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Contemporary Antiplatelet and Anticoagulant Therapies for Secondary Stroke Prevention: A Narrative Review of Current Literature and Guidelines
Curr Neurol Neurosci Rep. 2023 Apr 11. doi: 10.1007/s11910-023-01266-2. Online ahead of print.ABSTRACTPURPOSE OF REVIEW: Stroke is a leading cause of death and disability worldwide. The annual incidence of new or recurrent stroke is approximately 795,000 cases per year in the United States, of which 87% are ischemic in nature. In addition to the management of modifiable high-risk factors to reduce the risk of recurrent stroke, antithrombotic agents (antiplatelets and anticoagulants) play an important role in secondary stroke prevention. This review will discuss the published literature on the use of antiplatelets and antic...
Source: Atherosclerosis - April 10, 2023 Category: Cardiology Authors: Kunal Bhatia Lindsey M Ladd Kelsey H Carr Mario Di Napoli Jeffrey L Saver Louise D McCullough Maryam Hosseini Farahabadi Diana L Alsbrook Archana Hinduja Jorge G Ortiz Garcia Sara Y Sabbagh Alibay Jafarli Afshin A Divani Source Type: research

Recurrent Ischemic Stroke: Strategies for Prevention.
Abstract Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. The selection of antiplatelet therapy should be based on timing, safety, effectiveness, ...
Source: American Family Physician - October 1, 2017 Category: Primary Care Authors: Oza R, Rundell K, Garcellano M Tags: Am Fam Physician Source Type: research

Indications and Evidence for Dual Antiplatelet Therapy After Acute Ischemic Stroke
The antiplatelet landscape for the secondary prevention of ischemic stroke has changed significantly over the past decade. Poststroke dual antiplatelet regimens are becoming increasingly routine as supported by recent literature and guideline recommendations. Dual antiplatelet therapy after stroke generally consists of aspirin and clopidogrel and is considered in the short term after stroke in select populations including those with mild stroke or transient ischemic attack and in patients with severe intracranial atherosclerosis. When initiating dual antiplatelet therapy, factors that may increase a patient's risk of bleed...
Source: Critical Care Nursing Quarterly - February 22, 2020 Category: Nursing Tags: Original Articles Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

New Data From Two Large Studies Reinforce Effectiveness of Dual Pathway Inhibition (DPI) with XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Coronary Artery Disease (CAD) and/or Peripheral Artery Disease (PAD)
RARITAN, N.J., May 23, 2022 – Findings from the XARELTO® (rivaroxaban) Phase 3 COMPASS Long-Term Open Label Extension (LTOLE) study and the XARELTO® in Combination with Acetylsalicylic Acid (XATOA) registry have been published in the European Society of Cardiology’s (ESC) European Heart Journal, Cardiovascular Pharmacotherapy. Additionally, the XATOA registry was presented at the American Congress of Cardiology’s 71st Annual Scientific Session (ACC.22). These studies provide further evidence supporting the role of dual pathway inhibition (DPI) with the XARELTO® vascular dose (2.5 mg twice daily plus aspirin 100 mg...
Source: Johnson and Johnson - May 23, 2022 Category: Pharmaceuticals Source Type: news

Prasugrel and Ticagrelor in Patients with Drug-Eluting Stents and Kidney Failure
CONCLUSIONS: Prasugrel or ticagrelor does not seem to be associated with significant benefits compared with clopidogrel in patients with kidney failure treated with drug-eluting stents.PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_04_02_CJN12120720.mp3.PMID:33811128 | DOI:10.2215/CJN.12120720
Source: Clinical Journal of the American Society of Nephrology : CJASN - April 3, 2021 Category: Urology & Nephrology Authors: Thomas A Mavrakanas Omer Kamal David M Charytan Source Type: research

Associations between use of prasugrel vs clopidogrel and outcomes by type of acute coronary syndrome: an analysis from the PROMETHEUS registry
AbstractWe sought to investigate the utilization of prasugrel and its association with outcomes relative to clopidogrel in three typical subgroups of ACS in a real-world setting. Prasugrel is superior to clopidogrel for reducing risk of ischemic events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), but is associated with an increased risk of bleeding complications. PROMETHEUS was a retrospective multicenter observational study of 19,913 ACS patients undergoing PCI from 8 centers in the United States between 2010 and 2013. Major adverse cardiovascular events (MACE) were define...
Source: Journal of Thrombosis and Thrombolysis - June 8, 2019 Category: Hematology Source Type: research

O-052 The pennsylvania post-market multicenter experience with flow re-direction endoluminal device (FRED)
ConclusionThe results of the early post-market experience with the FRED device show reasonable safety and adequate aneurysmal occlusion rates comparable to other flow diverters. However, more extensive multicenter studies with more extended follow-up data are needed to assess the long-term safety and durability of the device.Abstract O-052 Table 1Baseline descriptive statistics Number of patients n=61 Gender Male 11 (18%) Female 50 (82%) Age (Years: median; IQR) 58 (51 – 68) Multiple Intracranial Aneurysms 21 (34.4%) Family history of aneurysms 9 (14.8%) Smoking History Never smokers 26 (42.6%) Past smokers 13 (21.3...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Salem, M., Kvint, S., Hendrix, P., Al Saiegh, F., Gajjar, A., Goren, O., Gross, B., Jabbour, P., Lang, M., Schirmer, C., Tjoumakaris, S., Griessenauer, C., Burkhardt, J. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

Anticoagulation and Antiplatelet Therapy for Prevention of Venous and Arterial Thrombotic Events in Critically Ill Patients with COVID-19: COVID-PACT
Conclusions: In critically-ill patients with COVID-19, full-dose anticoagulation, but not clopidogrel, reduced thrombotic complications with an increase in bleeding, driven primarily by transfusions in hemodynamically stable patients, and no apparent excess in mortality.PMID:36036760 | DOI:10.1161/CIRCULATIONAHA.122.061533
Source: Circulation - August 29, 2022 Category: Cardiology Authors: Erin A Bohula David D Berg Mathew S Lopes Jean M Connors Iljal Babar Christopher F Barnett Sunit-Preet Chaudhry Amit Chopra Wilson Ginete Michael H Ieong Jason N Katz Edy Y Kim Julia F Kuder Emilio Mazza Dalton McLean Jarrod M Mosier Ari Moskowitz Sabina Source Type: research