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Specialty: Internal Medicine
Drug: Aspirin

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Total 127 results found since Jan 2013.

Implications for your practice: Important changes in the 2014 guideline for the management of patients with atrial fibrillation.
Authors: Littrell R, Flaker G Abstract Atrial fibrillation (AF) is an increasingly common cardiac arrhythmia, currently affecting more than 5 million Americans. Management of patients with AF can be complex, with key strategies including selecting rhythm control versus heart rate control and reducing the patient's risk of stroke or other systemic embolization. The American Heart Association, American College of Cardiology, and Heart Rhythm Society released 2014 Guideline for the Management of Patients with Atrial Fibrillation, which outlines several new recommendations with important clinical implications. Among th...
Source: Postgraduate Medicine - April 1, 2015 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Management of atrial fibrillation: What is new in the 2014 ACC/AHA/HRS guideline?
Authors: Rajagopalan B, Curtis AB Abstract Abstract Recently, the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society published an updated guideline on the management of atrial fibrillation (AF). This document is a complete revision of the 2006 guideline. Prominent changes in the 2014 guideline include the use of the CHA2DS2-VASc score for risk stratification of stroke, recommendations on when and how to use newer oral anticoagulants for thromboprophylaxis, downgrading of the use of aspirin for thromboprophylaxis of moderate-risk patients, and the use of catheter ablation in...
Source: Postgraduate Medicine - March 11, 2015 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Efficacy and Safety of Oral Anticoagulants Versus Aspirin for Patients With Atrial Fibrillation: A Meta-Analysis
Abstract: The purpose of this study was to perform a meta-analysis comparing the effectiveness and safety of anticoagulation to antiplatelet therapy for the prevention of thromboembolic events in patients with atrial fibrillation (AF). MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched for studies published through May 31, 2014. Randomized controlled trials comparing anticoagulants (warfarin) and antiplatelet therapy in patients with AF were included. The primary outcomes were the rates of stroke and systemic embolism. Secondary outcomes included the rates of hemorrhage/major bleeding and death. Pooled o...
Source: Medicine - January 1, 2015 Category: Internal Medicine Tags: Article: Systematic Review and Meta-Analysis Source Type: research

Questions linger over POISE-2 and perioperative aspirin management
Commentary on: Devereaux PJ, Mrkobrada M, Sessler DI, et al.. Aspirin in patients undergoing noncardiac surgery. N Engl J Med 2014;370:1494–503. Context Aspirin therapy for secondary prevention in patients with cardiovascular (CV) disease was catalysed by the Antithrombotic Trialists’ Collaboration meta-analysis in which antiplatelet therapy (primarily aspirin) demonstrated a 22% reduction in mortality from any vascular cause.1 Based on this meta-analysis and American Heart Association (AHA) guidelines, high-risk patients (those with coronary artery, cerebrovascular or peripheral vascular disease) should be pre...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Gerstein, N. S., Charlton, G. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease Therapeutics Source Type: research

Aspirin resistant patients with recent ischemic stroke
Publication date: April 2014 Source:Revista Clínica Española (English Edition), Volume 214, Issue 3 Author(s): L. Castilla-Guerra , M.S. Navas-Alcántara , M.C. Fernández-Moreno Some patients with a recent ischemic stroke who are being treated with aspirin as an antiaggregant suffer a new ischemic stroke. These patients (15–25%) have been called unresponsive to aspirin or aspirin resistant. The aspirin-resistant patients have a four-time greater risk of suffering a stroke. Furthermore, these strokes are generally more severe, with increased infarct volume and greater risk of recurrence. There is currently no ideal l...
Source: Revista Clinica Espanola - November 6, 2014 Category: Internal Medicine Source Type: research

Dual antiplatelet therapy in recurrent stroke prevention: do the benefits outweigh the risks?
This study assessed seven randomised controlled trials, comprising 39 574 patients and comparing dual versus single antiplatelet therapies. Medications used included aspirin (50–325 mg daily), clopidogrel (75 mg daily), aspirin plus dipyridamole (50/400 mg daily) and ticlopidine (100 mg daily). Patients had a history of ischaemic stroke (three trials) or TIA (four...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Farooq, M. U., Gorelick, P. B. Tags: Clinical trials (epidemiology), Stroke Therapeutics Source Type: research

Meta-analysis finds benefit for dual antiplatelet therapy but limitations preclude changing standard mono antiplatelet therapy approach for acute non-cardioembolic ischaemic stroke or transient ischaemic attack
Commentary on: Wong KSL, Wang Y, Leng X, et al.. Early dual versus mono antiplatelet therapy for acute non-cardioembolic ischemic stroke or transient ischemic attack. An updated systematic review and meta-analysis. Circulation 2013;128:1656–66. Context Current guidelines recommend aspirin, aspirin plus clopidogrel or aspirin plus extended-release dipyridamole for treatment of acute ischaemic stroke (IS) or transient ischaemic attack (TIA) to prevent recurrent stroke, myocardial infarction and cardiovascular death.1 The Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial ra...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Aronow, W. S. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease Therapeutics Source Type: research

Implementation of best medical therapy for cardiovascular risk factors in vascular surgery patients treated in a tertiary referral regional unit
ConclusionDespite increased implementation of best medical therapy in the community with compliance rates greater than 73% for aspirin and statin therapy, further improvement is warranted. Vascular surgeons should remain vigilant for further opportunities to optimise medical therapy in this high‐risk patient group particularly with antithrombotic, lipid lowering and antihypertensive therapies.
Source: International Journal of Clinical Practice - March 27, 2014 Category: Internal Medicine Authors: D. McGrogan, D. Mark, B. Lee, M. E. O'Donnell Tags: Original Paper Source Type: research

Aspirin plus clopidogrel in acute minor ischaemic stroke or transient ischaemic attack is superior to aspirin alone for stroke risk reduction: CHANCE trial
Commentary on: Wang Y, Wang Y, Zhao X, et al.. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013;369:11–19. Context Combination therapy with aspirin added to clopidogrel has had a disappointing record in the prevention of recurrent stroke. The management of atherothrombosis with clopidogrel in high-risk patients (MATCH)1 and the secondary prevention of small subcortical strokes (SPS3)2 randomised controlled trials (RCTs) showed that combination therapy was not more effective than clopidogrel or aspirin alone, but was associated with two to three times the risk of major or ...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Gorelick, P. B., Farooq, M. U. Tags: Smoking and tobacco, Clinical trials (epidemiology), Genetics, Stroke, Hypertension, Diabetes, Health education, Smoking Therapeutics Source Type: research

Switching from aspirin to clopidogrel in patients with aspirin resistance after an ischemic stroke. Is it a good solution?
PMID: 24484620 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - January 28, 2014 Category: Internal Medicine Authors: Castilla-Guerra L, Del Carmen Fernandez-Moreno M, Sierra Navas-Alcantara M, Jimenez-Gonzalo F Tags: Eur J Intern Med Source Type: research

Long-term aspirin use and neovascular age-related macular degeneration: association or causation?
Commentary on: Liew G, Mitchell P, Wong TY, et al.. The association of aspirin use with age-related macular degeneration. JAMA Intern Med 2013;173:258–64. Context Aspirin is used by many for temporary pain relief, rheumatological conditions and where indicated, cardioprotection. However, recent findings from observational studies have raised the possibility that regular aspirin use may also increase the risk of some forms of age-related macular degeneration (AMD). Methods Liew and colleagues examined the relationship between long-term, low-dose aspirin use and risk of AMD in an Australian population-based cohort of 2...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Christen, W. G. Tags: EBM Aetiology, Smoking and tobacco, Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Pain (neurology), Stroke, Hypertension, Ophthalmology, Pain (palliative care), Pain (anaesthesia), Diabetes, Health education, Smoking Source Type: research

Adding clopidogrel to aspirin after TIA or minor ischemic stroke reduced stroke without increasing bleeding.
PMID: 24126666 [PubMed - in process]
Source: Annals of Internal Medicine - October 15, 2013 Category: Internal Medicine Authors: Hill MD Tags: Ann Intern Med Source Type: research

Recurrent headaches: a case of neurological Behçet's disease.
Abstract A 48-year-old black male, of Nigerian heritage, presented with a 24-hour history of frontal headache of gradual onset. The headache characteristic was migranous, being described as throbbing in nature and located to the right frontal area with associated blurring of vision. Although similar to prior frequent headaches, there was now increasing unsteadiness on walking. Diagnosed 10 years earlier with Behçet's disease, the initial presentation was with oral and genital ulceration. Recurrent episodes of headache caused by neurological flare-ups resulted in a stroke at the age of 46 years. This previous stro...
Source: British Journal of Hospital Medicine - October 9, 2013 Category: Internal Medicine Authors: M Ismail A, W Dubrey S, C Patel M Tags: Br J Hosp Med (Lond) Source Type: research

Clopidogrel with Aspirin in Minor Stroke or Transient Ischemic Attack
New England Journal of Medicine, Volume 369, Issue 14, Page 1375-1377, October 2013.
Source: New England Journal of Medicine - October 2, 2013 Category: Internal Medicine Tags: article Source Type: research

Risk-Benefit Profile of Long-Term Dual- Versus Single-Antiplatelet Therapy Among Patients With Ischemic Stroke: A Systematic Review and Meta-analysis.
CONCLUSION: Compared with monotherapy, dual-antiplatelet therapy lasting more than 1 year after an index ischemic stroke or transient ischemic attack is not associated with a greater reduction in overall recurrent stroke risk. However, long-term dual-antiplatelet therapy is linked to higher risk for ICH than clopidogrel monotherapy in this patient population. PRIMARY FUNDING SOURCE: Chang Gung Memorial Hospital. PMID: 24081287 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 1, 2013 Category: Internal Medicine Authors: Lee M, Saver JL, Hong KS, Rao NM, Wu YL, Ovbiagele B Tags: Ann Intern Med Source Type: research