well as their management patterns. METHODS: We collected data from 25 centres in Thailand. Patients with documented coronary artery disease or cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28532894/-spanish-adaptation-of-the-2016-european-guidelines-on-cardiovascular-disease-prevention-in-clinical-practice
#3
Miguel Ángel Royo-Bordonada, Pedro Armario, José María Lobos Bejarano, Juan Pedro-Botet, Fernando Villar Álvarez, Roberto Elosua, Carlos Brotons Cuixart, Olga Cortés, Benilde Serrano, Miguel Camafort Babkowski, Antonio Gil Núñez, Antonio Pérez, Antonio Maiques, Ana de Santiago Nocito, Almudena de Castro, Eduardo Alegría, Ciro Baeza, María Herranz, Susana Sans, Pilar Campos
The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk...
May 19, 2017: Semergen
https://www.readbyqxmd.com/read/28526159/anticoagulation-and-neuraxial-peripheral-anesthesia
#4
REVIEW
Mudit Kaushal, Ryan E Rubin, Alan D Kaye, Karina Gritsenko
Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable reference for the clinician who is met with these challenges...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#5
Nathaniel Moulson, Stephen A LaHaye, Olivier F Bertrand, Jimmy MacHaalany
OBJECTIVES: To determine the role of warfarin (WF) prophylaxis in the prevention of left ventricular thrombus (LVT) formation and subsequent embolic complications following an anterior ST elevation myocardial infarction (STEMI) complicated by reduced left ventricular ejection fraction (LVEF) and wall motion abnormalities. BACKGROUND: The role of oral anticoagulation prophylaxis, in addition to dual antiplatelet therapy (DAPT), in the current era of percutaneous coronary intervention has not been well studied, despite being a class IIb recommendation in the AHA/ACC STEMI guidelines...
May 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28480039/acute-mesenteric-ischemia-and-hepatic-infarction-after-treatment-of-ectopic-cushing-s-syndrome
#6
Shinobu Takayasu, Shingo Murasawa, Satoshi Yamagata, Kazunori Kageyama, Takeshi Nigawara, Yutaka Watanuki, Daisuke Kimura, Takao Tsushima, Yoshiyuki Sakamoto, Kenichi Hakamada, Ken Terui, Makoto Daimon
SUMMARY: Patients with Cushing's syndrome and excess exogenous glucocorticoids have an increased risk for venous thromboembolism, as well as arterial thrombi. The patients are at high risk of thromboembolic events, especially during active disease and even in cases of remission and after surgery in Cushing's syndrome and withdrawal state in glucocorticoid users. We present a case of Cushing's syndrome caused by adrenocorticotropic hormone-secreting lung carcinoid tumor. Our patient developed acute mesenteric ischemia after video-assisted thoracoscopic surgery despite administration of sufficient glucocorticoid and thromboprophylaxis in the perioperative period...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28476519/the-underutilisation-of-dual-antiplatelet-therapy-in-acute-coronary-syndrome
#7
Malcolm Anastasius, Jerrett K Lau, Karice Hyun, Mario D'Souza, Anushka Patel, Jamie Rankin, Darren Walters, Craig Juergens, Bernadette Aliprandi-Costa, Andrew T Yan, Shaun G Goodman, Derek Chew, David Brieger
BACKGROUND: Despite guideline recommendation of dual antiplatelet therapy (DAPT) in treating ACS, DAPT is underutilized. Our objective was to determine independent predictors of DAPT non-prescription in ACS and describe pattern of DAPT prescription over time. METHODS: Patients presenting to 41 Australian hospitals with an ACS diagnosis between 2009 and 2016 were stratified according to discharge prescription with DAPT and single antiplatelet therapy (SAPT) or no antiplatelet therapy...
April 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28473134/underuse-of-prevention-and-lifestyle%C3%A2-counseling-in-patients-with-peripheral-artery-disease
#8
Jeffrey S Berger, Joseph A Ladapo
BACKGROUND: Little is known about patterns of medication use and lifestyle counseling in patients with peripheral artery disease (PAD) in the United States. OBJECTIVES: The authors sought to evaluate trends in both medical therapy and lifestyle counseling for PAD patients in the United States from 2005 through 2012. METHODS: Data from 1,982 outpatient visits among patients with PAD were obtained from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, a nationally representative assessment of office-based and hospital outpatient department practice...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28454811/compliance-with-guideline-directed-therapy-in-diabetic-patients-admitted-with-acute-coronary-syndrome-findings-from-the-american-heart-association-s-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-program
#9
Prakash Deedwania, Tushar Acharya, Kamal Kotak, Gregg C Fonarow, Christopher P Cannon, Warren K Laskey, W Frank Peacock, Wenqin Pan, Deepak L Bhatt
BACKGROUND: To evaluate and compare baseline characteristics, outcomes and compliance with guideline based therapy at discharge among diabetic and non-diabetic patients admitted with acute coronary syndromes (ACS). METHODS AND RESULTS: Study population consisted of 151,270 patients admitted with ACS from 2002 through 2008 at 411 sites participating in the American Heart Association's Get with the Guidelines (GWTG) program. Demographic variables, physical exam findings, laboratory data, left ventricular ejection fraction, length of stay, in-hospital mortality and discharge medications were compared between diabetic and non-diabetic patients...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28436725/the-impact-of-medication-adherence-on-clinical-outcomes-of-coronary-artery-disease-a-meta-analysis
#10
Liping Du, Zhongwei Cheng, Yuxuan Zhang, Ying Li, Dan Mei
Background Long-term use of evidence-based medications is recommended by international guidelines for the management of stable coronary artery disease, however, non-adherence to medications is common. This meta-analysis aims to systematically evaluate the impact of medication adherence on clinical outcomes in patients with stable coronary artery disease. Methods Articles from January 1960-December 2015 were retrieved from the MEDLINE and EMBASE databases without any language restriction. A meta-analysis was performed to investigate the risk ratios of all-cause mortality, cardiovascular mortality, and myocardial infarction/hospitalization between groups with good medication adherence and poor medication adherence...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28420281/long-term-follow-up-of-antithrombotic-management-patterns-in-patients-with-acute-coronary-syndrome-in-russia-an-observational-study-epicor-rus-study
#11
Mikhail Ya Ruda, Oleg V Averkov, Yunona V Khomitskaya
OBJECTIVE: This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes. RESEARCH DESIGN AND METHODS: EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#12
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28405671/predictors-of-oral-cavity-bleeding-and-clinical-outcome-after-dental-procedures-in-patients-on-vitamin-k-antagonists-a-cohort-study
#13
Joseph S Biedermann, Willem M H Rademacher, Hendrika C A M Hazendonk, Denise E van Diermen, Frank W G Leebeek, Frederik Rozema, Marieke J H A Kruip
Patients on vitamin K antagonists (VKA) often undergo invasive dental procedures. International guidelines consider all dental procedures as low-risk procedures, while bleeding risk may differ between standard low-risk (e. g. extraction 1-3 elements) and extensive high-risk (e. g. extraction of >3 elements) procedures. Therefore current guidelines may need refinement. In this cohort study, we identified predictors of oral cavity bleeding (OCB) and evaluated clinical outcome after low-risk and high-risk dental procedures in patients on VKA...
April 13, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28400917/coronary-stenting-a-matter-of-revascularization
#14
EDITORIAL
Aldo Bonaventura, Fabrizio Montecucco, Luca Liberale
In the last few decades, the recommended treatment for coronary artery disease has been dramatically improved by percutaneous coronary intervention (PCI) and the use of balloon catheters, bare metal stents (BMSs), and drug-eluting stents (DESs). Catheter balloons were burdened by acute vessel occlusion or target-lesion re-stenosis. BMSs greatly reduced those problems holding up the vessel structure, but showed high rates of in-stent re-stenosis, which is characterized by neo-intimal hyperplasia and vessel remodeling leading to a re-narrowing of the vessel diameter...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28394469/medical-management-of-acute-coronary-syndromes
#15
REVIEW
Nicole Ciffone, Betsy B Dokken
BACKGROUND: Recent updates to clinical guidelines and pharmacological indications have added to the complexity of acute coronary syndrome (ACS) management. Advanced practice nurses working with ACS patients need clear and up-to-date information to optimize patient care. PURPOSE: To provide a practical overview of the management of ACS from patient presentation through to long-term secondary prevention based on recent guidelines and randomized controlled trials, with particular emphasis on medical management...
April 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28391560/adjuvant-antithrombotic-therapy-in-tavr
#16
REVIEW
Ryan G O'Malley, Kenneth W Mahaffey, William F Fearon
PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) has developed into an important alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis (AS). Adjuvant antithrombotic therapies are commonly used during and after TAVR to decrease the risk of valve thrombosis and thromboembolic cerebrovascular events (CVEs) but consequently increase the risk of bleeding. This article reviews the past and current clinical data regarding adjuvant antithrombotic therapies in TAVR...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28389612/benefits-of-emergency-departments-contribution-to-stroke-prophylaxis-in-atrial-fibrillation-the-emerg-af-study-emergency-department-stroke-prophylaxis-and-guidelines-implementation-in-atrial-fibrillation
#17
Blanca Coll-Vinent, Alfonso Martín, Juan Sánchez, Juan Tamargo, Coral Suero, Francisco Malagón, Mercedes Varona, Manuel Cancio, Susana Sánchez, José Carbajosa, José Ríos, Georgina Casanovas, Carles Ràfols, Carmen Del Arco
BACKGROUND AND PURPOSE: Long-term benefits of initiating stroke prophylaxis in the emergency department (ED) are unknown. We analyzed the long-term safety and benefits of ED prescription of anticoagulation in atrial fibrillation patients. METHODS: Prospective, multicenter, observational cohort of consecutive atrial fibrillation patients was performed in 62 Spanish EDs. Clinical variables and thromboprophylaxis prescribed at discharge were collected at inclusion...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28389196/improving-guideline-compliance-in-australia-with-a-national-percutaneous-coronary-intervention-outcomes-registry
#18
David Eccleston, Mark Horrigan, Tony Rafter, Geoffrey Holt, Stephen G Worthley, Peter Sage, Alan Whelan, Christopher Reid, Peter L Thompson
BACKGROUND: Secondary prevention strategies after percutaneous coronary intervention (PCI) include statins and dual anti-platelet therapy, however there are significant gaps between guidelines and practice. Contemporary PCI practice requires comprehensive data collection to allow dynamic auditing and benchmarking of key performance and safety indices. Genesis HeartCare is Australia's largest collaborative venture of cardiologists, practising at over 40 public and private hospitals. We hypothesised that measurement and local reporting of data would improve patient outcomes through improving compliance with guideline therapies...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28389125/use-of-cardiovascular-prevention-treatments-after-acute-coronary-syndrome-in-china-and-associated-factors
#19
Emily R Atkins, Xin Du, Yangfeng Wu, Runlin Gao, Anushka Patel, Clara K Chow
BACKGROUND: Prevention of repeat cardiovascular events is an important means of addressing the increasing burden of coronary heart disease in China, however there is minimal information about the use of cardiovascular prevention treatment following acute coronary syndrome (ACS) in China. METHODS: We analysed data from baseline and 6, 12, 18, and 24-month follow-up surveys of 15,140 consecutive ACS patients recruited in 70 hospitals from 17 provinces of China. We describe the use of indicated cardiovascular prevention medicines, risk factor control, change over time and factors associated with continued prevention...
March 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28384143/a-decade-of-improvement-in-the-management-of-new-zealand-st-elevation-myocardial-infarction-stemi-patients-results-from-the-new-zealand-acute-coronary-syndrome-acs-audit-group-national-audits-of-2002-2007-and-2012
#20
John M Elliott, Tom Kai Ming Wang, Greg D Gamble, Michael Ja Williams, Philip Matsis, Richard Troughton, Andrew Hamer, Gerry Devlin, Stewart Mann, Mark Richards, John K French, Harvey D White, Chris J Ellis
AIMS: To audit the management of ST-segment elevation myocardial infarction (STEMI) patients admitted to a New Zealand Hospital over three 14-day periods to review their number, characteristics, management and outcome changes over a decade. METHODS: The acute coronary syndrome (ACS) audits were conducted over 14 days in May of 2002, 2007 and 2012 at New Zealand Hospitals admitting patients with a suspected or definite ACS. Longitudinal analyses of the STEMI subgroup are reported...
April 7, 2017: New Zealand Medical Journal
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