CYP2C19 Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study Genetics

Conclusions There were significant differences in recurrent stroke by CYP2C19 genotype-inferred metabolizer status in white subcortical stroke patients receiving dual antiplatelet therapy with aspirin and clopidogrel, consistent with cardiovascular studies on CYP2C19 and clopidogrel; however, the bleeding risk that led to early termination of the antiplatelet arm of the SPS3 trial does not appear to be explained by CYP2C19 genotype. This study was relatively underpowered; therefore, these findings should be interpreted with caution and warrant replication. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique identifier: NCT00059306.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Genetics Source Type: research

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This study aimed to compare the long-term outcome of triple antithrombotic therapy (TAT) with that of dual antiplatelet therapy (DAPT) after AMI. This was a nationwide, propensity score-matched, case –control study of 186,112 first AMI patients, of whom 2,825 received TAT comprising aspirin, clopidogrel, and warfarin. Propensity score matching in a ratio of 1:4 by age, sex, comorbidities, and treatment was adopted, Finally, 2,813 AMI patients and 11,252 matched controls that were administered TAT and DAPT (aspirin and clopidogrel), respectively, were included in our analysis. The 12-year overall survival rate did not...
Source: Heart and Vessels - Category: Cardiology Source Type: research
We aimed to compare the outcomes of combined surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG) to concurrent transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) in a large U.S. population sample. The National Inpatient Sample (NIS) was queried for all patients diagnosed with aortic valve stenosis who underwent SAVR with CABG or TAVR with PCI during the years 2016-2017. Study outcomes included all-cause in-hospital mortality, acute stroke, pacemaker insertion, vascular complications, major bleeding, acute kidney injury, sepsis, non-home discharge, le...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
ConclusionDiscontinuing ASA after short-term use for the treatment of patients with T2DM following PCI was not associated with any increased cardiovascular outcomes. Also, discontinuing ASA after short-term use and continuing the use of a P2Y12 inhibitor were somewhat safer in these patients with T2DM. Further research should follow.
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
CONCLUSIONS: Ticagrelor was associated with a lower incidence of MACCEs without an increased risk of bleeding events in patients with SCAD receiving PCI. PMID: 32908113 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Effects of Body Weight on Bleeding and Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention - From the CREDO-Kyoto Registry Cohort-2. Circ J. 2020 Sep 05;: Authors: Yamamoto K, Natsuaki M, Yoshikawa Y, Morimoto T, Shiomi H, Watanabe H, Kato T, Saito N, Kadota K, Ando K, Furukawa Y, Tamura T, Sakamoto H, Toyofuku M, Inada T, Inoko M, Suwa S, Onodera T, Ishii K, Kanamori N, Kimura T, CREDO-Kyoto PCI/CABG Registry Cohort- Investigators Abstract BACKGROUND: The effect of body weight (BW) on bleeding and ischemic events has not been adequately evaluated in real-world percutaneous cor...
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Authors: Nagaraja V, Rashid M, Fischmann DL, Anderson HV, Kinnaird T, Ludman P, Kapadia SR, Starling RC, Alraies C, Kwok CS, Mohamed MO, Curzen N, Mamas MA Abstract AIMS: To compare and contrast the indications, clinical and procedural characteristics, and periprocedural outcomes of patients with cardiac transplant undergoing percutaneous coronary intervention (PCI) in the United States and United Kingdom. METHODS AND RESULTS: The British Cardiovascular Intervention Society Registry (BCIS) (2007-2014) and the United States National Inpatient Sample (NIS) (2004-2014) data were utilized for this analysis. There w...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Abstract Patients undergoing percutaneous coronary intervention (PCI) have an increased risk of both ischemic events and bleeding complications resulting from antithrombotic therapy. These events are particularly common in patients with a concomitant indication for oral anticoagulation, such as those with atrial fibrillation, and are associated with a substantial healthcare resource burden. Advances in procedural aspects of PCI have led to marked improvements in outcomes and a consequent reduction in the costs resulting from PCI-associated complications. Furthermore, recent randomized clinical trials have investig...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
ConclusionIn patients with ACS undergoing PCI, both prasugrel and ticagrelor were associated with similar cardiovascular outcomes and adverse bleeding events.
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
Authors: Ho CY, Nunn C, White J, Kerr A, Lee M Abstract BACKGROUND: Concomitant atrial fibrillation (AF) and acute coronary syndrome (ACS) present the difficult therapeutic dilemma of balancing bleeding, cardio-embolic and coronary thrombotic risks with appropriate combinations of antithrombotic medications. We aim to evaluate current New Zealand practice by identifying the incidence of AF in ACS; describe the population characteristics; and assess our antithrombotic management. METHODS: Consecutive patients ≥18y presenting with ACS who had coronary angiography (2017-2018) were identified from the All New Ze...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
CONCLUSIONS: The TALOS-AMI trial is the first large-scale, multicenter, randomized study exploring the efficacy and safety of the de-escalating antiplatelet therapy that switches ticagrelor to clopidogrel in stabilized AMI patients undergoing PCI. PMID: 32718912 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
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