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Antiplatelet therapy in Takotsubo cardiomyopathy: does it improve cardiovascular outcomes during index event?
Abstract Plasma catecholamines may play an important role in Takotsubo cardiomyopathy (TCM) pathophysiology. Patients with disproportionately high catecholamine responses to stressful events are prone to worse clinical outcomes. Catecholamines stimulate platelet activation and, therefore, may determine the clinical presentation and outcomes of TCM. We conducted a retrospective, descriptive study TCM patients admitted between 2003 and 2013 to Einstein Medical Center, Philadelphia, PA, USA and Danbury Hospital, Danbury, CT, USA. A total of 206 patients met Modified Mayo TCM criteria. Using a multiple logistic model,...
Source: Heart and Vessels - August 13, 2015 Category: Cardiology Source Type: research

Better than Aspirin for Your Heart
If you’ve been diagnosed with heart disease, the chances are you’ve been told to take low-dose aspirin every day as a preventative measure against heart attack and stroke. It’s most commonly prescribed for patients with congestive heart failure. This is the inability of your heart to pump as much blood as your body needs. And this is a big worry to me, because there is very little evidence that aspirin helps. In fact, regular use of aspirin — even baby aspirin — can do you more harm than good. Common Aspirin Beliefs The idea is that aspirin thins the blood, making it easier to pump.  It is also s...
Source: Al Sears, MD Natural Remedies - April 1, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Heart Health Source Type: news

Impact of Chronic Nitrate Therapy in Patients With Ischemic Heart Failure
Conclusion: Long-term nitrates use in patients with ischemic HF was associated with higher occurrence of ischemic events, defined as fatal or nonfatal myocardial infarction or stroke. Our results, although from a retrospective analysis, do not support a role for chronic nitrate use in HF.
Source: Journal of Cardiovascular Pharmacology and Therapeutics - August 4, 2016 Category: Cardiology Authors: Moreira-Silva, S., Urbano, J., Nogueira-Silva, L., Bettencourt, P., Pimenta, J. Tags: Clinical Study Source Type: research

Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm.
CONCLUSIONS: There is evidence from RCTs to suggest that neither oral anticoagulation with warfarin or platelet inhibition with aspirin is better for mortality in systolic heart failure with sinus rhythm (high quality of the evidence for all-cause mortality and moderate quality of the evidence for non-fatal cardiovascular events and major bleeding events). Treatment with warfarin was associated with a 20% reduction in non-fatal cardiovascular events but a twofold higher risk of major bleeding complications (high quality of the evidence). We saw a similar pattern of results for the warfarin versus clopidogrel comparison (lo...
Source: Cochrane Database of Systematic Reviews - September 14, 2016 Category: Journals (General) Authors: Shantsila E, Lip GY Tags: Cochrane Database Syst Rev Source Type: research

Risk factors for the primary effectiveness endpoint in secondary prevention of acute coronary syndrome with antiplatelet agents: A cohort in the nationwide French claims and hospitalisation database
Conclusions In this nationwide real-life study, the risk factor most associated with the primary effectiveness endpoint was a Charlson comorbidity index>5.
Source: Archives of Cardiovascular Diseases Supplements - January 5, 2018 Category: Cardiology Source Type: research

The association of clopidogrel and 2-oxo-clopidogrel plasma levels and the 40  months clinical outcome after primary PCI
Conclusion Clopidogrel dose-adjusted plasma concentration in STEMI patients, as well as multivessel coronary artery disease, showed significance in predicting an unfavorable composite clinical outcome after 40-month follow-up.
Source: International Journal of Clinical Pharmacy - October 26, 2018 Category: Drugs & Pharmacology Source Type: research

The association between clopidogrel and 2-oxo-clopidogrel plasma levels and the long-term clinical outcome after acute myocardial infarction 
.
CONCLUSION: In patients with acute MI treated with PCI, lower dose-adjusted clopidogrel and dose-adjusted 2-oxo-clopidogrel plasma concentrations were associated with an increased risk of ischemic events.
. PMID: 30431425 [PubMed - as supplied by publisher]
Source: International Journal of Clinical Pharmacology and Therapeutics - November 17, 2018 Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

Thromboprophylaxis in heart failure patients with sinus rhythm: aspirin and warfarin lead to similar cardiovascular outcomes
Commentary on: Homma S, Thompson JL, Pullicino PM, et al.. WARCEF Investigators. Warfarin and aspirin in patients with heart failure and sinus rhythm. N Engl J Med 2012;366:1859–69. Context Chronic heart failure (CHF) is common, affecting 1–2% of the population and 10% of people >70 years. Patients with CHF have an increased risk of thromboembolism. Those with atrial fibrillation (AF) should receive warfarin but whether CHF patients with sinus rhythm (SR), whose risk is 1.5–3.5%,1 should receive thromboprophylaxis is unclear. Previous studies, Warfarin/Aspirin Study in Heart failure (warfarin, asp...
Source: Evidence-Based Medicine - March 19, 2013 Category: Internal Medicine Authors: Witte, K. K. A., Jamil, H. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes, Arrhythmias Therapeutics Source Type: research

Who might benefit from early aspirin after coronary artery surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Early postoperative aspirin administered within 6 h following coronary artery bypass grafting (CABG) has been show...
Source: Interactive CardioVascular and Thoracic Surgery - August 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Gukop, P., Gutman, N., Bilkhu, R., Karapanagiotidis, G. T. Tags: Cardiac - physiology, Education, Congestive Heart Failure, Molecular biology Adult Cardiac Source Type: research

Optimal- vs. standard-antiplatelet therapy on platelet function and long-term clinical outcomes in patients with high on-treatment platelet reactivity: 2-year outcomes of the multicentre, randomized Optimal-antiPlatelet Therapy (OPT) trial
Optimal strategy for the management of high on-treatment platelet reactivity (HPR), an independent predictor of ischaemic events, is not yet clear. The aim of this study was to explore the safety and efficacy of personalized antiplatelet therapy based on platelet function testing in patients with HPR. A total of 840 patients with HPR who underwent coronary stenting for acute coronary syndrome (ACS) were randomly assigned in a 1:2 ratio to receive standard dual-antiplatelet therapy (n = 280) or platelet function-guided optimal-antiplatelet therapy (n = 560). In the optimal group, patients initially received clopidogrel 150 ...
Source: European Journal of Heart Failure Supplements - March 23, 2015 Category: Cardiology Authors: Li, Y., Han, Y., Guan, S., Sun, Y., Guo, L., Yang, B., Zang, H., Jing, Q., Wang, X., Ma, Y., Liu, X., Li, J., Zheng, L. Tags: Articles Source Type: research

Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2)
Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications.
Source: BMJ Open - December 15, 2015 Category: Journals (General) Authors: Kassaian, S. E., Masoudkabir, F., Sezavar, H., Mohammadi, M., Pourmoghaddas, A., Kojouri, J., Ghaffari, S., Sanaati, H., Alaeddini, F., Pourmirza, B., Mir, E., on-behalf of the IPACE2 registry investigators Tags: Open access, Cardiovascular medicine, Evidence based practice, Medical management Research Source Type: research

Current Use of Oral Anticoagulants and Prognostic Analysis in Patients with Atrial Fibrillation Undergoing Coronary Stenting.
CONCLUSIONS: In real-life AF patients undergoing coronary stenting, guideline-recommended VKA was less used. AF patients had adjusted worse prognosis during 12-month follow-up after discharge. It is of utmost importance to improve the current status of oral anticoagulants use. PMID: 28584203 [PubMed - in process]
Source: Chinese Medical Journal - June 7, 2017 Category: General Medicine Authors: Zhai HB, Liu J, Dong ZC, Wang DX, Zhang B Tags: Chin Med J (Engl) Source Type: research

Temporal changes in treatments and outcomes after acute myocardial infarction among cancer survivors and patients without cancer, 1995 to 2013
CONCLUSIONSAmong CS and NCP with AMI in Ontario, similar improvements in mortality and receipt of treatments were observed between 1995 and 2013. However, compared with NCP, CS had a higher risk of mortality and heart failure. Cancer 2017. © 2017 American Cancer Society.
Source: Cancer - December 6, 2017 Category: Cancer & Oncology Authors: Inna Y. Gong, Andrew T. Yan, Dennis T. Ko, Craig C. Earle, Winson Y. Cheung, Stuart Peacock, Marlous Hall, Chris P. Gale, Kelvin K. W. Chan Tags: Original Article Source Type: research

Relationship between Physical Inactivity and Long-term Outcome in Patients Aged ≥80 Years with Acute Coronary Syndrome
In this study, we aimed to investigate association between physical inactivity and allcause mortality in octogenarian patients with ACS. In this study, we included a total of 353 hospitalized patients, aged>80 years, with ACS during the period of 5-year follow-up. The association between physical inactivity and all-cause mortality was analyzed by multivariable Cox aggression. Of the enrolled patients, 132 (37.4%) were defined as physically inactive, and 221 (62.6%) as physically active. Patients with physical inactivity tended to have lower survival rate (21.2% vs. 56.5%,P<0.001) and higher mortality rate (78.8% vs. ...
Source: Journal of Huazhong University of Science and Technology -- Medical Sciences -- - February 1, 2018 Category: Research Source Type: research

Management of Antiplatelet Therapy During Continuous-Flow Left Ventricular Assist Device Support After Thrombotic Hemorrhagic Events
Hemorrhagic or thrombotic events are common complications in heart failure patients with continuous-flow left ventricular assist device (CF-LVAD) support. Aim of this study is to investigate the effect of change in antiplatelet therapy after thrombotic or hemorrhagic events in patients with CF-LVAD support. A total of 231 CF-LVAD patients were included in this study. Patients with CF-LVAD were categorized into three groups: (1) high antiplatelet regimen as control group (aspirin [ASA] 325 mg; n = 115), (2) low antiplatelet regimen (ASA 81 mg; n = 82), started after hemorrhagic complications, and (3) double antiplatelet...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

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