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antiplatelet review

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https://www.readbyqxmd.com/read/29240976/clopidogrel-plus-aspirin-versus-aspirin-alone-for-preventing-cardiovascular-events
#1
REVIEW
Alessandro Squizzato, Marta Bellesini, Andrea Takeda, Saskia Middeldorp, Marco Paolo Donadini
BACKGROUND: Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease. This is an update to a previously published review from 2011. OBJECTIVES: To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or were at high risk of atherothrombotic disease, but did not have a coronary stent...
December 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29240058/-venous-thromboembolic-complications-in-patients-with-cardiovascular-implantable-electronic-devices
#2
R E Kalinin, I A Suchkov, I I Shitov, N D Mzhavanadze, V O Povarov
The problem of venous thromboembolic complications (VTECs) in patients with cardiovascular implantable electronic devices (CIEDs) is extremely important today because of an annually increasing number of surgical interventions for life-threatening arrhythmias and chronic heart failure. There are hitherto no clearly defined reliable risk factors for VTECs due to heterogeneity of the available literature data. Some sources point to elevated thrombus formation in patients with a large number of electrodes, in repeat operative interventions, in the presence of a temporary pacemaker, in implantation on the left side, silicon cover of an electrode, others refute these facts...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29233507/bleeding-on-the-cutting-edge-a-systematic-review-of-anticoagulant-and-antiplatelet-continuation-in-minor-cutaneous-surgery
#3
REVIEW
Alexander Isted, Lilli Cooper, R James Colville
BACKGROUND: Anticoagulant and antiplatelet (AC/AP) use is common and practice surrounding AC/AP continuation or cessation peri-operatively for minor cutaneous surgery lacks evidence-based consensus. OBJECTIVE: To determine the risks of haemorrhagic and thromboembolic complications associated with the continuation or cessation of AC/AP therapy in minor cutaneous surgery. METHODS: A systematic literature search was conducted using PubMed, MEDLINE, Embase and CENTRAL, to identify all articles involving the use of AC/AP in patients undergoing minor cutaneous surgery, including skin grafts and local flaps...
November 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29233189/head-to-head-comparison-of-prasugrel-versus-ticagrelor-in-patients-with-acute-coronary-syndrome-a-systematic-review-and-meta-analysis-of-randomized-trials
#4
Pravesh Kumar Bundhun, Jia-Xin Shi, Feng Huang
BACKGROUND: Prasugrel and Ticagrelor are emerging antiplatelet drugs that might have the potential to replace currently used antiplatelet agents. Previous analyses comparing prasugrel with ticagrelor mainly focused on an indirect comparison whereas direct comparison was reported only in a few recently published trials. We aimed to systematically carry out a head to head comparison of the adverse clinical outcomes which were associated with prasugrel versus ticagrelor in patients with acute coronary syndrome (ACS)...
December 12, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29227290/postoperative-thrombocytopenia-why-you-should-consider-antiplatelet-therapy
#5
Andres O Raso Vasquez, Miklos D Kertai, Manuel L Fontes
PURPOSE OF REVIEW: This review addresses the role of platelets in perioperative ischemic complications involving the brain, kidneys, and gastrointestinal tract, and long-term survival in patients undergoing coronary artery bypass grafting surgery. Importantly, findings of several recent clinical studies will be discussed with emphasis on platelet activation and leukocyte inflammatory responses as important mediators of vascular microthrombosis and ischemic injury. RECENT FINDINGS: Our recent findings suggest that in some patients, the hemostatic balance during and after surgery may shift toward a hypercoagulable state and contribute to acute organ failure...
December 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29226707/managing-anticoagulation-in-patients-receiving-implantable-cardiac-devices
#6
Panagiota Anna Chousou, Peter J Pugh
A substantial proportion of patients who undergo cardiac device implantation receive oral anticoagulation to prevent thromboembolism or antiplatelets to prevent thrombotic events. Anticoagulation and antiplatelets increase the risk of hemorrhagic complications, while discontinuation may increase thromboembolic risk and thrombotic events. With the introduction of non-vitamin K antagonist oral anticoagulant agents and the newer antiplatelet agents such as prasugrel or ticagrelor, the perioperative management of patients has become more challenging...
December 11, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29214062/management-of-oral-antiplatelet-agents-and-anticoagulation-therapy-before-bronchoscopy
#7
REVIEW
Houssein A Youness, Jean Keddissi, Ilya Berim, Ahmed Awab
Although, bronchoscopy is a relatively safe procedure, small amount of bleeding in the airway can have serious consequences. Careful consideration of the risks of diagnostic and therapeutic bronchoscopic intervention can help minimize potential complications. With increasing number of patients using antiplatelet and anticoagulation therapies, strategies for minimizing thromboembolic and operative bleeding events need to be included in the risk and benefit analyses. Growing evidence suggests that aspirin is safe and does not increase bleeding during bronchoscopy...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29208494/bleeding-in-advanced-ckd-patients-on-antithrombotic-medication-a-critical-appraisal
#8
Alexandru Burlacu, Simonetta Genovesi, David Goldsmith, Patrick Rossignol, Alberto Ortiz, Philip A Kalra, Jolanta Małyszko, Maciej Banach, Mehmet Kanbay, Adrian Covic
Patients with advanced chronic kidney disease (CKD) are at an increased risk of bleeding, especially in the context of the complex therapeutic schemes of coronary artery disease (CAD) (from stable angina to acute coronary syndromes), atrial fibrillation or venous thromboembolism. The bleeding issue increases morbidity and mortality, a serious problem in daily medical practice. However, these patients are largely excluded from major randomized clinical trials, which results in the lack of medical evidence-based foundation for specific recommendations regarding antithrombotic treatment in a high bleeding risk setting...
December 2, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29206190/direct-fibrinolytic-snake-venom-metalloproteinases-affecting-hemostasis-structural-biochemical-features-and-therapeutic-potential
#9
REVIEW
Eladio F Sanchez, Renzo J Flores-Ortiz, Valeria G Alvarenga, Johannes A Eble
Snake venom metalloproteinases (SVMPs) are predominant in viperid venoms, which provoke hemorrhage and affect hemostasis and thrombosis. P-I class enzymes consist only of a single metalloproteinase domain. Despite sharing high sequence homology, only some of them induce hemorrhage. They have direct fibrin(ogen)olytic activity. Their main biological substrate is fibrin(ogen), whose Aα-chain is degraded rapidly and independently of activation of plasminogen. It is important to understand their biochemical and physiological mechanisms, as well as their applications, to study the etiology of some human diseases and to identify sites of potential intervention...
December 5, 2017: Toxins
https://www.readbyqxmd.com/read/29204620/should-this-patient-receive-aspirin-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#10
Risa B Burns, Kelly Graham, Mandeep S Sawhney, Eileen E Reynolds
Aspirin exerts antiplatelet effects through irreversible inhibition of cyclooxygenase-1, whereas its anticancer effects may be due to inhibition of cyclooxygenase-2 and other pathways. In 2009, the U.S. Preventive Services Task Force endorsed aspirin for primary prevention of cardiovascular disease. However, aspirin's role in cancer prevention is still emerging, and no groups currently recommend its use for this purpose. To help physicians balance the benefits and harms of aspirin in primary disease prevention, the Task Force issued a guideline titled, "Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer" in 2016...
December 5, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29197966/aetiological-profile-and-treatment-outcomes-of-epistaxis-at-a-major-teaching-hospital-a-review-of-721-cases
#11
Brian Carey, Patrick Sheahan
BACKGROUND: Epistaxis is the most prevalent ENT emergency and a significant burden on ENT services. Our objective was to study the incidence and outcomes of patients presenting with epistaxis at a major teaching hospital. METHODS: A retrospective descriptive study of 721 patients, who presented with epistaxis over a 1-year period, was carried out. Data collected was analysed using SPSS software version 20. RESULTS: Of the 721 patients, initial treatment consisted of nasal cautery (298), nasal packing (200), or no treatment (223)...
December 2, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29196251/effectiveness-of-ipsilateral-stroke-prevention-between-conservative-management-and-indirect-revascularization-for-moyamoya-disease-mmd-in-a-north-american-cohort
#12
Jose L Porras, Wuyang Yang, Risheng Xu, Tomas Garzon-Muvdi, Justin M Caplan, Geoffrey P Colby, Alexander L Coon, Edward S Ahn, Rafael J Tamargo, Judy Huang
BACKGROUND: Few reports compare surgical intervention with conservative treatment for moyamoya disease (MMD) in non-Asian cohorts. This study describes the effectiveness of follow-up stroke prevention by indirect revascularization relative to conservative management in a Northeast United States study population. METHOD: We retrospectively reviewed records of patients with MMD at our institution from 1990-2014. Baseline characteristics and follow-up results including subsequent ipsilateral strokes were collected, and compared between an indirect revascularization group and a conservatively managed group on a per-hemisphere basis...
November 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29192856/management-of-antiplatelet-therapy-in-patients-undergoing-neuroendovascular-procedures
#13
Keri S Kim, Justin F Fraser, Stephen Grupke, Aaron M Cook
Neuroendovascular techniques for treating cerebral aneurysms and other cerebrovascular pathology are increasingly becoming the standard of care. Intraluminal stents, aneurysm coils, and other flow diversion devices typically require concomitant antiplatelet therapy to reduce thromboembolic complications. The variability inherent with the pharmacodynamic response to common antiplatelet agents such as aspirin and clopidogrel complicates optimal selection of antiplatelet agents by clinicians. This review serves to discuss the literature related to antiplatelet use in neuroendovascular procedures and provides recommendations for clinicians on how to approach patients with variable response to antiplatelet agents, particularly clopidogrel...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29191640/incidence-of-visible-haematuria-among-antithrombotic-agents-a-systematic-review-of-over-175-000-patients
#14
Nikita R Bhatt, Niall F Davis, William J Nolan, Robert J Flynn, T E D McDermott, Arun Z Thomas, Rustom P Manecksha
OBJECTIVE: To determine the probability of visible haematuria with antithrombotic agents and to evaluate association of urological etiology in antithrombotic-related haematuria METHODS: PRISMA guidelines were followed to conduct a systematic review using search engines PUBMED and SCOPUS with the terms "(haematuria) OR (haematuria) OR urinary bleeding)) AND ((anticoagulants) OR anticoagulation) OR noac) OR novel anticoagulants) OR antiplatelet) OR dabigatran) OR rivaroxaban) OR apixaban) OR warfarin) OR aspirin) OR heparin) OR dipyridamole)"...
November 27, 2017: Urology
https://www.readbyqxmd.com/read/29188358/anticoagulation-strategies-in-patients-with-atrial-fibrillation-after-pci-or-with-acs-the-end-of-triple-therapy
#15
N Fluschnik, P M Becher, R Schnabel, S Blankenberg, D Westermann
Clinicians struggle daily with the optimal regimen for patients with an indication for antiplatelet therapy after stenting and in patients needing oral anticoagulation treatment for atrial fibrillation (AF). This is not only difficult in patients with acute coronary syndrome (ACS) but also in the large number of patients with AF undergoing elective percutaneous coronary intervention (PCI). The challenge is to strike a balance between the increasing risk of bleeding events and ischemic or thrombotic events. Until recently, guidelines were based on expert consensus and a few small, many of them retrospective, trials...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29183961/oral-anticoagulants-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#16
REVIEW
José A López-López, Jonathan A C Sterne, Howard H Z Thom, Julian P T Higgins, Aroon D Hingorani, George N Okoli, Philippa A Davies, Pritesh N Bodalia, Peter A Bryden, Nicky J Welton, William Hollingworth, Deborah M Caldwell, Jelena Savović, Sofia Dias, Chris Salisbury, Diane Eaton, Annya Stephens-Boal, Reecha Sofat
Objective To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation.Design Systematic review, network meta-analysis, and cost effectiveness analysis. Data sources Medline, PreMedline, Embase, and The Cochrane Library.Eligibility criteria for selecting studies Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation.Results 23 randomised trials involving 94 656 patients were analysed: 13 compared a DOAC with warfarin dosed to achieve a target INR of 2...
November 28, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29183523/hypoalbuminemia-and-clinical-outcomes-what-is-the-mechanism-behind-the-relationship
#17
REVIEW
Sunghye Kim, Stephen A McClave, Robert G Martindale, Keith R Miller, Ryan T Hurt
Albumin has a number of important physiologic functions, which include maintaining oncotic pressure, transporting various agents (fatty acids, bile acids, cholesterol, metal ions, and drugs), scavenging free oxygen radicals, acting as an antioxidant, and exerting an antiplatelet effect. Hypoalbuminemia in adults, defined by an intravascular albumin level of <3.5 g/dL, is associated with poor postoperative outcomes in patients undergoing surgical intervention. Although the relationship of hypoalbuminemia and poor surgical outcome has been known for many years, the pathophysiology behind the relationship is unclear...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29181519/role-of-antiplatelet-therapy-in-stroke-prevention-in-patients-with-atrial-fibrillation
#18
Rohini Manaktala, Jeffrey Kluger
Patients with atrial fibrillation are at increased risk of having a cardioembolic stroke. The use of oral anticoagulation is now well established to prevent strokes in patients with atrial fibrillation and a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [2 points], diabetes mellitus, prior stroke/transient ischemic attack or thromboembolism [2 points], vascular disease, age 65 to 74 years, and sex category) score of greater than 1, beyond sex. However, the role of antiplatelet therapy, specifically aspirin in low-risk patients or as an alternative to oral anticoagulation, remains controversial...
December 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29178510/the-pathogenesis-of-hemodialysis-vascular-access-failure-and-systemic-therapies-for-its-prevention-optimism-unfulfilled
#19
REVIEW
Andrea K Viecelli, Trevor A Mori, Prabir Roy-Chaudhury, Kevan R Polkinghorne, Carmel M Hawley, David W Johnson, Elaine M Pascoe, Ashley B Irish
In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are essential. Inadequate vascular remodeling and neointimal hyperplasia resulting in stenosis and frequently thrombosis are critical to the pathogenesis of access failure. Systemic medical therapies with pleiotropic effects including antiplatelet agents, omega-3 polyunsaturated fatty acids (fish oils), statins, and inhibitors of the renin-angiotensin-aldosterone system (RAAS) may reduce vascular access failure by promoting vascular access maturation and reducing stenosis and thrombosis through antiproliferative, antiaggregatory, anti-inflammatory and vasodilatory effects...
November 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29170312/15%C3%A2-a-clinical-decision-tool-for-prescribing-anti-platelet-medication-for-patients-with-suspected-acute-coronary-syndrome-pam
#20
Charles Reynard, Rick Body
BACKGROUND: The benefit of antiplatelet medication in confirmed acute coronary syndrome (ACS) is well established. In the Emergency Department (ED) diagnostic uncertainty may lead to over-treatment, with consequent risks (e.g., bleeding), or under-treatment, compromising clinical outcomes. Clinicians must subjectively balance the anticipated risks and benefits with their perceived probability of ACS in order to decide whether to prescribe these medications. We aimed to construct a clinical model to optimise and personalise recommendations for anti-platelet prescription in this context...
December 2017: Emergency Medicine Journal: EMJ
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