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aspirin and 'randomized control trial'

Dorairaj Prabhakaran
Among individuals with established CVD, multiple medications (aspirin, blood pressure lowering drugs and statins) are required to manage CVD and it is well established that non adherence to prescribed treatments is substantial in the long term. Such discontinuation of CV-preventive medications and low adherence rates has been shown to affect the success of CVD prevention efforts. In low- and middle income countries only less than 20% patients receive recommended therapy for CVD prevention, but even in high-income countries treatment coverage in the community is only about 50% in those with heart disease and 35% in those with stroke...
September 2016: Journal of Hypertension
Wenyi Tang, James Yeh, Jian Chen, Mao Liu, Jianting Ke, Guangyi Tan, Xiufang Lin, Wei Wu
BACKGROUND: The potential benefits and risks of extended thienopyridine therapy beyond 12 months after drug-eluting stent (DES) implantation remain unclear. METHODS: Randomized controlled trials (RCTs) were searched in PubMed, EMBASE, the Cochrane Library and China National Knowledge Infrastructure databases. The adverse clinical endpoints were compared between 12 months group (aspirin alone) and >12 months group (additional thienopyridine plus aspirin after 12-month dual antiplatelet therapy)...
October 2016: Cardiovascular Diagnosis and Therapy
Bassam Haddad, Norbert Winer, Yvon Chitrit, Véronique Houfflin-Debarge, Céline Chauleur, Karine Bages, Vassilis Tsatsaris, Alexandra Benachi, Florence Bretelle, Jean-Christophe Gris, Sylvie Bastuji-Garin
OBJECTIVE: To evaluate whether daily enoxaparin, added to low-dose aspirin, started before 14 weeks of gestation reduces placenta-mediated complications in pregnant women with previous severe preeclampsia diagnosed before 34 weeks of gestation. METHODS: In this open-label multicenter randomized trial, we enrolled consenting pregnant women with previous severe preeclampsia diagnosed before 34 weeks of gestation, gestational age at randomization of 7-13 weeks, singleton pregnancy, and no plan for anticoagulation...
October 6, 2016: Obstetrics and Gynecology
Sleiman Sebastian Aboul-Hassan, Tomasz Stankowski, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether continuation of administration of preoperative aspirin until the day of coronary artery bypass grafting (CABG) could minimize postoperative mortality, prevalence of postoperative myocardial infarction (MI) with or without influence on postoperative bleeding, packed red blood cell (PRBC) transfusion and reoperation for bleeding. Altogether, 662 papers were found using the reported search, 7 of which represented the best evidence to answer the clinical question...
October 4, 2016: Interactive Cardiovascular and Thoracic Surgery
Adina Hayek, Rohina Joshi, Tim Usherwood, Ruth Webster, Baldeep Kaur, Bandana Saini, Carol Armour, Ines Krass, Tracey-Lea Laba, Christopher Reid, Louise Shiel, Charlotte Hespe, Fred Hersch, Stephen Jan, Serigne Lo, David Peiris, Anthony Rodgers, Anushka Patel
BACKGROUND: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification...
2016: Implementation Science: IS
Dorairaj Prabhakaran
Among individuals with established CVD, multiple medications (aspirin, blood pressure lowering drugs and statins) are required to manage CVD and it is well established that non adherence to prescribed treatments is substantial in the long term. Such discontinuation of CV-preventive medications and low adherence rates has been shown to affect the success of CVD prevention efforts. In low- and middle income countries only less than 20% patients receive recommended therapy for CVD prevention, but even in high-income countries treatment coverage in the community is only about 50% in those with heart disease and 35% in those with stroke...
September 2016: Journal of Hypertension
Francis K L Chan, Moe Kyaw, Tetsuya Tanigawa, Kazuhide Higuchi, Kazuma Fujimoto, Pui Kuan Cheong, Vivian Lee, Yoshikazu Kinoshita, Yuji Naito, Toshio Watanabe, Jessica Y L Ching, Kelvin Lam, Angeline Lo, Heyson Chan, Rashid Lui, Raymond S Y Tang, Yasuhisa Sakata, Yee Kit Tse, Toshihisa Takeuchi, Osamu Handa, Hiroko Nebiki, Justin C Y Wu, Takashi Abe, Tsuyoshi Mishiro, Siew C Ng, Tetsuo Arakawa
BACKGROUND & AIMS: It is not clear whether H2-receptor antagonists (H2RAs) reduce the risk of gastrointestinal (GI) bleeding in aspirin users at high risk. We performed a double-blind randomized trial to compare the effects of a proton pump inhibitor (PPI) vs a H2RA antagonist in preventing recurrent upper gastrointestinal (GI) bleeding and ulcers in high-risk aspirin users. METHODS: We studied 270 users of low-dose aspirin (325 mg or less per day) with a history of endoscopically confirmed ulcer bleeding at 8 sites in Hong Kong and Japan...
September 15, 2016: Gastroenterology
Stephanie A Ward, Parnesh Raniga, Nicholas J Ferris, Robyn L Woods, Elsdon Storey, Michael J Bailey, Amy Brodtmann, Paul A Yates, Geoffrey A Donnan, Ruth E Trevaks, Rory Wolfe, Gary F Egan, John J McNeil
RATIONALE: Cerebral microbleeds seen on brain magnetic resonance imaging are markers of small vessel disease, linked to cognitive dysfunction and increased ischemic and hemorrhagic stroke risk. Observational studies suggest that aspirin use may induce cerebral microbleeds, and associated overt intracranial hemorrhage, but this has not been definitively resolved. AIMS: ASPREE-NEURO will determine the effect of aspirin on cerebral microbleed development over three years in healthy adults aged 70 years and over, participating in the larger 'ASPirin in Reducing Events in the Elderly (ASPREE)' primary prevention study of aspirin...
September 15, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Jiao Fan, Yiping Zhong, Cuina Chen
LABELED PROBLEM: Antinuclear antibody (ANA) could cause reproductive failure. But treatment for women with antinuclear antibody was controversial. METHODS: One hundred and thirty-three ANA+ women with one-time in vitro fertilization (IVF) implantation failure were divided into two groups randomly. The study group comprised 60 sero-positive for antinuclear antibody. These patients were treated with prednisone (10 mg/day) and aspirin (100 mg/day) starting 3 months before induction of ovulation in 60 IVF cycles...
November 2016: American Journal of Reproductive Immunology: AJRI
Gennaro Giustino, Alaide Chieffo, Tullio Palmerini, Marco Valgimigli, Fausto Feres, Alexandre Abizaid, Ricardo A Costa, Myeong-Ki Hong, Byeong-Keuk Kim, Yangsoo Jang, Hyo-Soo Kim, Kyung Woo Park, Martine Gilard, Marie-Claude Morice, Fadi Sawaya, Gennaro Sardella, Philippe Genereux, Bjorn Redfors, Martin B Leon, Deepak L Bhatt, Gregg W Stone, Antonio Colombo
BACKGROUND: Optimal upfront dual antiplatelet therapy (DAPT) duration after complex percutaneous coronary intervention (PCI) with drug-eluting stents (DES) remains unclear. OBJECTIVES: This study investigated the efficacy and safety of long-term (≥12 months) versus short-term (3 or 6 months) DAPT with aspirin and clopidogrel according to PCI complexity. METHODS: The authors pooled patient-level data from 6 randomized controlled trials investigating DAPT durations after PCI...
October 25, 2016: Journal of the American College of Cardiology
Michael Berk, R L Woods, M R Nelson, R C Shah, C M Reid, E Storey, S M Fitzgerald, J E Lockery, R Wolfe, M Mohebbi, A M Murray, B Kirpach, R Grimm, J J McNeil
BACKGROUND: Not only is depression associated with increased inflammation but inflammation is a risk factor for the genesis of depression. Many of the environmental risk factors for depression are transduced through inflammatory signaling. Anti-inflammatory agents show promise for the management of depression in preclinical, epidemiological, and early clinical studies. This opens the door to the potential for anti-inflammatory agents to treat and prevent depression. There are no evidence-based pharmacotherapies for depression prevention...
October 2016: International Psychogeriatrics
Amy Tawfik, Joanna M Bielecki, Murray Krahn, Paul Dorian, Jeffrey S Hoch, Heather Boon, Don Husereau, Petros Pechlivanoglou
BACKGROUND: In the last 4 years, four novel oral anticoagulants have been developed as alternatives to warfarin and antiplatelet agents for stroke prevention in atrial fibrillation (AF) patients. The objective of this review was to estimate the comparative effectiveness of all antithrombotic treatments for AF patients. MATERIALS AND METHODS: Data sources were Medline Ovid (1946 to October 2015), Embase Ovid (1980 to October 2015), and the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 9, 2015)...
2016: Clinical Pharmacology: Advances and Applications
Hamid Reza Sanati, Ali Zahedmehr, Ata Firouzi, Melody Farrashi, Kamyar Amin, Mohammad Mehdi Peighambari, Farshad Shakerian, Reza Kiani
Although aspirin and clopidogrel seem to be quite enough during low risk percutaneous coronary intervention (PCI), the combination may need some reinforcement in complex situations such as primary PCI. By modifying the route and also the duration of administration, glycoprotein IIb/IIIa inhibitors might be a viable option. The aim of this study is to compare the benefits and disadvantages of three different methods of administration of eptifibatide in primary PCI population. Primary PCI candidates were randomized in three groups on which three different methods of administration of eptifibitide were tested: intravenous bolus injection followed by 12-h infusion (IV-IV), intracoronary bolus injection followed by intravenous infusion (IC-IV) and, only intracoronary bolus injection (IC)...
August 17, 2016: Cardiovascular Intervention and Therapeutics
Gerasimos Siasos, Konstantinos Mourouzis, Evangelos Oikonomou, Manolis Vavuranakis, Georgia Vogiatzi, Alexandros Briasoulis, Nikolaos Papageorgiou, Theodore G Papaioannou, Thodoris Zografos, Aggeliki Papapanagiotou, Athanasios G Papavassiliou, Christodoulos Stefanadis, Dimitris Tousoulis
BACKGROUND: Dual antiplatelet therapy (DAPT) is one of the cornerstones of coronary artery disease (CAD) treatment. Standard DAPT requires one of, P2Y12 receptor inhibitors, clopidogrel, prasugrel or ticagrelor as an adjunct therapy to aspirin administration. The decision over DAPT duration depends on the evaluation of thrombotic risk and the assessment of the probability for major bleeding events. METHODS: The goal of this work was to identify which would be the appropriate combination of antiplatelet agents and the optimal duration of DAPT, based on the patient's medical history and clinical characteristics...
July 20, 2016: Current Pharmaceutical Design
Joanne Kacperski, Andrew D Hershey
Treatment of pediatric migraine remains an unmet medical need. There continues to be a paucity of pediatric randomized controlled trials for the treatment of migraine, both in the acute and preventive settings. Pediatric studies are often complicated by high placebo-response rates and much of our current practice is based on adult trials. This lack of significant pediatric studies results in a wide variation in migraine management both amongst clinicians and between institutions, and evidence-based treatments are not always administered...
September 2016: CNS Drugs
Konrad H Stopsack, Alexandra J Greenberg, Lorelei A Mucci
PURPOSE: Most prostate cancer patients also have comorbidities that are treated with both prescription and nonprescription medications; furthermore, many use dietary supplements. We assess their association with prognosis after prostate cancer diagnosis, and we discuss methodological challenges and clinical implications. METHODS: We reviewed high-quality observational studies investigating the association of commonly used medications and supplements with prostate cancer-specific mortality...
August 4, 2016: World Journal of Urology
Zaher Fanari, Amratash Malodiya, Sandra A Weiss, Sumaya Hammami, Paul Kolm, William S Weintraub
BACKGROUND: The potential benefit of long-term dual antiplatelet therapy (DAPT) for secondary prevention of atherothrombotic events is unclear. Data from different randomized controlled trials (RCT) using different agents in different subgroups showed inconsistent results. METHODS: We performed a systematic review and meta-analysis from RCTs that tested different prolonged durations of DAPT for secondary prevention. Long term DAPT arm was defined as those receiving DAPT for more than 12months...
July 20, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Samantha Forder, Michael Voelker, Angel Lanas
BACKGROUND AND AIM: Aspirin is a commonly used over-the-counter (OTC) agent for the symptomatic treatment of acute pain, fever, or the common cold, but data regarding safety in this context are limited. In order to characterize the safety of aspirin beyond single-dose or long-term use data, we conducted a meta-analysis of multiple-dose, multiple-day studies of OTC aspirin at a label-approved dosage. METHODS: We conducted a meta-analysis of individual patient data from three Bayer-sponsored studies...
September 2016: Drugs in R&D
Tomoya Hoshi, Akira Sato, Akihiko Nogami, Masahiko Gosho, Kazutaka Aonuma
BACKGROUND: Patients with atrial fibrillation who undergo coronary stenting require triple antithrombotic therapy, including aspirin, a P2Y12 inhibitor, and anticoagulation, to prevent both stroke and stent thrombosis. However, triple therapy may increase the risk of bleeding complications. The optimal management of triple therapy still presents a challenge in these patients. HYPOTHESIS: We hypothesized that 1-month P2Y12 inhibitor treatment after drug-eluting stent (DES) implantation, as compared with 6-month P2Y12 inhibitor treatment, in combination with aspirin and apixaban, would be associated with a decrease in the incidence of bleeding complications in patients with atrial fibrillation who undergo DES implantation...
July 18, 2016: Journal of Cardiology
Abigail Johnston, W Schuyler Jones, Adrian F Hernandez
Coronary artery disease (CAD) is the underlying cause of death in one out of seven deaths in the USA. Aspirin therapy has been proven to decrease mortality and major adverse cardiovascular events in patients with CAD. Despite a plethora of studies showing the benefit of aspirin in secondary prevention of cardiovascular events, debate remains regarding the optimal dose due to relatively small studies that had disparate results when comparing patients taking different aspirin dosages. More recently, aspirin dosing has been thoroughly studied in the CAD population with concomitant therapy (such as P2Y12 inhibitors); however, patients in these studies were not randomized to aspirin dose...
August 2016: Current Cardiology Reports
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