Pleiotropic actions of ticagrelor versus clopidogrel – Do molecular differences translate into superior clinical efficacy after myocardial infarction?
Publication date: Available online 3 April 2020Source: IJC Heart & VasculatureAuthor(s): Anke C. Fender, Dobromir Dobrev (Source: IJC Heart and Vasculature)
Source: IJC Heart and Vasculature - April 3, 2020 Category: Cardiology Source Type: research

Switching from clopidogrel to prasugrel resolves vascular inflammation in patients receiving long-term aspirin plus clopidogrel therapy after coronary stent implantation
(Source: Journal of Nuclear Cardiology)
Source: Journal of Nuclear Cardiology - March 31, 2020 Category: Nuclear Medicine Source Type: research

Exploring Medication Adherence with P2Y 12 Inhibitors Using Conditional and Unconditional Quantile Regression Approaches
ConclusionsUsing CQR and UQR allowed for heterogenous assessment of covariates along the adherence distribution, which is not possible with the traditional logistic regression method. The UQR framework revealed patients who initiate prasugrel or ticagrelor generally have lower adherence compared to those treated with branded clopidogrel, especially around the 30th quantile. Using these methods in other types of data sets, such as electronic health records, could help strengthen our results to develop policies to improve antiplatelet adherence in a targeted population. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 30, 2020 Category: Cardiology Source Type: research

Comparison of Hemorrhagic Risk between Prasugrel and Clopidogrel: a Retrospective Study using Adverse Drug Event Reporting Databases.
Conclusions: The hemorrhagic risk was found to be greater with prasugrel than clopidogrel in real-world patients, including Japanese patients. PMID: 32218694 [PubMed - as supplied by publisher] (Source: International Journal of Medical Sciences)
Source: International Journal of Medical Sciences - March 29, 2020 Category: Biomedical Science Tags: Int J Med Sci Source Type: research

Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation
New England Journal of Medicine, Ahead of Print. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - March 29, 2020 Category: Internal Medicine Authors: Vincent J. Nijenhuis Jorn Brouwer Ronak Delewi Renicus S. Hermanides Wouter Holvoet Christophe L.F. Dubois Peter Frambach Bernard De Bruyne Gert K. van Houwelingen Jan A.S. Van Der Heyden Petr Tou šek Frank van der Kley Ian Buysschaert Carl E. Schotborgh Source Type: research

Aspirin Versus Clopidogrel Monotherapy for the Secondary Prevention of Recurrent Cerebrovascular Attack Following Previous Ischemic Stroke in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
ConclusionClopidogrel monotherapy was neither inferior nor superior to aspirin monotherapy for the secondary prevention of recurrent cerebrovascular attack following previous ischemic stroke in patients with T2DM. Hence, clopidogrel or aspirin monotherapy is equally safe and effective in these patients with T2DM. (Source: Diabetes Therapy)
Source: Diabetes Therapy - March 27, 2020 Category: Endocrinology Source Type: research

A Reconciliation Attempt of the Acute Coronary Syndrome Clinical Trials on Clopidogrel, Prasugrel, and Ticagrelor
(Source: Cardiovascular Drugs and Therapy)
Source: Cardiovascular Drugs and Therapy - March 25, 2020 Category: Cardiology Source Type: research

Real-World Dual Antiplatelet Therapy Following Polymer-Free Sirolimus-Eluting Stent Implantations to Treat Coronary Artery Disease
The objective of this post hoc analysis was to analyze real-world dual antiplatelet therapy (DAPT) regimens following polymer-free sirolimus-eluting stent (PF-SES) implantations in an unselected patient population.MethodsPatient-level data from two all-comers observational studies ( Identifiers: NCT02629575 and NCT02905214) were pooled and analyzed in terms of their primary endpoint. During the data verification process, we observed substantial deviations from DAPT guideline recommendations. To illuminate this gap between clinical practice and guideline recommendations, we conducted a post hoc analysis of...
Source: Cardiovascular Drugs and Therapy - March 24, 2020 Category: Cardiology Source Type: research

A fatal case of mexiletine intoxication in a 25-year-old Korean man
We report a fatal mexiletine intoxication case of a 25-year-old Korean male. After the toxicological screening, mexiletine was initially identified by gas chromatography –mass spectrometry and subsequently confirmed by ultrahigh-performance liquid chromatography–tandem mass spectrometry.ResultsThe toxicological results described the mexiletine levels in femoral and heart blood as 14.3 (range 13.6 –14.6) and 22.4 (range 21.5–23.8) ng/mL, respectively. Clopidogrel was below the limit of quantification (
Source: Forensic Toxicology - March 19, 2020 Category: Forensic Medicine Source Type: research

Insulin Autoimmune Syndrome: A Case of Clopidogrel-induced Autoimmune Hypoglycemia.
CONCLUSIONS: This case highlights a case of severe IAS. Given the ubiquity of clopidogrel, IAS should be remembered as a rare adverse effect. PMID: 32182368 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - March 18, 2020 Category: Endocrinology Authors: Calder GL, Ward GM, Sachithanandan N, MacIsaac RJ Tags: J Clin Endocrinol Metab Source Type: research

P2Y12 Receptor Antagonist Clopidogrel Attenuates Lung Inflammation Triggered by Silica Particles
Silicosis is an occupational lung disease caused by inhalation of silica particles. It is characterized by intense lung inflammation, with progressive and irreversible fibrosis, leading to impaired lung function. Purinergic signaling modulates silica-induced lung inflammation and fibrosis through P2X7 receptor. In the present study, we investigate the role of P2Y12, the G-protein-coupled subfamily prototype of P2 receptor class in silicosis. To that end, BALB/c mice received an intratracheal injection of PBS or silica particles (20 mg), without or with P2Y12 receptor blockade by clopidogrel (20 mg/kg body weight by gavage ...
Source: Frontiers in Pharmacology - March 18, 2020 Category: Drugs & Pharmacology Source Type: research

60  mg dose ticagrelor provides stronger platelet inhibition than clopidogrel in Chinese patients with chronic coronary syndrome: A randomized, single-blind, crossover study
Ticagrelor is a new novel, reversibly binding, direct-acting P2Y12 receptor antagonist. When compared with clopidogrel, ticagrelor had a more potent and more predictable antiplatelet aggregation effect. Current guidelines recommend that ticagrelor 90  mg twice daily was superior to clopidogrel 75 mg once daily in coronary artery disease (CAD) patients [1]. However, increasing evidence showed ticagrelor increased the risk of bleeding, dyspnea and bradycardia [2–3], indicating that lower doses of ticagrelor could be a good option for patient s with CAD. (Source: Thrombosis Research)
Source: Thrombosis Research - March 18, 2020 Category: Hematology Authors: Meijiao He, Yun Zhang, Wei Yan, Guangzhong Liu, Danghui Sun, Yue Yuan, Jing Shi, Yihui Kong, Yue Li Tags: Letter to the Editors-in-Chief Source Type: research

The risk of dyspnea in patients treated with third-generation P2Y12 inhibitors compared with clopidogrel: a meta-analysis of randomized controlled trials
Ticagrelor and prasugrel are two third-generation oral P2Y12 inhibitors which are more commonly used in clinical practice. However, dyspnea has been consecutively reported in patients using third-generation oral ... (Source: BMC Cardiovascular Disorders)
Source: BMC Cardiovascular Disorders - March 17, 2020 Category: Cardiology Authors: Na Zhang, Weisen Xu, Ou Li and Bing Zhang Tags: Research article Source Type: research

Bleeding complications with clopidogrel or ticagrelor in ST-elevation myocardial infarction patients – A real life cohort study of two treatment strategies
Publication date: Available online 12 March 2020Source: IJC Heart & VasculatureAuthor(s): Joakim Alfredsson, Kime Omar, József Csog, Dimitrios Venetsanos, Magnus Janzon, Mattias Ekstedt (Source: IJC Heart and Vasculature)
Source: IJC Heart and Vasculature - March 13, 2020 Category: Cardiology Source Type: research

Prasugrel or ticagrelor relative to clopidogrel in triple-antiplatelet treatment combined with glycoprotein IIb/IIIa inhibitor for patients with STEMI undergoing PCI: a meta-analysis
For patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), the efficacy and safety of novel P2Y12 antagonists, including prasugrel or ticagrelor, has... (Source: BMC Cardiovascular Disorders)
Source: BMC Cardiovascular Disorders - March 12, 2020 Category: Cardiology Authors: Zhe Wang, Da-Yan Zhou, Yong Su, Liang-Yi Si and Qiang Xu Tags: Research article Source Type: research

Frailty and Co-Prescribing of Potentially Interacting Drugs in New Users of Warfarin
ConclusionsThe overall frequency of potential drug interactions was moderate and frail patients were not exposed to warfarin drug interactions more often than non-frail patients. Further studies in larger study populations are required to verify these results. (Source: Drugs and Aging)
Source: Drugs and Aging - March 9, 2020 Category: Geriatrics Source Type: research

Intensified P2Y12 inhibition for high-on treatment platelet reactivity
AbstractHigh on treatment platelet reactivity (HPR) during treatment with clopidogrel has been consistently found to be strong risk factor for recurrent ischemic events after percutaneous coronary intervention (PCI). Insufficient P2Y12 receptor inhibition contributes to HPR measured by the VerifyNow (VN) assay. Prasugrel and ticagrelor are more potent P2Y12 inhibitors than clopidogrel and commonly substituted for clopidogrel when HPR is documented, however benefit of VN guided intensified antiplatelet therapy is uncertain. We identified patients who had undergone platelet reactivity testing after PCI with VN after pretreat...
Source: Journal of Thrombosis and Thrombolysis - March 9, 2020 Category: Hematology Source Type: research

Severe acute respiratory failure due to a multifactorial diffuse alveolar haemorrhage
We here report the case of an 81 ‐year‐old male subject affected by a multifactorial diffuse alveolar haemorrhage (DAH), in which the bleeding was related to the administration of clopidogrel and warfarin, both implicated in the context of a polycythaemia. He developed a severe acute respiratory failure treated with a ventilato ry support by means of a continuous positive airway pressure (C‐PAP) therapy. An improvement of patient's clinical conditions was observed only after clopidogrel and warfarin discontinuation. Diffuse alveolar haemorrhage (DAH) is a life ‐threatening syndrome caused by infection, coagulation ...
Source: Respirology Case Reports - March 8, 2020 Category: Respiratory Medicine Authors: Ernesto Crisafulli, Barbara Burgazzi, Maria Majori, Walter Serra, Alfredo Chetta Tags: Case Report Source Type: research

[Principles of angiology in lower extremity arterial disease (LEAD)].
Authors: Espinola-Klein C Abstract Lower extremity arterial disease (LEAD) is a frequent manifestation of atherosclerosis with a high risk for cardiovascular events. The measurement of the ankle-brachial index (ABI) should be used as a screening method for LEAD. A differentiation is made between a stable stage of intermittent claudication and the stage of critical limb ischemia. The control of cardiovascular risk factors is crucial. Particular emphasis should be placed on smoking cessation and lipid-lowering treatment with statins and a target low-density lipoprotein (LDL)-cholesterol level of
Source: Herz - March 8, 2020 Category: Cardiology Tags: Herz Source Type: research

Clinical efficacy and prognosis of aspirin combined with clopidogrel in patients with cerebral hemorrhage after operation.
Authors: Guo XJ, Ding WL, Zhu HH Abstract OBJECTIVE: The aim of this study was to investigate clinical effect, the quality of life, and prognosis of patients with hypertensive cerebral hemorrhage treated with aspirin combined with clopidogrel after decompressive craniectomy and removal of intracranial hematoma. PATIENTS AND METHODS: The individual patient data of 120 patients with hypertensive cerebral hemorrhage admitted to Affiliated Hospital of Jining Medical University from January 2015 to July 2016 were retrospectively analyzed. The patients were divided into a research group (62 cases) and a control group...
Source: European Review for Medical and Pharmacological Sciences - March 7, 2020 Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research

Efficacy and safety of standard and low dose ticagrelor versus clopidogrel in east AsianPatients with chronic total occlusion undergoing percutaneous coronary intervention: a single center retrospective study
Patients with coronary chronic total occlusion (CTO) require effective antiplatelet therapy after percutaneous coronary intervention (PCI). Ticagrelor has more pronounced platelet inhibition than clopidogrel. ... (Source: BMC Cardiovascular Disorders)
Source: BMC Cardiovascular Disorders - March 5, 2020 Category: Cardiology Authors: Yong Wang, Hong-wei Zhao, Cheng-fu Wang, Xiao-jiao Zhang, Jie Tao, Chun-sheng Cui, Qing-kun Meng, Yu Zhu, De-feng Luo, Ai-jie Hou and Bo Luan Tags: Research article Source Type: research

Ticagrelor Versus Clopidogrel in Patients with Two CYP2C19 Loss-of-Function Alleles Undergoing Percutaneous Coronary Intervention
AbstractPurposeTo compare the risk of cardiovascular events between patients with two CYP2C19 loss-of-function alleles who were prescribed ticagrelor or clopidogrel after percutaneous coronary intervention (PCI).MethodsPatients with two loss-of-function alleles based on the CYP2C19 genotype were selected from patients enrolled in a retrospective institutional registry. Propensity score matching using logistic regression was performed to adjust for bias between patients prescribed ticagrelor or clopidogrel. Multivariate Cox regression was used to compare the risk of adverse events in the ticagrelor and clopidogrel groups. T...
Source: Cardiovascular Drugs and Therapy - March 5, 2020 Category: Cardiology Source Type: research

[Interests and limitations of percutaneous coronary intervention strategy in nonagenarian patients: A single center experience].
CONCLUSIONS: This study demonstrates that angioplasty in selected population of nonagenarians is perfectly feasible with a good risk/benefit ratio and specifies the different predictors of MACE, both short- and long-term mortality. PMID: 32145882 [PubMed - as supplied by publisher] (Source: Annales de Cardiologie et d'Angeiologie)
Source: Annales de Cardiologie et d'Angeiologie - March 4, 2020 Category: Cardiology Authors: Sanoussi H, Bitton N, Kourireche N, Bernasconi F, Tounsi A, Bellemain-Appaix A, Jacq L Tags: Ann Cardiol Angeiol (Paris) Source Type: research

Medical emergency team interventions in patients with ST-segment elevation myocardial infarction throughout Poland in 2018.
Abstract BACKGROUND: To reduce the burden of ST-segment elevation myocardial infarction (STEMI) in Poland the State Emergency Medical Services Management Support System (SEMS MSS), a unique teleinformatic system coordinating SEMS, was developed. According to the European Society of Cardiology (ESC) recommendations, medical emergency teams (METs) should diagnose STEMI using electrocardiogram (ECG) teletransmission and apply dual antiplatelet therapy (DAPT) as the initial treatment. AIM: The aim of this work was to analyze MET interventions in patients with STEMI from January 1, 2018, to December 31, 2018, in P...
Source: Polish Heart Journal - March 2, 2020 Category: Cardiology Authors: Nadolny K, Ładny JR, Gałązkowski R, Gąsior M, Kubica J, Zyśko D, Kaźmierczak J, Ponikowski P Tags: Kardiol Pol Source Type: research

Platelet activity with hemoglobin level in patients with hemodialysis: Prospective study
Background: VerifyNow (VN; Accumetrics, San Diego, CA) P2Y12 reaction unit (PRU) has an inverse relation with hemoglobin level (Hb). Chronic kidney disease (CKD) is associated with low response to clopidogrel and low Hb. Our aim is to investigate the relation between PRU and Hb, and to assess whether Hb directly affects PRU or not in patients with CKD undergoing hemodialysis (HD). Methods: We analyzed the relation between PRU and Hb in 43 HD patients and compared it with a control group of 127 patients with normal renal function. Both groups underwent percutaneous coronary intervention for stable coronary artery disea...
Source: Medicine - March 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Comparison between thromboelastography and the conventional coagulation test in detecting effects of antiplatelet agents after endovascular treatments in acute ischemic stroke patients: A STROBE-compliant study
This study was designed to provide initial data to compare thromboelastography (TEG) with the conventional coagulation test (CCT) to analyze the coagulation function of antiplatelet drugs in such patients. The present retrospective cohort study included 240 patients who received endovascular therapy from September 2012 to December 2017. The baseline and clinical characteristics of these patients were collected with respect to TEG (parameters: R, K, maximal amplitude (MA), and α angle) and CCT (parameters: PT, activated partial thromboplastin time (APTT), fibrinogen (FIB), international normalized ratio (INR), and pl...
Source: Medicine - March 1, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Low Response to Clopidogrel in Coronary Artery Disease
Background: In patients with coronary artery disease, cardiovascular mortality and other acute events showed a clear correlation with risk factors and biomarkers including platelet activation. Study Question of This Research: Which was the incidence of low response to clopidogrel and its correlation with risk factors and biomarkers in coronary artery disease? Study Design: Four hundred patients (pts) with coronary artery disease—stable angina (SA) and acute coronary syndrome—were divided into 8 groups of study, consistent with low response to clopidogrel and the type of coronary artery disease. Low resp...
Source: American Journal of Therapeutics - March 1, 2020 Category: Drugs & Pharmacology Tags: Original Investigations Source Type: research

The correlation between recurrent risk and CYP2C19 gene polymorphisms in patients with ischemic stroke treated with clopidogrel for prevention
Conclusion: For patients with IS treated with clopidogrel regularly for secondary prevention, poor metabolizer, and intermediate metabolizer patients had higher risk of recurrent stroke comparing with extensive metabolize ones. Carrying CYP2C19 LOF allele is an independent risk factor of stroke recurrence in patients with IS. (Source: Medicine)
Source: Medicine - March 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

An Upfront Two-Stent Strategy for True Coronary Bifurcation Lesions with A Large Side Branch in Acute Coronary Syndrome: A Two-Year Follow-Up Study.
Conclusion: U2SS is feasible and safe for the true CBLs with large and diseased SB in ACS patients, and is related to a relatively low incidence of MACE. Clopidogrel use and SES use may predict the MACE development in ACS patients treated using U2SS. PMID: 32121323 [PubMed - in process] (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - February 29, 2020 Category: Universities & Medical Training Authors: Yurtdaş M, Asoğlu R, Özdemir M, Asoğlu E Tags: Medicina (Kaunas) Source Type: research

Comparison between prasugrel and clopidogrel used as antiplatelet medication for endovascular treatment of unruptured intracranial aneurysms. A meta-analysis
Publication date: March 2020Source: Journal of Neuroradiology, Volume 47, Issue 2Author(s): Federico Cagnazzo, Paolo Perrini, Pierre-Henri Lefevre, Gregory Gascou, Cyril Dargazanli, Carlos Riquelme, Imad Derraz, Davide di Carlo, Alain Bonafe, Vincent Costalat (Source: Journal of Neuroradiology)
Source: Journal of Neuroradiology - February 28, 2020 Category: Radiology Source Type: research

Addendum: Drug Interaction between Opioids and Oral P2Y12 Platelet Inhibitors
Date: March 9, 2020 Issue #:  1593Summary:  Opioids delay gastric emptying and the absorption of many oral drugs, including the P2Y12 inhibitors clopidogrel (Plavix, and generics), prasugrel (Effient, and generics), and ticagrelor(Brilinta), which are commonly used for initial treatment of acute coronary syndrome (ACS). An article in our February 25, 2019 issue reviewed studies showing that coadministration of opioids delayed and decreased absorption of oral P2Y12 inhibitors and increased platelet reactivity. Recently published clinical outcomes data may add to these concerns. (Source: The Medical Letter)
Source: The Medical Letter - February 28, 2020 Category: Drugs & Pharmacology Authors: admin Tags: Brilinta cangrelor Clopidogrel Effient Kengreal Morphine Opioids Plavix Prasugrel ticagrelor Source Type: research

An adaptable implementation package targeting evidence-based indicators in primary care: A pragmatic cluster-randomised evaluation
ConclusionsIn this study, we observed that a multifaceted implementation package was clinically and cost-effective for targeting prescribing behaviours within the control of clinicians but not for more complex behaviours that also required patient engagement. Trial registrationThe study is registered with the ISRCTN registry (ISRCTN91989345). (Source: PLoS Medicine)
Source: PLoS Medicine - February 28, 2020 Category: Internal Medicine Authors: Thomas A. Willis Source Type: research

Severe clopidogrel ‐induced DRESS with eosinophilic pneumonia associated with Epstein–Barr virus reactivation
We report a case of severe clopidogrel ‐induced drug reaction with eosinophilia and systemic symptom (DRESS) with concomitant eosinophilic pneumonia associated with reactivation of Epstein–Barr virus (EBV). The patient was treated with systemic corticosteroids and mechanical ventilation management. DRESS can progress to severe respir atory failure, and presence of EBV or herpes virus in the serum or resected lymph node tissue is an important finding for its diagnosis. AbstractDrug reaction with eosinophilia and systemic symptoms (DRESS) is a type of hypersensitivity drug reaction. Here, we report the case of a 78 ...
Source: Respirology Case Reports - February 27, 2020 Category: Respiratory Medicine Authors: Yuji Inagaki, Kazunobu Tachibana, Yasushi Inoue, Takahiko Kasai, Yoshikazu Inoue Tags: Case Report Source Type: research

Safety and Pharmacokinetics of DS-1040 Drug-Drug Interactions With Aspirin, Clopidogrel, and Enoxaparin.
Abstract DS-1040, a novel low-molecular-weight inhibitor of activated thrombin-activatable fibrinolysis inhibitor, is under development for the treatment of thromboembolic diseases including venous thromboembolism and acute ischemic stroke. Here we describe the results of 3 studies that evaluated the safety and tolerability of DS-1040 along with the effect on DS-1040 pharmacokinetic (PK) parameters, when dosed alone or when coadministered with aspirin (NCT02071004), clopidogrel (NCT02560688), or enoxaparin in healthy subjects. Concomitant administration of single-dose DS-1040 with multiple-dose aspirin, multiple-d...
Source: The Journal of Clinical Pharmacology - February 27, 2020 Category: Drugs & Pharmacology Authors: Limsakun T, Dishy V, Mendell J, Pizzagalli F, Pav J, Kochan J, Vandell AG, Rambaran C, Kobayashi F, Orihashi Y, Warren V, McPhillips P, Zhou J Tags: J Clin Pharmacol Source Type: research

Efficacy and safety of different ticagrelor regimens versus clopidogrel in patients with coronary artery disease: a retrospective multicenter study (SUPERIOR).
This study (NCT03381742) retrospectively analyzed the data from 11 hospitals on 3,043 patients with coronary artery disease, who received C75QD, T90BID, ticagrelor 45 mg BID (T45BID), or ticagrelor 90 mg QD (T90QD). Compared with C75QD, both T45BID and T90QD showed significantly higher inhibition of platelet aggregation (P
Source: Platelets - February 26, 2020 Category: Hematology Tags: Platelets Source Type: research

Cangrelor use in a 6-year-old patient undergoing complex percutaneous coronary intervention after post-surgical myocardial infarction.
We report the case of a 6-year-old child with anomalous origin of right coronary artery from aortic left coronary sinus, who underwent elective surgical replacement of stenotic and calcified conduit between the right ventricle and the main pulmonary artery. The surgery was complicated by acute myocardial infarction secondary to coronary extrinsic compression. The patient was successfully treated with urgent percutaneous coronary intervention (simultaneous V-stenting) and cangrelor infusion, subsequently switched to clopidogrel therapy. PMID: 32090666 [PubMed - as supplied by publisher] (Source: Platelets)
Source: Platelets - February 26, 2020 Category: Hematology Tags: Platelets Source Type: research

Crystal Clots as Therapeutic Target in Cholesterol Crystal Embolism.
ders HJ Abstract Rationale: Cholesterol crystal embolism (CCE) can be a life-threatening complication of advanced atherosclerosis. Pathophysiology and molecular targets for treatment are largely unknown. Objective: We aimed to develop a new animal model of CCE to dissect the molecular mechanisms of cholesterol crystal (CC)-driven arterial occlusion, tissue infarction, and organ failure.Methods and Results: C57BL/6J mice were injected with CC into the left kidney artery. Primary endpoint was glomerular filtration rate (GFR). CC caused crystal clots occluding intrarenal arteries and a dose-dependent drop in GFR, fol...
Source: Circulation Research - February 24, 2020 Category: Cardiology Authors: Shi C, Kim T, Steiger S, Mulay SR, Klinkhammer BM, Bäuerle T, Melica ME, Romagnani P, Möckel D, Baues M, Mammadova-Bach E, Yang L, Brouns SL, Heemskerk JW, Braun A, Lammers T, Boor P, Anders HJ Tags: Circ Res Source Type: research

Indications and Evidence for Dual Antiplatelet Therapy After Acute Ischemic Stroke
The antiplatelet landscape for the secondary prevention of ischemic stroke has changed significantly over the past decade. Poststroke dual antiplatelet regimens are becoming increasingly routine as supported by recent literature and guideline recommendations. Dual antiplatelet therapy after stroke generally consists of aspirin and clopidogrel and is considered in the short term after stroke in select populations including those with mild stroke or transient ischemic attack and in patients with severe intracranial atherosclerosis. When initiating dual antiplatelet therapy, factors that may increase a patient's risk of bleed...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research

Adjuvant antithrombotic therapy in ST-elevation myocardial infarction: Contemporaneous Portuguese cross-sectional data
ConclusionsIn 2016, according to data from these national registries, almost all patients with STEMI were treated with aspirin and 76% with dual antiplatelet agents, mostly clopidogrel. GP IIb/IIIa inhibitors were used in few patients, and UFH was the most prevalent parenteral anticoagulant drug.ResumoIntroduçãoO tratamento do enfarte agudo do miocárdio com elevação do segment ST (EAMCSST) baseia-se na ativação da via verde coronária, na administração de terapêutica médica adjuvante e na reperfusão através de angioplastia prim&...
Source: Revista Portuguesa de Cardiologia - February 21, 2020 Category: Cardiology Source Type: research

Laboratory assessments of therapeutic platelet inhibition in endovascular neurosurgery: complication prediction using the VerifyNow P2Y12 assay and thromboelastography with platelet mapping.
CONCLUSIONS: There continues to be poor correlation between the results of TEG-PM and PRU. PRU accurately predicted complications, with a relatively narrow ideal value range of 118-144. The MA-ADP alone does not appear able to accurately predict either hemorrhagic or thrombotic complications in this group. PMID: 32084635 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)
Source: Journal of Neurosurgery - February 21, 2020 Category: Neurosurgery Authors: Corliss BM, Freedman R, Brennan MM, Smith J, Nerva JD, Harris NS, Polifka AJ, Hoh BL, Fox WC Tags: J Neurosurg Source Type: research

Contribution of exome sequencing to the identification of genes involved in the response to clopidogrel in cardiovascular patients.
Abstract BACKGROUND: On-clopidogrel platelet reactivity (PR) is associated with the risk of thrombotic or bleeding event in selected populations of high-risk patients. PR is a highly heritable phenotype and a few variants of cytochrome genes, essentially CYP2C19, are associated with PR but only explain 5-12% of the variability. OBJECTIVE: The aim of this study is to delineate genetic determinants of on-clopidogrel PR using high throughput sequencing. METHODS: We performed a whole exome sequencing of 96 low- and matched high-PR patients in a discovery cohort. Exomes from genes with variants significantly ...
Source: Thrombosis and Haemostasis - February 20, 2020 Category: Hematology Authors: Fontana P, Ibberson M, Stevenson B, Wigger L, Daali Y, Niknejad A, Mach F, Docquier M, Xenarios I, Cuisset T, Alessi MC, Reny JL Tags: J Thromb Haemost Source Type: research

Platelet Inhibition in Acute Coronary Syndrome and Percutaneous Coronary Intervention: Insights from the Past and Present.
Abstract Platelet activation and aggregation have a pivotal role in arterial thrombosis and in the pathogenesis of both acute coronary syndromes (ACS) and in the thrombotic complications that occur in patients undergoing percutaneous coronary intervention (PCI). The past 30 years has seen the progress from early trials of clopidogrel and glycoprotein IIb/IIIa inhibitors to the application of more potent P2Y12 inhibitors prasugrel and ticagrelor. Early enthusiasm for newer and more potent antiplatelet agents, which could reduce ischemic events, has led to the understanding of the importance of bleeding and a desire...
Source: Thrombosis and Haemostasis - February 19, 2020 Category: Hematology Authors: Gorog DA, Geisler T Tags: Thromb Haemost Source Type: research

Prasugrel effectively reduces the platelet reactivity units in patients with genetically metabolic dysfunction of cytochrome P450 2C19 who are treated with long-term dual antiplatelet therapy after undergoing drug-eluting stent implantation
This study examined the effect on PRU in Japanese coronary heart disease patients with long-term DAPT (aspirin  + clopidogrel) when switching from clopidogrel to prasugrel. Ninety-six patients were enrolled in this study. The median DAPT duration at enrollment was 1824.0 days. Twenty-three patients with PRU ≥ 208 at enrollment were randomly assigned into either continuing to receive clopidogrel (C ontinued Group;n = 11) or switching to prasugrel (Switched Group;n = 12). The primary endpoint was the rate of patients who achieved PRU 
Source: Heart and Vessels - February 17, 2020 Category: Cardiology Source Type: research

A Pharmacodynamic Study of CN-218, a Novel Antiplatelet and Antithrombotic Agent Primarily Targeting the P2Y 12 Receptor
ConclusionCN-218 may be a promising antithrombotic agent, with potent antiplatelet and significant anticoagulant activity, as well as a lower risk of bleeding compared to clopidogrel and prasugrel. (Source: Cardiovascular Drugs and Therapy)
Source: Cardiovascular Drugs and Therapy - February 15, 2020 Category: Cardiology Source Type: research

Clopidogrel or Prasugrel reduces mortality and lessens cardiovascular damage from acute myocardial infarction in Hypercholesterolemic male rats
Publication date: Available online 13 February 2020Source: Life SciencesAuthor(s): Hala M.F. Mohammad, Samy M. Makary, Hoda Atef, Mohamed El-Sherbiny, Hebatallah H. Atteia, Gehan A. Ibrahim, Abdelaty Shawky Mohamed, Sawsan A. ZaitoneAbstractAimsHypercholesterolemia is a hazard for increasing susceptibility of the heart to myocardial infarction (MI) by inducing platelet hyperaggregability. Clopidogrel and prasugrel have documented cardioprotective effects in clinical studies. Herein, we investigated whether clopidogrel and prasugrel could protect against isoproterenol-induced acute MI (A-MI) under hypercholesterolemic condi...
Source: Life Sciences - February 14, 2020 Category: Biology Source Type: research

Pharmacokinetics and Pharmacodynamics of Approved and Investigational P2Y12 Receptor Antagonists
AbstractCoronary artery disease remains the major cause of mortality worldwide. Antiplatelet drugs such as acetylsalicylic acid and P2Y12 receptor antagonists are cornerstone treatments for the prevention of thrombotic events in patients with coronary artery disease. Clopidogrel has long been the gold standard but has major pharmacological limitations such as a slow onset and long duration of effect, as well as weak platelet inhibition with high inter-individual pharmacokinetic and pharmacodynamic variability. There has been a strong need to develop potent P2Y12 receptor antagonists with more favorable pharmacological prop...
Source: Clinical Pharmacokinetics - February 13, 2020 Category: Drugs & Pharmacology Source Type: research

Antithrombotic treatment in patients with atrial fibrillation undergoing coronary angioplasty: rational convincement and supporting evidence.
Abstract BACKGROUND: The management of antithrombotic therapy in patients undergoing percutaneous coronary intervention (PCI) with an indication for long-term oral anticoagulant therapy (OAT) is still a matter of debate. We aim to evaluate the safety and the efficacy of dual therapy (DT) compared to triple therapy (TT) in this clinical setting. METHODS: A study level meta-analysis and a review of randomized trials selected using PubMed, Embase, EBSCO, Cochrane database of systematic reviews, Web of Science, and abstract from major cardiology congresses. Six randomized trials with 12,156 patients evaluating th...
Source: European Journal of Internal Medicine - February 13, 2020 Category: Internal Medicine Authors: Ricottini E, Nenna A, Melfi R, Giannone S, Lusini M, Sciascio GD, Chello M, Ussia GP, Grigioni F Tags: Eur J Intern Med Source Type: research

β-Amyloid and mitochondrial-derived peptide-c are additive predictors of adverse outcome to high-on-treatment platelet reactivity in type 2 diabetics with revascularized coronary artery disease
AbstractBackground and aimsIncreased β-amyloid and decreased mitochondrial-derived peptide (MOTS-c), are reported in diabetes. We investigated their additive value to high on-clopidogrel platelet reactivity (HPR) for adverse outcome in type 2 diabetics after recent revascularization.Patients and methodsIn 121 type II diabetics, treated with clopidogrel and aspirin, (93 males, mean age 67.2  years) we measured: (a) maximum platelet aggregation to adenosine diphosphate (ADP) by light transmission aggregometry (LTAmax), (b) malondialdehyde (MDA), as oxidative stress marker, (c) MOTS-c, (d) β-amyloid blood level...
Source: Journal of Thrombosis and Thrombolysis - February 12, 2020 Category: Hematology Source Type: research

Measurement of Platelet Function in an Experimental Stroke Model With Aspirin and Clopidogrel Treatment
Dual antiplatelet treatment (DAPT) increases the risk of tPA-associated hemorrhagic transformation (HT) in ischemic stroke. To investigate the effects of DAPT in rodents, reliable indicators of platelet function utilizing a minimally invasive procedure are required. We here established a fluorescence-based assay to monitor DAPT efficiency in a mouse model of ischemic stroke with HT. Male C57/BL6 mice were fed with aspirin and clopidogrel (ASA+CPG). Venous blood was collected, stimulated with thrombin, labeled with anti-CD41-FITC and anti-CD62P-PE, and analyzed by flow cytometry. Subsequently, animals were subjected to expe...
Source: Frontiers in Neurology - February 11, 2020 Category: Neurology Source Type: research

Comparison of Antiplatelet Therapies for Prevention of Patent Foramen Ovale-Associated Stroke
The REDUCE study demonstrated a reduction in the risk of recurrent stroke with patent foramen ovale closure and antiplatelet therapy compared to antiplatelet therapy alone. The clinicians were allowed to choose among aspirin, clopidogrel, or aspirin/dipyridamole with the expectation that all antiplatelet therapies would have similar efficacy in this population. We tested that presumption by comparing recurrent stroke rates among antiplatelet agents within the control arm of the trial. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - February 7, 2020 Category: Neurology Authors: Scott E. Kasner, Bryan Randall, Grethe Andersen, Helle K. Iversen, Risto Roine, Christina Sjostrand, John F. Rhodes, Lars S øndergaard, The Gore REDUCE Study Investigators Source Type: research