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Antiagregantes

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201 papers 0 to 25 followers
By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
https://www.readbyqxmd.com/read/29280403/ticagrelor-in-modern-cardiology-an-up-to-date-review-of-most-important-aspects-of-ticagrelor-pharmacotherapy
#1
Dorota Danielak, Marta Karaźniewicz-Łada, Franciszek Główka
Ticagrelor is a first drug of a new chemical class cyclopentyltriazolopyrimidines. It is an antiplatelet agent with a unique mechanism of action, allowing a direct and reversible competitive inhibition of P2Y12 receptor. According to newest guidelines, it is recommended for prevention of thrombotic events in patients with acute coronary syndromes. Moreover, it is preferred over clopidogrel, an older generation antiplatelet drug, and therefore gains more interest in modern cardiology and vascular medicine. Areas covered: This review is a comprehensive and thorough summary of the most important findings on ticagrelor...
December 27, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29131238/the-role-of-prasugrel-in-the-management-of-acute-coronary-syndromes-a-systematic-review
#2
M Spartalis, E Tzatzaki, E Spartalis, C Damaskos, A Athanasiou, D Moris, M Politou
OBJECTIVE: Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29150850/comparison-of-pharmacodynamic-effects-of-ticagrelor-vs-prasugrel-in-type-2-diabetes-mellitus-patients-with-coronary-heart-disease
#3
L-L Shang, D-D Guo, H-Y Zhao, A-J Quan, P-G Cao
WHAT IS KNOWN AND OBJECTIVE: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of thrombotic complications. Studies have indicated that patients with T2DM have impaired clopidogrel-induced antiplatelet effect. Ticagrelor and prasugrel are two latest generation P2Y12 inhibitors with advantageous platelet inhibitory profiles. However, the pharmacodynamic differences between the two drugs in patients with T2DM remain poorly explored. METHODS: This study, involving 140 patients with T2DM following percutaneous coronary intervention (PCI), evaluated the efficacy of aspirin upon concomitant use of prasugrel (10 mg/d) or ticagrelor (90 mg/d)...
November 17, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29046319/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-the-pacify-randomized-clinical-trial
#4
John W McEvoy, Khalil Ibrahim, Thomas S Kickler, William A Clarke, Rani K Hasan, Matthew J Czarny, Ali R Keramati, Rakesh R Goli, Travis P Gratton, Jeffrey A Brinker, Matthews Chacko, Chao-Wei Hwang, Peter V Johnston, Julie M Miller, Jeffrey C Trost, William R Herzog, Roger S Blumenthal, David R Thiemann, Jon R Resar, Steven P Schulman
Fentanyl is a potent opiate commonly administered during cardiac catheterization procedures in North America. The question of whether fentanyl could have adverse consequences in patients undergoing percutaneous coronary intervention (PCI) is raised by recent research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The presumed mechanism is slowed gastric emptying. The single-center Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial randomized adults undergoing clinically-indicated elective coronary angiography to receive the procedure with or without intravenous fentanyl (NCT02683707)...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29058279/comparison-of-treatment-outcomes-of-ticagrelor-and-clopidogrel-among-patients-undergoing-percutaneous-coronary-intervention-a-meta-analysis
#5
Jian Yang, Ping Zeng, Wan-Yin Cai
We performed a meta-analysis of randomized controlled trials (RCTs) to investigate the efficacy and safety of ticagrelor (TIC) vs. clopidogrel (CLO) in patients undergoing percutaneous coronary intervention (PCI). In Jun 2016, a literature search was started and all the studies were conducted from 2010 to 2015. We systematically searched the literature through the MEDLINE database, Cochrane library, and EMBASE database. Quality assessments were evaluated with Jadad quality scale. Data were extracted considering the characteristics of efficacy and safety designs...
October 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28945935/efficacy-and-safety-of-ticagrelor-in-patients-with-acute-coronary-syndrome-a-meta-analysis-of-randomized-controlled-trials
#6
Yunyan Jing, Bin Ni, Donglai Zhou, Xingwei Zhang, Shanxin Liu
Acute coronary syndrome (ACS) is a dangerous and urgent clinical pattern of coronary artery disease. Aspirin and adenosine diphosphate P2Y12 receptor antagonists are the standard dual anti-platelet therapy for patients with ACS. Ticagrelor is a new oral antagonist of the adenosine diphosphate P2Y12 receptor. Randomized controlled trials (RCTs) have evaluated the efficacy and safety of ticagrelor compared to clopidogrel or prasugrel in patients with ACS, obtaining conflicting results. Thus, we conducted a meta-analysis of these RCTs to determine the efficacy and safety of ticagrelor in patients with ACS...
September 25, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/27789556/protective-effects-of-ticagrelor-on-myocardial-injury-after-infarction
#7
Gemma Vilahur, Manuel Gutiérrez, Laura Casani, Lourdes Varela, Antoni Capdevila, Guillem Pons-Lladó, Francesc Carreras, Leif Carlsson, Alberto Hidalgo, Lina Badimon
BACKGROUND: The P2Y12 receptor antagonist ticagrelor has been shown to be clinically superior to clopidogrel. Although the underlying mechanisms remain elusive, ticagrelor may exert off-target effects through adenosine-related mechanisms. We aimed to investigate whether ticagrelor reduces myocardial injury to a greater extent than clopidogrel after myocardial infarction (MI) at a similar level of platelet inhibition and to determine the underlying mechanisms. METHODS: Pigs received the following before MI induction: (1) placebo-control; (2) a loading dose of clopidogrel (600 mg); (3) a loading dose of ticagrelor (180 mg); or (4) a loading dose of ticagrelor followed by an adenosine A1/A2-receptor antagonist [8-(p-sulfophenyl)theophylline, 4 mg/kg intravenous] to determine the potential contribution of adenosine in ticagrelor-related cardioprotection...
November 29, 2016: Circulation
https://www.readbyqxmd.com/read/28856572/safety-of-antiplatelet-agents-analysis-of-real-world-data-from-the-italian-national-pharmacovigilance-network
#8
Lucia Gozzo, Andrea Navarria, Giuseppe Benfatto, Laura Longo, Silvana Mansueto, Laura Sottosanti, Luca Pani, Salvatore Salomone, Filippo Drago
INTRODUCTION: According to the Italian National Report on drug use, thienopyridines (ticlopidine, clopidogrel and prasugrel) and ticagrelor represent the most prescribed antiplatelet agents, beside aspirin. The aim of this study was to analyse the safety profile of these drugs using data from spontaneous reporting of suspected adverse reactions (ADRs). METHODS: Suspected ADRs for ticlopidine, clopidogrel, prasugrel and ticagrelor, reported on the Italian National Pharmacovigilance Network between January 2009 and December 2016, were included in the analysis...
November 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#9
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
2017: Cardiology
https://www.readbyqxmd.com/read/28817535/can-prasugrel-decrease-the-extent-of-periprocedural-myocardial-injury-during-elective-pci
#10
Mariusz Tomaniak, Łukasz Kołtowski, Janusz Kochman, Zenon Huczek, Adam Rdzanek, Arkadiusz Pietrasik, Aleksandra Gasecka, Sylwia Gajda, Grzegorz Opolski, Krzysztof J Filipiak
INTRODUCTION    Periprocedural myocardial injury may be associated with an increased risk of cardiovascular events. The evidence on safety and efficacy of more potent P2Y12 antagonists in reduction of periprocedural myocardial injury among patients undergoing elective percutaneous coronary interventions (PCI) with inadequate response to clopidogrel is limited.  OBJECTIVES    The aim of the study was to evaluate the impact of prasugrel on the incidence of periprocedural myocardial injury among patients undergoing elective PCI with inadequate response to clopidogrel diagnosed by point-of-care genotyping and platelet function testing (PFT)...
August 17, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28581998/controversies-in-the-management-of-st-elevation-myocardial-infarction-thrombin-inhibition
#11
REVIEW
Neeraj Shah, David Cox
Anticoagulation is essential in patients with ST elevation myocardial infarction (STEMI) to prevent further thrombosis and to maintain patency of the infarct-related artery after reperfusion. The various anticoagulant medications available for use in patients with STEMI include unfractionated heparin (UFH), low-molecular-weight heparin, fondaparinux, and bivalirudin, a direct thrombin inhibitor. The authors review the current anticoagulation strategies for patients with STEMI undergoing primary percutaneous coronary intervention (PCI), fibrinolysis, or no reperfusion...
October 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28746721/association-between-administration-of-ticagrelor-and-microvascular-endothelial-function
#12
Shahar Lavi, Mistre Alemayehu, Klajdi Puka, Sabrina Wall, Ronit Lavi
No abstract text is available yet for this article.
September 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28768756/impact-of-timing-on-the-functional-recovery-achieved-with-platelet-supplementation-after-treatment-with-ticagrelor
#13
M Urooj Zafar, Donald A Smith, Usman Baber, Samantha Sartori, Kevin Chen, David W Lam, Carlos A Linares-Koloffon, Juan Rey-Mendoza, Gustavo Jimenez Britez, Gines Escolar, Valentin Fuster, Juan J Badimon
BACKGROUND: American College of Cardiology/American Heart Association guidelines advise waiting 5 to 7 days before operating on P2Y12 inhibitor-treated acute coronary syndrome patients, to allow dissipation of its antiplatelet effects. Platelet transfusion is often used to restore hemostasis during operations, but its effectiveness and optimal timing are unclear. We investigated the degree of functional gains obtained from platelet supplementation after loading and maintenance of dual antiplatelet therapy with ticagrelor and the influence of timing on this strategy...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28768760/platelet-transfusion-for-ticagrelor-reversal
#14
EDITORIAL
Paul Kruger, Noel Chan, John W Eikelboom
No abstract text is available yet for this article.
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28789568/temporal-trends-in-the-use-of-antiplatelet-therapy-in-patients-with-acute-coronary-syndromes
#15
María Asunción Esteve-Pastor, Juan Miguel Ruíz-Nodar, Esteban Orenes-Piñero, José Miguel Rivera-Caravaca, Miriam Quintana-Giner, Andrea Véliz-Martínez, Antonio Tello-Montoliu, Vicente PerniasEscrig, Miriam Sandín Rollán, Nuria Vicente-Ibarra, Manuel Jesús MacíasVillanego, Elena Candela Sánchez, Luna Carrillo Alemán, Teresa Lozano, Mariano Valdés, Francisco Marín
BACKGROUND: Current clinical guidelines of acute coronary syndromes (ACS) recommend the use of potent antiplatelet therapy, prasugrel or ticagrelor, because both drugs consistently reduce cardiovascular events. PURPOSE: The aim of this study was to examine temporal changes in the use of optimal antiplatelet therapy in patients with ACS. METHODS: A total of 1717 consecutive patients admitted for ACS in 3 tertiary hospitals from February 2014 to December 2015 were enrolled...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28697492/incidence-and-causes-for-early-ticagrelor-discontinuation-a-real-world-dutch-registry-experience
#16
Thomas O Bergmeijer, Paul W A Janssen, Mathijs van Oevelen, Dymphie van Rooijen, Thea C Godschalk, Johannes C Kelder, Vera H M Deneer, Victor L Serebruany, Jurriën M Ten Berg
OBJECTIVES: The PLATO trial revealed superiority of ticagrelor over clopidogrel for the prevention of atherothrombotic events in patients with acute coronary syndrome. However, adverse events such as bleeding, dyspnea, and bradycardia were frequently reported, potentially leading to excess early ticagrelor discontinuation (ETD), later confirmed in the PEGASUS trial. We here evaluated the incidence and causes for ETD in a real-world patient cohort in a high-volume nonacademic percutaneous coronary intervention center in the Netherlands...
July 12, 2017: Cardiology
https://www.readbyqxmd.com/read/28555946/comparative-effectiveness-of-oral-antiplatelet-agents-in-patients-with-acute-coronary-syndrome
#17
Kibum Kim, Todd A Lee, Amer K Ardati, Robert J DiDomenico, Daniel R Touchette, Surrey M Walton
OBJECTIVE: In randomized controlled trials, prasugrel and ticagrelor reduced cardiovascular complications in patients with acute coronary syndrome (ACS) compared with clopidogrel. However, limited head-to-head comparisons have been conducted across the three antiplatelet agents using real-world data. The aim of this study was to compare clinical outcomes of three strategies during a 1-year period after percutaneous coronary intervention (PCI). METHODS: Rates of all-cause and acute myocardial infarction (AMI) hospitalizations were compared retrospectively using an insurance claims database...
August 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28571507/the-genetic-basis-of-antiplatelet-and-anticoagulant-therapy-a-pharmacogenetic-review-of-newer-antiplatelets-clopidogrel-prasugrel-and-ticagrelor-and-anticoagulants-dabigatran-rivaroxaban-apixaban-and-edoxaban
#18
REVIEW
Cormac T O'connor, Thomas J Kiernan, Bryan P Yan
The study of pharmacogenomics presents the possibility of individualised optimisation of drug therapy tailored to each patients' unique physiological traits. Both antiplatelet and anticoagulant drugs play a key role in the management of cardiovascular disease. Despite their importance, there is a substantial volume of literature to suggest marked person-to-person variability in their effect. Areas covered: This article reviews the data available for the genetic cause for this inter-patient variability of antiplatelet and anticoagulant drugs...
July 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28342632/the-pharmacodynamics-of-low-and-standard-doses-of-ticagrelor-in-patients-with-end-stage-renal-disease-on-hemodialysis
#19
Jin Sug Kim, Jong Shin Woo, Jin Bae Kim, Woo-Shik Kim, Tae Won Lee, Kwon Sam Kim, Chun Gyoo Ihm, Weon Kim, Kyung Hwan Jeong
BACKGROUND: Patients with end-stage renal disease (ESRD) on maintenance hemodialysis (HD) respond poorly to clopidogrel. We assessed the utility of low-dose ticagrelor in ESRD patients on maintenance HD. METHODS: In this single-center, prospective, randomized pharmacodynamic study, 52 ESRD patients on HD were prescribed clopidogrel (300mg loading dose [LD], then 75mg daily), standard-dose ticagrelor (180mg LD, then 90mg twice daily), or low-dose ticagrelor (90mg LD, then 90mg daily) for 14days...
July 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#20
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
May 6, 2017: Lancet
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