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Combination Therapy with Dipyridamole and Clopidogrel for Secondary Stroke Prevention in Aspirin-Intolerant Patients After Myocardial Infarction: Results of a Nationwide Case-Control Study
ConclusionNo differences were observed in the 12-year survival rate between clopidogrel and clopidogrel –dipyridamole groups. The two groups had balanced event-free survival in recurrent stroke, ICH, GI bleeding, and myocardial infarction.
Source: CNS Drugs - January 16, 2019 Category: Neurology Source Type: research

Advances in Antiplatelet and Anticoagulant Therapies for NSTE-ACS
AbstractThe treatment of patients requiring anticoagulation who develop acute coronary syndrome (ACS) and/or require percutaneous coronary intervention (PCI) must balance the reduction in major adverse cardiovascular events, stroke, and major bleeding. The development of direct oral anticoagulants (DOACs) for the treatment of atrial fibrillation has ushered in an era of potential treatment options for these complex patients.Purpose of ReviewTo review the clinical evidence underlying the use of DOACs for the treatment of patients with atrial fibrillation and ACS or PCI.Recent FindingsThree trials studied this particular pat...
Source: Current Cardiology Reports - January 12, 2019 Category: Cardiology Source Type: research

NHLBI-Sponsored Randomized Trial of Postconditioning During Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction.
CONCLUSIONS: We found no early benefit of PostC on infarct size, MSI and LV function compared to routine PCI. However, PostC was associated with improved LV remodeling at one year of follow-up, especially in subjects with MVO. PMID: 30602360 [PubMed - as supplied by publisher]
Source: Circulation Research - January 3, 2019 Category: Cardiology Authors: Traverse JH, Swingen C, Henry TD, Fox J, Wang Y, Chavez IJ, Lips DL, Lesser JR, Pedersen WR, Burke NM, Pai A, Lindberg JL, Garberich R Tags: Circ Res Source Type: research

Oral Anticoagulants With Dual Antiplatelet Therapy Versus Clopidogrel in Patients After Percutaneous Coronary Intervention: A Meta-Analysis
Conclusions: In patients who are on OAC with vitamin K antagonist and underwent percutaneous coronary intervention, no significant differences were found in mortality, ischemic, and hemorrhagic complications between the patients treated with TT and DT. Thus, tailored treatment based on individual thromboembolic and bleeding risk might be the most reasonable approach in these patients.
Source: American Journal of Therapeutics - December 29, 2018 Category: Drugs & Pharmacology Tags: Reviews Source Type: research

Predictors and prognosis of left ventricular thrombus in post-myocardial infarction patients with left ventricular dysfunction after percutaneous coronary intervention.
Conclusions: This study indicated that the presence of left ventricular aneurysm, incomplete revascularization, higher SYNTAX score and D-dimer level were the independent predictors of LVT formation in post-MI and LV dysfunction patients, which related to worse clinical outcomes. Future studies for early intervention and complete revascularization in high-risk subgroup patients are expected. PMID: 30233865 [PubMed]
Source: Journal of Thoracic Disease - September 21, 2018 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial
Publication date: Available online 25 August 2018Source: The LancetAuthor(s): Marco Valgimigli, Enrico Frigoli, Sergio Leonardi, Pascal Vranckx, Martina Rothenbühler, Matteo Tebaldi, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Paolo Rubartelli, Carlo Briguori, Giuseppe Andó, Maurizio Ferrario, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Marco Nazzaro, Alessandro Lupi, Bernardo CorteseSummaryBackgroundThe Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (MATRIX) programme was designed to assess the comparative safety and effectiveness of ra...
Source: The Lancet - August 25, 2018 Category: General Medicine Source Type: research

Antiplatelet Therapy in ACS Patients: Comparing Appropriate P2Y12 Inhibition by Clopidogrel to the Use of New P2Y12 Inhibitors.
CONCLUSION: In PCI-treated ACS patients, clopidogrel therapy and PRI VASP ＜61% were not associated with increased risks of thrombotic events compared to prasugrel or ticagrelor therapy. PMID: 29415954 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - February 10, 2018 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians? Focused on ACS or PCI-treated Patients.
Abstract With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, coronary artery disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials includin...
Source: Current Vascular Pharmacology - January 16, 2018 Category: Drugs & Pharmacology Authors: Bae JS, Ahn JH, Tantry U, Gurbel PA, Jeong YH Tags: Curr Vasc Pharmacol Source Type: research

Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Publication date: Available online 1 November 2017 Source:The Lancet Author(s): Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve Background Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The ai...
Source: The Lancet - November 2, 2017 Category: General Medicine Source Type: research

Prognostic value of glucose metabolism for non-ST-segment elevation infarction patients with diabetes mellitus and single concomitant chronic total occlusion following primary percutaneous coronary intervention
Abstract Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutan...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Alteplase for Acute Ischemic Stroke after Heparin Reversal with Protamine: A Case Report and Review
We describe the first reported case of a patient receiving full‐dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. A 73‐year‐old man presented with AIS. He was treated with IV heparin, tirofiban, loading‐dose prasugrel, and aspirin before percutaneous coronary intervention (PCI) for placement of a right coronary artery stent. One hour following PCI, he abruptly developed left hemiparesis and dysphagia. The National Institutes of Health Stroke Scale was 12, and activated partial thromboplastin time (aPTT) was longer than 150 seconds. Head computed tomography (CT) showed no acute patholog...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - September 4, 2017 Category: Drugs & Pharmacology Authors: Gabriel V. Fontaine, Shawn M. Smith Tags: Case Report Source Type: research

Alteplase for acute ischemic stroke after heparin reversal with protamine – a case report and review
ConclusionsGiven the lack of adverse events associated with IV alteplase in our patient, we advocate cautious evaluation for potential reversal of acutely administered anticoagulation to facilitate alteplase administration in severely disabled patients who are not eligible for mechanical intervention, and who would have been excluded from definitive AIS treatment.This article is protected by copyright. All rights reserved.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - July 25, 2017 Category: Drugs & Pharmacology Authors: Gabriel V. Fontaine, Shawn M. Smith Tags: Case Report Source Type: research

Effects of Smoking on Ischemic Stroke, Intracranial Hemorrhage, and Coronary Artery Events in Japanese Patients With Non-Valvular Atrial Fibrillation.
Authors: Suzuki S, Otsuka T, Sagara K, Semba H, Kano H, Matsuno S, Takai H, Kato Y, Uejima T, Oikawa Y, Nagashima K, Kirigaya H, Yajima J, Kunihara T, Sawada H, Aizawa T, Yamashita T Abstract The effects of smoking on the prognosis of non-valvular atrial fibrillation (NVAF) patients are unclear.The Shinken Database 2004-11 (n = 17,517) includes all new patients visiting the Cardiovascular Institute between June 2004 and March 2012. Among these cases, 2,102 NVAF patients were identified. The effects of smoking on ischemic stroke (IS), intracranial hemorrhage (ICH), and coronary artery events including percutaneous c...
Source: International Heart Journal - July 15, 2017 Category: Cardiology Tags: Int Heart J Source Type: research

Prevalence, Management, and Long-Term (6-Year) Outcomes of Atrial Fibrillation Among Patients Receiving Drug-Eluting Coronary Stents
Conclusions Among patients receiving DES implantation, AF was not rare and was associated with increased ischemic and bleeding risk. In patients with AF, triple therapy was not associated with decreased ischemic events but was associated with increased bleeding risk compared to DAPT.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 5, 2017 Category: Cardiology Authors: Choi, H.-I., Ahn, J.-M., Kang, S. H., Lee, P. H., Kang, S.-J., Lee, S.-W., Kim, Y.-H., Lee, C. W., Park, S.-W., Park, D.-W., Park, S.-J. Tags: Coronary Source Type: research

Myocardial Wall Rupture Following tPA Administration: A Case Report and Review of the Literature (P3.270)
Conclusions:Although the frequency of pericarditis, mural hemorrhage and subsequent myocardial rupture after MI is declining following PCI, clinicians should be mindful of this potential complication in tPA treated patients with recent MI. Further, cardiac wall rupture should be considered in patients who develop acute hypotension and bradycardia following tPA administration. The current literature is limited and insufficient to provide generalizable guidance on managing AIS patients with recent MI.Disclosure: Dr. Neu has nothing to disclose. Dr. Albright has nothing to disclose. Dr. Lyerly has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Neu, M., Albright, K., Lyerly, M. Tags: Cerebrovascular Disease Case Reports II Source Type: research

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