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A Little Good...
Abstract My grandmother used to say: "If a little'll do a little good, a lot'll do a lotta good." Unfortunately, it is not that simple with antiplatelet agents. Many relevant facts are well-established. In identifiable subgroups of patients who present with TIA or minor stroke, the risk of a subsequent stroke is high.(1-3) Most of this risk is incurred during the first few days after a warning event.(2) Aspirin and other antiplatelet agents can lower the risk of secondary stroke by approximately 12-22%.(4,5) In patients with acute coronary syndromes, another thrombotic disorder, dual antiplatelet therapy offers a ...
Source: Circulation - September 12, 2013 Category: Cardiology Authors: Feske SK Tags: Circulation Source Type: research

Early Dual versus Mono Antiplatelet Therapy for Acute Non-Cardioembolic Ischemic Stroke or Transient Ischemic Attack: An Updated Systematic Review and Meta-Analysis.
CONCLUSIONS: For patients with acute non-cardioembolic ischemic stroke or TIA, dual therapy was more effective than monotherapy in reducing risks of early recurrent stroke. The results of the CHANCE study are consistent with previous studies done in other parts of the world. PMID: 24030500 [PubMed - as supplied by publisher]
Source: Circulation - September 12, 2013 Category: Cardiology Authors: Wong KS, Wang Y, Leng X, Mao C, Tang J, Bath PM, Markus HS, Gorelick PB, Liu L, Lin W, Wang Y Tags: Circulation Source Type: research

Antithrombotic Therapy for Patients with Atrial Fibrillation and Atherothrombotic Vascular Disease: Striking the Right Balance between Efficacy and Safety.
Abstract Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is estimated to affect 1.5 to 2.0% of the general population, i.e., at least 100 million people worldwide.(1) Left untreated, patients with nonvalvular AF (NVAF) are exposed to an annual risk of thromboembolic stroke of approximately 5%, resulting in 5 million AF-related strokes each year.(1) Properly dosed anticoagulation (e.g., warfarin adjusted to an international normalized ratio [INR] of 2.0 to 3.0) is extremely effective in preventing AF-related strokes, reducing risk by two-thirds compared with no therapy, and by one-half compared to ...
Source: Circulation - July 16, 2013 Category: Cardiology Authors: Patrono C, Andreotti F Tags: Circulation Source Type: research

Elderly Patients with Acute Coronary Syndromes Managed Without Revascularization Insights into the Safety of Long-Term Dual Antiplatelet Therapy with Reduced-Dose Prasugrel vs. Standard-Dose Clopidogrel.
CONCLUSIONS: Older age is associated with substantially increased long-term cardiovascular risk and bleeding among medically managed ACS patients, with no differences in ischemic or bleeding outcomes with reduced-dose prasugrel vs. clopidogrel in elderly patients. No significant interaction among weight, pharmacodynamic response, and bleeding risk was observed between reduced-dose prasugrel vs. clopidogrel in elderly patients. CLINICAL TRIAL REGISTRATION INFORMATION: http://clinicaltrials.gov/ct2/home. Identifier: NCT0069999. PMID: 23852610 [PubMed - as supplied by publisher]
Source: Circulation - July 12, 2013 Category: Cardiology Authors: Roe MT, Goodman SG, Ohman EM, Stevens SR, Hochman JS, Gottlieb S, Martinez F, Dalby AJ, Boden WE, White HD, Prabhakaran D, Winters KJ, Aylward PE, Bassand JP, McGuire DK, Ardissino D, Fox KA, Armstrong PW Tags: Circulation Source Type: research

Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients with Atrial Fibrillation: 2.3 Year Follow-Up of the PROTECT AF Trial.
CONCLUSIONS: The "local" strategy of LAA closure is noninferior to "systemic" anticoagulation with Warfarin. PROTECT AF has, for the first time, implicated the LAA in the pathogenesis of stroke in AF. CLINICAL TRIAL REGISTRATION INFORMATION: Clinicaltrials.gov; Unique Identifier: NCT00129545. PMID: 23325525 [PubMed - as supplied by publisher]
Source: Circulation - January 16, 2013 Category: Cardiology Authors: Reddy VY, Doshi SK, Siever H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes D Tags: Circulation Source Type: research

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