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The impact of renal function on platelet reactivity and clinical outcome in patients undergoing percutaneous coronary intervention with stenting.
In conclusion, the magnitude of platelet reactivity as well as the incidence of HPR was higher in patients with CKD. However, since the incidence of HPR was similar after adjustment, a higher rate of co-morbidities in patients with CKD might be the major cause for this observation rather than CKD itself. CKD-patients with HCPR were at the highest risk of long-term cardiovascular events. PMID: 25231776 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - September 18, 2014 Category: Hematology Authors: Breet NJ, de Jong C, Bos WJ, van Werkum JW, Bouman HJ, Kelder JC, Bergmeijer TO, Zijlstra F, Hackeng CM, Ten Berg JM Tags: Thromb Haemost Source Type: research

Triple Therapy for Atrial Fibrillation and Percutaneous Coronary Intervention A Contemporary Review
Chronic oral anticoagulant therapy is recommended (class I) in patients with mechanical heart valves and in patients with atrial fibrillation with a CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65 to 74 years, Sex category) score ≥1. When these patients undergo percutaneous coronary intervention with stenting, treatment with aspirin and a P2Y12 receptor inhibitor also becomes indicated. Before 2014, guidelines recommended the use of triple therapy (vitamin K antagonists, aspirin, and clopidog...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - September 15, 2014 Category: Cardiology Source Type: research

One‐Year Outcome of Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting: An Analysis of the AFCAS Registry
ConclusionsIn this large, real‐world population of AF patients undergoing PCI‐S, TT was the antithrombotic regimen most frequently prescribed. Although several limitations need to be acknowledged, in our study the 1‐year efficacy and safety of TT, dual antiplatelet therapy, and VKA plus clopidogrel was comparable.
Source: Clinical Cardiology - January 30, 2014 Category: Cardiology Authors: Andrea Rubboli, Axel Schlitt, Tuomas Kiviniemi, Fausto Biancari, Pasi P. Karjalainen, Josè Valencia, Mika Laine, Paulus Kirchhof, Matti Niemelä, Saila Vikman, Gregory Y. H. Lip, K. E. Juhani Airaksinen, Tags: Clinical Investigations Source Type: research

Oral Anticoagulation and Antiplatelets in Atrial Fibrillation Patients After Myocardial Infarction and Coronary Intervention
ConclusionsIn real-life AF patients with indication for multiple antithrombotic drugs after MI/PCI, OAC and clopidogrel was equal or better on both benefit and safety outcomes compared to triple therapy.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - September 3, 2013 Category: Radiology Source Type: research

Triple Therapy With Aspirin, Prasugrel, and Vitamin K Antagonists in Patients With Drug-Eluting Stent Implantation and an Indication for Oral Anticoagulation
This study sought to evaluate whether prasugrel may serve as an alternative to clopidogrel in patients with triple therapy.BackgroundApproximately 10% of patients who receive dual antiplatelet therapy after percutaneous coronary intervention have an indication for oral anticoagulation and are thus treated with triple therapy. The standard adenosine diphosphate receptor blocker in this setting is clopidogrel. Data regarding prasugrel as part of triple therapy are not available.MethodsWe analyzed a consecutive series of 377 patients who underwent drug-eluting stent implantation and had an indication for oral anticoagulation ...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 13, 2013 Category: Cardiology Source Type: research

Efficacy and safety of 12 versus 48 months of dual antiplatelet therapy after implantation of a drug-eluting stent: the OPTImal DUAL antiplatelet therapy (OPTIDUAL) trial: study protocol for a randomized controlled trial
DiscussionThis randomized trial is designed to assess the benefits and safety of 12 versus 48 months of dual antiplatelet therapy in patients that receive a DES. We aim to determine whether substantial prolongation of clopidogrel (a thienopyridine) after DES implantation offers an advantage over its discontinuation.Trial registration: ClinicalTrials.gov Identifier: NCT00822536
Source: Trials - February 21, 2013 Category: Journals (General) Authors: Gérard HelftClaude Le FeuvreJean GeorgesDidier CarrieFlorence LeclercqHélène EltchaninoffAlain FurberFabrice PrunierLaurent SebaghSimon CattanGuillaume CaylaEric VicautJean-Philippe Metzger Source Type: research

RCT: Clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention (WOEST)
Source: Lancet Area: News If percutaneous coronary intervention (PCI) is required in patients taking oral anticoagulants, double antiplatelet therapy with aspirin and clopidogrel is indicated. However, such triple therapy increases the risk of serious bleeding and this treatment strategy has not been tested prospectively.   Omission of oral anticoagulants could lead to an increased risk of thrombotic stroke, whereas clopidogrel is essential to prevent stent thrombosis. The exclusion of aspirin might, therefore, be useful to reduce the bleeding risk in patients with coronary artery disease.   The open-lab...
Source: NeLM - News - February 13, 2013 Category: Drugs & Pharmacology Source Type: news

Impact of clopidogrel and potent P2Y 12 -inhibitors on mortality and stroke in patients with acute coronary syndrome or undergoing percutaneous coronary intervention. A systematic review and meta-analysis.
Abstract Administration of a P2Y 12 -receptor antagonist in addition to aspirin is mandatory in patients with acute coronary syndromes (ACS) or undergoing percutaneous coronary intervention (PCI) to reduce the occurrence of thrombotic events; however, their impact on mortality and stroke is unclear. We aimed to evaluate the influence of moderate (clopidogrel) or potent (prasugrel/ticagrelor) P2Y 12 -receptor inhibition on major cardiovascular outcomes among patients with ACS or undergoing PCI. Systematic literature search was performed to find randomised, controlled clinical trials comparing the clinical impact o...
Source: Thrombosis and Haemostasis - January 8, 2013 Category: Hematology Authors: Aradi D, Komócsi A, Vorobcsuk A, Serebruany VL Tags: Thromb Haemost Source Type: research

Rationale and Design of the On‐Treatment PLAtelet Reactivity‐Guided Therapy Modification FOR ST‐Segment Elevation Myocardial Infarction (PLATFORM) Randomized Trial
ConclusionPLATFORM will determine whether the platelet reactivity‐guided use of ticagrelor in combination with 200 mg aspirin, compared with standard antiplatelet regimen, improves clinical outcome in moderate to high‐risk STEMI patients undergoing PPCI. Clinical Trial RegistrationU.S. National Institutes of Health (NIH) at www.clinicaltrials.gov. ClinicalTrials.gov Identifier: NCT01739556, and Current Controlled Trials at www.controlledtrials.com. International Standard Randomized Controlled Trial Number ISRCTN83081599.
Source: Journal of Interventional Cardiology - December 1, 2012 Category: Cardiology Authors: IGOR MRDOVIC, LIDIJA SAVIC, GORDANA KRLJANAC, MILIKA ASANIN, NATASA CVETINOVIC, NATASA BRDAR, MILENA STOJANOVIC, NEMANJA DJURICIC, SANJA STANKOVIC, JELENA MARINKOVIC, JOVAN PERUNICIC Tags: Randomized Trial Source Type: research

Dual non-responsiveness to antiplatelet treatment is a stronger predictor of cardiac adverse events than isolated non-responsiveness to clopidogrel or aspirin
Conclusions: Dual low responsiveness to clopidogrel and aspirin is a strong predictor of cardiac adverse events, especially in patients with diabetes mellitus, which underlines the need for personalized antiplatelet treatment.
Source: International Journal of Cardiology - February 3, 2012 Category: Cardiology Authors: Jolanta M. Siller-Matula, Georg Delle-Karth, Günter Christ, Thomas Neunteufl, Gerald Maurer, Kurt Huber, Alexander Tolios, Christa Drucker, Bernd Jilma Tags: Original Articles Source Type: research

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