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antiplatelet review

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https://www.readbyqxmd.com/read/29466171/-duration-of-dual-antiplatelet-therapy-in-patients-with-ischemic-heart-disease-after-implantation-of-endovascular-stents
#1
A B Sumarokov, L I Buryachkovskaya, N V Lomakin, Y V Dotsenko, I A Uchitel, L A Timofeeva
Optimal duration of dual antiplatelet therapy (DAPT) after stent implantation is uncertain. Some patients have an extended risk of thrombotic complications including that of very late stent thrombosis after cessation of recommended course of DAPT (6-12 months). On the other hand, there is a real risk of bleeding on DAPT. In this review, we present and discuss results of clinical trials of long-term DAPT and data of their meta-analyses. The review also contains consideration of some aspects of new AHA/ACC recommendations (2016) on duration of DAPT...
January 2018: Kardiologiia
https://www.readbyqxmd.com/read/29458246/antiplatelet-therapy-in-stemi-undergoing-primary-pci-when-which-one-and-how-long
#2
Giorgio Baralis, Roberta Rossini, Giuseppe Musumeci
Reperfusion therapy for patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) involves primary percutaneous coronary intervention (PPCI) and concomitant dual antiplatelet therapy (DAPT) with combination of a P2Y12 inhibitor and acetylsalicylic acid (ASA). Decision regarding DAPT can be challenging clinically in the modern era with the evolution of newer stents, more potent antiplatelet agents and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
February 19, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29452964/risk-factors-for-platelet-transfusion-in-glioblastoma-surgery
#3
Carlito Lagman, John P Sheppard, Prasanth Romiyo, Thien Nguyen, Giyarpuram N Prashant, Daniel T Nagasawa, Linda M Liau, Isaac Yang
The objectives of this study are to identify risk factors for and to evaluate clinical outcomes of platelet transfusion in glioblastoma surgery. The medical records of adult patients who underwent craniotomy for glioblastoma resection at a single academic medical center were retrospectively reviewed. We stratified patients into 2 groups: those who were transfused at least 1 unit of platelets intraoperatively or postoperatively (no more than 7 days after surgery), and those who were not transfused with platelets...
February 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29449126/thrombelastography-suggests-hypercoagulability-in-patients-with-renal-dysfunction-and-intracerebral-hemorrhage
#4
Kevin Meier, Daniel M Saenz, Glenda L Torres, Chunyan Cai, Mohammed H Rahbar, Mark McDonald, Stuart Fraser, Elena Espino, H Alex Choi, Nancy J Edwards, Kiwon Lee, James C Grotta, Tiffany R Chang
BACKGROUND: The objective of this study was to quantify coagulopathy using thrombelastography (TEG) in patients with renal dysfunction and intracerebral hemorrhage (ICH). METHODS: We reviewed patients admitted with spontaneous ICH between November 2009 and May 2015. TEG was performed at the time of admission. Creatinine clearance (CCr) was calculated using the Cockroft-Gault equation. Patients were divided into 2 groups based on normal (CCr ≥ 90) or reduced renal function (CCr < 90)...
February 12, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29448091/evidence-and-prospective-of-plant-derived-flavonoids-as-antiplatelet-agents-strong-candidates-to-be-drugs-of-future
#5
Harron Khan, Mohammad Jawad, Mohammad Ajmal Kamal, Alessandra Baldi, Jianbo Xiao, Seyed Mohammad Nabavi, Maria Daglia
Platelets are involved in hemostasis, inflammation, and thrombosis processes. Following a vascular damage, the endothelium releases protein factors, allowing the adhesion of subendothelium to platelets. Then platelets are activated, leading to the secretion of biologically-active ligands including thromboxane A2, adenosine diphosphate and serotonin. Aspirin, clopidogrel and warfarin are the most common drugs used to meet the challenges of platelet aggregation. However, these agents face issues with aspirin resistance and bleeding...
February 12, 2018: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/29443899/protease-activated-receptor-4-par4-a-promising-target-for-antiplatelet-therapy
#6
REVIEW
Gamariel Rwibasira Rudinga, Ghulam Jilany Khan, Yi Kong
Cardiovascular diseases (CVDs) are currently among the leading causes of death worldwide. Platelet aggregation is a key cellular component of arterial thrombi and major cause of CVDs. Protease-activated receptors (PARs), including PAR1, PAR2, PAR3 and PAR4, fall within a subfamily of seven-transmembrane G-protein-coupled receptors (GPCR). Human platelets express PAR1 and PAR4, which contribute to the signaling transduction processes. In association with CVDs, PAR4 not only contributes to platelet activation but also is a modulator of cellular responses that serve as hallmarks of inflammation...
February 14, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29438459/dietary-supplements-with-antiplatelet-activity-a-solution-for-everyone
#7
Beata Olas
Dietary supplements can have beneficial effects on a number of risk factors for cardiovascular diseases, and interest in the use of nonpharmacologic nutraceutical-based treatments for cardiovascular disorders is growing. The aim of this review is to present the role of dietary supplements with antiplatelet activity in the prophylaxis and treatment of cardiovascular disorders. In addition, this paper describes their effects on another very important element of hemostasis-blood coagulation. However, because controlled human clinical experiments are too limited to clearly identify the antiplatelet and anticoagulant properties of dietary supplements, used alone or in combination with classical antiplatelet therapy (e...
January 1, 2018: Advances in Nutrition
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#8
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29435272/optimal-antithrombotic-therapy-in-patients-with-atrial-fibrillation-following-percutaneous-coronary-intervention-a-systemic-review-and-meta-analysis
#9
Jing-Xiu Li, Yang Li, Shu-Jun Yan, Bai-He Han, Zhao-Yan Song, Wei Song, Shi-Hao Liu, Ji-Wei Guo, Shuo Yin, Ye-Ping Chen, De-Jun Xia, Xin Li, Xue-Qi Li, En-Ze Jin
A challenge for antithrombotic treatment is patients who present with atrial fibrillation (AF) and acute coronary syndrome, particularly in patients who have undergone coronary percutaneous intervention with stenting (PCIS). In the present study, a total of nine observational trials published prior to July 2017 that investigated the effects of dual antiplatelet therapy (DAPT; aspirin + clopidogrel) and triple oral antithrombotic therapy (TOAT; DAPT + warfarin) among patients with AF concurrent to PCIS were collected from the Medline, Cochrane and Embase databases and conference proceedings of cardiology, gastroenterology and neurology meetings...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29434628/antithrombotic-therapy-in-tavi
#10
REVIEW
Manolis Vavuranakis, Konstantinos Kalogeras, Angelos Michail Kolokathis, Dimitrios Vrachatis, Nikolaos Magkoutis, Gerasimos Siasos, Euaggelos Oikonomou, Maria Kariori, Theodoros Papaioannou, Maria Lavda, Carmen Moldovan, Ourania Katsarou, Dimitrios Tousoulis
Transcatheter aortic valve implantation (TAVI) carries a significant thromboembolic and concomitant bleeding risk, not only during the procedure but also during the periprocedural period. Many issues concerning optimal antithrombotic therapy after TAVI are still under debate. In the present review, we aimed to identify all relevant studies evaluating antithrombotic therapeutic strategies in relation to clinical outcomes after the procedure. Four randomized control trials (RCT) were identified analyzing the post-TAVI antithrombotic strategy with all of them utilizing aspirin lifelong plus clopidogrel for 3-6 months...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29431527/role-of-cardiac-electronic-implantable-device-in-the-stratification-and-management-of-embolic-risk-of-silent-atrial-fibrillation-are-all-atrial-fibrillations-created-equal
#11
Andrea Di Cori, Alessio Lilli, Giulio Zucchelli, Valerio Zaca
Ischemic strokes may be associated with atrial fibrillation (AF). AF detection is critical in ischemic stroke survivors, often recommending a switch from antiplatelet therapy to oral anticoagulants for secondary prevention. Areas covered: Cardiac implantable electronic devices (CIED) with their long-term recording capability allows to document AF and to quantify the arrhythmia burden. Recent series in pacemaker and implantable cardioverter-defibrillator (ICD) recipients with no prior stroke showed that short episodes of AF increased stroke risk compared with those without AF recorded...
February 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29429155/continuous-use-of-thienopyridine-may-be-as-safe-as-low-dose-aspirin-in-endoscopic-resection-of-gastric-tumors
#12
Sooyeon Oh, Sang Gyun Kim, Jung Kim, Ji Min Choi, Joo Hyun Lim, Hyo-Joon Yang, Jae Yong Park, Seung Jun Han, Jue Lie Kim, Hyunsoo Chung, Hyun Chae Jung
Background/Aims: Current guidelines recommend withholding antiplatelets for 5-7 days before high-risk endoscopic procedures. We investigated whether this reduces post-endoscopic submucosal dissection (ESD) bleeding. Methods: Gastric ESD cases with antiplatelets were retorospectively reviewed. Withholding antiplatelets for 5-7 days before ESD was defined as cessation and 0-4 days as continuation. The rate and risk of post-ESD bleeding according to the types and cessation of antiplatelets were assessed...
February 13, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29429146/graft-type-for-femoro-popliteal-bypass-surgery
#13
REVIEW
Graeme K Ambler, Christopher P Twine
BACKGROUND: Femoro-popliteal bypass is implemented to save limbs that might otherwise require amputation, in patients with ischaemic rest pain or tissue loss; and to improve walking distance in patients with severe life-limiting claudication. Contemporary practice involves grafts using autologous vein, polytetrafluoroethylene (PTFE) or Dacron as a bypass conduit. This is the second update of a Cochrane review first published in 1999 and last updated in 2010. OBJECTIVES: To assess the effects of bypass graft type in the treatment of stenosis or occlusion of the femoro-popliteal arterial segment, for above- and below-knee femoro-popliteal bypass grafts...
February 11, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29428263/evidence-based-diagnosis-and-management-of-chronic-subdural-hematoma-a-review-of-the-literature
#14
REVIEW
Vikram Mehta, Stephen C Harward, Eric W Sankey, Gautam Nayar, Patrick J Codd
Chronic subdural hematomas are encapsulated blood collections within the dural border cells with characteristic outer "neomembranes". Affected patients are more often male and typically above the age of 70. Imaging shows crescentic layering of fluid in the subdural space on a non-contrast computed tomography (CT) scan, best appreciated on sagittal or coronal reformats. Initial medical management involves reversing anticoagulant/antiplatelet therapies, and often initiation of anti-epileptic drugs (AEDs). Operative interventions, such as twist-drill craniostomy (TDC), burr-hole craniostomy (BHC), and craniotomy are indicated if imaging implies compression (maximum fluid collection thickness >1 cm) or the patient is symptomatic...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29424303/antiplatelet-for-coronary-artery-disease-in-specific-condition-no-size-fits-all
#15
Benny M Setiadi, Muhammad Munawar, Beny Hartono, Adhitia B Prakoso, Anggia C Lubis, Reza M Munandar
Antiplatelet is the cornerstone therapy for patient with coronary artery disease. Several comorbidities can influence the efficacy and safety of antiplatelet agent. Diabetes mellitus is characterized by increased platelet reactivity and reduced response to antiplatelet. Elderly patients have both reduced response to antiplatelet and increased risk of bleeding. Patients with renal dysfunction also had decreased efficacy of antiplatelet accompanied with increased risk of bleeding. In patients with atrial fibrillation, the concomitant use of anticoagulant with antiplatelet poses an increased risk of bleeding...
February 8, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29421416/primary-stenting-of-right-sided-subclavian-artery-stenosis-presenting-as-subclavian-steal-syndrome-report-of-three-cases-and-literature-review
#16
Georgios Sahsamanis, Georgios Vourliotakis, Konstantinos Pirgakis, Anastasios Lekkas, Ioannis Kantounakis, Alexandra Terzoglou, Vasileios Tzilalis
BACKGROUND: Right-sided subclavian artery stenosis is a rare cerebrovascular disease involving the upper extremities. Considering an endovascular approach for its management requires increased endovascular and catheterization skills, when compared to the left side, due to the close approximation of the right subclavian artery origin, vertebral and common carotid arteries. METHODS: Three patients suffering from proximal right sided subclavian artery stenosis were treated in our center through primary stenting...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29417147/direct-oral-anticoagulants-in-addition-to-antiplatelet-therapy-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#17
Mauro Chiarito, Davide Cao, Francesco Cannata, Cosmo Godino, Corrado Lodigiani, Giuseppe Ferrante, Renato D Lopes, John H Alexander, Bernhard Reimers, Gianluigi Condorelli, Giulio G Stefanini
Importance: Patients with acute coronary syndrome (ACS) remain at high risk for experiencing recurrent ischemic events. Direct oral anticoagulants (DOAC) have been proposed for secondary prevention after ACS. Objective: To evaluate the safety and efficacy of DOAC in addition to antiplatelet therapy (APT) after ACS, focusing on treatment effects stratified by baseline clinical presentation (non-ST-segment elevation ACS [NSTE-ACS] vs ST-segment elevation myocardial infarction [STEMI])...
February 7, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29410943/thrombotic-paradox-ischaemic-stroke-in-immune-thrombocytopaenia-a-case-report-and-review
#18
Chong Yau Ong, Farhad F Vasanwala
Immune thrombocytopaenia (also known as idiopathic thrombocytopaenic purpura) (ITP) is a chronic condition with isolated low platelet counts. Although it is largely perceived that ITP predisposes to bleeding risks, thrombotic events, such as ischaemic strokes, do happen paradoxically in patients with ITP. A 68-year-old lady presented with right upper limb weakness and was diagnosed with an ischaemic stroke and was started on clopidogrel. She had a history of ITP. Two months later, she again had another ischaemic stroke...
December 3, 2017: Curēus
https://www.readbyqxmd.com/read/29409813/duration-of-dual-antiplatelet-therapy-for-stented-patients-an-update-for-the-clinician
#19
REVIEW
Mahesh K Vidula, Eric A Secemsky, Robert W Yeh
Determining the optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention is a complex decision. Randomized controlled trials have shown that while shorter durations of DAPT may lower the risk of bleeding, longer durations of DAPT can reduce the risk of late stent thrombosis and ischemia-related events. In this review article, we will discuss the current guidelines, review contemporary trial data that have evaluated short and extended durations of DAPT, and address common clinical questions...
February 1, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29406201/proton-pump-inhibitors-review-of-emerging-concerns
#20
REVIEW
Avinash K Nehra, Jeffrey A Alexander, Conor G Loftus, Vandana Nehra
First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. PPIs inhibit gastric acid secretion, and the most commonly associated adverse effects include abdominal pain, diarrhea, and headache...
February 2018: Mayo Clinic Proceedings
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