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Colchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial
Conclusions In this small, open-label, randomised trial of non-critically ill hospitalised patients with COVID-19, the combination of colchicine and rosuvastatin in addition to standard of care did not appear to reduce the risk of progression of COVID-19 disease or thromboembolic events, although the trial was underpowered due to a lower-than-expected event rate. The trial leveraged the power of electronic medical records for efficiency and improved follow-up and demonstrates the utility of incorporating electronic medical records into future trials. Trial registration NCT04472611.
Source: BMJ Open - February 24, 2023 Category: General Medicine Authors: Shah, T., McCarthy, M., Nasir, I., Archer, H., Ragheb, E., Kluger, J., Kashyap, N., Paredes, C., Patel, P., Lu, J., Kandel, P., Song, C., Khan, M., Huang, H., Ul Haq, F., Ahmad, R., Howes, C., Cambi, B., Lancaster, G., Cleman, M., Dela Cruz, C., Parise, H Tags: Open access, Infectious diseases, COVID-19 Source Type: research

Antithrombotic treatment after stroke due to intracerebral haemorrhage
CONCLUSIONS: We did not identify beneficial or hazardous effects of short-term prophylactic dose parenteral anticoagulation and long-term oral antiplatelet therapy after ICH on important outcomes. Although there was a significant reduction in MACE and all major occlusive vascular events after long-term treatment with therapeutic dose oral anticoagulation for atrial fibrillation after ICH, the pooled estimates were imprecise, the certainty of evidence was only moderate, and effects on other important outcomes were uncertain. Large RCTs with a low risk of bias are required to resolve the ongoing dilemmas about antithrombotic...
Source: Cochrane Database of Systematic Reviews - January 26, 2023 Category: General Medicine Authors: Alexia Cochrane Chen Chen Jacqueline Stephen Ole Morten R ønning Craig S Anderson Graeme J Hankey Rustam Al-Shahi Salman Source Type: research

A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report
ConclusionsAcute renal infarction from thromboembolism is a rare but serious complication of arterial fibrillation. More efficient and different options for intervention methods will benefit the treatment of this disease. Here, we report a combination therapeutic method that has not been used in acute renal infarction associated with arterial fibrillation, and which restored renal perfusion and prevented long-term kidney injury.
Source: Journal of Medical Case Reports - October 19, 2022 Category: General Medicine Source Type: research

Continuation versus discontinuation of aspirin-based antiplatelet therapy for perioperative bleeding and ischaemic events in adults undergoing neurosurgery: protocol for a systematic review and meta-analysis
Introduction Antiplatelet therapy is commonly used in primary or secondary prevention of atherosclerotic and thrombotic diseases, such as coronary artery disease, transient ischaemic attack or stroke. Recent studies noted that antiplatelet therapy should be continued perioperatively in patients at high risk of thrombosis and low bleeding risk in orthopaedic, spinal or urological surgery. However, evidence in neurosurgery is lacking. Thus, we aim to conduct a systematic review and meta-analysis to assess whether the continuous use of antiplatelet drugs in neurosurgery increases the risk of perioperative bleeding. Methods a...
Source: BMJ Open - September 30, 2021 Category: General Medicine Authors: Wang, X., Wang, X., Yu, Y., Han, R. Tags: Open access, Anaesthesia Source Type: research

Use of Cerebrolysin in combination with high ‐dose aspirin antithrombotic treatment of ischemic stroke: A case report
The combined treatment of ischemic stroke with the high-dose aspirin and Cerebrolysin could act synergistically and contribute to a more complete neurological deficit recovery through the combined neuroprotective and neurotrophic effects AbstractThis clinical case is an example of a potential synergistic neuroprotective interaction of Cerebrolysin and high doses of aspirin. The case describes the significant recovery of neurological deficits in a patient with moderate ischemic stroke (NIHSS 12 points) caused by right posterior cerebral artery thrombosis (RPCAT) after treatment with Cerebrolysin in combination with high dos...
Source: Clinical Case Reports - September 24, 2021 Category: General Medicine Authors: Alexander Borisevich, Konstantin Veremeyuk Tags: CASE REPORT Source Type: research

Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis
This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management. Methods and analysis After searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TT...
Source: BMJ Open - August 10, 2021 Category: General Medicine Authors: Lin, J., Wu, B., Lin, L., Ding, Y., Zhong, B., Huang, Z., Lin, M., Xu, D.-P. Tags: Open access, Cardiovascular medicine Source Type: research

Net Adverse Clinical Events With Antiplatelet Therapy in Acute Coronary Syndromes
Clopidogrel, prasugrel, and ticagrelor are oral platelet P2Y12 receptor inhibitors that decrease the risk of platelet-mediated coronary artery thrombosis. Clinical guidelines have recommended ticagrelor or prasugrel over clopidogrel in combination with aspirin as dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS), whether or not percutaneous coronary intervention (PCI) is performed. The ticagrelor recommendation was based on the Study of Platelet Inhibition and Patient Outcomes (PLATO) trial, which enrolled 18  624 patients with ACS and randomized them to receive DAPT with either clopidogrel ...
Source: JAMA - October 27, 2020 Category: General Medicine Source Type: research

Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome.
CONCLUSIONS: The evidence identified indicates that NOACs compared with standard-dose VKAs may increase the risk of stroke and do not appear to alter the risk of other outcomes (moderate-certainty evidence). Using high-dose VKA versus standard-dose VKA did not alter the risk of any thromboembolic event or major bleeding but may increase the risk of any form of bleeding (low-certainty evidence). Standard-dose VKA combined with an AP agent compared with standard-dose VKA alone may increase the risk of any thromboembolic event and does not appear to alter the risk of major bleeding or other outcomes (low-certainty evidence). ...
Source: Cochrane Database of Systematic Reviews - October 12, 2020 Category: General Medicine Authors: Bala MM, Celinska-Lowenhoff M, Szot W, Padjas A, Kaczmarczyk M, Swierz MJ, Undas A Tags: Cochrane Database Syst Rev Source Type: research

Temporal Trends and Patient Characteristics Associated With Drug Utilisation After First-Ever Stroke: Insights From Chronic Disease Registry Data in Singapore.
CONCLUSION: This study reveals changes in prescription behaviour over time in a multiethnic Asian population with first-ever stroke. Patient characteristics including younger age, Malay ethnicity and certain comorbidities (i.e. hyperlipidaemia, atrial fibrillation) were associated with the combined use of all 3 guideline medications among ischaemic stroke patients. PMID: 32301477 [PubMed - in process]
Source: Ann Acad Med Singapo... - February 29, 2020 Category: General Medicine Authors: Yeo SH, Toh MPH, Lee SH, Seet RC, Wong LY, Yau WP Tags: Ann Acad Med Singapore Source Type: research

Antiplatelet therapy in secondary ischemic stroke prevention - a short review.
In conclusion, we can say that current recommendations focused primarily on the therapy with aspirin for the secondary prevention of stroke in patients that presented vascular events, such as ischemic stroke of non-cardioembolic cause or transient ischemic attack and, as appropriate, aspirin plus dipyridamol or clopidogrel. The new therapy with ticagrelor in secondary stroke prevention seems to be promising, but more randomized clinical trials are needed to accurately assess the safety and efficacy of this new antiplatelet drug. PMID: 31658310 [PubMed - in process]
Source: Romanian Journal of Morphology and Embryology - October 29, 2019 Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research

Clinical Considerations for Aspirin Use for Primary Prevention in 2019
Reducing platelet activity with aspirin and other antiplatelet agents is an important factor in the prevention and management of atherothrombotic vascular events. For this indication, aspirin has both beneficial and potentially harmful effects; it can diminish or reverse thrombus formation (eg, in the setting of acute myocardial infarction or stroke), but it also increases the risk of bleeding.
Source: JAMA - January 22, 2019 Category: General Medicine Source Type: research

Aortic stenosis in the elderly: The TAVI revolution.
Abstract TAVI is currently recommended for severe symptomatic aortic stenosis in patients at prohibitive, high or intermediate surgical risk as estimated by surgical risk scores (STS score and EuroSCORE II). Comorbidity, technical feasibility of TAVI and concurrent pathology with need for complementary surgical correction are conditions to be considered to choose between open surgery and TAVI. The decision is often made by the "Heart Team". The transfemoral access must be favored. Conduction disturbance, stroke, bioprosthesis thrombosis and durability are the main setbacks of TAVI. Double antiplatelet therapy with...
Source: Presse Medicale - December 10, 2018 Category: General Medicine Authors: Overtchouk P, Collet JP Tags: Presse Med Source Type: research

Recurrent cerebellar infarction associated with hereditary heterozygous protein C deficiency in a 35-year-old woman: A case report and genetic study on the pedigree.
In conclusion, the clinical manifestations of hereditary PROC deficiency may vary between individuals. The heterozygous mutation locus c.565C>T on the PROC gene is associated with thrombophilia. Awareness of the association between natural anticoagulants and thrombophilia may promote the prevention and therapy of stroke. PMID: 30210609 [PubMed]
Source: Experimental and Therapeutic Medicine - September 14, 2018 Category: General Medicine Tags: Exp Ther Med Source Type: research

6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial
Publication date: Available online 12 March 2018 Source:The Lancet Author(s): Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon Background Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients...
Source: The Lancet - March 13, 2018 Category: General Medicine Source Type: research

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