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Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or Transient Ischemic Attack Stroke
Conclusions Among patients treated within 12 hours, the combination of clopidogrel and aspirin was more effective than aspirin alone in reducing the risk of recurrent ischemic stroke during the 90-day follow-up and did not increase the hemorrhagic risk. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00979589.
Source: JAHA:Journal of the American Heart Association - March 20, 2016 Category: Cardiology Authors: Li, Z., Wang, Y., Zhao, X., Liu, L., Wang, D., Wang, C., Meng, X., Li, H., Pan, Y., Wang, X., Wang, C., Yang, X., Zhang, C., Jing, J., Xian, Y., Johnston, S. C., Wang, Y., on behalf of the CHANCE Investigators Tags: Secondary Prevention, Ischemic Stroke, Transient Ischemic Attack (TIA) Source Type: research

Long-Term Antiplatelet Mono- and Dual Therapies After Ischemic Stroke or Transient Ischemic Attack: Network Meta-Analysis Stroke
Conclusions Long-term monotherapy was a better choice than long-term dual therapy, and cilostazol had the best risk–benefit profile for long-term secondary prevention after stroke or transient ischemic attack. More randomized controlled trials in non–East Asian patients are needed to determine whether long-term use of cilostazol is the best option for the prevention of recurrent stroke.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Xie, W., Zheng, F., Zhong, B., Song, X. Tags: Stroke Source Type: research

Cost-Effectiveness of Clopidogrel-Aspirin Versus Aspirin Alone for Acute Transient Ischemic Attack and Minor Stroke Stroke
Conclusions Early 90-day clopidogrel-aspirin regimen for acute TIA or minor stroke is highly cost-effective in China. Although clopidogrel is generic, Plavix is brand in China. If Plavix were generic, treatment with clopidogrel-aspirin would have been cost saving.
Source: JAHA:Journal of the American Heart Association - June 5, 2014 Category: Cardiology Authors: Pan, Y., Wang, A., Liu, G., Zhao, X., Meng, X., Zhao, K., Liu, L., Wang, C., Johnston, S. C., Wang, Y., Wang, Y., the CHANCE Investigators Tags: Stroke Source Type: research

Clopidogrel Use Is Associated With an Increased Prevalence of Cerebral Microbleeds in a Stroke-Free Population: The Rotterdam Study Stroke
Conclusions In stroke-free individuals, clopidogrel use was associated with a higher prevalence and higher number of CMBs. Whether this association is causal requires confirmation in prospective studies, especially given the small number of participants taking clopidogrel and the possibility of residual confounding in this study.
Source: JAHA:Journal of the American Heart Association - September 26, 2013 Category: Cardiology Authors: Darweesh, S. K. L., Leening, M. J. G., Akoudad, S., Loth, D. W., Hofman, A., Arfan Ikram, M., Vernooij, M. W., Stricker, B. H. Tags: Stroke Source Type: research

CYP2C19 Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study Genetics
Conclusions There were significant differences in recurrent stroke by CYP2C19 genotype-inferred metabolizer status in white subcortical stroke patients receiving dual antiplatelet therapy with aspirin and clopidogrel, consistent with cardiovascular studies on CYP2C19 and clopidogrel; however, the bleeding risk that led to early termination of the antiplatelet arm of the SPS3 trial does not appear to be explained by CYP2C19 genotype. This study was relatively underpowered; therefore, these findings should be interpreted with caution and warrant replication. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique id...
Source: JAHA:Journal of the American Heart Association - May 27, 2015 Category: Cardiology Authors: McDonough, C. W., McClure, L. A., Mitchell, B. D., Gong, Y., Horenstein, R. B., Lewis, J. P., Field, T. S., Talbert, R. L., Benavente, O. R., Johnson, J. A., Shuldiner, A. R. Tags: Genetics Source Type: research

Impact of Proton Pump Inhibitor Therapy on the Efficacy of Clopidogrel in the CAPRIE and CREDO Trials Coronary Heart Disease
Conclusions In CREDO, the efficacy of clopidogrel was not significantly affected by PPI use. However, in CAPRIE, clopidogrel was beneficial to non-PPI users while apparently harmful to PPI users. Whether this negative interaction is clinically important for patients receiving clopidogrel without aspirin needs further study.
Source: JAHA:Journal of the American Heart Association - January 15, 2013 Category: Cardiology Authors: Dunn, S. P., Steinhubl, S. R., Bauer, D., Charnigo, R. J., Berger, P. B., Topol, E. J. Tags: Coronary Heart Disease Source Type: research

Early Clopidogrel Versus Prasugrel Use Among Contemporary STEMI and NSTEMI Patients in the US: Insights From the National Cardiovascular Data Registry Coronary Heart Disease
Conclusions With prasugrel as an antiplatelet treatment option, contemporary practice shows low uptake of prasugrel and delays in P2Y12 antagonist initiation among NSTEMI patients. We also note concerning evidence of inappropriate use of prasugrel, and inadequate targeting of this more potent therapy to maximize the benefit/risk ratio.
Source: JAHA:Journal of the American Heart Association - April 14, 2014 Category: Cardiology Authors: Sherwood, M. W., Wiviott, S. D., Peng, S. A., Roe, M. T., DeLemos, J., Peterson, E. D., Wang, T. Y. 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

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

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
Conclusions In community practice, prasugrel use may be driven more by bleeding risk rather than ischemic benefit. This may result in underutilization of higher potency ADP receptor inhibitor among patients more likely to derive ischemic benefit.
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 Coronary Heart Disease Source Type: research

Impact of Proton Pump Inhibitor Use on the Comparative Effectiveness and Safety of Prasugrel Versus Clopidogrel: Insights From the Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Health Services and Outcomes Research
ConclusionsPPIs did not significantly affect the MACE and bleeding risk associated with prasugrel use, relative to clopidogrel.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01088503.
Source: JAHA:Journal of the American Heart Association - September 27, 2016 Category: Cardiology Authors: Jackson, L. R., Peterson, E. D., McCoy, L. A., Ju, C., Zettler, M., Baker, B. A., Messenger, J. C., Faries, D. E., Effron, M. B., Cohen, D. J., Wang, T. Y. Tags: Quality and Outcomes Original Research 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

Relationship Between Peak Troponin Values and Long-Term Ischemic Events Among Medically Managed Patients With Acute Coronary Syndromes Coronary Heart Disease
BackgroundThe relationship between troponin level and outcomes among patients with non‐ST‐segment elevation ACS is established, but the relationship of troponin level with long‐term outcomes among medically managed non‐ST‐segment elevation ACS patients receiving contemporary antiplatelet therapy is inadequately defined.Methods and ResultsIn 6763 medically managed non‐ST‐segment elevation ACS patients randomized in TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) (prasugrel versus clopidogrel), we examined relationships between categories o...
Source: JAHA:Journal of the American Heart Association - April 11, 2017 Category: Cardiology Authors: Goldstein, S. A., Newby, L. K., Cyr, D. D., Neely, M., Luscher, T. F., Brown, E. B., White, H. D., Ohman, E. M., Roe, M. T., Hamm, C. W. Tags: Acute Coronary Syndromes Original Research Source Type: research