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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

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

The perioperative complications and short-term death in endovascular treatment for acute stroke induced by extracranial carotid occlusion: a systematic review and a meta-analysis
CONCLUSIONS: EVT can effectively improve neurological function and reduce 90-day mortality for acute extracranial carotid occlusion patients without increasing the risk of symptomatic intracranial hemorrhage. Endovascular therapy is safe to perform from 6 to 24 hours after symptom onset.PMID:33755964 | DOI:10.26355/eurrev_202103_25259
Source: European Review for Medical and Pharmacological Sciences - March 23, 2021 Category: Drugs & Pharmacology Authors: G-M Cao J Hu H-L Dong Source Type: research

Dual anti-platelet therapy following percutaneous coronary intervention in a population of patients with thrombocytopenia at baseline: a meta-analysis.
CONCLUSIONS: According to the results of this analysis, DAPT might have to be cautiously be used following PCI in a population of patients with thrombocytopenia at baseline due to the significantly higher bleeding rate including gastro-intestinal, intra-cranial bleeding and hemorrhagic stroke. Hence, special care might have to be taken when considering anti-platelet agents following PCI in these high risk patients. However, considering the present limitations of this analysis, this hypothesis will have to be confirmed in future trials. PMID: 32334636 [PubMed - as supplied by publisher]
Source: BMC Pharmacology and Toxicology - April 27, 2020 Category: Drugs & Pharmacology Tags: BMC Pharmacol Toxicol 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

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