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Total 391 results found since Jan 2013.

Beyond Stroke Prevention in Atrial Fibrillation: Exploring Further Unmet Needs with Rivaroxaban.
This article provides an update on three randomized controlled trials of rivaroxaban, a direct, oral factor Xa inhibitor, that are complete or are ongoing, in these unmet areas of stroke prevention: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in patients with Atrial Fibrillation who undergo Percutaneous Coronary Intervention (PIONEER AF-PCI) trial; the New Approach riVaroxaban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE E...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Gibson CM, Hankey GJ, Nafee T, Welsh RC Tags: Thromb Haemost Source Type: research

Glycoprotein IIb-IIIa inhibitors for acute ischaemic stroke.
CONCLUSIONS: The available trial evidence showed that, for individuals with acute ischaemic stroke, GP IIb-IIIa inhibitors are associated with a significant risk of intracranial haemorrhage with no evidence of any reduction in death or disability in survivors. These data do not support their routine use in clinical practice. The conclusion is driven by trials of Abciximab, which contributed 89% of the total number of study participants considered. PMID: 24609741 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 8, 2014 Category: Journals (General) Authors: Ciccone A, Motto C, Abraha I, Cozzolino F, Santilli I Tags: Cochrane Database Syst Rev Source Type: research

Risk of Stroke in Patients With High On-Clopidogrel Platelet Reactivity to Adenosine Diphosphate After Percutaneous Coronary Intervention
In conclusion, in patients with coronary artery disease undergoing PCI, the presence of HPR to adenosine diphosphate is a risk factor for stroke.
Source: The American Journal of Cardiology - March 17, 2014 Category: Cardiology Authors: Nevio Taglieri, Maria Letizia Bacchi Reggiani, Tullio Palmerini, Gabriele Ghetti, Francesco Saia, Pamela Gallo, Carolina Moretti, Gianni Dall'Ara, Cinzia Marrozzini, Antonio Marzocchi, Claudio Rapezzi Tags: Coronary Artery Disease Source Type: research

Dual antiplatelet therapy after noncardioembolic ischemic stroke or transient ischemic attack: pros and cons.
Authors: Hong KS Abstract Dual antiplatelet therapy simultaneously blocks different platelet activation pathways and might thus be more potent at inhibiting platelet activation and more effective at reducing major ischemic vascular events compared to antiplatelet monotherapy. Aspirin plus clopidogrel dual therapy is now the standard therapy for patients with acute coronary syndrome and for those undergoing percutaneous coronary intervention. However, dual antiplatelet therapy carries an increased risk of bleeding. Patients with ischemic stroke or transient ischemic attack (TIA) are generally older and likely to hav...
Source: Journal of Clinical Neurology - December 2, 2014 Category: Neurology Tags: J Clin Neurol Source Type: research

Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome
Conclusions The primary and secondary end points were not enhanced in patients undergoing PCI. Therefore PCI is safe in patients with stroke/TIA and concomitant ACS.
Source: Clinical Research in Cardiology - October 29, 2015 Category: Cardiology Source Type: research

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

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

Relationship of stroke and bleeding risk profiles to efficacy and safety of dabigatran dual therapy versus warfarin triple therapy in atrial fibrillation after PCI: An ancillary analysis from the RE-DUAL PCI trial
ConclusionDabigatran dual therapy reduced bleeding events irrespective of bleeding risk category and demonstrated similar efficacy regardless of stroke risk category when compared with warfarin triple therapy.
Source: American Heart Journal - March 4, 2019 Category: Cardiology Source Type: research

CYP2C19 Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study Genetics
Conclusions There were significant differences in recurrent stroke by CYP2C19 genotype-inferred metabolizer status in white subcortical stroke patients receiving dual antiplatelet therapy with aspirin and clopidogrel, consistent with cardiovascular studies on CYP2C19 and clopidogrel; however, the bleeding risk that led to early termination of the antiplatelet arm of the SPS3 trial does not appear to be explained by CYP2C19 genotype. This study was relatively underpowered; therefore, these findings should be interpreted with caution and warrant replication. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique id...
Source: JAHA:Journal of the American Heart Association - May 27, 2015 Category: Cardiology Authors: McDonough, C. W., McClure, L. A., Mitchell, B. D., Gong, Y., Horenstein, R. B., Lewis, J. P., Field, T. S., Talbert, R. L., Benavente, O. R., Johnson, J. A., Shuldiner, A. R. Tags: Genetics Source Type: research

Assessment of Ticagrelor Versus Clopidogrel Treatment in Patients With ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Conclusions: Among patients with STEMI undergoing PPCI, ticagrelor reduces the incidence of MACCE and the composite end point of cardiovascular death, nonfatal MI, and stroke compared with clopidogrel. Ticagrelor also reduces the need for GPIIb/IIIa inhibitors. However, no significant difference was observed in the risk of bleeding between the 2 groups.
Source: Journal of Cardiovascular Pharmacology - August 1, 2016 Category: Cardiology Tags: Original Article Source Type: research

Comparative efficacy and safety of antiplatelet or anticoagulant therapy in patients with chronic coronary syndromes after percutaneous coronary intervention: A network meta-analysis of randomized controlled trials
Aimed to evaluate and compare the interactive effects of different antiplatelet or anticoagulation strategies in patients with chronic coronary syndromes (CCS) after percutaneous coronary intervention (PCI). Randomized controlled trials comparing different antiplatelet or anticoagulant strategies in patients with CCS after PCI were included. The primary outcomes were major adverse cardiovascular event (MACE), mortality, ischemic and bleeding events. Compared to aspirin alone, addition of prasugrel or ticagrelor to aspirin resulted in lower risk of myocardial infarction (MI) [odds ratio (OR): 0.38 (95% confidence interval 0...
Source: Frontiers in Pharmacology - September 30, 2022 Category: Drugs & Pharmacology Source Type: research

Frequency and Practice-Level Variation in Inappropriate and Nonrecommended Prasugrel Prescribing Insights From the NCDR PINNACLE Registry
Prasugrel significantly decreased cardiovascular death, myocardial infarction (MI), and stroke compared with clopidogrel in TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel—Thrombolysis in Myocardial Infarction 38) (1). However, prasugrel use was associated with increased bleeding in patients with a history of previous stroke or transient ischemic attack (TIA) and was not associated with benefit in those ≥75 years of age. The prasugrel package insert (2) includes a black box warning for patients with previous stroke/TIA and also recommends against it...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 23, 2014 Category: Cardiology 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

Antithrombotic therapy after percutaneous coronary intervention in patients requiring oral anticoagulant treatment : A meta-analysis.
CONCLUSION: Our analysis found no statistically significant difference between TT and DT with regard to all-cause death and MACE/stroke risk. At the same time, the available data demonstrated that TT increased the risk of major bleeding. If the international normalized ratio is in the target range, the risk of bleeding may be lowered. The data from Asian countries were limited, and therefore we could not assess the difference between TT and DT in Asian populations. Finally,on the basis of our analysis, we do not recommend TT as conventional treatment for patients taking OACs and undergoing percutaneous coronary interventio...
Source: Herz - July 3, 2015 Category: Cardiology Tags: Herz Source Type: research

Clopidogrel Versus Aspirin for the Treatment of Acute Coronary Syndrome After a 12-Month Dual Antiplatelet Therapy: A Cost-effectiveness Analysis From China Payer's Perspective.
Abstract PURPOSE: Monotherapy with either aspirin or clopidogrel is recommended for long-term use after discontinuation of dual-antiplatelet therapy (DAPT) for acute coronary syndrome (ACS) management after percutaneous coronary intervention (PCI). The present study is to evaluate the cost-effectiveness of clopidogrel versus aspirin after 12-month DAPT for patients with ACS who underwent PCI in China. METHODS: A 2-part model was developed to estimate the cost-effectiveness of clopidogrel compared with aspirin. The short-term part was a decision tree that included health states such as myocardial infarction (M...
Source: Clinical Therapeutics - November 20, 2018 Category: Drugs & Pharmacology Authors: Zhang L, Lin Z, Yin H, Liu J, Xuan J Tags: Clin Ther Source Type: research