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Antiplatelet therapy

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https://www.readbyqxmd.com/read/29453687/impact-of-boosted-antiretroviral-therapy-on-the-pharmacokinetics-and-efficacy-of-clopidogrel-and-prasugrel-active-metabolites
#1
Niloufar Marsousi, Youssef Daali, Pierre Fontana, Jean-Luc Reny, Virginie Ancrenaz-Sirot, Alexandra Calmy, Serge Rudaz, Jules Alexandre Desmeules, Caroline Flora Samer
BACKGROUND AND OBJECTIVES: Prasugrel and clopidogrel are inhibitors of the ADP-P 2 Y 12 platelet receptor used in acute coronary syndrome patients. They require bioactivation via isoenzymes such as cytochrome P450 (CYP) 3A4, CYP2C19 and CYP2B6. Ritonavir and cobicistat are potent CYP3A inhibitors, prescribed as pharmacokinetic (PK) enhancers in the treatment of human immunodeficiency virus (HIV) infection. METHODS: In this study, the impact of boosted antiretroviral therapies (ARTs) on the PK of clopidogrel and prasugrel active metabolites (AMs), and on the efficacy of prasugrel and clopidogrel, were evaluated in a randomized crossover clinical trial...
February 16, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29452965/reversal-of-antiplatelet-therapy-in-traumatic-intracranial-hemorrhage-does-timing-matter
#2
Urmil Pandya, Alexander Malik, Michael Messina, Abdul-Rahman Albeiruti, Chance Spalding
Reversal of antiplatelet therapy with platelet transfusion in traumatic intracranial hemorrhage remains controversial. Several studies have examined this topic but few have investigated whether the timing of transfusion affects outcomes. Patients admitted to a level 1 trauma center from 1/1/14 to 3/31/16 with traumatic intracranial hemorrhage taking pre-injury antiplatelet therapy were retrospectively analyzed. Patients on concurrent pre-injury anticoagulant therapy were excluded. Per institutional guideline, patients on pre-injury clopidogrel received 2 doses of platelets while patients on pre-injury aspirin received 1 dose of platelets...
February 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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/29452691/recurrent-cardiovascular-events-in-survivors-of-myocardial-infarction-with-st-segment-elevation-from-the-ami-quebec-study
#4
Thao Huynh, Martine Montigny, Umair Iftikhar, Roxanne Gagnon, Mark Eisenberg, Claude Lauzon, Samer Mansour, Stephane Rinfret, Marc Afilalo, Michel Nguyen, Simon Kouz, Jean-Pierre Déry, Richard Harvey, Robert De LaRocheliere, Bernard Cantin, Eerick Schampaert, Jean-Claude Tardif
The characteristics and predictors of long-term recurrent ischemic cardiovascular events (RICEs) after myocardial infarction with ST-segment elevation (STEMI) have not yet been clarified. We aimed to characterize the 10-year incidence, types, and predictors of RICE. We obtained 10-year follow-up of STEMI survivors at 17 Quebec hospitals in Canada (the AMI-QUEBEC Study) in 2003. There were 858 patients; mean age was 60 years and 73% were male. The majority of patients receive reperfusion therapy; 53.3% and 39...
January 31, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29451832/circulating-progenitor-cells-and-their-interaction-with-platelets-in-patients-with-an-acute-coronary-syndrome
#5
Prokopia T Tatsidou, Vasileios G Chantzichristos, Maria E Tsoumani, Sofia Sidiropoulou, Ioannis V Ntalas, John A Goudevenos, Konstantinos Stellos, Alexandros D Tselepis
CD34 + cells expressing KDR (CD34 + /KDR + ) represent a small proportion of circulating progenitor cells that have the capacity to interact with platelets and to differentiate into mature endothelial cells, thus contributing to vascular homeostasis and regeneration as well as to re-endothelialization. We investigated the levels of CD34 + and CD34 + /KDR + progenitor cells as well as their interaction with platelets in acute coronary syndrome (ACS) patients before the initiation (baseline) of their treatment with a P2Y 12 receptor antagonist, and at 5-days post-treatment (follow-up)...
February 16, 2018: Platelets
https://www.readbyqxmd.com/read/29451664/update-on-antiphospholipid-antibody-syndrome
#6
Michelle Remião Ugolini Lopes, Adriana Danowski, Andreas Funke, Jozelia Rêgo, Roger Levy, Danieli Castro Oliveira de Andrade
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by antiphospholipid antibodies (aPL) associated with thrombosis and/or pregnancy morbidity. Most APS events are directly related to thrombotic events, which may affect small, medium or large vessels. Other clinical features like thrombocytopenia, nephropathy, cardiac valve disease, cognitive dysfunction and skin ulcers (called non-criteria manifestations) add significant morbidity to this syndrome and represent clinical situations that are challenging...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29449336/dual-anticoagulant-and-antiplatelet-therapy-for-coronary-artery-disease-and-peripheral-artery-disease-patients
#7
REVIEW
Nigel Mackman, Henri M H Spronk, George A Stouffer, Hugo Ten Cate
No abstract text is available yet for this article.
February 15, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29449145/antithrombotic-therapy-following-venous-stenting-international-delphi-consensus
#8
Kristijonas Milinis, Ankur Thapar, Joseph Shalhoub, Alun H Davies
OBJECTIVE/BACKGROUND: Deep venous stenting is increasingly used in the treatment of deep venous obstruction; however, there is currently no consensus regarding post-procedural antithrombotic therapy. The aim of the present study was to determine the most commonly used antithrombotic regimens and facilitate global consensus. METHODS: An electronic survey containing three clinical scenarios on venous stenting for non-thrombotic iliac vein lesions, acute deep vein thrombosis (DVT), and post-thrombotic syndrome was distributed to five societies whose members included vascular surgeons, interventional radiologists, and haematologists...
February 12, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29447787/rationale-and-design-of-the-comparison-between-a-p2y12-inhibitor-monotherapy-versus-dual-antiplatelet-therapy-in-patients-undergoing-implantation-of-coronary-drug-eluting-stents-smart-choice-a-prospective-multicenter-randomized-trial
#9
Young Bin Song, Seok Kyu Oh, Ju-Hyeon Oh, Eul-Soon Im, Deok-Kyu Cho, Byung Ryul Cho, Jong-Young Lee, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor reduces thrombotic events in patients undergoing percutaneous coronary intervention (PCI), but these benefits come at the expense of increased risk of bleeding when compared with aspirin monotherapy. It is unclear whether P2Y12 inhibitor monotherapy might maintain anti-ischemic efficacy while reducing the bleeding risk compared with DAPT after implantation of the current generation of drug-eluting stents (DES)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447773/percutaneous-coronary-intervention-and-antiplatelet-therapy-in-patients-with-atrial-fibrillation-receiving-apixaban-or-warfarin-insights-from-the-aristotle-trial
#10
David Kopin, W Schuyler Jones, Matthew W Sherwood, Daniel M Wojdyla, Lars Wallentin, Basil S Lewis, Freek W A Verheugt, Dragos Vinereanu, M Cecilia Bahit, Sigrun Halvorsen, Kurt Huber, Alexander Parkhomenko, Christopher B Granger, Renato D Lopes, John H Alexander
BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are reported. Of the 18,201 trial participants, 316 (1.7%) underwent PCI (152 in apixaban group, 164 in warfarin group). RESULTS: At the time of PCI, 84% (267) were on study drug (either apixaban or warfarin)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447772/the-optimal-anti-coagulation-for-enhanced-risk-patients-post-catheter-ablation-for-atrial-fibrillation-ocean-trial
#11
Atul Verma, Andrew C T Ha, Paulus Kirchhof, Gerhard Hindricks, Jeff S Healey, Michael D Hill, Mukul Sharma, D George Wyse, Jean Champagne, Vidal Essebag, George Wells, Dhiraj Gupta, Hein Heidbuchel, Prashanthan Sanders, David H Birnie
BACKGROUND: The optimal long-term antithrombotic regimen for patients after successful catheter-based atrial fibrillation (AF) ablation is not well defined. Presently, practice variation exists, and the benefits of oral anticoagulation over antiplatelet therapy across the entire spectrum of stroke risk profile remain undefined in the postablation population. To date, there are no randomized trials to inform clinicians on this therapeutic question. OBJECTIVE: The objective was to assess whether rivaroxaban is superior to acetylsalicylic acid (ASA) in reducing the risk of clinically overt stroke, systemic embolism, or covert stroke among patients without apparent recurrent atrial arrhythmias for at least 1 year after their most recent AF ablation procedure...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447770/efficacy-and-safety-of-dual-antiplatelet-therapy-after-coronary-stenting-in-patients-with-chronic-kidney-disease
#12
Doyeon Hwang, Kyung Woo Park, Joo Myung Lee, Tae-Min Rhee, Myeong-Ki Hong, Yangsoo Jang, Marco Valgimigli, Antonio Colombo, Martine Gilard, Tullio Palmerini, Gregg W Stone, Hyo-Soo Kim
BACKGROUND: We compared efficacy and safety of short- (3 or 6 months) versus long-term (≥12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS: Patient-level pooled analysis was performed with 7242 patients (87.2% with 2nd generation DES) from 5 randomized controlled trials. RESULTS: In both CKD (1273 patients) and non-CKD (5969 patients) population, the rates of patient-oriented composite outcomes at 1-year (POCO, all-cause death, any myocardial infarction [MI], stroke and TIMI major bleeding) were not different between the short- and long-term DAPT (hazard ratio [HR] 1...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29443899/protease-activated-receptor-4-par4-a-promising-target-for-antiplatelet-therapy
#13
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/29441841/efficacy-of-platelet-transfusion-for-acute-intracerebral-hemorrhage-among-patients-on-antiplatelet-therapy
#14
Onyinyechi Eke, Mercedeh Shanechi, Michael Gottlieb
Clinical question In patients taking antiplatelet therapy, does a platelet transfusion after acute spontaneous primary intracerebral hemorrhage reduce the risk of death or dependence? Article chosen Baharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral hemorrhage associated with antiplatelet therapy (PATCH): a randomized, open-label, phase 3 trial. Lancet 2016;387(10038):2605-13. Study objective The primary objective of this study was to investigate whether a platelet transfusion with standard care, compared with standard care alone, reduced death or dependence after intracerebral hemorrhage associated with antiplatelet therapy use...
February 14, 2018: CJEM
https://www.readbyqxmd.com/read/29441487/prior-antiplatelet-therapy-is-not-associated-with-larger-hematoma-volume-or-hematoma-growth-in-intracerebral-hemorrhage
#15
Verena van Ginneken, Patricia Engel, Jochen B Fiebach, Heinrich J Audebert, Christian H Nolte, Andrea Rocco
Hematoma volume (HV) and hematoma growth (HG) predict mortality and poor outcome in intracerebral hemorrhage (ICH). While the influence of oral anticoagulation on HV, HG and outcome is well established, the effect of prior antiplatelet therapy (APT) remains uncertain. We retrospectively examined data from all patients with acute, primary ICH, and baseline head CT admitted to our department between January 2005 and February 2014. HV were calculated by ABC/2 method. HG was defined as present if HV increased between baseline and follow-up CT ≥ 30% or ≥ 6 mL...
February 14, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29440137/basilar-artery-fenestration-an-unusual-possible-cause-of-ischaemic-stroke
#16
Xuan Wu, Aiyu Lin, Jiting Zhu, Bin Cai
Basilar artery fenestration is an uncommon congenital dysplasia and may be associated with ischaemic stroke. We present a case of a previously healthy 36-year-old man who presented with vertigo and vomiting. MRI showed posterior circulation territory infarction. High-resolution magnetic resonance angiography revealed a slit-like fenestration in the basilar artery. This patient had no traditional vascular risk factors or aetiology of cryptogenic stroke. The patient recovered from his neurological deficit after antiplatelet therapy and was given prophylactic aspirin therapy...
February 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29439446/the-t2238c-human-atrial-natriuretic-peptide-molecular-variant-and-the-risk-of-cardiovascular-diseases
#17
REVIEW
Speranza Rubattu, Sebastiano Sciarretta, Simona Marchitti, Franca Bianchi, Maurizio Forte, Massimo Volpe
Atrial natriuretic peptide (ANP) is a cardiac hormone which plays important functions to maintain cardio-renal homeostasis. The peptide structure is highly conserved among species. However, a few gene variants are known to fall within the human ANP gene. The variant rs5065 (T2238C) exerts the most substantial effects. The T to C transition at the 2238 position of the gene (13-23% allele frequency in the general population) leads to the production of a 30-, instead of 28-, amino-acid-long α-carboxy-terminal peptide...
February 11, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29438459/dietary-supplements-with-antiplatelet-activity-a-solution-for-everyone
#18
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/29437885/association-of-different-antiplatelet-therapies-with-mortality-after-primary-percutaneous-coronary-intervention
#19
Ivan Olier, Alex Sirker, David J R Hildick-Smith, Tim Kinnaird, Peter Ludman, Mark A de Belder, Andreas Baumbach, Jonathan Byrne, Muhammad Rashid, Nick Curzen, Mamas A Mamas
OBJECTIVES: Prasugrel and ticagrelor both reduce ischaemic endpoints in high-risk acute coronary syndromes, compared with clopidogrel. However, comparative outcomes of these two newer drugs in the context of primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) remains unclear. We sought to examine this question using the British Cardiovascular Interventional Society national database in patients undergoing primary PCI for STEMI. METHODS: Data from January 2007 to December 2014 were used to compare use of P2Y12 antiplatelet drugs in primary PCI in >89 000 patients...
February 2, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29437596/antiplatelet-therapy-changes-for-patients-with-myocardial-infarction-with-recurrent-ischemic-events-insights-into-contemporary-practice-from-the-translate-acs-treatment-with-adp-receptor-inhibitors-longitudinal-assessment-of-treatment-patterns-and-events-after
#20
Alexander C Fanaroff, Lisa A Kaltenbach, Eric D Peterson, Mohammed W Akhter, Mark B Effron, Timothy D Henry, Tracy Y Wang
BACKGROUND: Guidelines recommend P2Y 12 inhibitor therapy for 1 year after myocardial infarction (MI), yet little guidance is provided on antiplatelet management for patients with recurrent ischemic events during that year. We describe changes in P2Y 12 inhibitor type among patients with recurrent ischemic events in the first year after MI. METHODS AND RESULTS: The TRANSLATE-ACS (Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) study enrolled 12 365 patients with MI treated with percutaneous coronary intervention...
February 8, 2018: Journal of the American Heart Association
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