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Total 64 results found since Jan 2013.

Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial
This study is registered with ClinicalTrials.gov, number NCT01959451, and EudraCT, 2013-001636-22. Findings Between Dec 2, 2013, and May 20, 2016, 2610 patients were assigned to study groups; 1304 to the guided de-escalation group and 1306 to the control group. The primary endpoint occurred in 95 patients (7%) in the guided de-escalation group and in 118 patients (9%) in the control group (pnon-inferiority=0·0004; hazard ratio [HR] 0·81 [95% CI 0·62–1·06], psuperiority=0·12). Despite early de-escalation, there was no increase in the combined risk of cardiovascular death, myocardial infarction, or stroke in the de-es...
Source: The Lancet - August 29, 2017 Category: General Medicine Source Type: research

High post-clopidogrel platelet reactivity assessed by a point-of-care assay predicts long-term clinical outcomes in patients with ST-segment elevation myocardial infarction who underwent primary coronary stenting
Abstract: Background: Recent studies have shown that post-clopidogrel high platelet reactivity (HPR), assessed by a point-of-care assay, is associated with a higher risk of adverse events after percutaneous coronary intervention (PCI). We assessed the clinical impact of HPR by the VerifyNow P2Y12 point-of-care assay in 181 patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary PCI with drug-eluting stents (DES) at 3 hospitals.Methods: The primary endpoint of the study was the 12-month major adverse cardiovascular events (MACE), which comprised cardiovascular death, nonfatal MI and ischemic s...
Source: International Journal of Cardiology - June 11, 2012 Category: Cardiology Authors: Han-Young Jin, Tae-Hyun Yang, Doo-Il Kim, Sang-Ryul Chung, Jeong-Sook Seo, Jae-Sik Jang, Dae-Kyeong Kim, Dong-Kie Kim, Ki-Hun Kim, Sang-Hoon Seol, Chang-Wook Nam, Seung-Ho Hur, Woong Kim, Jong-Seon Park, Young-Jo Kim, Dong-Soo Kim Tags: Original Articles Source Type: research

Switching from clopidogrel to prasugrel in patients having coronary stent implantation
Abstract There are very few clinical data concerning the safety of switching from clopidogrel to prasugrel in patients undergoing coronary stenting. However, in the daily activity, clinicians face the decision of switching patients at high-risk of thrombotic events from clopidogrel to prasugrel. Thus, we sought to evaluate clinical events in patients undergoing coronary stent implantation and prasugrel therapy with (SWITCH group) or without (NAÏVE group) prior clopidogrel therapy. A total of 454 patients with stable or unstable coronary artery disease, aged 70 ± 10 years, underwent non-emergent stent implant...
Source: Journal of Thrombosis and Thrombolysis - September 25, 2014 Category: Hematology Source Type: research

Ticagrelor: A Review of Its Use in Adults with Acute Coronary Syndromes
Abstract Ticagrelor (Brilique™, Brilinta®), a cyclopentyl-triazolopyrimidine, is an orally active, reversible, and selective adenosine diphosphate (ADP) receptor antagonist indicated for use in patients with acute coronary syndromes (ACS). Ticagrelor has a faster onset of action and provides greater inhibition of platelet aggregation than clopidogrel. In the large well-designed, PLATO study in adult patients with ACS, 12 months’ treatment with ticagrelor was more effective than clopidogrel in reducing the incidence of the primary composite endpoint of myocardial infarction, stroke, or cardiovascular (CV) dea...
Source: American Journal of Cardiovascular Drugs - February 12, 2015 Category: Cardiology Source Type: research

The Challenge of Getting it Just Right Optimizing Long-Term Antithrombotic Therapy After Acute Coronary Syndrome ∗
Acute coronary syndrome (ACS) is associated with substantial morbidity and mortality (1,2). Initial treatment in the hospital consists of intensive antithrombotic therapy combining parenteral anticoagulation with antiplatelet therapy, whereas secondary prevention relies primarily on dual antiplatelet therapy (DAPT), most commonly aspirin and clopidogrel. However, patients with ACS remain at significant risk of recurrent adverse cardiovascular events (3). Mitigation of this risk requires a delicate balance between escalation of antithrombotic therapy to reduce ischemic events, while hoping the increase in bleeding is tolera...
Source: Journal of the American College of Cardiology - August 10, 2015 Category: Cardiology Source Type: research

Dual antiplatelet therapy reduces stroke but increases bleeding at the time of carotid endarterectomy
This study examined the effect of preoperative dual antiplatelet therapy (aspirin and clopidogrel) on in-hospital CEA outcomes.
Source: Journal of Vascular Surgery - February 28, 2016 Category: Surgery Authors: Douglas W. Jones, Philip P. Goodney, Mark F. Conrad, Brian W. Nolan, Eva M. Rzucidlo, Richard J. Powell, Jack L. Cronenwett, David H. Stone Tags: Clinical paper Source Type: research

A randomised trial on platelet function-guided de-escalation of antiplatelet treatment in ACS patients undergoing PCI. Rationale and design of the Testing Responsiveness to Platelet Inhibition on chronic Antiplatelet Treatment for Acute Coronary Syndromes (TROPICAL-ACS) Trial.
ieber J, Mudra H, Hausleiter J, Huber K, Neumann FJ, Koltowski L, Huczek Z, Mehilli J, Massberg S, TROPICAL-ACS Investigators Abstract Outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) have been significantly improved with the use of potent P2Y12 receptor inhibitors like prasugrel. While most of the ischaemic risk reduction for prasugrel versus clopidogrel was demonstrated in the early treatment period, the risk of bleeding became particularly prominent during the chronic course of therapy. It may therefore be a valid approach to substitute prasugrel for clopido...
Source: Thrombosis and Haemostasis - September 21, 2016 Category: Hematology Authors: Sibbing D, Aradi D, Jacobshagen C, Gross L, Trenk D, Geisler T, Orban M, Gori T, Hadamitzky M, Merkely B, Kiss RG, Komócsi A, Dézsi CA, Thalmeier A, Löw A, Holdt L, Teupser D, Ince H, Felix SB, Parma R, Malek L, Horstkotte J, Baylacher M, Schwinger R, Tags: Thromb Haemost Source Type: research

Factors Associated With Initial Prasugrel Versus Clopidogrel Selection for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From the Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Coronary Heart Disease
We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE‐ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection. Prasugrel use rates and associated 1‐year risk‐adjusted major adverse cardiovascular events and Global Utilization of Streptokinase and t‐PA for Occluded Coronary Arteries (GUSTO) moderate/severe bleeding outcomes were also examined in relation to predicted mortality and bleeding using the validated Ac...
Source: JAHA:Journal of the American Heart Association - September 22, 2016 Category: Cardiology Authors: Vora, A. N., Peterson, E. D., McCoy, L. A., Effron, M. B., Anstrom, K. J., Faries, D. E., Zettler, M. E., Fonarow, G. C., Baker, B. A., Stone, G. W., Wang, T. Y. Tags: Acute Coronary Syndromes, Coronary Artery Disease Original Research Source Type: research

Platelet-related biomarkers and their response to inhibition with aspirin and p2y 12 -receptor antagonists in patients with acute coronary syndrome
AbstractThe PLATelet inhibition and patient Outcomes (PLATO) trial showed that treatment with ticagrelor reduced the rate of death due to vascular causes, myocardial infarction and stroke when compared to clopidogrel in patients with ST-elevation or non-ST-elevation acute coronary syndrome (ACS). While the comparative benefit of ticagrelor over clopidogrel increased over time, event rates accrued in both groups during the study period. The purpose of our biomarker-based exploratory analysis was to determine whether long-term platelet inhibition may be associated with plateletadaptation. A sample of 4000 participants from t...
Source: Journal of Thrombosis and Thrombolysis - June 12, 2017 Category: Hematology 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

Evaluation of platelet activity by multiple electrode impedance aggregometry in acute coronary syndromes: pilot study in a Brazilian tertiary-care public hospital.
This study suggested that the evaluation of PA in ACS using MEA may identify non-responders to ASA. Larger studies are necessary to define, in a public health scenario, the value of MEA in the management of ACS. PMID: 30652826 [PubMed - in process]
Source: Braz J Med Biol Res - January 10, 2019 Category: Research Authors: De Lorenzo A, Dutra M, Mattos MA, Rey HCV, Tibirica E Tags: Braz J Med Biol Res Source Type: research

Effectiveness of Only Aspirin or Clopidogrel Following Percutaneous Left Atrial Appendage Closure
Percutaneous left atrial appendage closure (LAAC) offers a feasible option for stroke prevention in patients with atrial fibrillation (AF), but the optimal antithrombotic treatment strategy for patients with strict contraindications to oral anticoagulation (OAC) remains uncertain. We sought to evaluate short- and long-term outcome after percutaneous LAAC in these very patients discharged on single antiplatelet therapy (SAPT) alone. All consenting AF patients who underwent LAAC from February 2009 to August 2018 in Turku University Hospital, Finland, were enrolled into a prospectively maintained registry.
Source: The American Journal of Cardiology - September 25, 2019 Category: Cardiology Authors: Jussi-Pekka Pouru, Samuli Jaakkola, Juha Lund, Fausto Biancari, Antti Saraste, K. E. Juhani Airaksinen Source Type: research

Effects of cigarette smoking on older chinese men treated with clopidogrel monotherapy or aspirin monotherapy: a prospective study.
Authors: Cai Y, Xu W, Liu H, Wang F, Duan L, Li H, Li M, Li Y, Han L, Xiao H Abstract We investigated the comparative effects of smoking status on outcomes in older Chinese men receiving aspirin or clopidogrel monotherapy. This was a prospective observational study of outcomes in 668 men aged ≥ 60 years undergoing annual health examination in the Chinese People's Liberation Army General Hospital from March-April 2017. All patients received regular treatment with aspirin or clopidogrel. Platelet aggregation and phenotyping for rs762551 were measured in all patients. We recorded all major adverse cardiovascular an...
Source: Platelets - September 28, 2019 Category: Hematology Tags: Platelets Source Type: research

Secondary prevention of acute coronary syndrome with antiplatelet agents in real life: a high-dimensional propensity score matched cohort study in the French National claims database
This study was done in a newly available large-scale claims database, which may differ from other population databases, by it size and exhaustiveness•The methods elaborate on standard high-dimensional propensity scores as adapted to this claims databaseGraphical abstract
Source: MethodsX - January 24, 2020 Category: Science Source Type: research

Benefits and Risks of Prolonged Duration Dual Antiplatelet Therapy (Clopidogrel and Aspirin) after Percutaneous Coronary Intervention in High-Risk Patients with Diabetes Mellitus
The efficacy and safety of prolonged (>1-year) dual antiplatelet therapy (DAPT) duration in high-risk patients with diabetes mellitus (DM) undergoing PCI remain unknown. All patients undergoing PCI at Fuwai hospital between January 2013 and December 2013 were prospectively enrolled into the Fuwai PCI registry. 3696 high-risk diabetics patients with at least one additional atherothrombotic risk factor were screened for inclusion. The primary efficacy outcome was the composite of all-cause mortality, myocardial infarction, or stroke.
Source: The American Journal of Cardiology - December 4, 2020 Category: Cardiology Authors: Hao-Yu Wang, Zhong-Xing Cai, Dong Yin, Yue-Jin Yang, Wei-Hua Song, Ke-Fei Dou Source Type: research