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CYP2C19 loss-of-function alleles are not associated with clinical outcome of clopidogrel therapy in patients treated with newer-generation drug-eluting stents
Abstract: CYP2C19 loss-of-function (LOF) alleles adversely affect clinical outcome of clopidogrel therapy. Recent introduction of a newer-generation drug-eluting stent (DES) has significantly reduced the occurrence of stent thrombosis. The aim of this study was to evaluate the impact of CYP2C19 LOF alleles on clinical outcome in patients treated with the newer-generation DES. The effects of CYP2C19 genotypes were evaluated on clinical outcome of clopidogrel therapy in 2062 patients treated with percutaneous coronary intervention using either first-generation DES (sirolimus- and paclitaxel-eluting stent, n = 1349) or newe...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Impact of glycoprotein IIb/IIIa inhibitors on the efficacy and safety of ticagrelor compared with clopidogrel in patients with acute coronary syndromes: Analysis from the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Conclusions In patients with acute coronary syndrome undergoing early PCI, the efficacy and safety of ticagrelor as compared with clopidogrel were not modified by GPI use according to the primary efficacy and safety end point of the trial, although there were indications of greater benefit on definite stent thrombosis and more major or minor bleeding with ticagrelor in patients without (vs with) GPI treatment.
Source: American Heart Journal - May 7, 2016 Category: Cardiology Source Type: research

Impact of Glycoprotein IIb/IIIa Inhibitors on the Efficacy and Safety of Ticagrelor Compared to Clopidogrel in Patients with Acute Coronary Syndromes - Analysis from the PLATO (Platelet Inhibition and Patient Outcomes) Trial
Conclusions In patients with ACS undergoing early PCI the efficacy and safety of ticagrelor as compared with clopidogrel was not modified by GPI use according to the primary efficacy and safety endpoint of the trial, although there were indications of greater benefit on definite stent thrombosis and more major or minor bleeding with ticagrelor in patients without (vs. with) GPI treatment.
Source: American Heart Journal - April 13, 2016 Category: Cardiology Source Type: research

A Case of Transient Global Amnesia: A Review and How It May Shed Further Insight into the Neurobiology of Delusions
Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and the current situat...
Source: Innovations in Clinical Neuroscience - April 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research

Safety and efficacy of ticagrelor and clopidogrel in primary percutaneous coronary intervention
Conclusions In the subset of patients with STEMI treated with primary PCI, ticagrelor compared with clopidogrel was safe, and efficacy outcomes were consistent with the overall PLATO trial. Trial registration number NCT00391872; Results.
Source: Heart - March 22, 2016 Category: Cardiology Authors: Velders, M. A., Abtan, J., Angiolillo, D. J., Ardissino, D., Harrington, R. A., Hellkamp, A., Himmelmann, A., Husted, S., Katus, H. A., Meier, B., Schulte, P. J., Storey, R. F., Wallentin, L., Gabriel Steg, P., James, S. K., on behalf of the PLATO Investi Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Percutaneous intervention, Venous thromboembolism Coronary artery disease Source Type: research

Contemporary antiplatelet treatment in acute coronary syndrome patients undergoing percutaneous coronary intervention: One-year outcomes from the GReek AntiPlatelet Registry (GRAPE).
CONCLUSIONS: In real-word ACS/PCI patients, prasugrel offered better antiischemic protection than clopidogrel, while use of both novel agents is accompanied by more frequent bleeding events. This article is protected by copyright. All rights reserved. PMID: 26990959 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - March 16, 2016 Category: Hematology Authors: Alexopoulos D, Xanthopoulou I, Deftereos S, Hamilos M, Sitafidis G, Kanakakis I, Pentara I, Vavouranakis M, Davlouros P, Hahalis G, Goudevenos J Tags: J Thromb Haemost Source Type: research

Impact of Switching From Prasugrel to Clopidogrel Shortly After a Percutaneous Coronary Intervention Without a Loading Dose of Clopidogrel.
CONCLUSIONS: In this small, retrospective analysis, the results of loading patients with prasugrel for PCI and switching them to clopidogrel without a loading dose appear to be encouraging. PMID: 26378415 [PubMed - in process]
Source: The Journal of Invasive Cardiology - March 11, 2016 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Contemporary antiplatelet treatment in acute coronary syndrome patients undergoing percutaneous coronary intervention: One‐year outcomes from the GReek AntiPlatelet Registry (GRAPE)
ConclusionsIn real‐word ACS/PCI patients, prasugrel offered better antiischemic protection than clopidogrel, while use of both novel agents is accompanied by more frequent bleeding events.This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - March 1, 2016 Category: Hematology Authors: D. Alexopoulos, I. Xanthopoulou, S. Deftereos, M. Hamilos, G. Sitafidis, I. Kanakakis, I. Pentara, M. Vavouranakis, P. Davlouros, G. Hahalis, J. Goudevenos Tags: Original Article ‐ Cardiovascular Medicine 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

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

Percutaneous left atrial appendage occlusion: Device thrombosis in clopidogrel non-responders
Percutaneous left atrial appendage closure (LAAC) has been recently proposed as a safe and effective strategy to reduce the embolic stroke risk in patients with atrial fibrillation that are not amenable to long lasting oral anticoagulation [1]. After LACC, a temporary double anti-platelets regimen with aspirin and clopidogrel is suggested to prevent closure device thrombosis and enhance its endothelization [2]. Although clopidogrel resistance has been associated with recurrent cardiac events after percutaneous coronary intervention [3], no reports exist concerning the occurrence of LAAC device thrombosis in patients with c...
Source: International Journal of Cardiology - November 24, 2015 Category: Cardiology Authors: Ulrike Ketterer, Giuseppe D´ Ancona, Isabel Siegel, Jasmin Ortak, Hueseyin Ince, Stephan Kische Tags: Correspondence Source Type: research

Genetic and platelet function testing of antiplatelet therapy for percutaneous coronary intervention: the ARCTIC-GENE study
Conclusions The genetic clopidogrel profile was a good marker of platelet function response on clopidogrel but was not related to clinical outcome suggesting that the genetic added little to the pharmacodynamic information used in the study to adjust antiplatelet therapy. ClinicalTrials.gov: NCT00827411.
Source: European Journal of Clinical Pharmacology - October 23, 2015 Category: Drugs & Pharmacology Source Type: research

Duration of clopidogrel-based dual antiplatelet therapy and clinical outcomes after endeavor sprint zotarolimus-eluting stent implantation in patients presenting with acute coronary syndrome.
CONCLUSION: DAPT for >6months do not seem to be associated with improved clinical outcomes in patients with ACS undergoing percutaneous coronary intervention (PCI) with ZES. PMID: 26153337 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 4, 2015 Category: Internal Medicine Authors: Song PS, Hahn JY, Kim DI, Song YB, Choi SH, Choi JH, Ryu DR, Hur SH, Jeong JO, Park HS, Kim HS, Gwon HC Tags: Eur J Intern Med Source Type: research

Novel Oral P2Y12 Inhibitor Prasugrel vs. Clopidogrel in Patients with Acute Coronary Syndrome: Evidence Based on 6 Studies.
CONCLUSIONS Prasugrel has similar effects as clopidogrel in terms of all causes of death, MI, and stroke in ACS patients. For the patients who underwent PCI, prasugrel contributes to lower risk of stent thrombosis. However, prasugrel is associated with significantly higher risk of bleeding. For the patients with active pathological bleeding or a history of stroke and/or TIA, prasugrel should not be recommended. PMID: 25893318 [PubMed - in process]
Source: Medical Science Monitor - April 22, 2015 Category: Research Tags: Med Sci Monit Source Type: research

Current antiplatelet agents: place in therapy and role of genetic testing
Abstract Antiplatelet therapies play a central role in reducing the risk of cardiovascular events such as myocardial infarction and stroke. While aspirin, a cyclo-oxygenase-1 inhibitor has been the cornerstone of antithrombotic treatment for several decades, P2Y12 receptor inhibitors cangrelor, clopidogrel, prasugrel, and ticagrelor and protease-activated receptor-1 antagonist vorapaxar, have emerged as additional therapies to reduce the risk of recurrent cardiovascular events in high-risk patients. Recent clinical trials evaluating the role of these agents and major society guideline updates for use of antiplatel...
Source: Journal of Thrombosis and Thrombolysis - February 21, 2015 Category: Hematology Source Type: research

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