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Drug: Clopidogrel
Nutrition: Vitamins

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Total 75 results found since Jan 2013.

Platelet Surface CD62p and Serum Vitamin D Levels are Associated with Clopidogrel Resistance in Chinese Patients with Ischemic Stroke
Background: To explore the association of platelet activation markers, vitamin D, and antiplatelet drugs resistance in ischemic stroke patients. Methods: A total of 230 patients with ischemic stroke were enrolled in this study. Platelet aggregation, platelet activation marker (CD62p), and vitamin D were measured after 7-14 days of dual antiplatelet treatment (aspirin  + clopidogrel). All individuals were divided into a drug resistance group and a drug sensitive group according to the platelet maximum aggregation rate induced by antagonist adenosine diphosphate or arachidonic acid.
Source: Journal of Stroke and Cerebrovascular Diseases - February 20, 2019 Category: Neurology Authors: Bi-Chao Lu, Xiao-Jie Shi, Lin Liang, Na Dong, Zhi-Zhong Liu Source Type: research

Oral Anticoagulants With Dual Antiplatelet Therapy Versus Clopidogrel in Patients After Percutaneous Coronary Intervention: A Meta-Analysis
Conclusions: In patients who are on OAC with vitamin K antagonist and underwent percutaneous coronary intervention, no significant differences were found in mortality, ischemic, and hemorrhagic complications between the patients treated with TT and DT. Thus, tailored treatment based on individual thromboembolic and bleeding risk might be the most reasonable approach in these patients.
Source: American Journal of Therapeutics - December 29, 2018 Category: Drugs & Pharmacology Tags: Reviews Source Type: research

EP News: Clinical
Sindet-Pedersen et  al (J Am Coll Cardiol 2018;72:1790, PMID 30286922) investigated the risk of bleeding, ischemic stroke, myocardial infarction (MI), and all-cause mortality associated with direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) in combination with aspirin, clopidogrel, or both in patients with atrial fibrillation (AF) after MI and/or percutaneous coronary intervention (PCI). Overall, 3222 patients were included in the retrospective registry analysis; 875 (27%) were treated with VKA+single antiplatelet therapy (SAPT), 595 (18%) were treated with DOAC+SAPT, 1074 (33%) were treated wi...
Source: Heart Rhythm - November 23, 2018 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

A Study of Haemostatic Parameters in Patients with Philadelphia-Negative Myeloproliferative Neoplasms. Correlation with, Clinical, Laboratory, Molecular, and Treatment Characteristics
DiscussionGlobal assays such as thromboelastography are more useful than conventional hemostatic laboratory tests in depicting the hypercoagulable state in MPN. They may be useful in combination with other parameters such as the mutational status in identifying patients with MPN at higher risk for thrombosis and guide clinicians for the type of treatment (both cytoreductive and anticoagulants). Tests of platelet function assessment may help the clinicians adjust the type and dose of antiplatelet therapy.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Giannakopoulou, N., Politou, M., Diamantopoulos, P. T., Korakakis, D., Efstathopoulou, M., Kassi, T., Kontandreopoulou, C.-N., Zoi, K., Giannopoulos, A., Dimou, M., Panayiotidis, P., Viniou, N.-A. Tags: 634. Myeloproliferative Syndromes: Clinical: Poster III Source Type: research

Indications, Efficacy and Complications of Kcentra Use in Reversing Coagulopathy
ConclusionsKcentra was used in several off-label clinical settings, with comparable mortality among the coumadin, rivaroxaban and apixaban groups and no identifiable benefit in the setting of cirrhosis, DIC or antiplatelet medications, but with an increased incidence of deep vein thrombosis and stroke.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Sritharan, N., Triulzi, D. Tags: 401. Basic Science and Clinical Practice in Blood Transfusion: Poster III Source Type: research

Anticoagulation in Atherosclerotic Disease.
Abstract The prevention of atherothrombotic events is an essential therapeutic goal in the treatment of patients with arteriosclerotic diseases. After plaque rupture, a rapidly growing thrombus can lead to acute vascular occlusion and thus heart attack, stroke or limb ischaemia. The acute therapy combines anticoagulation and platelet inhibition. However, the only available therapy so far in the primary and secondary prevention of stable patients is the platelet inhibitors aspirin and clopidogrel. Despite the use of antiplatelet therapies, including aspirin and P2Y12-receptor antagonists, some patients with artery ...
Source: Hamostaseologie - October 17, 2018 Category: Hematology Authors: Al Said S, Bode C, Duerschmied D Tags: Hamostaseologie Source Type: research

Pharmacodynamic safety of clopidogrel monotherapy in patients under oral anticoagulation with a vitamin K antagonist undergoing coronary stent implantation.
This study enrolled 100 patients on aspirin plus clopidogrel (DAPT-cohort, without indication for VKA) and 100 patients on clopidogrel monotherapy plus phenprocoumon (OAC-cohort) undergoing elective PCI. Platelet reactivity was assessed by impedance aggregometry on day 1 following PCI. Ischemic (death, stroke, or myocardial infarction) and bleeding (BARC 2-5) events within 12 months were compared in a propensity score adjusted model. Platelet reactivity was not different in the OAC- and DAPT-cohort (187 [127-242] vs. 167 [126-218] AU×min; p = 0.23). Overall, 17 ischemic and 34 bleeding events were recorded during follo...
Source: Platelets - September 14, 2018 Category: Hematology Tags: Platelets Source Type: research

Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report.
CONCLUSIONS: Oral anticoagulation is the optimal choice of antithrombotic therapy for patients with AF with ≥1 non-gender CHA2DS2VASc stroke risk factor(s). PMID: 30144419 [PubMed - as supplied by publisher]
Source: Chest - August 21, 2018 Category: Respiratory Medicine Authors: Lip GYH, Banerjee A, Boriani G, Chiang CE, Fargo R, Freedman B, Lane DA, Ruff CT, Turakhia M, Werring D, Patel S, Moores L Tags: Chest Source Type: research

Optimal antithrombotic treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: triple therapy is too much!
Abstract Patients with atrial fibrillation who undergo a coronary intervention are eligible for both anticoagulation and (dual) antiplatelet therapy ((D)APT). An optimal balance has to be found to reduce the thromboembolic risk (i.e. stroke, systemic embolism and myocardial infarction) and to minimise the increased risk of bleeding with concomitant use of an anticoagulant and (D)APT. Owing to a lack of evidence, the guideline recommendations are predominantly based on expert opinion. Current evidence indicates that the combination of a non-vitamin K oral anticoagulant (NOAC) and clopidogrel is safer than vitam...
Source: Netherlands Heart Journal - May 8, 2018 Category: Cardiology Authors: Jacobs MS, Tieleman RG Tags: Neth Heart J Source Type: research

Antithrombotic therapy in patients with non-valvular atrial fibrillation undergoing percutaneous coronary intervention: should we change our practice after the PIONEER AF-PCI and RE-DUAL PCI trials?
AbstractThe number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2DS2-VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known. In the rather small randomized WOEST trial, the combination of a vi...
Source: Clinical Research in Cardiology - April 20, 2018 Category: Cardiology Source Type: research

Beyond Stroke Prevention in Atrial Fibrillation: Exploring Further Unmet Needs with Rivaroxaban.
This article provides an update on three randomized controlled trials of rivaroxaban, a direct, oral factor Xa inhibitor, that are complete or are ongoing, in these unmet areas of stroke prevention: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in patients with Atrial Fibrillation who undergo Percutaneous Coronary Intervention (PIONEER AF-PCI) trial; the New Approach riVaroxaban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE E...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Gibson CM, Hankey GJ, Nafee T, Welsh RC Tags: Thromb Haemost Source Type: research

Is there a role for oral triple therapy in patients with acute coronary syndromes without atrial fibrillation?
CONCLUSION: More potent antithrombotic regimens increase bleeding and should only be considered on an individual basis, after careful risk stratification. Accurate risk stratification of ACS patients, for both ischaemic and bleeding risk, is essential to allow individualised treatment. PMID: 29345587 [PubMed - as supplied by publisher]
Source: Current Vascular Pharmacology - January 16, 2018 Category: Drugs & Pharmacology Authors: Spinthakis N, Farag M, Akhtar Z, Gorog DA Tags: Curr Vasc Pharmacol Source Type: research

Integrative medicine on optimizing clopidogrel and aspirin therapy
This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that theCYP2C19 gene mutation (CYP2C19*2 andCYP2C19*3) could affect> 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI). Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation (AF), and warfar...
Source: Chinese Journal of Integrative Medicine - January 15, 2018 Category: Internal Medicine Source Type: research

Primary Prevention of Stroke in Chronic Kidney Disease Patients: A Scientific Update
Background: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking.Summary: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population. The use of oral anticoagulation in AF appears safe...
Source: Cerebrovascular Diseases - January 9, 2018 Category: Neurology Source Type: research

Predictors of Mortality in Patients with Atrial Fibrillation (From the Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events ACTIVE a)
The mortality rate of most patients with atrial fibrillation (AF) exceeds the stroke rate, but predictors of mortality have not been well defined. The Atrial Fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE) recruited AF patients who were unsuitable to receive vitamin K-antagonists and were randomized to aspirin alone vs. aspirin plus clopidogrel. We investigated independent predictors of all-cause mortality by multivariable Cox regression analysis and explored interactions with assigned antiplatelet therapy.
Source: The American Journal of Cardiology - December 11, 2017 Category: Cardiology Authors: Kanjana S. Perera, Lesly A. Pearce, Mukul Sharma, Oscar Benavente, Stuart J. Connolly, Robert G. Hart, ACTIVE (Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events) Steering Committee and Investigators Source Type: research