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Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Influence of CYP2C19 genotype on antiplatelet treatment outcomes after percutaneous coronary intervention in patients with coronary heart disease.
Authors: Yu D, Ma L, Zhou J, Li L, Yan W, Yu X Abstract The aim of the study was to compare the clinical efficacy and safety of ticagrelor and clopidogrel in patients with coronary heart disease one year after percutaneous coronary intervention (PCI), and to explore their association with the CYP2C19 gene polymorphism. A total of 971 patients with coronary heart disease who were hospitalized and underwent PCI from April 2016 to May 2017 were studied. All 971 patients were divided into three subgroups according to CYP2C19 gene types as fast metabolizing, slow metabolizing and very slow metabolizing type. Patients we...
Source: Experimental and Therapeutic Medicine - April 10, 2020 Category: General Medicine Tags: Exp Ther Med Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Antithrombotic therapy in patients with combined coronary heart disease and atrial fibrillation.
CONCLUSION: In each clinical scenario, the risks of coronary artery or stent thrombosis in CHD and risks of stroke in AF need to be carefully balanced against the risks of bleeding. We make recommendations for management based on the evidence which is available at this time and indicate the many gaps which are currently being addressed by randomised clinical trials. PMID: 26658287 [PubMed - as supplied by publisher]
Source: Panminerva Medica - December 15, 2015 Category: Journals (General) Tags: Panminerva Med Source Type: research

Is clopidogrel better than aspirin following breakthrough strokes while on aspirin? A retrospective cohort study
Conclusions Among patients with an ischaemic stroke while taking aspirin, clopidogrel initiation was associated with fewer recurrent vascular events than aspirin reinitiation.
Source: BMJ Open - December 2, 2014 Category: Journals (General) Authors: Lee, M., Wu, Y.-L., Saver, J. L., Lee, H.-C., Lee, J.-D., Chang, K.-C., Wu, C.-Y., Lee, T.-H., Wang, H.-H., Rao, N. M., Ovbiagele, B. Tags: Open access, Cardiovascular medicine, Epidemiology, Neurology Research Source Type: research

Novel oral anticoagulants: too good to be true?
It is fair to say that the pharmacological therapy of cardiovascular disease has not been an area of spectacular growth in recent years. Little has happened in the treatment of hypertension and heart failure. There has been interest in the development of antiplatelet drugs in acute coronary syndromes and percutaneous interventions, but not in long-term cardiovascular prevention to compete with aspirin and clopidogrel. The one major area of intense interest has been the novel oral anticoagulants (NOACs), dabigatran, rivaroxaban and apixaban. The first of these is a direct thrombin inhibitor, while the other two are blockers...
Source: Postgraduate Medical Journal - August 18, 2014 Category: Journals (General) Authors: Schachter, M. Tags: Editor's choice, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Arrhythmias Editorials Source Type: research