13,112 results match your criteria Clopidogrel Dosing and CYP2C19


Incidence, Characteristics, and Outcomes of Myocardial Infarction in Patients With Peripheral Artery Disease: Insights From the EUCLID Trial.

JAMA Cardiol 2018 Dec 12. Epub 2018 Dec 12.

Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California.

Importance: Patients with peripheral artery disease (PAD) are at high risk for myocardial infarction (MI).

Objective: To characterize the incidence and types of MI in a PAD population, identify factors associated with MI, and determine the association of MI with cardiovascular mortality and acute limb ischemia.

Design, Setting, And Participants: The Study Comparing Cardiovascular Effects of Ticagrelor and Clopidogrel in Patients With Peripheral Artery Disease (EUCLID) was a double-blind randomized clinical trial conducted at 811 sites in 28 countries that randomized 13 885 patients with symptomatic PAD to monotherapy with ticagrelor or clopidogrel. Read More

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December 2018

Anti-platelet and anti-coagulant therapy in peripheral arterial disease prior to surgical intervention.

Vascular 2018 Dec 12:1708538118818622. Epub 2018 Dec 12.

3 Ysbyty Gwynedd, Bangor, Wales, UK.

Objective: Peripheral artery disease is a major clinical co-morbidity that can significantly affect quality of life, especially in the presence of diabetes mellitus and older age. The focus of this literature review is on medical management, through anti-platelet and anti-coagulation, of peripheral artery disease prior to undergoing surgical or endovascular management.

Method: Extensive electronic literature search performed in four major databases (PubMed, SCOPUD, Embase and Ovid) to identify the published randomized and non-randomized studies that compared and discussed the management of peripheral artery disease with different anti-thrombotic agents. Read More

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December 2018

Post-operative simultaneous very late two-vessel drug eluting stent thrombosis with sparing of bare metal stent in a Jehovah's witness after clopidogrel withdrawal.

J Cardiol Cases 2014 Feb 13;9(2):57-60. Epub 2013 Dec 13.

Department of Surgery/Anesthesiology, University of South Florida, Tampa, FL, USA.

Very late stent thrombosis is a feared complication after drug-eluting stent (DES) implantation. Several factors related to the patient, generation and type of the deployed stent, procedure, and premature antiplatelet withdrawal are known to contribute to this complication. Herein, we describe a case of a Jehovah's witness patient who developed simultaneous two-vessel 1st generation DES thrombosis 5. Read More

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February 2014

Repetitive early stent thrombosis in a patient with the CYP2C19*3/*3 genotype.

J Cardiol Cases 2011 Aug 24;4(1):e16-e19. Epub 2011 Jun 24.

Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.

A 45-year-old man presented with acute inferior myocardial infarction and underwent emergent coronary angiography (CAG). CAG revealed total occlusion of both the proximal right coronary artery (RCA) and distal left circumflex artery, and two bare-metal stents were deployed in the RCA. After the procedure, dual antiplatelet therapy (DAT) with 100 mg aspirin and 75 mg clopidogrel daily were given as usual, however, stent thrombosis occurred three times and he underwent repeat interventions. Read More

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Acute myocardial infarction due to antiphospholipid antibody syndrome in a young pregnant woman.

J Cardiol Cases 2011 Aug 31;4(1):e8-e12. Epub 2011 May 31.

Istanbul University Cerrahpasa School of Medicine, Department of Cardiology, Istanbul, Turkey.

Myocardial infarction (MI) in pregnant patients confer additional risks and unique problems related to necessity of concomitant obstetric interventions and coexistence of disorders as hypercoagulability. Therefore, patients usually have a more complicated course which demands prompt diagnosis and appropriate treatment. Here we report a 22 year old pregnant woman with an acute anterior myocardial infarction and the complicated course of the management. Read More

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Clopidogrel reduces lipopolysaccharide-induced inflammation and neutrophil-platelet aggregates in an experimental endotoxemic model.

J Biochem Mol Toxicol 2018 Dec 10:e22279. Epub 2018 Dec 10.

Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, China.

Platelet activation contributes to organs failure in inflammation and plays an important role in endotoxemia. Clopidogrel inhibits platelet aggregation and activation. However, the role of clopidogrel in modulating inflammatory progression of endotoxemia remains largely unexplored. Read More

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December 2018

Discontinuation of dual antiplatelet therapy and bleeding in intensive care in patients undergoing urgent coronary artery bypass grafting: a retrospective analysis.

Interact Cardiovasc Thorac Surg 2018 Dec 6. Epub 2018 Dec 6.

Department of Anaesthesiology and Surgical Intensive Care, University Hospital Basel, Basel, Switzerland.

Objectives: Our goal was to evaluate the impact of the discontinuation times of dual antiplatelet therapy with clopidogrel, prasugrel or ticagrelor on postoperative bleeding rates and the use of blood products in patients undergoing isolated urgent coronary artery bypass grafting (CABG).

Methods: We retrospectively analysed 334 patients with acute coronary syndrome undergoing urgent CABG at the University Hospital Basel. A total of 262 patients continued to take dual antiplatelet therapy during the surgery (72 received clopidogrel; 68, prasugrel; and 122, ticagrelor). Read More

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December 2018

Analysis of comprehensive pharmacogenomic profiling to impact in-hospital prescribing.

Pharmacogenet Genomics 2018 Dec 6. Epub 2018 Dec 6.

Center for Personalized Therapeutics.

Introduction: In-hospital adverse medication events result in increased morbidity and mortality. Many implicated drugs carry pharmacogenomic information. We hypothesized that comprehensive pre-emptive pharmacogenomic profiling could have high relevance for in-hospital prescribing. Read More

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December 2018

Impact of Point-of-Care Platelet Function Testing Among Patients With and Without Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents (from the ADAPT-DES Study).

Am J Cardiol 2018 Nov 23. Epub 2018 Nov 23.

NewYork-Presbyterian/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.

We sought to examine if the risk conferred by high on-treatment platelet reactivity (HPR) varies based upon clinical presentation. We examined the relation between HPR (P2Y12 reaction units >208) and adverse ischemic and bleeding events among patients with and without acute coronary syndromes (ACS) from ADAPT-DES; 51.7% of patients had ACS. Read More

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November 2018

Effect of Clopidogrel vs Ticagrelor on Platelet Aggregation and Inflammation Markers After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction.

Can J Cardiol 2018 Dec 20;34(12):1606-1612. Epub 2018 Aug 20.

Department of Cardiology, Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.

Background: Patients with acute coronary syndrome show an inflammatory response that is known to affect platelet aggregation. We aimed to clarify the relationship between the inflammation severity and the effect of antiplatelet therapy after percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI).

Methods: This retrospective, single-center study included 203 patients with STEMI who underwent primary PCI and were stratified on the basis of the antiplatelet therapy on admission (clopidogrel vs ticagrelor). Read More

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December 2018
3.711 Impact Factor

The transtelephonic electrocardiogram-based triage is an independent predictor of decreased hospital mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

J Telemed Telecare 2018 Dec 10:1357633X18814335. Epub 2018 Dec 10.

2 Division of Cardiology, University of Debrecen, Hungary.

Introduction: The transtelephonic electrocardiogram has been shown to have a great value in the management of out-of-hospital chest pain emergencies. In our previous study it not only improved the pre-hospital medical therapy and time to intervention, but also the in-hospital mortality in ST-segment elevation myocardial infarction. It was hypothesised that the higher in-hospital survival rate could be due to improved transtelephonic electrocardiogram-based pre-hospital management (electrocardiogram interpretation and teleconsultation) and consequently, better coronary perfusion of patients at the time of hospital admission. Read More

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December 2018

Prevalence of pharmacogenomic variants affecting the efficacy of clopidogrel therapy in the Hispanic Community Health Study/Study of Latinos cohort.

Pharmacogenomics 2018 Dec 6. Epub 2018 Dec 6.

Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.

Purpose: Although clopidogrel is the most widely used oral P2Y12 receptor antagonist, up to 10% of acute coronary syndrome patients treated with clopidogrel will experience a recurrent myocardial infarction and 2-3% will experience stent thrombosis within 1 year. The purpose of this research is to describe the prevalence of pharmacogene variants associated with clopidogrel responsiveness (CYP2C19, B4GALT2, ABCB1, PON1, CES1 and P2RY12) in Hispanic/Latino patients of diverse backgrounds.

Methods: Minor allele frequencies of nine variants from participants of Hispanic Community Health Study/Study of Latinos were compared between subpopulations as well as to continental ancestry references using z-test for independent proportions. Read More

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December 2018
3 Reads

Functional study of Carboxylesterase 1 protein isoforms.

Proteomics 2018 Dec 5:e1800288. Epub 2018 Dec 5.

Department of Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, US.

Carboxylesterase1 (CES1) is a primary human hepatic hydrolase involved in hydrolytic biotransformation of numerous medications. Considerable interindividual variability in CES1 expression and activity has been consistently reported. Four isoforms of the CES1 protein are produced by alternative splicing (AS). Read More

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December 2018
1 Read

Risk of Post-polypectomy Bleeding With Uninterrupted Clopidogrel Therapy in an Industry-independent, Double-blind, Randomized Trial.

Gastroenterology 2018 Oct 25. Epub 2018 Oct 25.

Department of Medicine & Therapeutics, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China (SAR); State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China (SAR).

Background & Aims: Guidelines recommend withholding clopidogrel 7 days before polypectomy to reduce bleeding risk, but these were written based on limited evidence. We investigated whether uninterrupted clopidogrel therapy increases the risk of delayed post-polypectomy bleeding in patients undergoing colonoscopy.

Methods: We identified patients receiving clopidogrel for cardiovascular disease undergoing elective colonoscopies in Hong Kong, from 28 February 2012 through 11 April 2018. Read More

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October 2018
1 Read

Platelet reactivity in patients with chronic kidney disease undergoing percutaneous coronary intervention.

Platelets 2018 Dec 5:1-7. Epub 2018 Dec 5.

a Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases , The Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China.

This study aimed to evaluate the platelet reactivity in real-world patients with different chronic kidney disease (CKD) stages after percutaneous coronary intervention (PCI), and to examine whether high residual platelet reactivity (HRPR) is associated with higher incidence of adverse cardiovascular events in a 2-year follow up. A total of 10 724 consecutive patients receiving DAPT with aspirin and clopidogrel after PCI throughout 2013 were enrolled. We applied modified thromboelastography (mTEG) in 6745 patients. Read More

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December 2018

Systematic review with meta-analysis: the risk of gastrointestinal bleeding in patients taking third-generation P2Y inhibitors compared with clopidogrel.

Aliment Pharmacol Ther 2018 Dec 2. Epub 2018 Dec 2.

Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.

Background: Ticagrelor and prasugrel are third-generation oral P2Y receptor antagonists with rapid onset and pronounced platelet inhibition. However, higher overall bleeding rates have been reported for these agents when compared with clopidogrel.

Aim: To compare the risk of gastrointestinal bleeding (GIB) among users of third-generation P2Y inhibitors with clopidogrel. Read More

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December 2018

Network meta-analysis of antiplatelet therapy following coronary artery bypass grafting (CABG): none versus one versus two antiplatelet agents.

Ann Cardiothorac Surg 2018 Sep;7(5):577-585

The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia.

Background: Numerous agents have been trialed following coronary artery bypass grafting (CABG) to maintain long-term graft patency. While clear evidence exists for the use of aspirin in maintaining graft patency, the role of dual-antiplatelet therapy in CABG patients is not as well established. This network meta-analysis aimed to compare the short-term post-CABG graft patency outcomes for patients with none, one or two antiplatelet agents. Read More

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September 2018

Patients Prescribed Direct-acting Oral Anticoagulants Have Low Risk of Post-Polypectomy Complications.

Clin Gastroenterol Hepatol 2018 Nov 29. Epub 2018 Nov 29.

Division of Gastroenterology, San Francisco Veterans Affairs Medical Center, University of California San Francisco, San Francisco, CA, United States.

Background & Aims: Use of direct-acting oral anticoagulants (DOACs) is increasing, but little is known about the associated risks in patients undergoing colonoscopy with polypectomy. We aimed to determine the risk of post-polypectomy complications in patients prescribed DOACs.

Methods: We performed a retrospective analysis using the Clinformatics Data Mart Database (a de-identified administrative database from a large national insurance provider) to identify adults who underwent colonoscopy with polypectomy or endoscopic mucosal resection (EMR) from January 1, 2011, through December 31, 2015. Read More

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November 2018
3 Reads

Antiplatelet effects of ticagrelor versus clopidogrel after coronary artery bypass graft surgery: A single-center randomized controlled trial.

J Thorac Cardiovasc Surg 2018 Oct 19. Epub 2018 Oct 19.

Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China. Electronic address:

Objective: The study objective was to compare the onset of platelet inhibition (inhibition of platelet aggregation) between ticagrelor 90 mg twice per day and clopidogrel 75 mg once per day in patients receiving coronary artery bypass grafting.

Methods: In a single-center, randomized, open-label study, 140 patients receiving coronary artery bypass grafting were randomly assigned to the aspirin + ticagrelor group or the aspirin + clopidogrel group in a 1:1 ratio. Participants in the aspirin + ticagrelor group took aspirin 100 mg once per day and ticagrelor 90 mg twice per day. Read More

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October 2018

Outcome postponement as a potential patient centred measure of therapeutic benefit: examples in cardiovascular medicine.

Acta Cardiol 2018 Dec 4:1-10. Epub 2018 Dec 4.

d Department of Clinical Pharmacology and Pharmacy , University of Southern Denmark , Odense , Denmark.

Background: The impact of randomised controlled trials (RCTs) depends heavily on the presentation of the findings.

Objective: Classically, RCT findings are presented in the form of absolute risk reduction (ARR), number needed to treat (NNT) to prevent one adverse outcome, and relative risk reduction (RRR) or hazard ratio (the most favourable means for drug marketing). However, the estimation of average survival gain (i. Read More

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December 2018
2 Reads

Evaluation of selected commercial pharmacotherapeutic drugs as potential pancreatic lipase inhibitors and antiproliferative compounds.

Drug Dev Res 2018 Dec 3. Epub 2018 Dec 3.

School of Pharmacy, University of Jordan, Amman, Jordan.

In this study, 15 commercial acidic drugs have been evaluated for pancreatic lipase (PL) inhibitory activity using an in vitro spectrophotometric method. The acidity was the basis of selection, since most PL inhibitors exhibit acidic groups and high lipophilicity. Orlistat was the robust reference agent for potency and efficacy determinations. Read More

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December 2018

Clopidogrel and aspirin after ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis of randomized clinical trials.

J Thromb Thrombolysis 2018 Dec 3. Epub 2018 Dec 3.

Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.

Recurrent stroke is common immediately following a transient ischemic attack (TIA) or ischemic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin may provide greater protection against subsequent stroke than monotherapy. Electronic databases were searched for randomized clinical trials (RCTs) comparing DAPT with monotherapy in ischemic stroke/TIA. Read More

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December 2018

PPIs Are Not Responsible for Elevating Cardiovascular Risk in Patients on Clopidogrel-A Systematic Review and Meta-Analysis.

Front Physiol 2018 19;9:1550. Epub 2018 Nov 19.

Division of Gastroenterology, First Department of Internal Medicine, University of Pécs Medical School, Pécs, Hungary.

Clopidogrel and proton pump inhibitors (PPIs) are metabolized by cytochrome P450 enzymes. Contradictory results have been reported on possible complications of simultaneous PPI and clopidogrel use. Our aim was to investigate the clinical relevance of this debate with a systematic review and meta-analysis. Read More

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November 2018

Antithrombotic Regimens in Patients With Percutaneous Coronary Intervention Whom an Anticoagulant Is Indicated: A Systematic Review and Network Meta-Analysis.

Front Pharmacol 2018 19;9:1322. Epub 2018 Nov 19.

Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.

Patients undergoing percutaneous coronary intervention (PCI) who require anticoagulant therapy are at increased risk of bleeding. The optimal regimen for these patients is uncertain. This study aimed to compare safety and efficacy of antithrombotic regimens used in patients undergoing PCI with concomitant anticoagulant therapy. Read More

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November 2018
4 Reads

Antiplatelet effects of aspirin and clopidogrel after left atrial appendage (LAA) occluder implantation.

Int J Cardiol 2019 Jan 16;275:95-100. Epub 2018 Oct 16.

Department of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany. Electronic address:

Background: The optimal antithrombotic strategy after interventional left atrial appendage closure (LAAC) is controversial. Dual antiplatelet therapy with aspirin and clopidogrel is the most frequently used regiment. However, pharmacodynamic response to antiplatelet medication differs significantly between individuals. Read More

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January 2019

Association of potent P2Y12 blockers with ischemic and bleeding outcomes in non-ST-segment elevation myocardial infarction.

J Cardiol 2019 Feb 26;73(2):142-150. Epub 2018 Oct 26.

Kyungsang National University Hospital, Jinju, Republic of Korea.

Background: Potent P2Y12 blockers are preferred in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). However, the risk of bleeding remains a major concern. We assessed the association of potent P2Y12 blockers with ischemic and bleeding outcomes in patients with NSTEMI. Read More

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February 2019
1 Read

Effects of switching ticagrelor to clopidogrel on cardiovascular outcomes in patients with acute coronary syndrome.

Medicine (Baltimore) 2018 Nov;97(48):e13381

Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China.

Present study was to evaluate whether switching ticagrelor to clopidogrel would impact platelet reactivity and cardiovascular outcomes in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI).A total of 202 ACS patients after PCI were enrolled and prescribed ticagrelor. Before discharge, 138 (68%) patients were switched to clopidogrel. Read More

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November 2018

Effect of P2Y inhibitors on thrombus stability and endogenous fibrinolysis.

Thromb Res 2018 Nov 24;173:102-108. Epub 2018 Nov 24.

Postgraduate Medical School, University of Hertfordshire, Hertfordshire, UK; Department of Cardiology, East and North Hertfordshire NHS Trust, Hertfordshire, UK; National Heart & Lung Institute, Imperial College, London, UK. Electronic address:

Although used routinely to reduce thrombotic events in patients with coronary disease, the effects of P2Y inhibitors on thrombus stability and endogenous fibrinolysis are largely unknown. Blood taken from patients pre- and post-aspirin (n = 20) and on aspirin alone and on dual antiplatelet therapy comprising aspirin plus clopidogrel (n = 20), ticagrelor (n = 20) or cangrelor (n = 20), was tested using the Global Thrombosis Test. The number of "rebleeds" or drops (D) after early platelet-rich thrombus formation (occlusion time, OT), and before final lasting occlusion, was used as an inverse measure of thrombus stability. Read More

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November 2018
4 Reads

Monitoring platelet function: what have we learned from randomized clinical trials?

Cardiovasc Diagn Ther 2018 Oct;8(5):621-629

Département de Cardiologie, CHU Timone, Marseille, France.

Dual antiplatelet therapy, with aspirin plus a P2Y12 inhibitor agent, remains the cornerstone treatment after percutaneous coronary intervention. However, significant proportion of patients did experience recurrent ischemic events on aspirin plus clopidogrel and the concept of non-response to P2Y12 inhibitor emerged. Evaluation of platelet reactivity has known a promising era aiming to improve platelet inhibition conferred by clopidogrel. Read More

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October 2018
1 Read

Diabetes and antiplatelet therapy: from bench to bedside.

Cardiovasc Diagn Ther 2018 Oct;8(5):594-609

Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA.

Diabetes mellitus (DM) is a metabolic disorder associated with accelerated atherogenesis and an increased risk of atherothrombotic complications. Multiple mechanisms contribute to the pro-thrombotic status which characterizes DM patients underscoring the importance of antiplatelet therapies used for secondary prevention in these patients. For many years, dual antiplatelet therapy (DAPT) with aspirin and the P2Y inhibitor clopidogrel has represented the mainstay of treatment following an acute coronary syndrome (ACS) or in patients undergoing percutaneous coronary interventions (PCI). Read More

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October 2018
1 Read

Interaction between platelets and endothelium: from pathophysiology to new therapeutic options.

Cardiovasc Diagn Ther 2018 Oct;8(5):568-580

Department of Cardiology, University Hospital of Heraklion, Heraklion, Crete, Greece.

Platelets were traditionally considered to purely have a role in the maintenance of haemostasis. Recently their role in vasomotor function, inflammation and atherosclerosis has been very well-recognized. Endothelium which was originally considered as a simple passive barrier, it is now viewed as an organ whose normal functioning is crucial for maintaining vascular health. Read More

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October 2018
2 Reads

The Herb-Drug Interaction of Clopidogrel and Xuesaitong Dispersible Tablet by Modulation of the Pharmacodynamics and Liver Carboxylesterase 1A Metabolism.

Evid Based Complement Alternat Med 2018 18;2018:5651989. Epub 2018 Oct 18.

The First Affiliated Hospital of Bengbu Medical College, China.

Objective: Clopidogrel and Xuesaitong dispersible tablet (XST) have been clinically proven to be effective for treating cardiocerebrovascular disease. The present study was to investigate the herb-drug interaction of Clopidogrel and XST by modulation of the pharmacodynamics and liver Carboxylesterase 1A(CES1A) metabolism.

Methods: 30 male SD rats were randomly divided into a control group (equal volumes of saline, 6 rats for mRNA analysis), a clopidogrel group (clopidogrel with dose 30 mg/kg), and a combination group (clopidogrel and XST, with dose 30 and 50 mg/kg respectively, each group continuous administration once daily for 30 days). Read More

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October 2018
1 Read

Effect and safety of antithrombotic therapies for secondary prevention after acute coronary syndrome: a network meta-analysis.

Drug Des Devel Ther 2018 25;12:3583-3594. Epub 2018 Oct 25.

Department of Cardiology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.

Background: Dual antiplatelet therapy is a standard protocol for secondary prevention after acute coronary syndrome, but despite a variety of new dual antithrombotic strategies, there is a dearth of studies evaluating the effects and safety of some popular therapies. This study used a network meta-analysis to compare the efficacy and safety of all available antithrombotic therapies.

Methods: PubMed, MEDLINE, and Cochrane library databases were searched for randomized controlled trials, published up to July 1, 2017, that evaluated the efficacy of antithrombotic therapy in acute coronary syndrome treatment. Read More

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October 2018

Compared efficacy of clopidogrel and ticagrelor in treating acute coronary syndrome: a meta-analysis.

BMC Cardiovasc Disord 2018 Nov 29;18(1):217. Epub 2018 Nov 29.

Department of Sixth Cardiovascular Medicine, Second Hospital of Hebei Medical University, No. 309 North Zhonghua Street, Shijiazhuang, 05400, Hebei, China.

Background & Aims: Ticagrelor has been acknowledged as a new oral antagonist of P2Y12-adenosine diphosphate receptor, as a strategy with more rapid onset as well as more significant platelet inhibition function in acute coronary syndrome (ACS) patients. The clinical benefit of ticagrelor compared with clopidogrel remains controversial. The current meta-analysis was conducted to better evaluate the role of ticagrelor in comparison of clopidogrel in treating ACS patients. Read More

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November 2018
1 Read

Whole blood aggregometry prior to Pipeline embolization device treatment of intracranial aneurysms: defining an optimal platelet inhibition cutoff value for clopidogrel.

Authors:

J Neurosurg 2018 Nov 1:1-8. Epub 2018 Nov 1.

OBJECTIVEDual antiplatelet therapy is required for the treatment of intracranial aneurysms with the Pipeline embolization device (PED). Platelet function testing (PFT) is often used to assess the efficacy of the antiplatelet regimen prior to PED placement. The optimal impedance values for whole blood aggregometry in this setting have not been defined. Read More

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November 2018
1 Read

Dual antiplatelet therapy does not affect the incidence of low-dose aspirin-induced small intestinal mucosal injury in patients after percutaneous coronary intervention for coronary stenosis: a multicenter cross-sectional study.

J Clin Biochem Nutr 2018 Nov 25;63(3):224-229. Epub 2018 May 25.

Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.

Although low-dose aspirin (LDA) is known to induce small intestinal mucosal injury, the effect of dual antiplatelet therapy (DAPT; LDA + clopidogrel) on small intestinal mucosa in patients after percutaneous coronary intervention (PCI) for coronary stenosis is unknown. Fifty-one patients with a history of PCI and LDA use were enrolled, and 45 eligible patients were analyzed. Patients were grouped based on DAPT (DAPT:  = 10 and non-DAPT:  = 35) and proton pump inhibitor (PPI) use (PPI user:  = 22 and PPI-free patients:  = 23) to compare small intestinal endoscopic findings. Read More

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November 2018
1 Read

Influences of an NR1I2 polymorphism on heterogeneous antiplatelet reactivity responses to clopidogrel and clinical outcomes in acute ischemic stroke patients.

Acta Pharmacol Sin 2018 Nov 28. Epub 2018 Nov 28.

Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006, China.

Pregnane X receptor (PXR) is a member of nuclear receptor subfamily 1 (NR1I2) that is a transcriptional regulator of several metabolic enzymes involved in clopidogrel metabolism. In this study we identified and evaluated the contributions of single nucleotide polymorphisms (SNPs) in NR1I2 and cytochrome P450 (CYP) 2C19 alleles to clopidogrel resistance (CR) and long-term clinical outcomes in acute ischemic stroke (IS) patients. A total of 634 patients with acute IS were recruited, who received antiplatelet medication (clopidogrel or aspirin) every day and completed a 1-year follow-up. Read More

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November 2018
1 Read

Intensive Statin Therapy for Acute Ischemic Stroke to Reduce the Number of Microemboli: A Preliminary, Randomized Controlled Study.

Eur Neurol 2018 Nov 28;80(3-4):163-170. Epub 2018 Nov 28.

Background: To assess whether intensive statin therapy reduces the occurrence of microemboli in patients with acute ischemic stroke.

Methods: Patients with acute ischemic stroke within 72 h of onset were randomized to the intensive statin (atorvastatin 60 mg/day, adjusted to 20 mg/day after 7 days) and control (atorvastatin 20 mg/day) groups. Combined aspirin and clopidogrel were used for antiplatelet therapy. Read More

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November 2018
1 Read

Eosinophilic colitis and colonic eosinophilia.

Curr Opin Gastroenterol 2019 Jan;35(1):42-50

Faculty of Health and Medicine, School of Medicine & Public Health, University of Newcastle, Callaghan, Australia.

Purpose Of Review: Eosinophilic colitis is a rare condition, with a prevalence rate in the USA of 2-3/100 000 persons (0.003%), but diagnosed in 0.1% of biopsies in those colonoscoped for diarrhoea. Read More

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January 2019
10 Reads

Ticagrelor for Refractory Migraine/Patent Foramen Ovale (TRACTOR): An open-label pilot study.

Neurology 2018 Nov;91(22):1010-1017

From the Herbert and Sandi Feinberg Interventional Cardiology and Heart Valve Center (A.M.R., B.T.R., L.P., T.N., R.J.S.) and Headache Center, Department of Neurology (D.E.C., M.S.Y., G.J.G.), New York-Presbyterian Hospital/Columbia University Medical Center, NY.

Objective: After finding that the thienopyridines clopidogrel and prasugrel reduced migraine headache (MHA) symptoms in some patients with patent foramen ovale (PFO), this small pilot study was undertaken to determine whether ticagrelor, a nonthienopyridine P2Y12 inhibitor, would have similar MHA effects and might be better suited for a future randomized trial.

Methods: MHA patients were screened for PFO. Participants with documented right to left shunt (RLS) and ≥6 monthly MHA days received ticagrelor therapy for 28 days. Read More

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November 2018
6 Reads

Retrospective review of thienopyridine therapy in migraineurs with patent foramen ovale.

Neurology 2018 Nov;91(22):1002-1009

From the Herbert and Sandi Feinberg Interventional Cardiology and Heart Valve Center, New York-Presbyterian Hospital/Columbia University Medical Center, NY.

Objective: We retrospectively reviewed our clinical experience using off-label thienopyridine agents in patients with migraine headache (MHA) and patent foramen ovale (PFO).

Methods: Between 2011 and 2017, MHA/PFO patients referred to our practice were clinically treated with clopidogrel specifically for MHA. Those with ≥50% reduction in monthly MHA days compared with baseline were deemed MHA responders. Read More

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November 2018
5 Reads

Patterns of treatment with antiplatelet therapy after an acute coronary syndrome: Data from a large database in a community setting.

Eur J Prev Cardiol 2018 11 26:2047487318814970. Epub 2018 Nov 26.

2 ReS (Research & Health) Foundation, Rome, Italy.

Aims: Current guidelines strongly recommend antiplatelet therapy with aspirin plus a P2Y receptor inhibitor (dual therapy) for patients with acute coronary syndrome (ACS). To better understand how antiplatelet treatment is prescribed in clinical practice, the aim of this study was to provide a more detailed description of real-world patients with and without antiplatelet treatment after an ACS, their outcomes at one-year follow-up and the related integrated cost.

Methods: The ReS database, including more than 12 million inhabitants, was evaluated. Read More

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November 2018
1 Read
2.675 Impact Factor

Predictors of strut coverage of drug eluting stent implantation in diabetic patients.

Int J Cardiol 2018 Nov 9. Epub 2018 Nov 9.

Department of Molecular Medicine and Medical Biotechnologies, "Federico II" University of Naples, IEOS, CNR, Naples, Italy.

Background: Incomplete re-endothelialization of drug eluting stent (DES) segments has been associated with the occurrence of major adverse cardiac events after DES implantation. It is unknown whether on-clopidogrel platelet reactivity (OPR) and/or circulating endothelial progenitor cells (EPC) levels may predict uncovered strut rate in diabetic patients treated by DES implantation.

Methods: One-hundred and five diabetic patients undergoing elective DES implantation were included into the study. Read More

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November 2018
1 Read

Preventing Arteriovenous Shunt Failure in Hemodialysis Patients: A Population-Based Cohort Study.

J Thromb Haemost 2018 Nov 25. Epub 2018 Nov 25.

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, and Department of Medicine, Chang Gung University, Taoyuan, Taiwan.

Background: Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis.

Objectives: This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. Read More

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November 2018
7 Reads

Clopidogrel Versus Aspirin for the Treatment of Acute Coronary Syndrome After a 12-Month Dual Antiplatelet Therapy: A Cost-effectiveness Analysis From China Payer's Perspective.

Clin Ther 2018 Nov 20. Epub 2018 Nov 20.

Health Economic Research Institute, Sun Yat-sen University, Guangzhou, China. Electronic address:

Purpose: Monotherapy with either aspirin or clopidogrel is recommended for long-term use after discontinuation of dual-antiplatelet therapy (DAPT) for acute coronary syndrome (ACS) management after percutaneous coronary intervention (PCI). The present study is to evaluate the cost-effectiveness of clopidogrel versus aspirin after 12-month DAPT for patients with ACS who underwent PCI in China.

Methods: A 2-part model was developed to estimate the cost-effectiveness of clopidogrel compared with aspirin. Read More

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November 2018
2 Reads

Recurrent Kawasaki Disease: A Case Report of Three Separate Episodes at >4-Year Intervals.

Children (Basel) 2018 Nov 21;5(11). Epub 2018 Nov 21.

CHLA Pediatric Cardiology, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.

Kawasaki disease (KD) is a self-limited systemic vasculitis, most often occurring in children 1⁻5 years old. It has a 2% recurrence rate and is associated with coronary aneurysms (CA), which can develop within two weeks of onset. A 25% increased risk is noted in patients who are recalcitrant to treatment. Read More

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November 2018
9 Reads

DAPT Plus Cilostazol is Better Than Traditional DAPT or Aspirin Plus Ticagrelor as Elective PCI for Intermediate-to-Highly Complex Cases: Prospective, Randomized, PRU-Based Study in Taiwan.

Am J Cardiovasc Drugs 2018 Nov 23. Epub 2018 Nov 23.

Division of Cardiovascular Surgery, Department of Surgery, Tri Service General Hospital, Taipei, Taiwan, ROC.

Purpose: Current treatment guidelines do not recommend different antiplatelet treatments for patients in different coronary risk categories; nor do they consider ethnic differences in responses to individual drugs.

Objectives: We performed a prospective, single-blind, randomized, comparative study of Taiwanese patients with stable angina and scheduled stent implantation for intermediate-to-highly complex coronary lesions and compared the platelet reactivity unit (PRU) levels and 24-month outcomes of groups receiving three different antiplatelet treatments.

Methods: Patients (N = 334) were randomized into three treatment groups (aspirin + clopidogrel, aspirin + ticagrelor, or aspirin + clopidogrel + cilostazol) for 6 months of treatment and were then switched to aspirin only. Read More

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November 2018
1 Read

Exploratory Ingestions of Novel Anticoagulants and Antiplatelets: What Is the Risk?

Pediatr Emerg Care 2018 Nov 19. Epub 2018 Nov 19.

Banner Poison Control and Drug Information Center, Banner University Medical Center, Phoenix, Phoenix, AZ.

Background: Historically, anticoagulants and antiplatelet agents included warfarin and aspirin, respectively. In recent years, numerous novel anticoagulants (eg, direct thrombin inhibitors and factor Xa inhibitors) as well as the adenosine diphosphate receptor antagonists have increased significantly. Little information on the bleeding risk after exploratory ingestion of these agents is available. Read More

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November 2018
11 Reads

Ticagrelor Versus Prasugrel for the Treatment of Patients with Type 2 Diabetes Mellitus Following Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

Diabetes Ther 2018 Nov 19. Epub 2018 Nov 19.

Department of Internal Medicine, Ealing Hospital, University of Buckingham, London, UK.

Introduction: Antiplatelet therapy is very important following percutaneous coronary intervention (PCI). New generation P2Y inhibitors (ticagrelor and prasugrel) might potentially replace clopidogrel for the treatment of post-interventional acute coronary syndrome (ACS). In this analysis, we aimed to systematically compare the post-interventional clinical outcomes and bleeding events observed with ticagrelor versus prasugrel in patients with type 2 diabetes mellitus (T2DM). Read More

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November 2018
7 Reads