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Antiplatelet guidelines

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https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#1
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29143147/-esc-guidelines-2017-on-peripheral-arterial-diseases-summary-of-the-most-important-recommendations-and-innovations
#2
C Espinola-Klein
The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis...
November 15, 2017: Herz
https://www.readbyqxmd.com/read/29138182/disparities-in-the-quality-of-cardiovascular-care-between-hiv-infected-versus-hiv-uninfected-adults-in-the-united-states-a-cross-sectional-study
#3
Joseph A Ladapo, Adam K Richards, Cassandra M DeWitt, Nina T Harawa, Steven Shoptaw, William E Cunningham, John N Mafi
BACKGROUND: Cardiovascular disease is emerging as a major cause of morbidity and mortality among patients with HIV. We compared use of national guideline-recommended cardiovascular care during office visits among HIV-infected versus HIV-uninfected adults. METHODS AND RESULTS: We analyzed data from a nationally representative sample of HIV-infected and HIV-uninfected patients aged 40 to 79 years in the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey, 2006 to 2013...
November 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29129761/are-antiplatelet-and-anticoagulants-drugs-a-risk-factor-for-bleeding-in-mild-traumatic-brain-injury
#4
Laura Uccella, Cesare Zoia, Daniele Bongetta, Paolo Gaetani, Franz Martig, Christian Candrian, Raffaele Rosso
OBJECT: facing mild traumatic brain injury (mTBI) clinicians must decide whether to perform a CT scan to detect a potential intracranial hemorrhage.Many useful guidelines have been developed for general population, but there is no general consensus about the best practice to adopt when dealing with patients on antiplatelet or anticoagulation drugs. The relatively recent introduction of new anticoagulants and second generation antiplatelet drugs poses new challenges in this field. There is no data in the literature about the relative risk of intracranial bleeding in such categories...
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#5
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29112547/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-chronic-treatments-with-antiplatelet-agents
#6
Juan V Llau, Pieter Kamphuisen, Pierre Albaladejo
: Antiplatelet agents (APA) are considered first-line therapy in preventing cardiovascular thrombotic events, but they are of limited value in the prophylaxis of venous thromboembolism (VTE) during the perioperative period. Consequently, many patients should receive both an APA and an anticoagulant. This combination can increase the bleeding risk and it is necessary to make some recommendations to minimise that risk. In patients receiving APA chronically, if the risk of VTE outweighs the risk of bleeding, we suggest pharmacological prophylaxis (grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29108469/the-incidence-of-traumatic-intracranial-hemorrhage-in-head-injured-older-adults-transported-by-ems-with-and-without-anticoagulant-or-antiplatelet-use
#7
Daniel Kiden Nishijima, Samuel D Gaona, Trent Waechter, Ric Maloney, Adam Blitz, Andrew R Elms, Roel D Farrales, James Montoya, Troy Bair, Calvin Howard, Megan Gilbert, Renee Trajano, Kaela Hatchel, Mark Faul, Jeneita M Bell, Victor Coronado, David R Vinson, Dustin W Ballard, Daniel J Tancredi, Hernando Garzon, Kevin E Mackey, Kiarash Shahlaie, James F Holmes
Field triage guidelines recommend transport of head-injured patients on anticoagulants or antiplatelets to a higher-level trauma center based on studies suggesting a high incidence of traumatic intracranial hemorrhage (tICH). We compared the incidence of tICH in older adults transported by EMS with and without anticoagulation or antiplatelet use and evaluated the accuracies of different sets of field triage criteria to identify tICH. This was a prospective, observational study at 5 EMS agencies and 11 hospitals...
November 6, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29101990/acr-appropriateness-criteria-%C3%A2-iliac-artery-occlusive-disease
#8
Alexander Z Copelan, Baljendra S Kapoor, Ali F AbuRahma, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Stephen P Reis, Paul J Rochon, Colette M Shaw, Jonathan M Lorenz
Iliac artery occlusive disease can present as a sudden-onset acute thrombotic or thromboembolic event or as a chronic progressive atherosclerotic process that presents as claudication progressing to rest pain. Depending on the clinical presentation, the diagnosis is usually confirmed through Doppler vascular ultrasound, CT angiography, or MR angiography; the choice of imaging is usually based on modality availability and the presence of patient comorbidities such as chronic kidney disease. The Trans-Atlantic Inter-Society Consensus II classification system is commonly used to describe the extent of the peripheral vascular disease...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29075924/contemporary-use-of-p2y12-inhibitors-in-patients-with-st-segment-elevation-myocardial-infarction-referred-to-primary-percutaneous-coronary-interventions-in-poland-data-from-orpki-national-registry
#9
Tomasz Rakowski, Zbigniew Siudak, Artur Dziewierz, Krzysztof Plens, Paweł Kleczyński, Dariusz Dudek
According to guidelines, it is recommended to give P2Y12 inhibitors (preferably ticagrelor or prasugrel) at the time of first medical contact in patients with STEMI. However, in real life antiplatelet treatment strategies are different among countries. We analyzed data on antiplatelet treatment in STEMI patients included into Polish ORPKI national registry. A total of 23,139 STEMI patients from 153 invasive cardiology centers were reported in ORPKI registry between September 2015 and August 2016. Finally 19,437 patients from 122 centers (immediate PCI in 94%) were included into the analysis (lack of ticagrelor or prasugrel usage reported in 31 centers)...
October 26, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29071124/management-of-anticoagulation-in-hip-fractures-a-pragmatic-approach
#10
Rafik Yassa, Mahdi Yacine Khalfaoui, Ihab Hujazi, Hannah Sevenoaks, Paul Dunkow
Hip fractures are common and increasing with an ageing population. In the United Kingdom, the national guidelines recommend operative intervention within 36 hours of diagnosis. However, long-term anticoagulant treatment is frequently encountered in these patients which can delay surgical intervention. Despite this, there are no set national standards for management of drug-induced coagulopathy pre-operatively in the context of hip fractures.The aim of this study was to evaluate the management protocols available in the current literature for the commonly encountered coagulopathy-inducing agents...
September 2017: EFORT open reviews
https://www.readbyqxmd.com/read/29048211/ureteroscopy-in-patients-with-bleeding-diathesis-a-systematic-review-and-meta-analysis-of-the-literature
#11
Ala'a Sharaf, Tarik Amer, Bhaskar Somani, Omar M Aboumarzouk
Ureteroscopy (URS) is the most common surgical treatment of urolithiasis and can be problematic in patients with a bleeding diathesis. The intent of this review is to systematically review the literature to assess the safety and efficacy of ureteroscopic procedures in these groups of patients. Methods The systematic review was performed according to the Cochrane diagnostic accuracy reviews guidelines. The search strategy was conducted to perform a comprehensive database search (1990-2017). A cumulative analysis was done and where applicable a comparative analysis between bleeding diathesis patients and those without...
October 19, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29044393/duration-of-dual-antiplatelet-therapy-and-associated-outcomes-following-percutaneous-coronary-intervention-for-acute-myocardial-infarction-contemporary-practice-insights-from-the-canadian-observational-antiplatelet-study
#12
Juan J Russo, Shaun G Goodman, Akshay Bagai, Jean-Pierre Déry, Mary K Tan, Harold N Fisher, Xiang Zhang, Yajun Emily Zhu, Robert C Welsh, Anthony Della Siega, Andre Kokis, Brian Y L Wong, Mark Henderson, Sohrab Lutchmedial, Shahar Lavi, Shamir R Mehta, Andrew T Yan
Aims: There is a paucity of real-world, contemporary data of practice patterns and clinical outcomes following dual-antiplatelet therapy (DAPT) in acute myocardial infarction (AMI) patients treated with percutaneous coronary intervention (PCI). Methods and results: The Canadian Observational Antiplatelet Study was a prospective, multicentre, cohort study examining adenosine diphosphate receptor antagonist use following PCI for AMI. We compared practice patterns, patient characteristics, and clinical outcomes in relation to DAPT duration (<6 weeks, 6 weeks to <6 months, 6 to <12, and ≥12 months)...
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29043405/-focused-update-on-dual-antiplatelet-treatment-esc-guidelines-2017
#13
A Schäfer, J Bauersachs
Dual antiplatelet treatment (DAPT) is a cornerstone of maintenance medication of patients following elective percutaneous coronary interventions or an acute coronary syndrome (ACS), e. g. ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina. In recent years the inclusion of P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. Following the introduction of the modern generation of drug-eluting stents for elective coronary interventions, the duration of the necessary DAPT has been clearly reduced...
October 17, 2017: Herz
https://www.readbyqxmd.com/read/29042700/preoperative-risk-factors-for-conversion-of-laparoscopic-cholecystectomy-to-open-cholecystectomy-and-the-usefulness-of-the-2013-tokyo-guidelines
#14
Masashi Utsumi, Hideki Aoki, Tomoyoshi Kunitomo, Yutaka Mushiake, Isao Yasuhara, Fumitaka Taniguchi, Takashi Arata, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi
To identify predictive factors for conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy performed for mixed indications as an acute or elective procedure. We retrospectively analyzed the data of 236 consecutive cases of LC performed in our department between January 2012 and January 2015, and evaluated preoperative risk factors for conversion and the usefulness of the 2013 Tokyo guidelines (TG2013) for diagnosing acute cholecystitis. The conversion rate in our series was 8% (19/236 cases)...
October 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29035427/differences-in-the-korea-acute-myocardial-infarction-registry-compared-with-western-registries
#15
REVIEW
Doo Sun Sim, Myung Ho Jeong
The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels...
September 18, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29016963/risks-and-benefits-of-ceasing-or-continuing-anticoagulant-medication-for-image-guided-procedures-for-spine-pain-a-systematic-review
#16
Clark C Smith, Byron Schneider, Zachary L McCormick, Jatinder Gill, Vivek Loomba, Andrew J Engel, Belinda Duszynski, Wade King
Objective: To determine the risks of continuing or ceasing anticoagulant or antiplatelet medications prior to image-guided procedures for spine pain. Design: Systematic review of the literature with comprehensive analysis of the published data. Interventions: Following a search of the literature for studies pertaining to spine pain interventions in patients on anticoagulant medication, seven reviewers appraised the studies identified and assessed the quality of evidence presented...
July 28, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29016553/bleeding-and-neurologic-complications-in-58-000-interventional-pain-procedures
#17
Nafisseh S Warner, W Michael Hooten, Matthew A Warner, Tim J Lamer, Jason S Eldrige, Halena M Gazelka, Daryl J Kor, Bryan C Hoelzer, William D Mauck, Susan M Moeschler
BACKGROUND AND OBJECTIVES: Interventional pain procedures are commonly performed on patients receiving antiplatelet therapy. However, there is limited evidence to support or refute the safety of this practice. The goal of this investigation was to assess the rate of bleeding complications in a large cohort of patients undergoing intermediate- and low-risk pain procedures, with a specific focus on antiplatelet and anticoagulant medication use and baseline coagulation abnormalities. METHODS: This is a retrospective cohort study of adult patients undergoing low- and intermediate-risk pain procedures from 2005 through 2014 by the division of pain medicine at a single academic tertiary care center...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28994036/comparison-of-4-different-strategies-of-dapt-after-pci-in-acs-real-world-population-from-a-northern-italy-registry
#18
Marta Rasia, Emilia Solinas, Massimiliano Marino, Paolo Guastaroba, Alberto Menozzi, Maria Alberta Cattabiani, Iacopo Tadonio, Rossana De Palma, Luigi Vignali
Aim of the study was to compare four different strategies of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) treated with PCI. DAPT with Clopidogrel, Ticagrelor and Prasugrel has proved to be effective in patients with ACS treated with percutaneous coronary intervention (PCI) by reducing major adverse cardiovascular outcomes (MACE). However, the effect of the different strategies in a real-world population deserves further verification. A retrospective analysis of 2404 discharged ACS patients treated with PCI was performed, with a median follow-up of 1 year...
November 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28993349/aspirin-safety-in-glucose-6-phosphate-dehydrogenase-deficiency-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#19
Julien Feghaly, Abdul Rahman Al Hout, Mattew Mercieca Balbi
The use of aspirin, as part of a dual antiplatelet therapy regimen, is an established standard following coronary stenting in patients suffering from acute coronary syndrome (ACS). However, in glucose-6-phosphate dehydrogenase (G6PD) deficient patients, precaution is always taken with aspirin use, due to the risk of haemolysis. We reviewed all previous cases of G6PD deficient patients with ACS, in addition to a review of the available literature, to better understand the safety of aspirin use in this population...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#20
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
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