In SPS3 Trial dual anti-platelet therapy compared to aspirin alone exhibited no benefit and significant evidence of harm including risk of hemorrhage of 2.1% for dual anti-platelet therapy compared to 1.1% for aspirin alone and the dual anti-platelet therapy group also showed higher rates of mortality
The REPLACE-2 trial validated bivalirudin plus provisional GP IIb/IIIa blockade as an alternative anticoagulant regimen to heparin plus planned GP IIb/IIIa blockade during urgent or elective PCI. This substudy of the REPLACE-2 trial focused on the role of clopidogrel pretreatment with both these treatment strategies. Although administration of clopidogrel before PCI was associated with a trend toward lower rates of periprocedural ischemic events for patients who received either bivalirudin or heparin plus GP IIb/IIIa blockade, bivalirudin with provisional GP IIb/IIIa blockade was noninferior to heparin plus planned GP IIb/IIIa blockade in all subgroups irrespective of pretreatment or the duration of pretreatment. Moreover, there was no evidence that clopidogrel pretreatment attenuated the reduction in bleeding complications by bivalirudin. Therefore, clopidogrel pretreatment appears to improve clinical outcomes without compromising safety, but is not required for bivalirudin to achieve efficacy ...
To the Editor:. We read with interest the work by Chen et al,1 which reported that triple antiplatelet therapy seems to be superior to dual antiplatelet therapy in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention with drug-eluting stents. Chen et al1 reported the mortality benefits of triple antiplatelet therapy obtained mainly within 30 days after STEMI, reflecting the importance of the addition of cilostazol to aspirin and clopidogrel before stenting. Meanwhile, the authors pointed out the limitation of the nonrandomized trial, that several baseline differences were present between the groups. In our opinion, the advantage of the short-term outcome of triple therapy should be emphasized in higher-risk patients with STEMI undergoing primary percutaneous coronary intervention regardless of whether cilostazol or abciximab was selected.. Because glycoprotein IIb/IIIa inhibitors (abciximab) as adjunctive pharmacological therapy ...
Background: The potential benefits and risks of the use of dual anti-platelet therapy (DAT) beyond 12 months in patients receiving drug-eluting stents (DES) with acute myocardial infarction (AMI) have not been clearly established.. Methods: We analyzed 795 patients who had undergone DES implantation with AMI and had been free of major adverse cardiac or cerebrovascular events at least for 12 months in prospective multi-center registry (Infarct Prognosis Study). The duration of DAT was categorized in group 1 (N=185): ≤ 12 months and group 2 (N=610): , 12 months. The incidence of cardiac death or recurrent MI was compared between 2 groups.. Results: The median duration of follow up was 28.4 months. The Kaplan Meier analysis indicated a benefit of group 2 compared with less than group 1. (2.5 % vs. 8.6 %, log rank test p , 0.001). Continuation of DAT beyond 12 months showed the significant reduction of cardiac death or recurrent MI in Cox proportional hazards analysis even after controlling of ...
Participating Centers : 38 french high PCI volume (,700) centers Rationale: Clopidogrel / Prasugrel (75 mg/day), in combination with aspirin (75 mg/day), is currently the antiplatelet treatment of choice for prevention of stent thrombosis, and clinical trials have shown that, in high-risk patients, prolonged dual antiplatelet treatment is more effective than aspirin alone in preventing major cardiovascular events. However, despite the use of clopidogrel, a considerable number of patients continue to have cardiovascular events. Numerous in VITRO studies have shown that individual responsiveness to clopidogrel but also to aspirin is not uniform in all patients and is subject to inter- and intraindividual variability. The recent possibility of bedside monitoring of oral antiplatelet therapy offers the unique opportunity of tailoring antiplatelet therapy. However, the relevance of such strategy has never been evaluated in a randomized prospective adequately powered study having long term follow-up ...
TY - JOUR. T1 - Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation a randomized, controlled trial. AU - Lee, Cheol Whan. AU - Ahn, Jung Min. AU - Park, Duk Woo. AU - Kang, Soo Jin. AU - Lee, Seung Whan. AU - Kim, Young Hak. AU - Park, Seong Wook. AU - Han, Seungbong. AU - Lee, Sang Gon. AU - Seong, In Whan. AU - Rha, Seung Woon. AU - Jeong, Myung Ho. AU - Lim, Do Sun. AU - Yoon, Jung Han. AU - Hur, Seung Ho. AU - Choi, Yun Seok. AU - Yang, Joo Young. AU - Lee, Nae Hee. AU - Kim, Hyun Sook. AU - Lee, Bong Ki. AU - Kim, Kee Sik. AU - Lee, Seung Uk. AU - Chae, Jei Keon. AU - Cheong, Sang Sig. AU - Suh, Il Woo. AU - Park, Hun Sik. AU - Nah, Deuk Young. AU - Jeon, Doo Soo. AU - Seung, Ki Bae. AU - Lee, Keun. AU - Jang, Jae Sik. AU - Park, Seung Jung. PY - 2014/1/21. Y1 - 2014/1/21. N2 - Background-The risks and benefits of long-term dual antiplatelet therapy remain unclear. Methods and Results-This prospective, multicenter, open-label, randomized comparison trial was ...
OBJECTIVE: To determine the effects of antiplatelet therapy among patients at high risk of occlusive vascular events. DESIGN: Collaborative meta-analyses (systematic overviews). INCLUSION CRITERIA: Randomised trials of an antiplatelet regimen versus control or of one antiplatelet regimen versus another in high risk patients (with acute or previous vascular disease or some other predisposing condition) from which results were available before September 1997. Trials had to use a method of randomisation that precluded prior knowledge of the next treatment to be allocated and comparisons had to be unconfounded-that is, have study groups that differed only in terms of antiplatelet regimen. STUDIES REVIEWED: 287 studies involving 135 000 patients in comparisons of antiplatelet therapy versus control and 77 000 in comparisons of different antiplatelet regimens. MAIN OUTCOME MEASURE: Serious vascular event: non-fatal myocardial infarction, non-fatal stroke, or vascular death. RESULTS: Overall, among these
We investigated the impact of suboptimal platelet reactivity on clinical outcomes after percutaneous coronary intervention (PCI). We enrolled 500 patients with stable coronary artery disease...
To help prevent this, physicians may prescribe antiplatelets in patients who are at high risk for developing a thrombus within their blood vessels. Antiplatelets are types of anticoagulants - medications used to help prevent the formation of blood clots when no injury has occurred. They work by reducing the platelets stickiness (viscosity). The most common antiplatelet in use today is the over-the-counter drug aspirin, which has been found to prevent platelet binding and clot formation. Today, many physicians place their heart patients on a small daily dose of aspirin (generally 81 milligrams) to prevent the formation of blood clots that may injure the heart. For patients who do not respond to aspirin as a preventive therapy, other antiplatelet medications are available. The most common are clopidogrel and ticlopidine ...
We read with interest the CILON-T (Influence of Cilostazol-based Triple Antiplatelet Therapy on Ischemic Complication After Drug-Eluting Stent Implantation) trial on the efficacy of cilostazol on ischemic complications after drug-eluting stent (DES) implantation (1), which suggested the potential link between platelet reactivity and ischemic events in Asians.. Asians exhibit poor response to clopidogrel, maybe due to the high prevalence of CYP2C19*2/*3 allele carriage (∼55% to 70%) (1). In the CILON-T study, ,50% of the patients receiving dual antiplatelet therapy had high platelet reactivity based on Western population (P2Y12 reaction units [PRU] ,235). However, similar to other Asian studies, the CILON-T study showed a low ischemic events rate (∼2% during 6 months). In the CILON-T study, patients under the certain PRU (,210) were absent from ischemic events (1). Meanwhile, the GRAVITAS trial demonstrated a different threshold (∼175 PRU), showing the complete immunity against 6-month ...
Prolonging dual antiplatelet therapy with aspirin plus clopidogrel (Plavix) for more than one year after the placement of a drug-eluting stent confers no clinical benefit.
IMPORTANCE: Dual antiplatelet therapy after percutaneous coronary intervention (PCI) reduces ischemia but increases bleeding.. OBJECTIVE: To develop a clinical decision tool to identify patients expected to derive benefit vs harm from continuing thienopyridine beyond 1 year after PCI.. DESIGN, SETTING, AND PARTICIPANTS: Among 11,648 randomized DAPT Study patients from 11 countries (August 2009-May 2014), a prediction rule was derived stratifying patients into groups to distinguish ischemic and bleeding risk 12 to 30 months after PCI. Validation was internal via bootstrap resampling and external among 8136 patients from 36 countries randomized in the PROTECT trial (June 2007-July 2014).. EXPOSURES: Twelve months of open-label thienopyridine plus aspirin, then randomized to 18 months of continued thienopyridine plus aspirin vs placebo plus aspirin.. MAIN OUTCOMES AND MEASURES: Ischemia (myocardial infarction or stent thrombosis) and bleeding (moderate or severe) 12 to 30 months after ...
The use of drug-eluting stents has resulted in a significant reduction in the restenosis rate and in the need for repeat angioplasty of the stented lesion. However, the occurrence of late stent thrombosis has resulted in an increase in the duration of dual antiplatelet treatment.. According to the guidelines of the ESC, the current recommended duration of dual antiplatelet treatment is 12 months.. A relationship has been demonstrated between the occurrence of late stent thrombosis and aspirin resistance.. Furthermore, dual anti-platelet treatment is associated with an increase in bleeding, the severity of which has been well documented. In addition, the patients involved, and especially those over 70, have significant co-morbidities often requiring extra-cardiac surgery which cannot easily be carried out in patients on dual antiplatelet treatment or clopidogrel.. The objective of this study is to determine whether, after a period of 6 months following Drug eluting stent (DES) implantation in ...
To the Editor:. We read with great interest the recent article published by Fiorella et al who report a multicenter experience with the use of the Wingspan stent system (Boston Scientific) for the treatment of intracranial atherosclerosis.1 This collaborative effort should be applauded, but we would advocate for closer scrutiny to future registry designs in order to enhance our understanding of treatment modalities being used.. A total of 78 patients with 82 lesions were treated with a high technical success rate and a periprocedural complication rate (stroke or death) of 6.1%.1 We would like to bring attention to 3 issues that may help with further study in this area. The first is the patient selection for the registry. Nineteen of the 78 (24%) patients were not on antiplatelet therapy at the time of their stroke or transient ischemic attack. The natural history of patients who were not on antiplatelet therapy is not clear to date; thus, selection of such patients for angioplasty and stenting ...
Get a Sample of Global Oral Antiplatelets Sales Market Report from- http://www.absolutereports.com/enquiry/request-sample/10374538. Whereas, on the basis of sales, data related to sales volume, sales price, cost, sales income, and profit margin etc. of Global Oral Antiplatelets Sales Market used in different fields, sold in different regions and by different companies is provided in this report.. Regions Covered in Global Oral Antiplatelets Sales Market Report:. • United States. • China. • Europe. • Japan. • Southeast Asia. • India. Have any Query Regarding this Report? Contact us at: http://www.absolutereports.com/enquiry/pre-order-enquiry/10374538. With a purpose of enlightening new entrants about the possibilities in this market, this Global Oral Antiplatelets Sales Market report investigates new project feasibility. A thorough SWOT analysis & investment analysis is provided in the report which forecasts imminent opportunities for the Global Oral Antiplatelets Sales market ...
Arguably, antiplatelet agents are the most important therapy we administer to stented patients. Antiplatelet agents are given to prevent the most dreaded event that often has catastrophic consequences, coronary thrombosis. It is well established that platelet reactivity to adenosine diphosphate (ADP) mediated by the P2Y12 receptor plays a central role in the development of post-percutaneous coronary intervention (PCI) ischemic events, including stent thrombosis. The active metabolite of clopidogrel blocks this pivotal receptor (1,2). Platelet reactivity to ADP during clopidogrel therapy has been determined by turbidimetric aggregometry, VerifyNow (Accumetrics, San Diego, California) assay, Thrombelastography (TEG, Hemonetics, Braintree, Massachusetts), Multiplate Analyzer (Dynabyte Informationssysteme GmbH, Munich, Germany), and flow cytometry to measure phosphorylated vasodilator stimulated phosphoprotein (VASP Assay, Biocytex, Marseille, France). All of these methods have demonstrated ...
Dual antiplatelet therapy (DAPT) with acetylsalicylic acid and an inhibitor of the adenosine diphosphate platelet receptor P2Y12 has been shown to reduce the risk of stent thrombosis (ST), myocardial infarction and cardiac death after percutaneous coronary intervention (PCI) with bare-metal stents (BMS) and drug-eluting stents (DES). However, while there is consensus on 1-month DAPT after BMS, the optimal duration and the risk-benefit ratio of DAPT duration after DES implantation remains controversial. Controversy surrounding this issue is demonstrated by differences in guideline recommendations for DAPT duration after PCI with DES. For example, while the ACC/AHA recommends a minimum of 12 months, ESC guidelines recommend at least 6 months of DAPT. Recent reports suggest that 6 months of DAPT after second-generation DES implantation might be safe compared with longer durations. Large randomized controlled trials powered to examine ST and bleeding events are currently ongoing and will shed novel ...
CO Clopidogrel: Clopidogrel belongs to the class of medications called platelet aggregation inhibitors or antiplatelets. Clopidogrel is used to help prevent heart attacks, strokes, and other circulation problems in people who have atherosclerosis (narrowed blood vessels caused by hardening of the arteries) and have already experienced at least one atherothrombotic event such as heart attack, stroke, or diagnosed peripheral arterial disease (problems with blood flow in the arteries). It is also used with ASA (acetylsalicylic acid) by people with acute coronary syndrome or atrial fibrillation (a fast, irregular heartbeat).
In patients with ACS (NSTE-ACS or STEMI) treated with coronary stent implantation who have tolerated DAPT without a bleeding complication and who are not at high bleeding risk (e.g., prior bleeding on DAPT, coagulopathy, oral anticoagulant use), continuation of DAPT (clopidogrel, prasugrel, or ticagrelor) for longer than 12 months may be reasonable (Class IIb). A new risk score (the "DAPT score"), derived from the Dual Antiplatelet Therapy study, may be useful for decisions about whether to continue (prolong or extend) DAPT in patients treated with coronary stent implantation ...
Part I Concepts in Platelet Physiology, Function and Measurement. 1 Platelet physiology and the role of the platelet in ischemic heart disease.. Robert F. Storey .. 2 Laboratory assessment of platelet function and the effects of antiplatelet agents.. Alan D. Michelson, A.L. Frelinger .. Part II Pharmacology of Oral Antiplatelet Agents.. 3 Cyclooxygenase inhibitors.. Nina Chetty Raju, John W. Eikelboom .. 4 Aspirin response variability and resistance.. Wai-Hong Chen, Daniel I. Simon .. 5 P2Y12 inhibitors: Thienopyridines and direct oral inhibitors.. Jean-Philippe Collet, Boris Aleil, Christian Gachet, Gilles Montalescot .. 6 Thienopyridine response variability and resistance.. Udaya S. Tantry, Thomas A. Suarez, Paul A. Gurbel .. Part III Pharmacology of Intravenous Antiplatelet Agents.. 7 Pharmacology of intravenous glycoprotein IIb/IIIa antagonists.. James C. Blankenship, Peter B. Berger .. 8 Intravenous P2Y12 inhibitors.. Steven P. Dunn, Steven R. Steinhubl .. 9 Antiplatelet effects of thrombin ...
There are limited real-world data on prevalence and predictors of dual antiplatelet therapy (DAPT) prolongation beyond one year after acute coronary syndrome (ACS). We have explored such issue in the START ANTIPLATELET Registry, which is a prospective, observational, multicenter, Italian registry performed in seven Italian cardiology institutions including patients admitted for ACS and followed up to one year. Out of a total population of 840 ACS patients, 596 patients had completed 12-month follow-up being on DAPT. Decision to prolong DAPT beyond one year was taken in 79 patients (13%), whereas in 517 patients DAPT was stopped. The strongest predictors of DAPT continuation were a new cardiovascular events after the index admission event (OR 3.3, 95% CI 1.4-7.7), no bleeding complications (OR 3.2, 95% CI 1.2-8.3) and no anemia during one-year follow-up (OR 2.6, 95% CI 1.1-5.9); other independent predictors were renal failure (OR 2.5, 95% CI 1.3-5.0) and peripheral artery disease (OR 1.8, 95% CI ...
People with peripheral vascular disease are at high risk of vascular events and major adverse limb events. Use of antiplatelet therapy is effective at reducing this risk. Other antithrombotic strategies that have been tested, such as use of anticoagulation, dual antiplatelet therapy or novel antiplatelet agents, have not been found to be superior to single antiplatelet therapy. The new oral factor Xa inhibitors such as rivaroxaban have been shown to be at least as effective as vitamin K antagonists in preventing thromboembolic events in atrial fibrillation,1 and offer a potential alternative strategy, either in addition to, or instead of, a single antiplatelet agent. ...
Clopidogrel has anti-platelet activity by irreversible inhibition of the P2Y12 platelet receptor. Clopidogrel must be converted into an active metabolite in order to show anti-platelet activity. Hepatic CYP2C19 enzyme is one of the key hepatic enzymes which convert clopidogrel into active metabolite and its genetic polymorphism is related to clopidogrel resistance. CYP2C19 poor or intermediate metabolizer groups show reduced anti-platelet activity of clopidogrel compared to extensive metabolizer group ...
Health, ...The findings were presented by Dr Jolanta Siller-Matula from Medical U...Standard antiplatelet treatment in patients undergoing percutaneous co...But measurements of platelet aggregation in clopidogrel treated patien...Personalized antiplatelet treatment involves choosing a therapy base...,Personalized,antiplatelet,treatment,improves,outcome,after,PCI,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Objective We retrospectively assessed the incidence of hemorrhagic complications associated with pacemaker implantation in patients receiving one or more antiplatelet agents.
Three year follow-up of patients who received dual antiplatelet therapy (DAPT) after placement of a drug-eluting stent (DES) shows that a short course of the therapy continues to be as beneficial as a longer course.
Clopidogrel belongs to the class of medications called platelet aggregation inhibitors or antiplatelets. Clopidogrel is used to help prevent heart attacks, strokes, and other circulation problems in people who have atherosclerosis (narrowed blood vessels caused by
Novel oral anti-coagulants (NOACs) are increasingly being used in clinical practice and are set to almost entirely replace the vitamin K antagonists, such as warfarin, in the near future. Similarly, new antiplatelet agents are now regularly used in place of older agents, such as aspirin and clopidogrel. In an ageing population, with an increasing burden of complex comorbidities, urologists will frequently encounter patients who will be using such agents. Some background knowledge, and an understanding, of these drugs and the issues that surround their usage, is essential. The present article will provide readers with an understanding of these new drugs, including their mechanisms of action, the up-to-date evidence justifying their recent introduction into clinical practice and the appropriate interval for stopping them before surgery. It will also consider the risks of perioperative bleeding for patients taking these drugs and the risks of venous thromboembolism in those in whom they are ...
Antiplatelet agentsThese agents inhibit the cyclo-oxygenase system, decreasing the level of thromboxane A2, which is a potent platelet activator.Aspirin (Bayer Buffered Aspirin, Bayer Aspirin, Anacin)... more
Platelet adhesion, activation and aggregation to the injured vessel wall are crucially involved in the pathogenesis of thrombus formation. Agents in theory thwarting thes..
Dr. Routh responded: Different Actions. Anticoagulants are medicines which keep the blood from clotting by action on factors in the blood which are needed to stop bleeding. Oral examples would include |a href="/topics/warfarin" track_data="{
Jamp-Clopidogrel: Clopidogrel belongs to the class of medications called platelet aggregation inhibitors or antiplatelets. Clopidogrel is used to help prevent heart attacks, strokes, and other circulation problems in people who have atherosclerosis (narrowed blood vessels caused by hardening of the arteries) and have already experienced at least one atherothrombotic event such as heart attack, stroke, or have been diagnosed peripheral arterial disease (problems with blood flow in the arteries). It is also used with ASA (acetylsalicylic acid) by people with acute coronary syndrome or atrial fibrillation (a fast, irregular heartbeat) to reduce the risk of heart attack or stroke.
Riva-Clopidogrel: Clopidogrel belongs to the class of medications called platelet aggregation inhibitors or antiplatelets. Clopidogrel is used to help prevent heart attacks, strokes, and other circulation problems in people who have atherosclerosis (narrowed blood vessels caused by hardening of the arteries) and have already experienced at least one atherothrombotic event such as heart attack, stroke, or have been diagnosed peripheral arterial disease (problems with blood flow in the arteries). It is also used with ASA (acetylsalicylic acid) by people with acute coronary syndrome or atrial fibrillation (a fast, irregular heartbeat) to reduce the risk of heart attack or stroke.
The ARCTIC study randomized 2440 patients scheduled for stent implantation to a strategy of platelet function monitoring with drug adjustment in patients who had a poor response to antiplatelet therapy or to a conventional strategy without monitoring and drug adjustment. No significant improvement in clinical outcomes with platelet function monitoring was observed. The purpose of this study is to assess the relationships between CYP2C19 genotypes, clopidogrel pharmacodynamic response, and clinical outcome. In the ARCTIC-GENE study, 1394 patients were genotyped for loss- and gain-of-function CYP2C19 alleles. Randomization of treatment strategy was well balanced. Slow metabolizers identified as carriers of at least one loss-of-function allele CYP2C19*2 (n = 459) were more likely poor responders at randomization (41.6 vs. 31.6 %, p = 0.0112) and 14 days later (23.8 vs. 10.4 %, p | 0.0001) and more frequently on prasugrel (11.5 vs. 8.1 %, p = 0.039) as compared with rapid metabolizers (n = 935).
January 8, 2018 -- The DAPT-STEMI trial, presented at the November Transcatheter Cardiovascular Therapeutics (TCT) Annual Meeting in Denver, showed the two-year patient outcomes of STEMI patients treated with the Resolute Integrity Drug-Eluting Stent, randomized to six or 12 months of dual antiplatelet therapy (DAPT). The data was presented by Dr. Elvin Kedhi, MD, PhD of Isala Hartcentrum in Zwolle, the Netherlands. The result: after two years, there was no significant difference in the primary or secondary endpoints between the standard 12 month regimen of DAPT and the shortened duration. This is reassuring news for physicians and patients since, although 12 months is currently the recommended duration for DAPT after primary PCI for STEMI, a large number of patients prematurely discontinue DAPT. In fact the RESOLUTE Pooled Analysis of 5,000 patients showed that 1 in 6 stopped taking clopidogrel, prasugrel, or ticagrelor (plus aspirin) in the first few months after stenting. There are a number ...
The correct answer is: D. Stop the aspirin but continue ticagrelor 90 mg twice daily. Using data from eight different trials, the PRECISE DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy) bleeding score was developed and validated.1 An online calculator is currently available: http://www.precisedaptscore.com/predapt/webcalculator.html. This patient has a PRECISE DAPT bleeding score of 35, indicating a high risk for bleeding with an estimated 12-month risk of Thrombolysis in Myocardial Infarction major bleeding of 1.9% and Thrombolysis in Myocardial Infarction major or minor bleeding of 3.8%.. Bleeding is not uncommon among patients treated with dual antiplatelet therapy (DAPT), may not always be reported to the clinician, and may contribute to early DAPT discontinuation.2. The TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention) trial examined the effect of ticagrelor monotherapy ...
May 15, 2012 -- Paris -- Abbott (NYSE: ABT) today announced that the XIENCE PRIME and the XIENCE V Everolimus Eluting Coronary Stent Systems have received CE Mark in Europe for the use of dual anti-platelet therapy (DAPT) for at least three months after stent implantation in patients with coronary artery disease. This is the shortest duration of DAPT for any major drug eluting stent (DES) in Europe. Patients are prescribed DAPT, a combination of aspirin and an anti-platelet medication, following stent implantation to protect them from developing blood clots and experiencing other adverse safety events. The most recent European Society of Cardiology (ESC) guidelines for myocardial revascularization, which were published in 2010, recommend that patients treated with a DES remain on DAPT for six to 12 months. Long-term DAPT use can lead to additional safety risks, such as increased bleeding events, which is why shorter-term duration of DAPT may be meaningful for patients. In addition, having a ...
Références: 1. Information professionelle Brilique (www.swissmedicinfo.ch). 2. Storey, R.F., et al., Inhibition of platelet aggregation by AZD6140, a reversible oral P2Y12 receptor antagonist, compared with clopidogrel in patients with acute coronary syndromes. J Am Coll Cardiol, 2007. 50(19): p. 1852-6.. 3. Wallentin, L., et al., Prasugrel achieves greater and faster P2Y12receptor-mediated platelet inhibition than clopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease. Eur Heart J, 2008. 29(1): p. 21-30.. 4. Wallentin, L., P2Y(12) inhibitors: differences in properties and mechanisms of action and potential consequences for clinical use. Eur Heart J, 2009. 30(16): p. 1964-77.. 5. Gurbel, P.A., et al., Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. Circulation, 2009. 120(25): p. ...
Referenzen: 1. Fachinformation Schweiz Brilique (www.swissmedicinfo.ch). 2. Storey, R.F., et al., Inhibition of platelet aggregation by AZD6140, a reversible oral P2Y12 receptor antagonist, compared with clopidogrel in patients with acute coronary syndromes. J Am Coll Cardiol, 2007. 50(19): p. 1852-6.. 3. Wallentin, L., et al., Prasugrel achieves greater and faster P2Y12receptor-mediated platelet inhibition than clopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease. Eur Heart J, 2008. 29(1): p. 21-30.. 4. Wallentin, L., P2Y(12) inhibitors: differences in properties and mechanisms of action and potential consequences for clinical use. Eur Heart J, 2009. 30(16): p. 1964-77.. 5. Gurbel, P.A., et al., Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. Circulation, 2009. 120(25): p. ...
Clopidogrel is an anti-platelet drug, that is, a drug that inhibits the ability of platelets to clump together as part of a blood clot. It is similar to ticlopidine (Ticlid) in chemical structure and in the way it works. Unlike ticlopidine, clopidogrel does not cause serious reductions of white cells in the blood and, therefore, routine blood testing to determine if the white blood cell count is low is not necessary during treatment. The risk of heart attacks and strokes (which usually are caused by blood clots) is increased in patients with a recent history of stroke or heart attack and patients with peripheral vascular disease. (Peripheral vascular disease is the same as atherosclerotic arterial disease or "hardening" of the arteries in which the arteries become narrowed. It frequently occurs in the legs and often causes claudication or pain in the legs upon walking). Clopidogrel is used to reduce the risk of heart attacks and strokes in these patients. Clopidogrel was approved by the FDA in ...
Clopidogrel is an anti-platelet drug, that is, a drug that inhibits the ability of platelets to clump together as part of a blood clot. It is similar to ticlopidine (Ticlid) in chemical structure and in the way it works. Unlike ticlopidine, clopidogrel does not cause serious reductions of white cells in the blood and, therefore, routine blood testing to determine if the white blood cell count is low is not necessary during treatment. The risk of heart attacks and strokes (which usually are caused by blood clots) is increased in patients with a recent history of stroke or heart attack and patients with peripheral vascular disease. (Peripheral vascular disease is the same as atherosclerotic arterial disease or "hardening" of the arteries in which the arteries become narrowed. It frequently occurs in the legs and often causes claudication or pain in the legs upon walking). Clopidogrel is used to reduce the risk of heart attacks and strokes in these patients. Clopidogrel was approved by the FDA in ...
RIDGEWOOD, N.J. -- Preoperative use of both aspirin and clopidogrel (Plavix) was associated with an increased risk of postoperative infection in patients undergoing coronary artery bypass grafting (C
ORLANDO -- The addition of clopidogrel (Plavix) to aspirin for high-risk patients with atrial fibrillation adds significantly to stroke prevention, researchers found.
The presentation of the PLATO study showed that ticagrelor reduced the rate of cardiovascular events from 11.7 percent to 9.8 percent compared clopidogrel, without an increase in major bleeding.
The TRIGGER-PCI trial, comparing prasugrel 10 mg and clopidogrel 75 mg in patients with high platelet reactivity on clopidogrel after receiving a drug- ...
Elective surgery in the first 3 months is associated with much higher MACE rates. These rates stabilize by 9 months s/p CVA.. The authors did multiple analyses to try to limit the confounding effect that early surgery after stroke might indicate a not-elective indication for surgery. For example, they looked at the association of time after stroke and total knee or hip replacement (without fracture - presumably elective), and found similar elevated rates of MACE in the first 3 months.. There is possible room for improvement, since only 52% of prior CVA patients were chronically on statins, and only 65% on antiplatelet meds (such as aspirin and/or plavix) before surgery. Indeed, when adjusted for comorbidities, they found that in patients with prior CVA, chronic statins and antiplatelets meds were associated with reductions in postop MACE, including death from any cause.. What are some take away points?. ...
Buy Tisten Online! Tisten is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent (dual antiplatelet therapy).
A UOHI clinical trial known as RAPID GENE studied 200 patients undergoing coronary stent implantation for acute coronary syndrome or stable angina. Use of a simple, saliva swab test performed by nurses at the bedside on half of the patients allowed doctors to almost instantly identify those with the genetic variant, known as CYP2C19*2, which puts them at risk of reacting poorly to standard anti-platelet drug therapy, and administer an alternative drug.. The study demonstrated that tailored drug treatment therapy made possible by the genetic testing successfully protected all of the patients with the at-risk genetic variant from subsequent adverse events, while 30 per cent of patients treated with standard therapy did not receive adequate protection.. "These results are extremely promising, not only in the field of cardiology but for all areas of medicine. If you can administer a simple, rapid genetic test at the bedside, doctors can prescribe the right drug to the right patient at the right ...
Anti-platelet drugs are drugs used to prevent platelet aggregation and prevent heart disease or stroke. Blood clotting factors are normal in the body to heal injury and wounds where it stops the blood from exiting the body. Usually platelet aggregation is a good thing; but in cases wher...
Antiplatelet reversal Antiplatelet therapy is common and complicates the operative management of acute intracranial hemorrhage. Little data exist to guide antiplatelet reversal strategies. The use of antithrombotic agents, including anticoagulants, antiplatelet agents, and thrombolytics has increased and is expected to continue to rise. Although antithrombotic-associated