• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study
Conclusions Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the decision to prescribe a polypill for secondary prevention of stroke. Acceptability among survivors, caregivers and GPs is likely to determine the uptake and subsequent use of a polypill in the future.
Source: BMJ Open - May 12, 2016 Category: Journals (General) Authors: Jamison, J., Graffy, J., Mullis, R., Mant, J., Sutton, S. Tags: Open access, Cardiovascular medicine, Qualitative research Source Type: research

Statin and dual antiplatelet therapy for the prevention of early neurological deterioration and recurrent stroke in branch atheromatous disease: a protocol for a prospective single-arm study using a historical control for comparison
Introduction Branch atheromatous disease (BAD) contributes to small-vessel occlusion in cases of occlusion or stenosis of large calibre penetrating arteries, and it is associated with a higher possibility of early neurological deterioration (END) and recurrent stroke in acute ischaemic stroke. As the pathology of BAD is due to atherosclerosis, we postulate that early intensive medical treatment with dual antiplatelet therapy (DAPT) and high-intensity statins may prevent END and recurrent stroke in acute small subcortical infarction caused by BAD. Methods and analysis In this prospective, single-centre, open-label, non-ran...
Source: BMJ Open - November 26, 2021 Category: General Medicine Authors: Huang, Y.-C., Lee, J.-D., Weng, H.-H., Lin, L.-C., Tsai, Y.-H., Yang, J.-T. Tags: Open access, Neurology Source Type: research

Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis
Conclusions Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75–162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.
Source: BMJ Open - March 17, 2016 Category: Journals (General) Authors: Niu, P.-P., Guo, Z.-N., Jin, H., Xing, Y.-Q., Yang, Y. Tags: Open access, Evidence based practice, Neurology, Pharmacology and therapeutics Research Source Type: research

Renal safety evaluation of aspirin plus edaravone in patients with ischaemic stroke: a retrospective cohort study
Conclusions Our study indicated that edaravone in patients with ischaemic stroke didn’t increase the nephrotoxicity of aspirin, and even had a protective effect on mild renal deterioration. Nevertheless, there is a need to be cautious when patients are in bad pathophysiological conditions and at high risk of bleeding.
Source: BMJ Open - April 19, 2022 Category: General Medicine Authors: Yang, H.-q., Yin, W.-J., Liu, K., Liu, M.-C., Zuo, X.-c. Tags: Open access, Cardiovascular medicine 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

Analysis of CYP2C19 genetic variants with ischaemic events in UK patients prescribed clopidogrel in primary care: a retrospective cohort study
Conclusions A substantial proportion of the UK population carry genetic variants that reduce metabolism of clopidogrel to its active form. In family practice patients on clopidogrel, CYP2C19 LoF variants are associated with substantially higher incidence of ischaemic events. Genotype-guided selection of antiplatelet medications may improve outcomes in patients carrying CYP2C19 genetic variants.
Source: BMJ Open - December 13, 2021 Category: General Medicine Authors: Pilling, L. C., Türkmen, D., Fullalove, H., Atkins, J. L., Delgado, J., Kuo, C.-L., Kuchel, G. A., Ferrucci, L., Bowden, J., Masoli, J. A. H., Melzer, D. Tags: Open access, Cardiovascular medicine Source Type: research

A short-term risk-benefit analysis of occasional and regular use of low-dose aspirin in primary prevention of vascular diseases: a nationwide population-based study
Conclusions Short-term regular use of low-dose aspirin might not be better than occasional use for preventing major vascular diseases in primary prevention. Prescribing regular low-dose aspirin for primary prevention should be done with caution. Future studies should explore the risk–benefit effect of long-term low-dose aspirin use in primary prevention.
Source: BMJ Open - January 9, 2015 Category: Journals (General) Authors: Wu, I.-C., Hsieh, H.-M., Wu, M.-T. Tags: Open access, Epidemiology Research Source Type: research

Outcome of patients admitted with acute coronary syndrome on palliative treatment: insights from the nationwide AMIS Plus Registry 1997-2014
Conclusions Patients with ACS treated palliatively were older, sicker, with more heart failure at admission and very high in-hospital mortality. While refraining from more active therapy may often constitute the most humane and appropriate approach, we think it is important to also evaluate these patients and include them in registries and outcome evaluations. Clinical trial number ClinicalTrials.gov Identifier: NCT01 305 785.
Source: BMJ Open - March 2, 2015 Category: Journals (General) Authors: Erne, P., Radovanovic, D., Seifert, B., Bertel, O., Urban, P., on behalf of the AMIS Plus Investigators, Lessing, P., Hess, F., Simon, R., Hangartner, P., Hufschmid, U., Hornig, B., Jeger, R., Trummler, S., Windecker, S., Rueff, T., Loretan, P., Roethlisb Tags: Open access, Cardiovascular medicine Research Source Type: research

Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2)
Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications.
Source: BMJ Open - December 15, 2015 Category: Journals (General) Authors: Kassaian, S. E., Masoudkabir, F., Sezavar, H., Mohammadi, M., Pourmoghaddas, A., Kojouri, J., Ghaffari, S., Sanaati, H., Alaeddini, F., Pourmirza, B., Mir, E., on-behalf of the IPACE2 registry investigators Tags: Open access, Cardiovascular medicine, Evidence based practice, Medical management Research Source Type: research

Referral pathways for patients with TIA avoiding hospital admission: a scoping review
Conclusions Research literature has focused on assessment and referral by family doctors and ED physicians to reduce hospitalisation of patients with TIA. No pathways for paramedical use were reported. We will use results of this scoping review to inform development of a paramedical referral pathway to be tested in a feasibility trial. Trial registration number ISRCTN85516498. Stage: pre-results.
Source: BMJ Open - February 13, 2017 Category: Journals (General) Authors: Evans, B. A., Ali, K., Bulger, J., Ford, G. A., Jones, M., Moore, C., Porter, A., Pryce, A. D., Quinn, T., Seagrove, A. C., Snooks, H., Whitman, S., Rees, N., on behalf of the TIER Trial Research Management Group Tags: Open access, Emergency medicine, Evidence based practice, Health services research Source Type: research

Continuation versus discontinuation of aspirin-based antiplatelet therapy for perioperative bleeding and ischaemic events in adults undergoing neurosurgery: protocol for a systematic review and meta-analysis
Introduction Antiplatelet therapy is commonly used in primary or secondary prevention of atherosclerotic and thrombotic diseases, such as coronary artery disease, transient ischaemic attack or stroke. Recent studies noted that antiplatelet therapy should be continued perioperatively in patients at high risk of thrombosis and low bleeding risk in orthopaedic, spinal or urological surgery. However, evidence in neurosurgery is lacking. Thus, we aim to conduct a systematic review and meta-analysis to assess whether the continuous use of antiplatelet drugs in neurosurgery increases the risk of perioperative bleeding. Methods a...
Source: BMJ Open - September 30, 2021 Category: General Medicine Authors: Wang, X., Wang, X., Yu, Y., Han, R. Tags: Open access, Anaesthesia Source Type: research

Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis
This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management. Methods and analysis After searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TT...
Source: BMJ Open - August 10, 2021 Category: General Medicine Authors: Lin, J., Wu, B., Lin, L., Ding, Y., Zhong, B., Huang, Z., Lin, M., Xu, D.-P. Tags: Open access, Cardiovascular medicine Source Type: research

Colchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial
Conclusions In this small, open-label, randomised trial of non-critically ill hospitalised patients with COVID-19, the combination of colchicine and rosuvastatin in addition to standard of care did not appear to reduce the risk of progression of COVID-19 disease or thromboembolic events, although the trial was underpowered due to a lower-than-expected event rate. The trial leveraged the power of electronic medical records for efficiency and improved follow-up and demonstrates the utility of incorporating electronic medical records into future trials. Trial registration NCT04472611.
Source: BMJ Open - February 24, 2023 Category: General Medicine Authors: Shah, T., McCarthy, M., Nasir, I., Archer, H., Ragheb, E., Kluger, J., Kashyap, N., Paredes, C., Patel, P., Lu, J., Kandel, P., Song, C., Khan, M., Huang, H., Ul Haq, F., Ahmad, R., Howes, C., Cambi, B., Lancaster, G., Cleman, M., Dela Cruz, C., Parise, H Tags: Open access, Infectious diseases, COVID-19 Source Type: research