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Acute coronary syndrome in very elderly patients —a real-world experience
AbstractVery elderly population constitutes an increasingly larger proportion of patients admitted for acute coronary syndromes (ACS). Notably, age represents both a proxy of frailty and an exclusion criterion in clinical randomized trials, which probably contributes to lack of data and undertreatment of real-world elderly patients. The aim of the study is to describe patterns of treatment and outcome of very elderly patients with ACS. All consecutive patients aged  ≥ 80 years old (yo) admitted between January 2017 and December 2019 with ACS were included. The primary endpoint was in-hospital occurrence of major adv...
Source: Heart and Vessels - July 15, 2023 Category: Cardiology Source Type: research

Treatment of progressive ischemic stroke with low ‑dose eptifibatide: A retrospective case‑control study
Exp Ther Med. 2022 Nov 22;25(1):22. doi: 10.3892/etm.2022.11721. eCollection 2023 Jan.ABSTRACTProgressive ischemic stroke (PIS) is a therapeutic challenge in clinical practice. The present retrospective study aimed to investigate the safety and effectiveness of eptifibatide in the treatment of PIS. The present study enrolled patients with PIS admitted to Xiangtan Central Hospital (Xiangtan, China) between March 2020 and March 2021 with National Institutes of Health Stroke Scale (NIHSS) progression scores of ≥2 points during the initial 72 h. Patients were then divided into two groups according to their different anti-pla...
Source: Atherosclerosis - December 23, 2022 Category: Cardiology Authors: Long Luo Jinsheng Lin Ye Deng Zhigang Li Ying Yuan Wen Zhang Source Type: research

Benefits and Risks of Prolonged Duration Dual Antiplatelet Therapy (Clopidogrel and Aspirin) after Percutaneous Coronary Intervention in High-Risk Patients with Diabetes Mellitus
The efficacy and safety of prolonged (>1-year) dual antiplatelet therapy (DAPT) duration in high-risk patients with diabetes mellitus (DM) undergoing PCI remain unknown. All patients undergoing PCI at Fuwai hospital between January 2013 and December 2013 were prospectively enrolled into the Fuwai PCI registry. 3696 high-risk diabetics patients with at least one additional atherothrombotic risk factor were screened for inclusion. The primary efficacy outcome was the composite of all-cause mortality, myocardial infarction, or stroke.
Source: The American Journal of Cardiology - December 4, 2020 Category: Cardiology Authors: Hao-Yu Wang, Zhong-Xing Cai, Dong Yin, Yue-Jin Yang, Wei-Hua Song, Ke-Fei Dou Source Type: research

Effectiveness of Only Aspirin or Clopidogrel Following Percutaneous Left Atrial Appendage Closure
Percutaneous left atrial appendage closure (LAAC) offers a feasible option for stroke prevention in patients with atrial fibrillation (AF), but the optimal antithrombotic treatment strategy for patients with strict contraindications to oral anticoagulation (OAC) remains uncertain. We sought to evaluate short- and long-term outcome after percutaneous LAAC in these very patients discharged on single antiplatelet therapy (SAPT) alone. All consenting AF patients who underwent LAAC from February 2009 to August 2018 in Turku University Hospital, Finland, were enrolled into a prospectively maintained registry.
Source: The American Journal of Cardiology - September 25, 2019 Category: Cardiology Authors: Jussi-Pekka Pouru, Samuli Jaakkola, Juha Lund, Fausto Biancari, Antti Saraste, K. E. Juhani Airaksinen Source Type: research

Effect of Antiplatelet Therapy (Aspirin  + Dipyridamole Versus Clopidogrel) on Mortality Outcome in Ischemic Stroke
The optimal regimen of antiplatelet therapy for secondary prevention in noncardioembolic ischemic stroke remains controversial. We aimed to determine which regimen was associated with the greatest reduction in adverse outcomes. We analysed prospectively collected data from the Norfolk and Norwich University Hospital Stroke Register. The sample population consisted of 3,572 participants (mean age 74.96 ± 12.67) with ischemic stroke, who were consecutively admitted between 2003 and 2015. Patients were placed on one of three antiplatelet regimens at hospital discharge; aspirin monotherapy, aspirin plus dipyridamole and clopidogrel.
Source: The American Journal of Cardiology - July 2, 2018 Category: Cardiology Authors: Raphae S. Barlas, Yoon K. Loke, Mamas A. Mamas, Joao H Bettencourt-Silva, Isobel Ford, Allan B. Clark, Kristian M. Bowles, Anthony K. Metcalf, John F. Potter, Phyo K. Myint Source Type: research

Effect of Antiplatelet Therapy (Aspirin  + Dipyridamole vs Clopidogrel) on Mortality Outcome in Ischemic Stroke
The optimal regimen of antiplatelet therapy for secondary prevention in noncardioembolic ischemic stroke remains controversial. We aimed to determine which regimen was associated with the greatest reduction in adverse outcomes. We analysed prospectively collected data from the Norfolk and Norwich University Hospital Stroke Register (NNUHSR). The sample population consisted of 3,572 participants (mean age 74.96 ± 12.67) with ischemic stroke, who were consecutively admitted between 2003-2015. Patients were placed on one of three antiplatelet regimens at hospital discharge; aspirin monotherapy, aspirin plus dipyridamole and clopidogrel.
Source: The American Journal of Cardiology - July 2, 2018 Category: Cardiology Authors: Raphae S. Barlas, Yoon K. Loke, Mamas A. Mamas, Joao H Bettencourt-Silva, Isobel Ford, Allan B. Clark, Kristian M. Bowles, Anthony K. Metcalf, John F. Potter, Phyo K. Myint 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

Antiplatelet therapy in Takotsubo cardiomyopathy: does it improve cardiovascular outcomes during index event?
Abstract Plasma catecholamines may play an important role in Takotsubo cardiomyopathy (TCM) pathophysiology. Patients with disproportionately high catecholamine responses to stressful events are prone to worse clinical outcomes. Catecholamines stimulate platelet activation and, therefore, may determine the clinical presentation and outcomes of TCM. We conducted a retrospective, descriptive study TCM patients admitted between 2003 and 2013 to Einstein Medical Center, Philadelphia, PA, USA and Danbury Hospital, Danbury, CT, USA. A total of 206 patients met Modified Mayo TCM criteria. Using a multiple logistic model,...
Source: Heart and Vessels - August 13, 2015 Category: Cardiology Source Type: research

The Challenge of Getting it Just Right Optimizing Long-Term Antithrombotic Therapy After Acute Coronary Syndrome ∗
Acute coronary syndrome (ACS) is associated with substantial morbidity and mortality (1,2). Initial treatment in the hospital consists of intensive antithrombotic therapy combining parenteral anticoagulation with antiplatelet therapy, whereas secondary prevention relies primarily on dual antiplatelet therapy (DAPT), most commonly aspirin and clopidogrel. However, patients with ACS remain at significant risk of recurrent adverse cardiovascular events (3). Mitigation of this risk requires a delicate balance between escalation of antithrombotic therapy to reduce ischemic events, while hoping the increase in bleeding is tolera...
Source: Journal of the American College of Cardiology - August 10, 2015 Category: Cardiology Source Type: research

Ticagrelor: A Review of Its Use in Adults with Acute Coronary Syndromes
Abstract Ticagrelor (Brilique™, Brilinta®), a cyclopentyl-triazolopyrimidine, is an orally active, reversible, and selective adenosine diphosphate (ADP) receptor antagonist indicated for use in patients with acute coronary syndromes (ACS). Ticagrelor has a faster onset of action and provides greater inhibition of platelet aggregation than clopidogrel. In the large well-designed, PLATO study in adult patients with ACS, 12 months’ treatment with ticagrelor was more effective than clopidogrel in reducing the incidence of the primary composite endpoint of myocardial infarction, stroke, or cardiovascular (CV) dea...
Source: American Journal of Cardiovascular Drugs - February 12, 2015 Category: Cardiology Source Type: research

High post-clopidogrel platelet reactivity assessed by a point-of-care assay predicts long-term clinical outcomes in patients with ST-segment elevation myocardial infarction who underwent primary coronary stenting
Abstract: Background: Recent studies have shown that post-clopidogrel high platelet reactivity (HPR), assessed by a point-of-care assay, is associated with a higher risk of adverse events after percutaneous coronary intervention (PCI). We assessed the clinical impact of HPR by the VerifyNow P2Y12 point-of-care assay in 181 patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary PCI with drug-eluting stents (DES) at 3 hospitals.Methods: The primary endpoint of the study was the 12-month major adverse cardiovascular events (MACE), which comprised cardiovascular death, nonfatal MI and ischemic s...
Source: International Journal of Cardiology - June 11, 2012 Category: Cardiology Authors: Han-Young Jin, Tae-Hyun Yang, Doo-Il Kim, Sang-Ryul Chung, Jeong-Sook Seo, Jae-Sik Jang, Dae-Kyeong Kim, Dong-Kie Kim, Ki-Hun Kim, Sang-Hoon Seol, Chang-Wook Nam, Seung-Ho Hur, Woong Kim, Jong-Seon Park, Young-Jo Kim, Dong-Soo Kim Tags: Original Articles Source Type: research