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antiplatelet review

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https://www.readbyqxmd.com/read/29650125/restenosis-stent-thrombosis-and-bleeding-complications-navigating-between-scylla-and-charybdis
#1
REVIEW
Juan Torrado, Leo Buckley, Ariel Durán, Pedro Trujillo, Stefano Toldo, Juan Valle Raleigh, Antonio Abbate, Giuseppe Biondi-Zoccai, Luis A Guzmán
The field of interventional cardiology has significantly evolved over 40 years by overcoming several challenges. The introduction of first-generation drug-eluting stents significantly reduced the rates of restenosis, but at the expense of an increase of late stent thrombosis. Prolonged antithrombotic therapy reduced rates of stent thrombosis, but at the cost of increased bleeding. Although the advent of second-generation drug-eluting stents subsequently reduced the incidence of late stent thrombosis, its permanent nature prevents full recovery of vascular structure and function with accordant risk of very late stent failure...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29644398/stent-placement-in-patients-with-acute-subarachnoid-haemorrhage-when-is-it-justified
#2
Andrew G Murchison, Victoria Young, Tanja Ddjurdjevic, Martino Cellerini, Rufus Corkill, Wilhelm Küker
PURPOSE: Endovascular stents are widely used for the elective treatment of cerebral aneurysms. Acute stenting is performed in the management of dissections, pseudo-aneurysms, broad-based aneurysms or as a 'bail out' measure after coil migration. The purpose of this study is to review the safety of using stents in acute subarachnoid haemorrhage. METHODS: The stent registry of our institution was reviewed for procedures in patients with acute subarachnoid haemorrhage...
April 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#3
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging 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...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29627909/technological-advances-in-stent-therapies-a-year-in-review
#4
REVIEW
Jad Raffoul, Ammar Nasir, Andrew J P Klein
Stent technology has rapidly evolved since the first stainless steel bare metal stents with substantial developments in scaffolding, polymer, drug choice, drug delivery, and elution mechanisms. Most recently, there has been the evolution of bioabsorbable vascular scaffolds, potentially eliminating the need for long-term foreign object retention. These rapid developments have led to an ever-expanding selection of new stents, making the choice of which to use in which patient challenging. Operators must balance potential short- and long-term clinical ramifications, namely stent thrombosis, in-stent restenosis, target lesion revascularization, and target lesion failure...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29627068/role-of-fish-oil-in-post-cardiotomy-bleeding-a-summary-of-the-basic-science-and-clinical-trials
#5
REVIEW
John Alfred Carr
BACKGROUND: Omega-3 fatty acids are widely used. This article reviews the coagulopathic effects of fish oil. METHODS: A review was performed of all English articles that addressed the topic from 1980 to 2017. RESULTS: Fish oil induces an in vitro coagulopathy in humans due to inhibitory effects in platelet-to-platelet adhesion and platelet-stimulated thrombin generation. The effect from fish oil alone is weak, but it is enhanced and may become clinically noticeable in patients taking antiplatelet therapy, and, to a lesser extent, in patients on factor Xa inhibitors and warfarin...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29614843/role-of-plant-derived-flavonoids-and-their-mechanism-in-attenuation-of-alzheimer-s-and-parkinson-s-diseases-an-update-of-recent-data
#6
REVIEW
Ghulam Hussain, Longbin Zhang, Azhar Rasul, Haseeb Anwar, Muhammad Umar Sohail, Aroona Razzaq, Nimra Aziz, Asghar Shabbir, Muhammad Ali, Tao Sun
Neurodegeneration is a progressive loss of neuronal cells in certain regions of the brain. Most of the neurodegenerative disorders (NDDs) share the communal characteristic such as damage or reduction of various cell types typically including astrocytes and microglial activity. Several compounds are being trialed to treat NDDs but they possess solitary symptomatic advantages along with copious side effects. The finding of more enthralling and captivating compounds to suspend and standstill the pathology of NDDs will be considered as a hallmark of present times...
April 2, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29611483/management-of-antithrombotic-therapy-in-patients-with-coronary-artery-disease-or-atrial-fibrillation-who-underwent-abdominal-surgical-operations
#7
Dimitrios Schizas, Maria Kariori, Konstantinos Dean Boudoulas, Gerasimos Siasos, Nikolaos Patelis, Charalampos Kalantzis, Moldovan Carmen-Maria, Manolis Vavuranakis
BACKGROUND: Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. METHODS: The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations...
April 2, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29611444/combination-oral-antithrombotic-therapy-for-the-treatment-of-myocardial-infarction-recent-developments
#8
Udaya S Tantry, Eliano P Navarese, Aung Myat, Rahul Chaudhary, Paul A Gurbel
There have been significant new developments in the treatment of patients with myocardial infarction with respect to oral antithrombotic agents over the past decade. Recent studies have explored the potential utility of targeting the dual pathway inhibition of platelet function with single or dual antiplatelet agents and the thrombin pathway with direct thrombin inhibitors or factor Xa inhibitors. Areas covered: In this review, the authors focus on the recent developments of oral antithrombotic agents including antiplatelet and antithrombin agents...
April 3, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29608747/pharmacy-mediated-antiplatelet-management-protocol-compared-to-one-time-platelet-function-testing-prior-to-pipeline-embolization-of-cerebral-aneurysms-a-propensity-score-matched-cohort-study
#9
Christoph J Griessenauer, Abhi Jain, Alejandro Enriquez-Marulanda, Raghav Gupta, Nimer Adeeb, Justin M Moore, Stacey A Grassi, Shamsher S Dalal, Christopher S Ogilvy, Ajith J Thomas, Clemens M Schirmer
BACKGROUND: There is ongoing controversy regarding the optimal antiplatelet regimen, and extent or even need for platelet function testing surrounding Pipeline flow diverter (Medtronic Inc, Dublin, Ireland) embolization of cerebral aneurysms. OBJECTIVE: To compare a unique pharmacy-mediated antiplatelet medication management protocol to a 1-time platelet function testing strategy prior to Pipeline placement. METHODS: A retrospective review of patients with cerebral aneurysms who underwent Pipeline embolization at 2 academic institutions was performed...
March 27, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29604173/cerebral-amyloid-angiopathy-review-of-clinico-radiological-features-and-mimics
#10
REVIEW
Rohit Sharma, Stephanie Dearaugo, Bernard Infeld, Richard O'Sullivan, Richard P Gerraty
Cerebral amyloid angiopathy (CAA) is an important cause of lobar intracerebral haemorrhage (ICH) in the elderly, but has other clinico-radiological manifestations. In the last two decades, certain magnetic resonance imaging (MRI) sequences, namely gradient-recalled echo imaging and the newer and more sensitive susceptibility-weighted imaging, have been utilised to detect susceptibility-sensitive lesions such as cerebral microbleeds and cortical superficial siderosis. These can be utilised sensitively and specifically by the Modified Boston Criteria to make a diagnosis of CAA without the need for 'gold-standard' histopathology from biopsy...
March 31, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29602648/dual-antiplatelet-therapy-after-coronary-stent-implantation-individualizing-the-optimal-duration
#11
REVIEW
Leslie Marisol Lugo, José Luis Ferreiro
Dual antiplatelet therapy (DAPT) with a P2Y12 receptor antagonist in addition to aspirin is the antiplatelet treatment of choice in patients undergoing percutaneous coronary intervention. Despite DAPT being one of the most widely investigated treatment strategies in the cardiology field, its optimal duration after coronary stenting remains controversial. The balance between the possible benefit of preventing a thrombotic event and the risk of suffering a bleeding complication due to maintenance of therapy is of critical relevance to determine the duration of DAPT in a given patient...
March 27, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29596078/reduction-in-postpercutaneous-coronary-intervention-angina-in-addition-to-gastrointestinal-events-in-patients-on-combined-proton-pump-inhibitors-and-dual-antiplatelet-therapy-a-systematic-review-and-meta-analysis
#12
Muhammad Y Khan, Waqas J Siddiqui, Chikezie Alvarez, Sandeep Aggarwal, Syed F Hasni, Asyia Ahmad, Howard Eisen
BACKGROUND: Primary percutaneous coronary intervention (PCI) is a standard treatment in patients with acute coronary syndrome. Studies have shown that proton pump inhibitors (PPIs) can potentially attenuate the antiplatelet effects of P2Y12 inhibitors with associated adverse cardiovascular outcomes. MATERIALS AND METHODS: Medline was searched using Pubmed from inception to 8 November 2017 for randomized control trials studying the effect of PPIs on coronary artery disease with concomitant use of dual antiplatelet therapy (DAPT)...
March 28, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29589672/the-synergy-stent-in-high-bleeding-risk-patients-why-design-matters
#13
Mauro Chiarito, Davide Cao, Francesco Cannata, Cristina Panico, Bernhard Reimers, Giulio G Stefanini
Antithrombotic management after percutaneous coronary intervention is based on dual antiplatelet therapy (DAPT), that has unequivocally shown to reduce the risk of recurrent ischemic events at cost of an important risk of bleeding. In order to balance ischemic and bleeding risks, DAPT duration should be based on patients and lesions features as well as stent type. Based on these considerations, patients at high bleeding risk (HBR) undergoing PCI represent a challenging subgroup. The Synergy stent (Boston Scientific, Marlborough, MA, USA) is a new-generation everolimus-eluting stent with a biodegradable polymer coating, presenting several features that have the potential to reduce acute and long-term thrombogenicity and the subsequent need for DAPT...
March 28, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29589492/predictors-of-compartment-syndrome-of-the-foot-after-fracture-of-the-calcaneus
#14
Y H Park, J W Lee, J Y Hong, G W Choi, H J Kim
Aims Identifying predictors of compartment syndrome in the foot after a fracture of the calcaneus may lead to earlier diagnosis and treatment. The aim of our study was to identify any such predictors. Patients and Methods We retrospectively reviewed 303 patients (313 fractures) with a fracture of the calcaneus who presented to us between October 2008 and September 2016. The presence of compartment syndrome and potential predictors were identified by reviewing their medical records. Potential predictors included age, gender, concomitant foot injury, mechanism of injury, fracture classification, time from injury to admission, underlying illness, use of anticoagulant/antiplatelet agents, smoking status and occupation...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29581711/dual-versus-single-antiplatelet-therapy-for-patients-with-long-term-oral-anticoagulation-undergoing-coronary-intervention-a-systematic-review-and-meta-analysis
#15
Jing-Jing Yu, Chan Zou, Wen-Yu Liu, Guo-Ping Yang
Objective: The main aim of this meta-analysis is to compare the efficacy and safety of dual versus single antiplatelet therapy for patients taking oral anticoagulation (OAC) after coronary intervention. Background: The optimal regimen remains controversial for patients taking OAC after coronary intervention. Methods: PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for eligible studies including data of triple therapy (TT) versus OAC plus single antiplatelet therapy for patients requiring OAC after coronary intervention...
December 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29580113/platelet-biomechanics-platelet-bioenergetics-and-applications-to-clinical-practice-and-translational-research
#16
Mitchell J George, James Bynum, Prajeeda Nair, Andrew P Cap, Charles E Wade, Charles S Cox, Brijesh S Gill
The purpose of this review is to explore the relationship between platelet bioenergetics and biomechanics and how this relationship affects the clinical interpretation of platelet function devices. Recent experimental and technological advances highlight platelet bioenergetics and biomechanics as alternative avenues for collecting clinically relevant data. Platelet bioenergetics drive energy production for key biomechanical processes like adhesion, spreading, aggregation, and contraction. Platelet function devices like thromboelastography, thromboelastometry, and aggregometry measure these biomechanical processes...
March 26, 2018: Platelets
https://www.readbyqxmd.com/read/29577768/antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-where-are-we-now
#17
Ryan G D'Angelo, Thaddeus McGiness, Laura H White
OBJECTIVE: To synthesize the literature and provide guidance to practitioners regarding double therapy (DT) and triple therapy (TT) in patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI). DATA SOURCES: PubMed and MEDLINE (January 2000 to February 2018) were searched using the following terms: atrial fibrillation, myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, anticoagulation, dual-antiplatelet therapy, clopidogrel, aspirin, ticagrelor, prasugrel, and triple therapy...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29575675/novel-oral-anticoagulant-use-in-adult-fontan-patients-a-single-center-experience
#18
Justin Georgekutty, Amir Kazerouninia, YunFei Wang, Peter R Ermis, Dhaval R Parekh, Wayne J Franklin, Wilson W Lam
OBJECTIVE: Adult Fontan patients are at increased risk for thrombosis and thromboembolic complications leading to increased morbidity and mortality. Most are prescribed antiplatelet or anticoagulant therapy for thromboprophylaxis; novel oral anticoagulants (NOACs) are uncommonly used given lack of data on their use in this population and generalized concerns regarding Fontan patients' abnormal coagulation. We report the largest single-center experience with the use of NOACs for treatment and prophylaxis of thrombosis and thromboembolism in adult Fontan patients...
March 24, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29573815/safety-of-lumbar-puncture-performed-on-dual-antiplatelet-therapy
#19
Ivan D Carabenciov, Maximiliano A Hawkes, Sara Hocker
Practice guidelines generally recommend delaying lumbar puncture (LP) in patients on dual antiplatelet therapy, with these recommendations often citing an increased risk of hemorrhagic complications, specifically the development of epidural hematomas. However, no data exist about the risks of performing an LP in the setting of dual antiplatelet therapy and conclusions are often based on data from spinal anesthesia literature. We reviewed the medical records of 100 patients who underwent LP while taking dual antiplatelet therapy...
March 22, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29566413/rivaroxaban-a-new-treatment-paradigm-in-the-setting-of-vascular-protection
#20
Rupert Bauersachs, Faiez Zannad
The pathophysiology of atherosclerosis involves a diseased endothelium, lipid accumulation and low-grade inflammation. In later stages of coronary artery disease (CAD) and peripheral arterial disease (PAD), plaque rupture may induce atherothrombosis caused by fibrin formation and platelet activation, leading to vessel occlusion with subsequent organ damage such as myocardial infarction, stroke or limb ischaemia. Because of the high disease burden associated with CAD and PAD, there is a need for continuous vascular protection beyond currently available treatments including antiplatelet agents...
March 22, 2018: Thrombosis and Haemostasis
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