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Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry
Conclusion Ticagrelor vs. clopidogrel post-ACS was associated with a lower risk of death, MI, or stroke, as well as death alone. Risk of bleeding was higher with ticagrelor. These real-world outcomes are consistent with randomized trial results.
Source: European Heart Journal - December 21, 2016 Category: Cardiology Authors: Sahlen, A., Varenhorst, C., Lagerqvist, B., Renlund, H., Omerovic, E., Erlinge, D., Wallentin, L., James, S. K., Jernberg, T. Tags: Acute coronary syndromes Source Type: research

Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
Authors: Robson A, Sturman J, Williamson P, Conboy P, Penney S, Wood H Abstract This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hypertens...
Source: Journal of Laryngology and Otology - November 15, 2016 Category: ENT & OMF Tags: J Laryngol Otol Source Type: research

Factors Associated With Initial Prasugrel Versus Clopidogrel Selection for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From the Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Coronary Heart Disease
We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE‐ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection. Prasugrel use rates and associated 1‐year risk‐adjusted major adverse cardiovascular events and Global Utilization of Streptokinase and t‐PA for Occluded Coronary Arteries (GUSTO) moderate/severe bleeding outcomes were also examined in relation to predicted mortality and bleeding using the validated Ac...
Source: JAHA:Journal of the American Heart Association - September 22, 2016 Category: Cardiology Authors: Vora, A. N., Peterson, E. D., McCoy, L. A., Effron, M. B., Anstrom, K. J., Faries, D. E., Zettler, M. E., Fonarow, G. C., Baker, B. A., Stone, G. W., Wang, T. Y. Tags: Acute Coronary Syndromes, Coronary Artery Disease Original Research Source Type: research

Mechanistic understanding of the effect of Dengzhan Shengmai capsule on the pharmacokinetics of clopidogrel in rats
Conclusions DZSM significantly affects the pharmacokinetics of clopidogrel and its active metabolite by inhibiting the P-gp-mediated efflux transport and CYP450-mediated metabolism of clopidogrel. Thus, caution is needed when DZSM is co-administered with clopidogrel in the clinic because the interaction of these drugs may result in altered plasma concentrations of clopidogrel and its active metabolite. Graphical abstract
Source: Journal of Ethnopharmacology - August 7, 2016 Category: Drugs & Pharmacology Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Better than Aspirin for Your Heart
If you’ve been diagnosed with heart disease, the chances are you’ve been told to take low-dose aspirin every day as a preventative measure against heart attack and stroke. It’s most commonly prescribed for patients with congestive heart failure. This is the inability of your heart to pump as much blood as your body needs. And this is a big worry to me, because there is very little evidence that aspirin helps. In fact, regular use of aspirin — even baby aspirin — can do you more harm than good. Common Aspirin Beliefs The idea is that aspirin thins the blood, making it easier to pump.  It is also s...
Source: Al Sears, MD Natural Remedies - April 1, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Heart Health Source Type: news

Design and Rationale for the Effects of Ticagrelor and Clopidogrel in Patients with Peripheral Artery Disease (EUCLID) Trial
Conclusions The EUCLID study is investigating whether treatment with ticagrelor versus clopidogrel, given as antiplatelet monotherapy, will reduce the incidence of cardiovascular and limb-specific events in patients with symptomatic PAD.
Source: American Heart Journal - January 30, 2016 Category: Cardiology Source Type: research

Antithrombotic therapy in patients with combined coronary heart disease and atrial fibrillation.
CONCLUSION: In each clinical scenario, the risks of coronary artery or stent thrombosis in CHD and risks of stroke in AF need to be carefully balanced against the risks of bleeding. We make recommendations for management based on the evidence which is available at this time and indicate the many gaps which are currently being addressed by randomised clinical trials. PMID: 26658287 [PubMed - as supplied by publisher]
Source: Panminerva Medica - December 15, 2015 Category: Journals (General) Tags: Panminerva Med Source Type: research

Individual Proton Pump Inhibitors and Outcomes in Patients With Coronary Artery Disease on Dual Antiplatelet Therapy: A Systematic Review Coronary Heart Disease
Conclusions Several frequently used PPIs previously thought to be safe for concomitant use with clopidogrel were associated with greater risk of adverse cardiovascular events. Although the data are observational, they highlight the need for randomized controlled trials to evaluate the safety of concomitant PPI and clopidogrel use in patients with coronary artery disease.
Source: JAHA:Journal of the American Heart Association - October 29, 2015 Category: Cardiology Authors: Sherwood, M. W., Melloni, C., Jones, W. S., Washam, J. B., Hasselblad, V., Dolor, R. J. Tags: Coronary Heart Disease Source Type: research

Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and Chronic Obstructive Pulmonary Disease: An Analysis From the Platelet Inhibition and Patient Outcomes (PLATO) Trial Coronary Heart Disease
Conclusions In this post-hoc analysis, COPD patients experienced high rates of ischemic events. Ticagrelor versus clopidogrel reduced and substantially decreased the absolute risk of ischemic events (5.8%) in COPD patients, without increasing overall major bleeding events. The benefit-risk profile supports the use of ticagrelor in patients with ACS and concomitant COPD. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
Source: JAHA:Journal of the American Heart Association - October 9, 2015 Category: Cardiology Authors: Andell, P., James, S. K., Cannon, C. P., Cyr, D. D., Himmelmann, A., Husted, S., Keltai, M., Koul, S., Santoso, A., Steg, P. G., Storey, R. F., Wallentin, L., Erlinge, D., the PLATO Investigators Tags: Coronary Heart Disease Source Type: research

Antiplatelet therapy following transcatheter aortic valve implantation
Conclusions No difference in 30-day NACE rate was observed between ASA-only or DAPT following TAVI. Moreover, a trend towards less life-threatening and major bleeding was observed in favour of ASA. Consequently the additive value of clopidogrel warrants further investigation.
Source: Heart - June 25, 2015 Category: Cardiology Authors: Hassell, M. E. C. J., Hildick-Smith, D., Durand, E., Kikkert, W. J., Wiegerinck, E. M. A., Stabile, E., Ussia, G. P., Sharma, S., Baan, J., Eltchaninoff, H., Rubino, P., Barbanti, M., Tamburino, C., Poliacikova, P., Blanchard, D., Piek, J. J., Delewi, R. Tags: Drugs: cardiovascular system, Epidemiology Valvular heart disease Source Type: research

Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure
Conclusions LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation.
Source: Heart - May 12, 2015 Category: Cardiology Authors: Minguez, J. R. L., Asensio, J. M. N., Gragera, J. E., Costa, M., Gonzalez, I. C., de Carlos, F. G., Diaz, J. A. F., Yuste, V. M., Gonzalez, R. M., Dominguez-Franco, A., Buendia, A. B., Garibi, J. H., Hernandez, F. H., Ribeiro, V. G. Tags: Congenital heart disease in adult patients, Editor's choice, Drugs: cardiovascular system, Heart failure, Hypertension, Epidemiology Arrhythmias and sudden death Source Type: research

Is clopidogrel better than aspirin following breakthrough strokes while on aspirin? A retrospective cohort study
Conclusions Among patients with an ischaemic stroke while taking aspirin, clopidogrel initiation was associated with fewer recurrent vascular events than aspirin reinitiation.
Source: BMJ Open - December 2, 2014 Category: Journals (General) Authors: Lee, M., Wu, Y.-L., Saver, J. L., Lee, H.-C., Lee, J.-D., Chang, K.-C., Wu, C.-Y., Lee, T.-H., Wang, H.-H., Rao, N. M., Ovbiagele, B. Tags: Open access, Cardiovascular medicine, Epidemiology, Neurology Research Source Type: research

Predictors of Mortality in Patients With Lacunar Stroke in the Secondary Prevention of Small Subcortical Strokes Trial Clinical Sciences
Conclusions— Unexpected interactions between assigned antiplatelet therapy and each of ischemic heart disease and normal/prehypertensive status accounted for increased mortality among patients with recent lacunar stroke given dual antiplatelet therapy. Despite extensive exploratory analyses, the mechanisms underlying these interactions are uncertain. Clinical Trial Registration— URL: http://www.SPS3ClinicalTrials.gov. Unique identifier: NCT00059306.
Source: Stroke - September 22, 2014 Category: Neurology Authors: Sharma, M., Pearce, L. A., Benavente, O. R., Anderson, D. C., Connolly, S. J., Palacio, S., Coffey, C. S., Hart, R. G. Tags: Cerebral Lacunes, Antiplatelets Clinical Sciences Source Type: research

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