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Specialty: Internal Medicine
Condition: Bleeding
Drug: Aspirin

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Total 44 results found since Jan 2013.

Efficacy and safety of clopidogrel and/or aspirin for ischemic stroke/transient ischemic attack: An overview of systematic reviews and meta-analysis
Conclusions: High-quality evidence suggested that clopidogrel plus aspirin was more efficient than monotherapy, although the risk for hemorrhagic stroke was relatively higher in combined therapy regimens lasting>1 month.
Source: Medicine - December 17, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Dual therapy with an oral non-vitamin K antagonist and a P2Y12 inhibitor vs triple therapy with aspirin, a P2Y12 inhibitor and a vitamin K antagonist for the treatment of diabetes mellitus patients with co-existing atrial fibrillation following percutaneous coronary intervention: A meta-analysis
Conclusions: DT with a NOAC and a P2Y12 inhibitor was associated with significantly less bleeding events without increasing the adverse cardiovascular outcomes when compared to TT with aspirin, a P2Y12 inhibitor and a Vitamin K antagonist for the treatment of DM patients with co-existing AF following PCI. Hence, DT is comparable in efficacy, but safer compared to TT. This interesting hypothesis will have to be confirmed in future studies.
Source: Medicine - April 16, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Antithrombotic Management in Ischemic Stroke with Essential Thrombocythemia: Current Evidence and Dilemmas
Thrombotic diseases like ischemic stroke are common complications of essential thrombocythemia (ET) due to abnormal megakaryopoiesis and platelet dysfunction. Ischemic stroke in ET can occur as a result of both cerebral arterial and venous thrombosis. Management of ET is aimed at preventing vascular complications including thrombosis. Acute management of ischemic stroke in ET is the same as that in the general population without myeloproliferative disorder. However, an ET patient with ischemic stroke is at high risk for re-thrombosis and therefore additionally managed with cytoreductive therapy and antithrombotic agents. G...
Source: Medical Principles and Practice - April 12, 2021 Category: Internal Medicine Source Type: research

In acute ischemic stroke or TIA, adding ticagrelor to aspirin reduced stroke or death and increased severe bleeding.
Abstract SOURCE CITATION: Johnston SC, Amarenco P, Denison H, et al. Ticagrelor and aspirin or aspirin alone in acute ischemic stroke or TIA. N Engl J Med. 2020;383:207-17. 32668111. PMID: 33316187 [PubMed - in process]
Source: Annals of Internal Medicine - December 15, 2020 Category: Internal Medicine Authors: Hill MD Tags: Ann Intern Med Source Type: research

An investigation into the impact of enteric coated of aspirin in patients with newly diagnosed ischemic stroke (ECASIS)
Discussion: This trial will determine potential differences in the efficacy of EC Aspirin and plain Aspirin on the Thromboxane B2 level. Additionally, it will ascertain the tolerability and safety of both formulations of Aspirin in patients with newly diagnosed ischemic stroke. These results will either support the current notion of no difference between the two formulations. However, if a difference is found, this will invite for future trials exploring clinical outcomes occurrence between various formulations. Clinical trial registration: Clinicaltrials.gov NCT04330872 registered on April 2, 2020
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Dual Versus Triple Therapy for Atrial Fibrillation After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.
Conclusion: In adults with AF after PCI, dual therapy reduces risk for bleeding compared with triple therapy, whereas its effects on risks for death and ischemic end points are still unclear. Primary Funding Source: None. PMID: 32176890 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - March 16, 2020 Category: Internal Medicine Authors: Khan SU, Osman M, Khan MU, Khan MS, Zhao D, Mamas MA, Savji N, Al-Abdouh A, Hasan RK, Michos ED Tags: Ann Intern Med Source Type: research

Antithrombotic treatment in patients with atrial fibrillation undergoing coronary angioplasty: rational convincement and supporting evidence.
CONCLUSIONS: Our findings suggest that DT is safer than TT with regard to occurrence of major bleeding. DT with a direct oral anticoagulant plus clopidogrel at discharge could be effective in most patients, maintaining aspirin in periprocedural phase and as longer "tailored" treatment for patients at higher ischemic risk. PMID: 32063489 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - February 12, 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

r-tPA with loading dose of clopidogrel and aspirin therapies for capsular warning syndrome attributed to middle cerebral artery atherosclerotic stenosis: A CARE-compliant case report
Rationale: The capsular warning syndrome (CWS) is a rare and special type of transient ischemic attacks (TIAs) syndrome. The pathophysiology of CWS is very complicate, and intracranial atherosclerotic stenosis (ICAS) is rare cause. Moreover, the effective and standard therapy has not yet been established. Patient concerns: A 47-year-old man experienced repeated and exacerbated TIAs of right hemiparesis and dysarthria. Fourteen hours after the first episode of TIAs, he developed more severe right hemiparesis and dysarthria, the National Institute of Health Stroke Scale (NIHSS) score was 12 points, and did not recover i...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Aspirin vs. P2Y12 Inhibitor Rivalry: Which One Can be Continued During Gastrointestinal Bleeding.
Authors: Bestari MB, Joewono IR Abstract Dual antiplatelet therapy (DAPT) is the mainstay of secondary prevention treatment for acute coronary syndrome (ACS) and ischemic stroke, especially after coronary intervention. DAPT consists of aspirin and P2Y12 receptor inhibitor (e.g. clopidogrel), and the use of DAPT has been increased over time. The most serious and common adverse effect is gastrointestinal bleeding. Guidelines in managing such condition are available among Gastroenterologist Societies and Cardiologist Societies. Most guidelines are consistent with each other to continue the use of aspirin while withhol...
Source: Acta medica Indonesiana - November 9, 2019 Category: Internal Medicine Tags: Acta Med Indones Source Type: research

In embolic stroke of undetermined source, rivaroxaban vs aspirin did not reduce recurrence and increased bleeding.
PMID: 30242405 [PubMed - in process]
Source: Annals of Internal Medicine - September 18, 2018 Category: Internal Medicine Authors: Frieden RW Tags: Ann Intern Med Source Type: research

Efficacy and safety of CYP2C19 genotype in stroke or transient ischemic attack patients treated with clopidogrel monotherapy or clopidogrel plus aspirin: Protocol for a systemic review and meta-analysis
Conclusions: The results will bring about vigorous evidence in this issue and guide both clinical decision-making and future research.
Source: Medicine - June 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Over-the-counter analgesic powder use in patients presenting with intracerebral hemorrhage: A case series
Conclusions: Over-the-counter analgesic powders containing high doses of aspirin including BC Powder and Goody's Powder may contribute to ICH in patients with no or minimal risk factors. Providers should inquire about the use of these powders in ICH patients particularly among African Americans.
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Should This Patient Receive Aspirin?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2017 Dec 05;167(11):786-793 Authors: Burns RB, Graham K, Sawhney MS, Reynolds EE Abstract Aspirin exerts antiplatelet effects through irreversible inhibition of cyclooxygenase-1, whereas its anticancer effects may be due to inhibition of cyclooxygenase-2 and other pathways. In 2009, the U.S. Preventive Services Task Force endorsed aspirin for primary prevention of cardiovascular disease. However, aspirin's role in cancer prevention is still emerging, and no groups currently recommend its use for this purpose. To help physicians bala...
Source: Annals of Internal Medicine - December 5, 2017 Category: Internal Medicine Authors: Burns RB, Graham K, Sawhney MS, Reynolds EE Tags: Ann Intern Med Source Type: research

WATCHMAN device-related thrombus successfully treated with apixaban: A case report
Rationale: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. Patient concerns: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The effectiveness and safety of dual antiplatelet therapy in ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis in Chinese patients: A randomized and controlled trail
We examined the main endpoints including the recurrence of stroke, death from cardiovascular causes, and bleeding events. Results: In all, 200 patients were recruited and followed for 90 days. Ischemic stroke occurred in 6 patients (9.1%) treated with 50 mg clopidogrel and aspirin, 6 patients (9.1%) receiving 75 mg clopidogrel and aspirin, whereas 19 patients (27.9%) in the aspirin group (aspirin alone vs copidogrel 50 mg plus aspirin; 95% confidence intervals 1.704–23.779, P 
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research