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antiplatelet review

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https://www.readbyqxmd.com/read/29025918/contemporary-endovascular-and-open-aneurysm-treatment-in-the-era-of-flow-diversion
#1
REVIEW
Marcus D Mazur, Philipp Taussky, Min S Park, William T Couldwell
Clinical outcomes have improved considerably over the last decade for patients with ruptured and unruptured aneurysms. Modern endovascular techniques, such as flow diversion, are associated with high aneurysm occlusion rates and have become a popular treatment modality for many types of aneurysms. However, the safety and effectiveness of flow diversion has not yet been established in trials comparing it with traditional aneurysm treatments. Moreover, there are some types of aneurysms that may not be appropriate for endovascular coiling, such as wide-necked aneurysms located at branch points of major vessels, large saccular aneurysms with multiple efferent arteries, dolichoectatic aneurysms, large aneurysms with mass effect, when there are technical complications with endovascular treatment, when patients cannot tolerate or have contraindications to antiplatelet therapy or in the setting of a subarachnoid haemorrhage...
October 12, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29023526/antithrombotic-therapy-strategies-for-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-network-meta-analysis
#2
Xiaoxuan Gong, Shaowen Tang, Jiangjin Li, Xiwen Zhang, Xiaoyi Tian, Shuren Ma
OBJECTIVE: The aim of this systematic review and network meta-analysis was to evaluate the comparative efficacy and safety of antiplatelet agents, vitamin K antagonist (VKA) and non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify clinical trials comparing antiplatelet drugs with VKA and NOACs or their combination in AF patients undergoing PCI with a mean/median follow-up of at least 12 months...
2017: PloS One
https://www.readbyqxmd.com/read/29022423/combination-antiplatelet-treatment-in-coronary-artery-disease-patients-a-necessary-evil-or-an-overzealous-practice
#3
Dimitrios Alexopoulos, Konstantinos Katogiannis, Danai Sfantou, John Lekakis
In seeking to improve care in coronary artery disease patients, further platelet inhibition has been occasionally applied beyond that provided by aspirin and a P2Y12 receptor antagonist. This review aims to offer insights about the rationale, the efficacy and safety of combination antiplatelet therapy, involving three or more agents. Overall, the use of glycoprotein (GP) IIb/IIIa inhibitors did not significantly modify the treatment effect of different antiplatelet strategies, including double vs standard clopidogrel, prasugrel vs clopidogrel, ticagrelor vs clopidogrel, cangrelor vs clopidogrel, and vorapaxar vs placebo...
October 12, 2017: Platelets
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
#4
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/29016367/updates-in-nutrition-and-polypharmacy
#5
Milta O Little
PURPOSE OF REVIEW: Medications have the potential to affect nutritional status in negative ways, especially as the number of medications increase. The inter-relation between polypharmacy and malnutrition is complex and not fully delineated in previous studies. More research has been done and compiled in the last year, which helps to clarify this relationship. This review brings together the most recent literature with the previous research to help healthcare providers to better assess and manage medication therapy in older adults...
October 7, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28993349/aspirin-safety-in-glucose-6-phosphate-dehydrogenase-deficiency-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#6
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/28991499/outcome-of-traumatic-brain-injury-in-patients-on-antiplatelet-agents-a-retrospective-20-year-observational-study-in-a-single-neurosurgery-unit
#7
Kyoko Sumiyoshi, Takanori Hayakawa, Hiroshi Yatsushige, Keigo Shigeta, Toshiya Momose, Masaya Enomoto, Shin Sato, Yoshio Takasato
OBJECTIVE: To evaluate the outcomes after Traumatic Brain Injury (TBI) in patients taking Antiplatelet Agents (APAs). METHODS: We reviewed the clinical records of 934 patients with TBI between 1995 and 2014. Multivariate analysis was performed to correlate patient outcome with various factors, including pre-injury APA intake. Cause of death was compared among groups stratified according to APA dose. RESULTS: Increasing doses of APAs were positively associated with mortality rates, however, differences were primarily due to non-traumatic causes...
October 9, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28987393/perioperative-outcomes-of-patients-undergoing-lobectomy-on-clopidogrel
#8
Scott M Atay, Arlene M Correa, Wayne L Hofstetter, Reza J Mehran, David C Rice, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett Walsh, Mara B Antonoff
BACKGROUND: Perioperative management of antiplatelet therapy for patients undergoing pulmonary resection must balance the risk of cardiovascular events with that of hemorrhage. An optimal approach has not been defined in this population. We sought to characterize outcomes of patients undergoing pulmonary lobectomy on antiplatelet therapy with clopidogrel. METHODS: A prospective institutional database was retrospectively reviewed to identify all patients undergoing pulmonary lobectomy from 2007 to 2015 who received perioperative clopidogrel...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28981961/contemporary-use-of-oral-antithrombotic-agents-focus-on-dual-and-triple-therapeutic-approaches
#9
Antoine T Jenkins, Alexander Kantorovich, Luba Burman
Atherosclerotic cardiovascular disease (ASCVD) represents a long-standing health care burden in most industrialized countries. Management of ASCVD is multifaceted, and utilization of antithrombotic agents is a key component of care in order to reduce vascular events. Minimizing thrombotic risk can be accomplished via antiplatelet or anticoagulant drugs; however, combination therapy is warranted for some indications. Although reducing thrombotic complications is important, it is equally vital to consider the safety of combination regimens...
October 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28972795/embolization-for-the-treatment-of-intractable-epistaxis-12-month-outcomes-in-a-two-centre-case-series
#10
Anthony E Robinson, William McAuliffe, Timothy J Phillips, Constantine C Phatouros, Tejinder P Singh
OBJECTIVE: Embolization is a treatment option for intractable epistaxis, however concerns regarding tissue necrosis, stroke and blindness persist in the literature. METHODS: A retrospective review of patients from September 2010 - January 2016 treated with embolization for epistaxis was performed. No patient was excluded. Followup was 12 months and no patient was lost. RESULTS: 62 embolizations on 59 patients occurred. 21 cases were taking anticoagulants, P2Y12 inhibiting agents or had a systemic coagulopathy...
October 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28969559/genetic-signatures-in-ischemic-stroke-focus-on-aspirin-resistance
#11
Anjana Munshi, Kanika Vasudeva, Pratibha Chaurasia, Sulena Singh
Stroke is one of the leading causes of death. There has been compelling evidence that stroke has a genetic component. Genetic variants not only influence susceptibility to stroke but have also been found to alter the response to pharmacological agents and influence the clinical outcome of the disease. Stroke patients are treated with antiplatelet drugs like aspirin and clopidogrel to prevent a secondary stroke. Inspite the fact that many new antiplatelet drugs have been developed; aspirin is still considered as a golden standard for the antiplatelet therapy...
October 2, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28969538/triple-therapy-versus-dual-antiplatelet-therapy-for-patients-with-atrial-fibrillation-and-acute-coronary-syndromes-a-systematic-literature-review
#12
Aimee Louise Fake, Anil Ranchord, Scott Harding, Peter Larsen
BACKGROUND: Patients with acute coronary syndromes (ACS) and a history of atrial fibrillation (AF) have indications for both dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC). Triple therapy (TT), the combination of DAPT and OAC, is recommended in guidelines. We examined studies comparing clinical outcomes on DAPT versus TT for patients with AF and ACS. METHODS: We searched Medline, Medline pending, EMBASE and Evidence-Based Medicine Reviews databases for studies published between January 2000 to December 2016 in AF patients with ACS that compared DAPT and TT that reported ischaemic and/or bleeding outcomes...
September 27, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28968483/antiplatelet-and-anticoagulant-agents-for-secondary-prevention-of-stroke-and-other-thromboembolic-events-in-people-with-antiphospholipid-syndrome
#13
REVIEW
Malgorzata M Bala, Magdalena Celinska-Lowenhoff, Wojciech Szot, Agnieszka Padjas, Mateusz Kaczmarczyk, Mateusz J Swierz, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial or venous thrombosis (or both) and/or pregnancy morbidity in association with the presence of antiphospholipid antibodies. The prevalence is estimated at 40 to 50 cases per 100,000 people. The most common sites of thrombosis are cerebral arteries and deep veins of the lower limbs. People with a definite APS diagnosis have an increased lifetime risk of recurrent thrombotic events. OBJECTIVES: To assess the effects of antiplatelet or anticoagulant agents, or both, for the secondary prevention of recurrent thrombosis, particularly ischemic stroke, in people with antiphospholipid syndrome...
October 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28966153/endovascular-treatment-of-unruptured-intracranial-aneurysms-by-the-woven-endobridge-device-web-are-there-any-aspects-influencing-aneurysm-occlusion
#14
Nicola Limbucci
BACKGROUND: The experience with Woven Endobridge Device (WEB) is still limited. The aim of this study is to discuss the efficacy of this new device focusing on any anatomical and procedural factors influencing aneurysm occlusion. METHODS: Between October 2011 and November 2016, 24 patients (10 females,14 males) harbouring 24 cerebral aneurysms treated with WEB in a single centre were retrospectively reviewed. Patients underwent 6-months and 12-24 months (median 18 months) clinical and neuroradiological follow-up...
September 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28961750/flow-diverting-stents-for-the-obliteration-of-symptomatic-infectious-cavernous-carotid-artery-aneurysms
#15
Andrew Joshua Kobets, Aleka Scoco, Jonathan Nakhla, Allan Leonard Brook, Merritt Drew Kinon, Nrupen Baxi, David Altschul
BACKGROUND: Intracavernous aneurysms constitute up to 9% of all intracranial aneurysms and 6% are infectious (IIA). First line therapy is a protracted antibiotic course, yet with failure, surgery and endovascular parent vessel sacrifice have been utilized. Reconstructive endovascular therapies have emerged for aneurysm control and may demonstrate a safer therapeutic alternative. OBJECTIVE: To present an IIA treated with a flow-diverting Pipeline stent (ev3 Neurovascular, Irvine, California)...
August 5, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28958334/antiplatelet-agents-for-the-treatment-and-prevention-of-coronary-atherothrombosis
#16
REVIEW
Carlo Patrono, Joao Morais, Colin Baigent, Jean-Philippe Collet, Desmond Fitzgerald, Sigrun Halvorsen, Bianca Rocca, Agneta Siegbahn, Robert F Storey, Gemma Vilahur
Antiplatelet drugs provide first-line antithrombotic therapy for the management of acute ischemic syndromes (both coronary and cerebrovascular) and for the prevention of their recurrence. Their role in the primary prevention of atherothrombosis remains controversial because of the uncertain balance of the potential benefits and risks when combined with other preventive strategies. The aim of this consensus document is to review the evidence for the efficacy and safety of antiplatelet drugs, and to provide practicing cardiologists with an updated instrument to guide their choice of the most appropriate antiplatelet strategy for the individual patient presenting with different clinical manifestations of coronary atherothrombosis, in light of comorbidities and/or interventional procedures...
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28956170/role-of-antithrombotic-therapy-in-the-risk-of-hematoma-recurrence-and-thromboembolism-after-chronic-subdural-hematoma-evacuation-a-population-based-consecutive-cohort-study
#17
Ida Fornebo, Kristin Sjåvik, Mark Alibeck, Helena Kristiansson, Fredrik Ståhl, Petter Förander, Asgeir Store Jakola, Jiri Bartek
OBJECTIVE: To establish the risk of recurrence in patients with chronic subdural hematoma (cSDH) on antithrombotic treatment (AT, i.e., antiplatelets and anticoagulants). Secondary end points were perioperative morbidity and mortality between groups (AT vs. no-AT group) and exploration if timing of resumption of AT treatment (i.e., prophylactic early vs. late resumption) influenced the occurrence of thromboembolism and hematoma recurrence. MATERIALS: In a population-based consecutive cohort, we conducted a retrospective review of 763 patients undergoing primary burr hole procedures for cSDH between January 1, 2005, and December 31, 2010, at the Karolinska University Hospital, Stockholm, Sweden...
September 27, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28955697/cilostazol-for-secondary-prevention-of-stroke-should-the-guidelines-perhaps-be-extended
#18
REVIEW
George Galyfos, Argyri Sianou
Cilostazol belongs to the new generation antiplatelet agents that have been introduced and studied regarding a potential role in cardiovascular disease prevention or treatment. Although data on peripheral artery disease are sufficient, and the drug has been recommended as first line treatment for intermittent claudication, it has not been approved nor recommended as far as cerebrovascular events are concerned. However, a great volume of randomized as well as pooled data has been published during the last years...
September 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28948496/risk-factors-for-and-management-of-mpn-associated-bleeding-and-thrombosis
#19
REVIEW
Karlyn Martin
PURPOSE OF THE REVIEW: The Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) are characterized by both thrombotic and bleeding complications. The purpose of this review is to describe the risk factors associated with bleeding and thrombosis in MPN, as well as to review prevention strategies and management of these complications. RECENT FINDINGS: Well-described risk factors for thrombotic complications include older age and history of prior thrombosis, along with traditional cardiovascular and venous thromboembolic risk factors...
September 25, 2017: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/28938240/atrial-fibrillation-bleeding-and-coronary-intervention-current-recommendations
#20
Serdar Farhan, Roxana Mehran
The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain...
September 21, 2017: Coronary Artery Disease
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