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Condition: Bleeding
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Total 422 results found since Jan 2013.

Antiplatelet treatment in diabetic patients with acute coronary syndrome undergoing percutaneous coronary intervention: a GReek AntiPlatElet registry substudy
Conclusion In ‘real-life’ ACS undergoing PCI, diabetic patients have higher – although not significantly – MACE rate and no difference in bleeding events. This difference in MACE was significant among clopidogrel-treated patients, whereas when newer antiplatelet agents were used the negative impact of DM on ischemic events was eliminated.
Source: Coronary Artery Disease - January 1, 2018 Category: Cardiology Tags: Original Research Source Type: research

Cryptogenic acute limb ischemia: a retrospective cohort study defining a previously undescribed clinical entity
AbstractAcute limb ischemia (ALI) is generally secondary to cardioembolism or progression of peripheral vascular disease, however, a discrete population of patients with ALI exists in which no precipitant is ever established. Unlike cryptogenic arterial occlusion in other arenas, such as cryptogenic stroke, cryptogenic acute limb ischemia (cALI) has not been well-described, and no routine management has been established. The aim of this study is to describe patients with cALI, and the risk of recurrence based on the treatment they received. We performed a retrospective cohort study of patients evaluated for ALI at a single...
Source: Journal of Thrombosis and Thrombolysis - January 22, 2018 Category: Hematology Source Type: research

Randomized Comparisons of Double-Dose Clopidogrel or Adjunctive Cilostazol versus Standard Dual Anti-platelet in Patients with High Post-Treatment Platelet Reactivity: Results of the CREATIVE Trial (Clopidogrel Response Evaluation and AnTi-platelet InterVEntion in High Thrombotic Risk PCI Patients).
Conclusions -In patients with low responsiveness to clopidogrel, as measured by thromboelastography, the intensified antiplatelet strategies with adjunctive use of cilostazol significantly improved the clinical outcomes without increasing the risk of major bleeding. Decreased trend of negative outcomes could be observed in patients with double dosage of clopidogrel, but the difference was not significant. Clinical Trial Registration -URL: http://www.clinicaltrials.gov Unique Identifier: NCT01779401. PMID: 29420189 [PubMed - as supplied by publisher]
Source: Circulation - February 2, 2018 Category: Cardiology Authors: Tang YD, Wang W, Yang M, Zhang K, Chen J, Qiao S, Yan H, Wu Y, Huang X, Xu B, Gao R, Yang Y, CREATIVE investigators Tags: Circulation Source Type: research

A Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients with Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization.
Conclusions -The present study in elderly ACS patients showed no difference in the primary endpoint between reduced-dose prasugrel and standard-dose clopidogrel. However, the study should be interpreted in the light of premature termination of the trial. Clinical Trial Registration -URL: https://clinicaltrials.gov/ Unique Identifier: NCT01777503. PMID: 29459361 [PubMed - as supplied by publisher]
Source: Circulation - February 19, 2018 Category: Cardiology Authors: Savonitto S, Ferri LA, Piatti L, Grosseto D, Piovaccari G, Morici N, Bossi I, Sganzerla P, Tortorella G, Cacucci M, Ferrario M, Murena E, Sibilio G, Tondi S, Toso A, Bongioanni S, Ravera A, Corrada E, Mariani M, Di Ascenzo L, Petronio AS, Cavallini C, Vit Tags: Circulation Source Type: research

Quality of direct oral anticoagulant prescribing in elderly patients with non-valvular atrial fibrillation: results from a large urban health system
AbstractNon-valvular atrial fibrillation (NVAF) is common in older adults. Oral anticoagulation is indicated to reduce the risk of stroke and systemic embolism, but it also poses a risk of bleeding, particularly in the elderly. Direct oral anticoagulants (DOACs) provide an alternative to warfarin and their use in the treatment of AF is growing. We conducted a retrospective cohort study to assess the quality of DOAC prescribing in elderly patients with NVAF in a large academic health system and to compare practice with consensus best practice recommendations. We searched the electronic medical record for patients  ≥ 6...
Source: Journal of Thrombosis and Thrombolysis - April 2, 2018 Category: Hematology Source Type: research

Dual Antithrombotic Therapy with Clopidogrel and Novel Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Real-world Study
ConclusionsIn this long-term study of high-risk and real-world AF-patients with PCI, DT with NOAC and P2Y12 inhibitor (6  months) followed by NOAC monotherapy was safe and effective.
Source: Cardiology and Therapy - April 9, 2018 Category: Cardiology Source Type: research

In-Hospital Bleeding and Utility of a Maintenance Dose of Prasugrel 2.5 mg in High Bleeding Risk Patients With Acute Coronary Syndrome.
CONCLUSIONS: The maintenance dose of adjusted prasugrel 2.5 mg/day seems to be one option in ACS patients at high bleeding risk. PMID: 29695656 [PubMed - as supplied by publisher]
Source: Circulation Journal - April 26, 2018 Category: Cardiology Authors: Ohya M, Shimada T, Osakada K, Kuwayama A, Miura K, Murai R, Amano H, Kubo S, Otsuru S, Habara S, Tada T, Tanaka H, Fuku Y, Katoh H, Goto T, Kadota K Tags: Circ J Source Type: research

Safety of Percutaneous Coronary Intervention Without P2Y12 Inhibitor Pretreatment From a Cohort of Unselected Patients.
CONCLUSIONS: In an unselected population admitted for elective PCI or NSTEMI in real-world clinical practice, administration of a P2Y12 inhibitor only after coronary angiography is associated with a low rate of ischemic and bleeding events at 30 days. PMID: 30012889 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - July 18, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Ticagrelor versus clopidogrel after fibrinolytic therapy in patients with ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials
AbstractDual antiplatelet therapy with aspirin and clopidogrel are recommended as adjuncts to fibrinolytic-treated patients with ST-elevation myocardial infarction (STEMI). However, the role of switching to ticagrelor within 24  h of fibrinolytics compared with clopidogrel continuation in this setting is uncertain. Hence, we conducted a comprehensive search of electronic databases for all randomized clinical trials (RCTs) that evaluated the safety and efficacy of ticagrelor versus clopidogrel after fibrinolytic therapy in patients with STEMI. A random-effects model was used to calculate the risk ratios (RRs) and 95% confi...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2018 Category: Hematology Source Type: research

Chronic Kidney Disease and Third-Generation P2Y12 Inhibitors Use in Patients With Acute Coronary Syndrome: Impact on the Prognosis at 1 Year.
In conclusion, the use of third-generation P2Y12 inhibitors among non-CKD patients was associated with better outcomes. CKD patients receiving third-generation P2Y12 inhibitors treatment showed no statistically significant lower mortality and thrombotic events. Bleeding risk was not increased with the use of third-generation P2Y12 inhibitors in either group of patients. PMID: 30207603 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Pharmacology - September 12, 2018 Category: Drugs & Pharmacology Authors: Tello-Montoliu A, Ruiz-Nodar JM, Esteve-Pastor MA, Véliz-Martínez A, Orenes-Piñero E, Macías-Villanego MJ, Lozano T, Carrillo-Alemán L, Vicente-Ibarra N, Pernias-Escrig V, Martínez-Martínez JG, Rivera-Caravaca JM, Marín F Tags: J Clin Pharmacol Source Type: research

The value of Stanford integrated psychosocial assessment for transplantation (SIPAT) in prediction of clinical outcomes following left ventricular assist device (LVAD) implantation
ConclusionIn this single-center retrospective study, SIPAT did not predict cumulative re-admissions. Further study is required to validate SIPAT before clinical implementation.
Source: Heart and Lung: The Journal of Acute and Critical Care - September 16, 2018 Category: Respiratory Medicine Source Type: research

Platelet Reactivity and Early Outcomes after Transfemoral Aortic Valve Implantation.
Abstract Beyond thromboembolic events, peri-procedural bleeding remains one of the most frequent complications after transcatheter aortic valve implantation (TAVI). The majority of TAVI patients receive a dual anti-platelet treatment (DAPT) regimen. This analysis from the EVERY-TAVI register database aimed to analyse whether the level of on-treatment adenosine diphosphate-induced platelet reactivity predicts early outcomes at 30 days after TAVI. A total of 146 consecutive TAVI patients on DAPT who underwent platelet function testing with the Multiplate analyser were included here. Definition of bleeding events was...
Source: Thrombosis and Haemostasis - September 20, 2018 Category: Hematology Authors: Gross L, Jochheim D, Nitschke T, Baquet M, Orban M, Holdt L, Zadrozny M, Hagl C, Teupser D, Bauer A, Massberg S, Mehilli J, Sibbing D Tags: Thromb Haemost Source Type: research

Dual Antithrombotic Therapy with Clopidogrel and Novel Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Real-world Study
ConclusionsIn this long-term study of high-risk and real-world AF-patients with PCI, DT with NOAC and P2Y12 inhibitor (6  months) followed by NOAC monotherapy was safe and effective.
Source: Cardiology and Therapy - June 1, 2018 Category: Cardiology Source Type: research

An Urban 911 System's Experience with Left Ventricular Assist Device Patients.
CONCLUSIONS: EMS interactions with LVAD patients are infrequent but have high rates of admission and incidence of life-threatening diagnoses. The most common prehospital presenting symptoms were weakness and chest pain, and most prehospital interactions did not require LVAD-specific interventions. In addition to acquiring technical knowledge regarding LVADs, EMS providers should be aware of non-device-related complications including intracranial and GI bleeding and take this into account during their assessment. PMID: 30285520 [PubMed - as supplied by publisher]
Source: Prehospital Emergency Care - October 6, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Ticagrelor Versus Prasugrel for the Treatment of Patients with Type 2 Diabetes Mellitus Following Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis
ConclusionTicagrelor and prasugrel were not associated with significantly different adverse clinical outcomes and bleeding events in these patients with T2DM. Therefore, both antiplatelet agents might safely be used in patients with T2DM following coronary intervention. However, this head-to-head comparison still remains a major challenge which should be resolved in larger clinical trials.
Source: Diabetes Therapy - November 19, 2018 Category: Endocrinology Source Type: research