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Antiplatelet guidelines

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https://www.readbyqxmd.com/read/29777848/effects-on-mortality-and-cardiovascular-events-of-adherence-to-guideline-recommended-therapy-4-years-after-lower-extremity-arterial-revascularization
#1
M Thiney, N Della Schiava, R Ecochard, P Feugier, P Lermusiaux, A Millon, A Long
OBJECTIVES: All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin converting enzyme inhibitors (ACE) or Angiotensin receptor blockers (ARB), and HMG-CoA-reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the current risk for cardiovascular (CV) events and mortality and also to evaluate the effect of pharmacologic treatment on patient's survival, CV events and additional vascular surgery in vascularized LE-PAD patients...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770854/german-contribution-to-development-and-innovations-in-the-management-of-acute-myocardial-infarction-and-cardiogenic-shock
#2
REVIEW
Hans-Josef Feistritzer, Steffen Desch, Suzanne de Waha, Alexander Jobs, Uwe Zeymer, Holger Thiele
Treatment of acute coronary syndromes has evolved over time leading to a significantly reduced mortality. Multiple major trials have been performed in Germany leading to new treatment strategies in acute coronary syndromes including cardiogenic shock. This review article will summarize major trials and their impact on guideline recommendations in acute myocardial infarction highlighting reperfusion strategies, antiplatelet regimens, prognosis assessment and also mechanical circulatory support in stable infarction patients and in cardiogenic shock...
May 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29768314/medication-administration-delays-in-non-st-elevation-myocardial-infarction-analysis-of-1002-patients-admitted-to-an-academic-medical-center
#3
LeAnn N Denlinger, Ellen C Keeley
Our goal was to assess adherence to American College of Cardiology/American Heart Association guideline-based medical therapy in patients admitted with type I non-ST elevation myocardial infarction (NSTEMI) and to determine factors associated with medication administration delay. We performed a retrospective analysis using data from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry. Baseline patient demographics, 12-lead electrocardiogram (ECG) findings, laboratory values, medications administered and the time they were administered, and in-hospital clinical outcomes were collected...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29764885/compliance-with-current-vte-prophylaxis-guidelines-and-risk-factors-linked-to-complications-of-vte-prophylaxis-in-medical-inpatients-a-prospective-cohort-study-in-a-spanish-internal-medicine-department
#4
Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Alba Costa-Grille, Javier Suárez-Dono, Fernando Ferrón-Vidan, Antonio Pose-Reino
OBJECTIVES: To evaluate the degree of compliance with the current guidelines regarding venous thromboembolism (VTE) prophylaxis in medical patients during admission and to identify risk factors linked to complications of VTE prophylaxis. DESIGN: Prospective cohort study. SETTING: The Internal Medicine Department of the University Hospital of Santiago de Compostela (tertiary referral hospital). PARTICIPANTS: A total of 396 hospitalised, elderly patients who did not undergo surgery and had no active or previous oral anticoagulation or low molecular weight heparin (LMWH) treatment (during the previous year) and who received VTE prophylaxis during admission...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29750227/facilitators-context-of-and-barriers-to-acute-coronary-syndrome-care-at-kenyatta-national-hospital-nairobi-kenya-a-qualitative-analysis
#5
Ehete Bahiru, Tecla Temu, Julia Mwanga, Kevin Ndede, Sophie Vusha, Bernard Gitura, Carey Farquhar, Frederick Bukachi, Mark D Huffman
BACKGROUND: The prevalence of ischaemic heart disease and its acute manifestation, acute coronary syndrome (ACS), is growing throughout sub-Saharan Africa, including Kenya. To address this increasing problem, we sought to understand the facilitators, context of and barriers to ACS care at Kenyatta National Hospital, with the aim of improving the quality of care of ACS. METHODS: We conducted in-depth interviews with healthcare providers involved in the management of ACS patients from January to February 2017 at Kenyatta National Hospital in Nairobi, Kenya...
April 20, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29747859/comparison-of-long-term-mortality-in-patients-with-previous-coronary-artery-bypass-grafting-who-underwent-percutaneous-coronary-intervention-with-versus-without-optimal-medical-therapy
#6
Yuichi Nakamura, Yasuhide Asaumi, Tadayoshi Miyagi, Michikazu Nakai, Kunihiro Nishimura, Hiroki Sugane, Hideo Matama, Yu Kataoka, Yoshihiro Miyamoto, Yasuchika Takeishi, Teruo Noguchi, Satoshi Yasuda
Although current guidelines have highlighted the importance of evidence-based optimal medical therapy (OMT) in patients with previous coronary artery bypass grafting (CABG), the effect of OMT on post-CABG patients requiring secondary coronary revascularization on prognosis remains unknown. We sought to examine the impact of OMT on post-CABG patients who underwent percutaneous coronary intervention (PCI) as secondary revascularization. A total of 632 consecutive post-CABG patients who underwent PCI between 2001 and 2013 at our hospital (84% men, median age 71 years) were divided into 2 groups: patients who were discharged with OMT and patients who were discharged without OMT (non-OMT)...
April 12, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29740755/optimal-antithrombotic-treatment-of-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-triple-therapy-is-too-much
#7
REVIEW
M S Jacobs, R G Tieleman
Patients with atrial fibrillation who undergo a coronary intervention are eligible for both anticoagulation and (dual) antiplatelet therapy ((D)APT). An optimal balance has to be found to reduce the thromboembolic risk (i.e. stroke, systemic embolism and myocardial infarction) and to minimise the increased risk of bleeding with concomitant use of an anticoagulant and (D)APT. Owing to a lack of evidence, the guideline recommendations are predominantly based on expert opinion. Current evidence indicates that the combination of a non-vitamin K oral anticoagulant (NOAC) and clopidogrel is safer than vitamin-K oral antagonists plus DAPT, which increases the risk of bleeding, without clear advantages in regard to efficacy...
May 8, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29738309/pharmacogenetic-testing-by-polymorphic-markers-681g-a-and-636g-a-cyp2c19-gene-in-patients-with-acute-coronary-syndrome-and-gastric-ulcer-in-the-republic-of-sakha-yakutia
#8
Denis S Fedorinov, Karin B Mirzaev, Dmitriy V Ivashchenko, Ilyas I Temirbulatov, Dmitriy A Sychev, Nadezda R Maksimova, Jana V Chertovskih, Nyurguiana V Popova, Ksenia S Tayurskaya, Zoya A Rudykh
BACKGROUND: The focus of the study is to determine the prevalence of CYP2C19 alleles, associated with the risk of changes in the pharmacological response to clopidogrel and proton pump inhibitors in patients with acute coronary syndrome (ACS) and gastric ulcer from Russian and Yakut ethnic groups. METHODS: The research included 411 patients with ACS (143 Russians and 268 Yakuts) and 204 patients with histologically confirmed gastric ulcer (63 Russians and 141 Yakuts)...
May 8, 2018: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/29734199/are-shorter-durations-of-dual-antiplatelet-therapy-acceptable-following-percutaneous-coronary-intervention
#9
Jessica M Lewis, James J Nawarskas
Much debate has centered on whether or not the standard 12 month duration of dual antiplatelet therapy (DAPT) is still necessary post-percutaneous coronary intervention (PCI) given recent improvements in stent technology. The benefits of shorter (3-6 months) durations of DAPT include a potential lower risk for bleeding and less patient drug cost and pill burden. While randomized clinical trials have shown non-inferiority for shorter versus longer DAPT regimens in many regards, some endpoints (e.g. myocardial infarction) may still occur less frequently with longer DAPT regimens, particularly in higher risk populations (e...
May 4, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29723662/critical-evaluation-on-proper-antithrombotic-treatment-in-different-groups-of-vascular-surgery-patients
#10
REVIEW
Konstantinos Filis, Costas Tsioufis, Argyri Sianou, Konstantinos Triantafillou, Fragiska Sigala, George Galyfos
Antithrombotic treatment including anticoagulants and antiplatelets has been evolved during the last decades, and several recommendations have been included in the latest guidelines regarding the proper management of vascular surgery patients. However, there are significant differences compared to older recommendations, and indications vary among patients with peripheral artery disease, carotid disease and abdominal aortic aneurysm. In this mini review, we critically evaluate all this data in order to produce useful conclusions for everyday clinical practice...
April 30, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29718528/established-and-potential-echocardiographic-markers-of-embolism-and-their-therapeutic-implications-in-patients-with-ischemic-stroke
#11
Paulina E Gąsiorek, Maciej Banach, Marek Maciejewski, Andrzej Głąbiński, Aleksandra Paduszyńska, Jacek Rysz, Agata Bielecka-Dąbrowa
Cardiogenic strokes comprised 11% of all strokes and 25% of ischemic strokes. An accurate identification of the cause of stroke is necessary in order to prepare an adequate preventive strategy. In this review the confirmed and potential causes of embolic strokes are presented, which can be detected in echocardiography in the context of present treatment guidelines and gaps in evidence. There remains a need for further studies assessing the meaning of potential cardiac sources of embolism and establishment of rules for optimal medical prevention (antiplatelet therapy [APT] vs...
May 2, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29713989/optimal-duration-of-dual-antiplatelet-therapy-for-coronary-artery-disease
#12
REVIEW
W J Kikkert, P Damman
The optimal duration of dual antiplatelet therapy (DAPT) for stable coronary artery disease and acute coronary syndrome is a complex decision. We review current literature on standard duration DAPT versus short duration DAPT (6 months or shorter) or extended duration DAPT (>12 months) after percutaneous coronary intervention with drug-eluting stent placement, and prolonged treatment after 12 months in acute coronary syndrome. Current guideline recommendations are summarised, including the use of risk scores for ischaemic and bleeding risk assessment...
April 30, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29708956/optimal-management-of-cancer-patients-with-acute-coronary-syndrome
#13
Waldemar Banasiak, Robert Zymliński, Anetta Undas
Cancer at various stages and therapy is observed in about 15% of patients with acute coronary syndrome (ACS). Current guidelines for invasive and conservative treatment of ACS cannot be applied to all patients with cancer. The choice of antiplatelet and anticoagulant drugs should be individualized with clopidogrel as a key P2Y12 inhibitor in this population. Major challenges of therapy in patients with ACS and cancer include limitations for the use of the recommended antithrombotic therapy (particularly in case of cancer-related thrombocytopenia or when anticoagulation is needed due to concomitant atrial fibrillation or venous thromboembolism), the management of bleeding complications, eligibility criteria for cancer surgery, and reinitiation of chemotherapy or radiotherapy after ACS...
April 30, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29704214/expert-opinion-paper-on-atrial-fibrillation-detection-after-ischemic-stroke
#14
REVIEW
Karl Georg Haeusler, Klaus Gröschel, Martin Köhrmann, Stefan D Anker, Johannes Brachmann, Michael Böhm, Hans-Christoph Diener, Wolfram Doehner, Matthias Endres, Christian Gerloff, Hagen B Huttner, Manfred Kaps, Paulus Kirchhof, Darius Günther Nabavi, Christian H Nolte, Waltraud Pfeilschifter, Burkert Pieske, Sven Poli, Wolf Rüdiger Schäbitz, Götz Thomalla, Roland Veltkamp, Thorsten Steiner, Ulrich Laufs, Joachim Röther, Rolf Wachter, Renate Schnabel
This expert opinion paper on atrial fibrillation detection after ischemic stroke includes a statement of the "Heart and Brain" consortium of the German Cardiac Society and the German Stroke Society. This paper was endorsed by the Stroke Unit-Commission of the German Stroke Society and the German Atrial Fibrillation NETwork. In patients with ischemic stroke, detection of atrial fibrillation should usually lead to a change in secondary stroke prevention, since oral anticoagulation is superior to antiplatelet drugs...
April 27, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29703518/the-safira-study-a-reflection-on-the-prevalence-and-treatment-patterns-of-atrial-fibrillation-and-cardiovascular-risk-factors-in-7500-elderly-subjects
#15
Pedro Monteiro
INTRODUCTION AND AIM: Atrial fibrillation (AF) is a common arrhythmia and an important risk factor for ischemic stroke. The current ESC guidelines state that all patients aged 65 and over should be regularly screened for AF. The SAFIRA study aimed to determine the prevalence, epidemiology and clinical and therapeutic characterization of AF in the Portuguese elderly population. METHODS: The study population (7500 subjects) were recruited from all Portuguese administrative regions...
April 24, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29691276/asia-pacific-working-group-consensus-on-non-variceal-upper-gastrointestinal-bleeding-an-update-2018
#16
Joseph Jy Sung, Philip Cy Chiu, Francis K L Chan, James Yw Lau, Khean-Lee Goh, Lawrence Hy Ho, Hwoon-Young Jung, Jose D Sollano, Takuji Gotoda, Nageshwar Reddy, Rajvinder Singh, Kentaro Sugano, Kai-Chun Wu, Chun-Yin Wu, David J Bjorkman, Dennis M Jensen, Ernst J Kuipers, Angel Lanas
Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages...
April 24, 2018: Gut
https://www.readbyqxmd.com/read/29690773/therapeutic-inertia-in-antiplatelet-therapy-in-patients-with-a-cardiovascular-event-attended-in-an-emergency-department
#17
José Antonio García-Macías, Antonio Palazón-Bru, María Ángeles Carbonell-Torregrosa, Miguel Navarro-Juan, Vicente Francisco Gil-Guillén
OBJECTIVE: As very few studies have assessed therapeutic inertia (TI) in antiplatelet therapy in patients in secondary cardiovascular prevention, we designed a study in our hospital emergency department to quantify its magnitude and its associated factors. METHODS: This descriptive cross-sectional observational study involved a sample of 223 patients with a history of cardiovascular disease and recommendation for antiplatelet therapy who attended the emergency department in a Spanish region in 2016...
April 25, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29685692/antiplatelet-and-anticoagulation-regimen-in-patients-with-mechanical-valve-undergoing-pci-state-of-the-art-review
#18
Deepakraj Gajanana, Toby Rogers, Micaela Iantorno, Kyle D Buchanan, Itsik Ben-Dor, Augusto D Pichard, Lowell F Satler, Rebecca Torguson, Petros G Okubagzi, Ron Waksman
A common clinical dilemma regarding treatment of patients with a mechanical valve is the need for concomitant antiplatelet therapy for a variety of reasons, referred to as triple therapy. Triple therapy is when a patient is prescribed aspirin, a P2Y12 antagonist, and an oral anticoagulant. Based on the totality of the available evidence, best practice in 2017 for patients with mechanical valves undergoing percutaneous coronary intervention (PCI) is unclear. Furthermore, the optimal duration of dual antiplatelet therapy after PCI is evolving...
April 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29678650/femoseal%C3%A2-device-use-for-femoral-artery-closure-by-different-techniques
#19
Roberto Gabrielli, Maria Sofia Rosati, Massiliano Millarelli, Angelica Dante, Maurizio Maiorano, Aldo Musilli, Roberto Chiappa, Marco Ventura
BACKGROUND: Common femoral artery is still the most frequently site used for vascular access, mostly for peripheral arterial interventions and its puncture remains a significant source of patient's morbidity. Manual compression (MC) has been the gold standard for hemostasis after femoral catheterization until recently, but only in the last few years, vascular closure devices (VCDs) are replacing MC due to their rapid development. Nowadays also vascular surgeons are becoming familiar with VCDs...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29671864/treatment-of-patients-with-acute-coronary-syndrome-recommendations-for-medical-emergency-teams-focus-on-antiplatelet-therapies-updated-experts-standpoint
#20
Jacek Kubica, Piotr Adamski, Przemysław Paciorek, Jerzy R Ładny, Zbigniew Kalarus, Waldemar Banasiak, Wacław Kochman, Jarosław Gorący, Beata Wożakowska-Kapłon, Eliano Pio Navarese, Andrzej Kleinrok, Robert Gil, Maciej Lesiak, Jarosław Drożdż, Aldona Kubica, Krzysztof J Filipiak, Jarosław Kaźmierczak, Aleksander Goch, Stefan Grajek, Andrzej Basiński, Łukasz Szarpak, Grzegorz Grześk, Piotr Hoffman, Wojciech Wojakowski, Zbigniew Gąsior, Sławomir Dobrzycki, Jolanta M Siller-Matula, Adam Witkowski, Wiktor Kuliczkowski, Marcin Gruchała, Dariusz Timler, Grzegorz Opolski, Dariusz Dudek, Jacek Legutko, Marzenna Zielińska, Jarosław Wójcik
A group of Polish experts in cardiology and emergency medicine, encouraged by the European Society of Cardiology (ESC) guidelines, have recently published common recommendations for medical emergency teams regarding the pre-hospital management of patients with acute coronary syndrome. Due to the recent publication of the 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation and 2017 focused update on dual antiplatelet therapy in coronary artery disease the current panel of experts decided to update the previous standpoint...
April 19, 2018: Cardiology Journal
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