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Journal articles on the topic 'Dual Anti-Platelet Therapy'

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Author: Grafiati

Published: 10 December 2022

Last updated: 29 January 2023

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1

Webster, Tyler D., Prashant Vaishnava, and Kim A. Eagle. "Perioperative management of dual anti-platelet therapy." Hospital Practice 44, no. 5 (October 19, 2016): 237–41. http://dx.doi.org/10.1080/21548331.2016.1260997.

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2

Segal, Jonathan, and Guven Kaya. "Dual Anti-Platelet Therapy and Gastrointestinal Protection Audit." American Journal of Gastroenterology 107 (October 2012): S116. http://dx.doi.org/10.14309/00000434-201210001-00269.

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3

Cutlip, Donald E. "Dual Anti-platelet Therapy after Coronary Stenting: Rationale for Personalized Duration of Therapy." US Cardiology Review 11, no. 1 (2017): 31. http://dx.doi.org/10.15420/usc.2017:7:2.

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There is controversy regarding the appropriate duration of dual anti-platelet therapy after coronary stenting. Recent guidance has been updated to reflect improved outcomes after second-generation drug-eluting stenting, but a standard duration for all patients is not rational given the different risks for ischemic and bleeding complications. This paper reviews the data for short- and long-term dual anti-platelet therapy and considers approaches for developing a personalized strategy.

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4

Abuzaid, Ahmed, Pragya Ranjan, Carly Fabrizio, Kevin Felpel, Raveen Chawla, Adrienne Topic, and Islam Y. Elgendy. "Single Anti-Platelet Therapy versus Dual Anti-Platelet Therapy after Transcatheter Aortic Valve Replacement: A Meta-Analysis." Structural Heart 2, no. 5 (August 1, 2018): 408–18. http://dx.doi.org/10.1080/24748706.2018.1491082.

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5

Diener, Hans-Christoph. "Update on clopidogrel and dual anti-platelet therapy: neurology." European Heart Journal Supplements 8, suppl_G (October 1, 2006): G15—G19. http://dx.doi.org/10.1093/eurheartj/sul049.

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6

Mărginean, Alina, Claudia Bănescu, Alina Scridon, and Minodora Dobreanu. "Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities." Journal of Critical Care Medicine 2, no. 1 (January 1, 2016): 6–15. http://dx.doi.org/10.1515/jccm-2015-0021.

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AbstractIt is well known that critically ill patients require special attention and additional consideration during their treatment and management. The multiple systems and organ dysfunctions, typical of the critical patient, often results in different patterns of enteral absorption in these patients. Anti-platelet drugs are the cornerstone in treating patients with coronary and cerebrovascular disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment of choice in patients undergoing elective percutaneous coronary interventions and is still widely used in patients with acute coronary syndromes. However, despite the use of dual anti-platelet therapy, some patients continue to experience cardiovascular ischemic events. Recurrence of ischemic events is partly attributed to the fact that some patients have poor inhibition of platelet reactivity despite treatment. These patients are considered low- or nonresponders to therapy. The underlying mechanisms leading to resistance are not yet fully elucidated and are probably multifactorial, cellular, genetic and clinical factors being implicated. Several methods have been developed to asses platelet function and can be used to identify patients with persistent platelet reactivity, which have an increased risk of thrombosis. In this paper, the concept of anti-platelet therapy resistance, the underlying mechanisms and the methods used to identify patients with low responsiveness to anti-platelet therapy will be highlighted with a focus on aspirin and clopidogrel therapy and addressing especially critically ill patients.

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7

Warner, Timothy D., Sven Nylander, and Carl Whatling. "Anti-platelet therapy: cyclo-oxygenase inhibition and the use of aspirin with particular regard to dual anti-platelet therapy." British Journal of Clinical Pharmacology 72, no. 4 (September 9, 2011): 619–33. http://dx.doi.org/10.1111/j.1365-2125.2011.03943.x.

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8

Feitosa, Mateus Paiva Marques, Carla David Soffiatti, Jaime Paula Pessoa Linhares Filho, Daniel Valente Batista, Heraldo Guedis Lobo Filho, Eduardo Gomes Lima, and Carlos Vicente Serrano Júnior. "Dual platelet antiaggregation therapy after myocardial revascularization surgery." Revista da Associação Médica Brasileira 65, no. 3 (March 2019): 316–18. http://dx.doi.org/10.1590/1806-9282.65.3.316.

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SUMMARY Coronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Recently, subgroup analyses of studies with different anti-platelet therapies have shown reduced mortality and cardiovascular events in patients on dual anti-platelet antiplatelet therapy (DAPT) undergoing CABG, although such studies have not been designed to evaluate this patient profile. However, there is still an insufficient number of randomized studies using DAPT in this context, resulting in a disagreement between the European and American cardiology societies guidelines regarding their indication and generating doubts in clinical practice.

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9

Henriksen, P. A., K. Palmer, and N. A. Boon. "Management of upper gastrointestinal haemorrhage complicating dual anti-platelet therapy." QJM 101, no. 4 (February 12, 2008): 261–67. http://dx.doi.org/10.1093/qjmed/hcm148.

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10

Lee, Dong Hyun, Moo Hyun Kim, Long Zhe Guo, Cai De Jin, Young Rak Cho, Kyungil Park, Jong Sung Park, Tae-Ho Park, and Victor Serebruany. "Concomitant nitrates enhance clopidogrel response during dual anti-platelet therapy." International Journal of Cardiology 203 (January 2016): 877–81. http://dx.doi.org/10.1016/j.ijcard.2015.11.068.

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11

Garcia, Daniel, and Mohammad Ansari. "COMPARISON BETWEEN MONO OR DUAL ANTI-PLATELET THERAPY POST TAVR." Journal of the American College of Cardiology 73, no. 9 (March 2019): 2028. http://dx.doi.org/10.1016/s0735-1097(19)32634-8.

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12

Bang, Vigyan V., and Michael S. Levy. "Duration of dual anti-platelet therapy following drug eluting stents." Catheterization and Cardiovascular Interventions 87, no. 4 (March 2016): 733–34. http://dx.doi.org/10.1002/ccd.26491.

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13

Zeymer, Uwe, Benedikt Schrage, and Dirk Westermann. "Dual Pathway Inhibition with Low-Dose Direct Factor Xa Inhibition after Acute Coronary Syndromes—Why Is It Not Used in Clinical Practice?" Thrombosis and Haemostasis 118, no. 09 (August 13, 2018): 1528–34. http://dx.doi.org/10.1055/s-0038-1668133.

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AbstractThe optimal anti-thrombotic therapy for secondary prevention after an acute coronary syndrome is still a matter of debate. While current guidelines recommend dual anti-platelet therapy with aspirin and a P2Y12 inhibitor over 12 months especially in patients with stent implantation, the value of prolonged anticoagulation is still controversial. In the ATLAS-TIMI 52 trial, a low-dose direct factor Xa inhibition with rivaroxaban compared with placebo reduced the combined primary endpoint of cardiovascular mortality, myocardial infraction and stroke with an increase in major bleeding complications. This article discusses the value and problems of adding low-dose rivaroxaban to anti-platelet therapy as secondary prevention measure after an acute myocardial infarction. It will describe the pros and cons of intensified anti-platelet therapy versus dual pathway inhibition and give recommendations for different patient groups in clinical practice.

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14

Patel, N., V. Patel, D. Sarkar, T. Nokes, and P. Blacklock. "Dual anti-platelet therapy and dento-alveolar surgery. How do we manage patients on anti-platelet medication?" British Dental Journal 217, no. 11 (December 2014): E24. http://dx.doi.org/10.1038/sj.bdj.2014.1055.

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15

Henkes, Hans, Pervinder Bhogal, Marta Aguilar Pérez, Tim Lenz-Habijan, Catrin Bannewitz, Marcus Peters, Christina Sengstock, Oliver Ganslandt, Pedro Lylyk, and Hermann Monstadt. "Anti-thrombogenic coatings for devices in neurointerventional surgery: Case report and review of the literature." Interventional Neuroradiology 25, no. 6 (June 27, 2019): 619–27. http://dx.doi.org/10.1177/1591019919858000.

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Background: Stent-assisted coiling and extra-saccular flow diversion require dual anti-platelet therapy due to the thrombogenic properties of the implants. While both methods are widely accepted, thromboembolic complications and the detrimental effects of dual anti-platelet therapy remain a concern. Anti-thrombogenic surface coatings aim to solve both of these issues. Current developments are discussed within the framework of an actual clinical case. Case description: A 33-year-old male patient lost consciousness while doing sport and was administered 500 mg acetylsalicylic acid on site. Computed tomography revealed a massive subarachnoid haemorrhage, and digital subtraction angiography showed an aneurysm of the right middle cerebral artery. Stent-assisted coiling using a neck bridging device with a hydrophilic coating (pCONUS_HPC) was considered as an appropriate approach. Another 500 mg acetylsalicylic acid IV was given. After the single anti-platelet therapy was seen to be effective, a pCONUS_HPC was implanted, and the aneurysm sac subsequently fully occluded using coils. No thrombus formation was encountered. During the following days, 2 × 500 mg acetylsalicylic acid IV daily were required to maintain single anti-platelet therapy, monitored by frequent response testing. Follow-up digital subtraction angiography after 13 days confirmed the occlusion of the aneurysm and the patency of the middle cerebral artery. Conclusion: A variety of ways to reduce the thrombogenicity of neurovascular stents is discussed. Hydrophilic surface coatings are a valid concept to improve the haemocompatibility of neurovascular implants while avoiding the use of dual anti-platelet therapy. Phosphorylcholine and phenox hydrophilic polymer coating are currently the most promising candidates. This concept is supported by anecdotal experience. However, formalised registries and randomised trials are currently being established.

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16

Barillà, Francesco, Francesco Pelliccia, Mauro Borzi, Paolo Camici, Livio Dei Cas, Matteo Di Biase, Ciro Indolfi, et al. "Optimal duration of dual anti-platelet therapy after percutaneous coronary intervention." Journal of Cardiovascular Medicine 18, no. 1 (January 2017): 1–9. http://dx.doi.org/10.2459/jcm.0000000000000434.

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17

Jäger, Bernhard, Editha Piackova, Paul Michael Haller, Tijana Andric, Beatrice Kahl, Günther Christ, Alexander Geppert, Johann Wojta, and Kurt Huber. "Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy." Archives of Medical Science 15, no. 1 (2019): 65–71. http://dx.doi.org/10.5114/aoms.2018.81035.

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18

Harky, Amer, Perry Maskell, and Mika Burgess. "Anti-platelet and anti-coagulant therapy in peripheral arterial disease prior to surgical intervention." Vascular 27, no. 3 (December 12, 2018): 299–311. http://dx.doi.org/10.1177/1708538118818622.

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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. Results A total of 17 studies were identified to meet the inclusion criteria of this review. Among them, 4 were systematic review and meta-analyses, 1 was observational study and 12 were randomized controlled trials. The reported outcomes in each study are summarized and reported separately within this review. Conclusion Peripheral artery disease is a complex and multifactorial clinical condition. The use of dual anti-platelets, such as aspirin and clopidogrel, are the key in preventing major cardiovascular events as well as stroke and death. Utilization of anti-coagulation such as direct oral anti-coagulants’ as additional parameters for the prevention of disease progression, is paramount. Eventually, the choice of either dual-antiplatelet therapy or combined anti-coagulation with anti-platelets should be carefully considered, particularly following the most recent published debatable studies.

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19

Elbadawi, Ayman, Ravi Thakker, Ahmed A. Abuzaid, Wissam Khalife, Sachin S. Goel, Syed Gilani, Mirvat Alasnag, and Islam Y. Elgendy. "Single Anti-platelet Versus Dual Anti-platelet Therapy After Transcatheter Aortic Valve Implantation: A Meta-Analysis of Randomized Trials." American Journal of Cardiology 140 (February 2021): 152–54. http://dx.doi.org/10.1016/j.amjcard.2020.11.002.

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20

Abrecht, Linda, Marcel Zwahlen, Kurt Schmidlin, Stephan Windecker, Bernhard Meier, Andre Haeberli, Otto Hess, Peter Wenaweser, and Parham Eshtehardi. "A randomised determination of the Effect of Fluvastatin and Atorvastatin on top of dual antiplatelet treatment on platelet aggregation after implantation of coronary drug-eluting stents." Thrombosis and Haemostasis 104, no. 09 (2010): 554–62. http://dx.doi.org/10.1160/th09-11-0765.

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SummaryDrug-drug interaction between statins metabolised by cytochrome P450 3A4 and clopidogrel have been claimed to attenuate the inhibitory effect of clopidogrel. However, published data regarding this drug-drug interaction are controversial. We aimed to determine the effect of fluvastatin and atorvastatin on the inhibitory effect of dual anti-platelet therapy with acetylsalicylic acid (ASA) and clopidogrel. One hundred one patients with symptomatic stable coronary artery disease undergoing percutaneous coronary intervention and drug-eluting stent implantation were enrolled in this prospective randomised study. After an interval of two weeks under dual antiplatelet therapy with ASA and clopidogrel, without any lipid-lowering drug, 87 patients were randomised to receive a treatment with either fluvastatin 80 mg daily or atorvastatin 40 mg daily in addition to the dual antiplatelet therapy for one month. Platelet aggregation was assessed using light transmission aggregometry and whole blood impedance platelet aggregometry prior to randomisation and after one month of receiving assigned statin and dual antiplatelet treatment. Platelet function assessment after one month of statin and dual antiplatelet therapy did not show a significant change in platelet aggregation from 1st to 2nd assessment for either statin group. There was also no difference between atorvastatin and fluvastatin treatment arms. In conclusion, neither atorvastatin 40 mg daily nor fluvastatin 80 mg daily administered in combination with standard dual antiplatelet therapy following coronary drug-eluting stent implantation significantly interfere with the antiaggregatory effect of ASA and clopidogrel.

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21

Upadhaya, Sunil, Seetharamprasad Madala, and Kanchan Tiwari. "DUAL ANTI-PLATELET THERAPY AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION- A META-ANALYSIS." Journal of the American College of Cardiology 77, no. 18 (May 2021): 944. http://dx.doi.org/10.1016/s0735-1097(21)02303-2.

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22

Lee, Seung-Yul, and Myeong-Ki Hong. "Dual anti-platelet therapy score after percutaneous coronary intervention: An increased uncertainty." International Journal of Cardiology 304 (April 2020): 21–22. http://dx.doi.org/10.1016/j.ijcard.2019.12.036.

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23

Gill, Baljinder, Sandeep Soman, and Amit Bhan. "Comparison of the Glasgow-Blatchford Risk Score vs AIMS65 Score in Patients on Coumadin and Anti-platelet Therapy or Dual Anti-platelet Therapy." American Journal of Gastroenterology 111 (October 2016): S494—S495. http://dx.doi.org/10.14309/00000434-201610001-01130.

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24

Lee, Robert Hugh, and Wolfgang Bergmeier. "Impact of Platelet Count on Bleeding in the Setting of Anti-Platelet Therapy." Blood 136, Supplement 1 (November 5, 2020): 18. http://dx.doi.org/10.1182/blood-2020-142893.

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Anti-platelet therapy (APT) is used for secondary prevention of thrombosis. The most commonly prescribed anti-platelet drugs are aspirin and P2Y12 inhibitors, including clopidogrel, prasugrel and ticagrelor. Dual anti-platelet therapy (DAPT) consisting of aspirin and a P2Y12 inhibitor is often used in the first 1-12 months after an initial thrombotic event and has a greater anti-thrombotic effect than single agents, but is also associated with a higher risk of bleeding. Due to this risk of hemorrhage, the appropriate use of DAPT in patients requiring percutaneous coronary intervention (PCI) with baseline or periprocedural thrombocytopenia remains unclear. To study the impact of thrombocytopenia on bleeding with APT, we used intravital imaging in a murine hemostasis model and adoptive platelet transfer to generate mice with specific platelet counts with or without platelet inhibition. To generate experimental mice, we used transgenic mice in which platelets express a chimeric GPIb receptor with the extracellular domain replaced with a domain of the human IL-4R (hIL-4R/GPIb-Tg). Endogenous platelets were depleted by injection of anti-hIL-4R antibody, and the recipient mice were then transfused with wild-type (WT) platelets from donor mice treated, or not, with single or dual APT (aspirin 20 mg/kg; clopidogrel 25 mg/kg) to achieve specific platelet counts ranging from 50,000 to 400,000 platelets/μL. We also compared these mice with WT mice (with normal platelet counts, ~1,200,000 platelets/μL) treated with APT. Platelet inhibition was confirmed prior to performing in vivo experiments. Hemostasis was determined by intravital imaging in our saphenous vein laser injury model, in which a 50 μm injury was induced by laser ablation. Real-time top-down epifluorescence imaging was used to determine time to initial hemostasis, rebleeding events, and platelet and fibrin accumulation. In each mouse, 3-5 injuries were induced at different sites and each injury was visualized for 10 minutes. Following real-time imaging, spinning disk confocal Z-stacks of platelet plugs were obtained for 3D reconstruction to compare platelet plug volume. In untreated WT mice, hemostasis was achieved in ~20 seconds. In WT mice treated with DAPT, initial hemostasis was often rapidly achieved but this was followed by significant rebleeding events. Paradoxically, platelet accumulation was increased in WT + DAPT mice due to extravascular accumulation of platelets which occurred during bleeding. However, in plugs that stabilized, plug volume was reduced in WT + DAPT mice. In hIL-4R/GPIb-Tg mice with reduced platelet counts, untreated platelets were able to form a stable hemostatic plug even at 50,000/μL, although time to hemostasis was slightly prolonged. However, as platelet counts decreased in mice with DAPT-treated platelets, initial hemostasis became more prolonged and many injuries never achieved initial hemostasis. These results suggest that DAPT may not be safe in the setting of severe thrombocytopenia. Disclosures No relevant conflicts of interest to declare.

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Tourdot, Benjamin, Paul F. Bray, Leonard C. Edelstein, and Michael Holinstat. "Pharmacogenocis of PAR4: PAR4 Polymorphism Determines Platelet Response in the Presence of Dual Anti-Platelet Therapy." Blood 126, no. 23 (December 3, 2015): 3446. http://dx.doi.org/10.1182/blood.v126.23.3446.3446.

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Abstract Aberrant platelet activation contributes to the mortality associated with coronary heart disease (CHD). Our lab group has recently shown that platelets from black donors were hyper-responsive to activation of the thrombin receptor Protease-Activated Receptor-4 (PAR4) compared to platelets from white donors. The racial difference observed through PAR4 persists in platelets treated ex vivo with dual antiplatelet inhibitors (COX-1 and P2Y12 receptor inhibitors), a standard of care for many CHD patients. The racial difference in PAR4 signaling is largely attributable to one PAR4 variant more frequently expressed in blacks than whites, PAR4 T120A. Independent of race, T120 is associated with greater PAR4-mediated platelet reactivity compared to the A120 variant. The role PAR4 variation plays in regulating thrombin-mediated platelet activation in CHD has not been elucidated to date. We hypothesize that people homozygous for the T120 will have an increase in PAR4-mediated platelet reactivity compared to patients homozygous for A120. To investigate this hypothesis, we studied PAR4 signaling in platelets obtained from healthy donors. Platelet activity was assessed in each subject at the beginning of the study. Subsequently subjects were placed on a 7-day treatment of either COX-1 or P2Y12 inhibitors and on day 7 their blood was again drawn and tested for PAR4-AP-mediated platelet activation. Subjects who are homozygous for T120, have an increase in platelet reactivity as measured by aggregation, αIIbβ3 activation and granule secretion compared to individuals who are homozygous for A120. Further distal signaling nodes such as calcium and Rap1 are hyperactive in individuals who are homozygous for T120. This study reinforces the personalized medicine approach to therapeutic intervention and challenges the one size fits all approach which often leaves at risk populations without adequate protection from thrombotic events and stroke. This study was supported in part by grants MD007880, GM105671, and HL 114405 (MH) from the NIH. Disclosures No relevant conflicts of interest to declare.

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Mishra, SandeepKumar, K. Sudeeep, AshokShankar Badhe, and Satyen Parida. "Right middle cerebral artery aneurysm posted for clipping on dual anti-platelet therapy." Indian Journal of Anaesthesia 54, no. 1 (2010): 73. http://dx.doi.org/10.4103/0019-5049.60510.

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Cheng, Victoria E., Anne Oppermen, Dinesh Natarajan, Deepak Haikerwal, and Jeremy Pereira. "Spontaneous Omental Bleeding in the Setting of Dual Anti-platelet Therapy with Ticagrelor." Heart, Lung and Circulation 23, no. 4 (April 2014): e115-e117. http://dx.doi.org/10.1016/j.hlc.2013.11.002.

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Liou, Kevin, and John Lambros. "Delayed Left Ventricular Apical Thrombus Formation Following Discontinuation of Dual Anti-Platelet Therapy." Heart, Lung and Circulation 23, no. 11 (November 2014): e237-e239. http://dx.doi.org/10.1016/j.hlc.2014.06.007.

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Pappas, Christos, Konstantina Ntai, John T. Parissis, and Maria Anastasiou-Nana. "Dual anti-platelet therapy in patients with G6PD deficiency after percutaneous coronary intervention." International Journal of Cardiology 165, no. 2 (May 2013): 380–82. http://dx.doi.org/10.1016/j.ijcard.2012.08.024.

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30

Tnay, Trevor, Nisal Perera, Siven Seevanayagam, George Matalanis, and Sean Galvin. "Should all Patients Receive Dual Anti-platelet Therapy following Coronary Artery Bypass Surgery?" Heart, Lung and Circulation 25, no. 8 (August 2016): e114. http://dx.doi.org/10.1016/j.hlc.2015.12.080.

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31

Ohmori, Tsukasa, Yuichiro Yano, Asuka Sakata, Tomokazu Ikemoto, Masahisa Shimpo, Seiji Madoiwa, Takaaki Katsuki, et al. "Lack of association between serum paraoxonase-1 activity and residual platelet aggregation during dual anti-platelet therapy." Thrombosis Research 129, no. 4 (April 2012): e36-e40. http://dx.doi.org/10.1016/j.thromres.2011.10.033.

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Schäfer, Andreas, Ulrike Flierl, and Johann Bauersachs. "Anti-thrombotic strategies in elderly patients receiving platelet inhibitors." European Heart Journal - Cardiovascular Pharmacotherapy 6, no. 1 (August 6, 2019): 57–68. http://dx.doi.org/10.1093/ehjcvp/pvz032.

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Abstract Acetyl-salicylic acid is the basic anti-thrombotic therapy used for single anti-platelet therapy in primary as well as secondary prevention of atherosclerotic disease. Dual anti-platelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary intervention or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction, unstable angina). DAPT duration has been frequently discussed. Currently, guideline recommendations strengthen the importance of individualized treatment to reduce bleeding risk based on clinical predictors, of which older age is an important one. Patients aged ≥75 years are often underrepresented in randomized clinical trials, but present a patient cohort deemed both at heightened ischaemic as well as bleeding risk. We aimed to summarize the evidence or the lack of evidence for anti-platelet treatment strategies in patients aged ≥75 years including combinations with anticoagulants in secondary prevention or coronary interventions in elderly patients with atrial fibrillation. This review article represents the author’s interpretation of available data and is not discussed by a formal task force; it is intended to point out missing evidence and to provide age-specific data for individualized decision making, which is currently encouraged by the guidelines.

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Mojica Muñoz, Ann-Katrin, Janina Jamasbi, Kerstin Uhland, Heidrun Degen, Götz Münch, Martin Ungerer, Richard Brandl, et al. "Recombinant GPVI-Fc added to single or dual antiplatelet therapy in vitro prevents plaque-induced platelet thrombus formation." Thrombosis and Haemostasis 117, no. 08 (2017): 1651–59. http://dx.doi.org/10.1160/th16-11-0856.

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SummaryThe efficiency of current dual antiplatelet therapy might be further improved by its combination with a glycoprotein (GP) VI-targeting strategy without increasing bleeding. GPVI-Fc, a recombinant dimeric fusion protein binding to plaque collagen and concealing binding sites for platelet GPVI, acts as a lesion-focused antiplatelet drug, and does not increase bleeding in vivo. We investigated, whether GPVI-Fc added in vitro on top of acetylsalicylic acid (ASA), the P2Y12 antagonist ticagrelor, and the fibrinogen receptor antagonist abciximab alone or in combination would increase inhibition of platelet activation by atherosclerotic plaque. Under static conditions, GPVI-Fc inhibited plaque-induced platelet aggregation by 53%, and increased platelet inhibition by ASA (51%) and ticagrelor (64%) to 66% and 80%, respectively. Under arterial flow, GPVI-Fc inhibited plaque-induced platelet aggregation by 57%, and significantly increased platelet inhibition by ASA (28%) and ticagrelor (47%) to about 81% each. The triple combination of GPVI-Fc, ASA and ticagrelor achieved almost complete inhibition of plaque-induced platelet aggregation (93%). GPVI-Fc alone or in combination with ASA or ticagrelor did not increase closure time measured by the platelet function analyzer (PFA)-200. GPVI-Fc added on top of abciximab, a clinically used anti-fibrinogen receptor antibody which blocks platelet aggregation, strongly inhibited total (81%) and stable (89%) platelet adhesion. We conclude that GPVI-Fc added on top of single or dual antiplatelet therapy with ASA and/or a P2Y12 antagonist is likely to improve anti-atherothrombotic protection without increasing bleeding risk. In contrast, the strong inhibition of platelet adhesion by GPVI-Fc in combination with GPIIb/IIIa inhibitors could be harmful.Note: The review process for this manuscript was fully handled by Gregory Y. H. Lip, Editor in Chief.Supplementary Material to this article is available at www.thrombosis-online.com.

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Zhang, Lijie, Ying Lv, Jianyu Dong, Nana Wang, Zhan Zhan, Yuan Zhao, and Shanshan Jiang. "Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI." Clinical and Applied Thrombosis/Hemostasis 28 (January 2022): 107602962210836. http://dx.doi.org/10.1177/10760296221083674.

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Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (109/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (109/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.

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Arya, Abhishek, Sonali Turki, Rajeev Chauhan, and GorlaDeep Kanth. "Successful administration of unilateral spinal anaesthesia in a patient receiving dual anti-platelet therapy under platelet transfusion cover." Indian Journal of Anaesthesia 66, no. 4 (2022): 300. http://dx.doi.org/10.4103/ija.ija_734_21.

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Lee, Ki Hong, Youngkeun Ahn, Sung Soo Kim, Shi Hyun Rhew, Young Wook Jeong, Soo Young Jang, Jae Yeong Cho, et al. "Comparison of Triple Anti-Platelet Therapy and Dual Anti-Platelet Therapy in Patients With Acute Myocardial Infarction Who Had No-Reflow Phenomenon During Percutaneous Coronary Intervention." Circulation Journal 77, no. 12 (2013): 2973–81. http://dx.doi.org/10.1253/circj.cj-13-0594.

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37

Ansari, Ahmed, Tomotaka Ohshima, Shunsaku Goto, Taiki Yamamoto, Kojiro Ishikawa, and Yoko Kato. "Efficacy of carotid thrombus penetration with a balloon guiding catheter to fast recanalization of acute extra- and intra-cranial carotid artery tandem occlusion - a preliminary report." Romanian Neurosurgery 32, no. 1 (March 1, 2018): 65–72. http://dx.doi.org/10.2478/romneu-2018-0008.

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Abstract Acute ischemic stroke with ipsilateral Internal carotid artery (ICA) stenosis presents a great management dilemma. We present our preliminary report of retrograde retrieval of clot from middle cerebral artery (MCA) followed by delayed carotid artery stenting (CAS) with dual anti platelet therapy (DAPT).

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KOBAT, Mehmet Ali, Serkan DÜNDAR, Alihan BOZOĞLAN, Mehmet Ali GELEN, Tarik KIVRAK, Gökhan ARTAŞ, and Suna AYDIN. "The effects of dual anti-platelet therapy on titanium implant osseointegration: an experimental study." Journal of Health Sciences and Medicine 5, no. 1 (January 17, 2022): 144–49. http://dx.doi.org/10.32322/jhsm.1013209.

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Warner, Timothy D., Paul C. Armstrong, Melissa V. Chan, and Rebecca B. Knowles. "The importance of endothelium-derived mediators to the efficacy of dual anti-platelet therapy." Expert Review of Hematology 9, no. 3 (March 2016): 223–25. http://dx.doi.org/10.1586/17474086.2016.1140035.

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Bassand, Jean-Pierre. "Drug interactions in the setting of acute coronary syndromes and dual anti-platelet therapy." European Heart Journal Supplements 8, suppl_G (October 1, 2006): G35—G37. http://dx.doi.org/10.1093/eurheartj/sul053.

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Habib, Anwer, and Aloke V. Finn. "Endothelialization of drug eluting stents and its impact on dual anti-platelet therapy duration." Pharmacological Research 93 (March 2015): 22–27. http://dx.doi.org/10.1016/j.phrs.2014.12.003.

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Yudi, M., N. Andrianopoulos, O. Farouque, J. Ramchand, N. Jones, J. Theuerle, A. Brennan, et al. "Pre-Treatment With Dual Anti-Platelet Therapy in STEMI – Does it Make Any Difference?" Heart, Lung and Circulation 25 (August 2016): S189—S190. http://dx.doi.org/10.1016/j.hlc.2016.06.443.

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43

Natarajan, Piruthiviraj, Sudhagar Thangarasu, Lela Ruck, Paul Estrada, Mahesh Gajendran, Gowri Renganathan, Bharat Ved Prakash, and Olufemi Aduroja. "Atraumatic Splenic Rupture in a Patient on Apixaban and Dual Antiplatelet Therapy." Journal of Investigative Medicine High Impact Case Reports 9 (January 2021): 232470962110264. http://dx.doi.org/10.1177/23247096211026492.

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Splenic rupture due to any cause is a life-threatening complication and commonly attributed to trauma. Atraumatic splenic rupture is very rarely reported, and the incidence is currently unknown. Anticoagulants and dual anti-platelet medication can increase the chances of a splenic rupture. Surgical removal of the spleen may be warranted to prevent a life-threatening bleeding. Early identification and intervention are required for most patients as only a few qualify for medical management.

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Egholm, Gro, Troels Thim, Kevin Olesen, Morten Madsen, Henrik Sorensen, Svend Jensen, Lisette Jensen, Hans Botker, Steen Kristensen, and Michael Maeng. "Dual anti-platelet therapy after coronary drug-eluting stent implantation and surgery-associated major adverse events." Thrombosis and Haemostasis 116, no. 07 (January 2016): 172–80. http://dx.doi.org/10.1160/th15-12-0954.

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SummarySurgery may necessitate interruption of dual antiplatelet therapy (DAPT) within the first year after coronary drug-eluting stent (DES) implantation. We conducted a population-based cohort study to assess the rate of surgery within the first year after DES implantation, surgery-associated major adverse cardiac events (MACE), reoperation for bleeding within 30 days after surgery, and two nested case-control analyses to explore any association between preoperative antiplatelet therapy, MACE, and reoperation for bleeding. In the cohort of 22,654 patients treated with DES, 1,944 patients (8.6 %) underwent moderate- to high-risk surgery within 12 months. Of these, 62 (3.2 %) experienced MACE and 54 (2.8 %) needed reoperation for bleeding within 30 days. In the nested case-control analyses of 458 cases and controls, where 70 % (n=324) had a first generation DES, absence of preoperative antiplatelet therapy was associated with an increased MACE rate (OR 2.36, 95 % CI 1.02–5.48) compared to single antiplatelet therapy (SAPT) or DAPT. Preoperative SAPT versus DAPT showed no difference in MACE rates (OR 0.85, 95 % CI 0.30–2.40). Surgery within the first month was associated with increased MACE rate (OR 4.67, 95 % CI 2.22–9.83) compared to surgery 2–12 months after DES implantation. Absence of preoperative antiplatelet therapy did not reduce reoperation for bleeding as compared to patients on SAPT or DAPT (OR 1.32, 95 % CI 0.56–3.12). In conclusion, absence of preoperative antiplatelet therapy and surgery within the first month after DES implantation were associated with increased MACE rates.

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O'Mahony, Constantinos, Martin Rothman, and Anthony Mathur. "A clinical update on the use of resolute stents with dual anti-platelet therapy interruption." Interventional Cardiology 6, no. 5 (October 2014): 453–62. http://dx.doi.org/10.2217/ica.14.47.

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Biyik, Ismail, Ibrahim Faruk Akturk, Ahmet Arif Yalcin, Ibrahim Cansaran Tanidir, and Mehmet Erturk. "Cannabis joint triggered recurrent anterior myocardial infarction in an adolescent taking dual anti-platelet therapy." Advances in Interventional Cardiology 2 (2012): 156–59. http://dx.doi.org/10.5114/pwki.2012.29658.

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Reale, Giuseppe, Aurelia Zauli, Giuseppe La Torre, Alice Mannocci, Michael V. Mazya, Marialuisa Zedde, Silvia Giovannini, Marco Moci, Chiara Iacovelli, and Pietro Caliandro. "Dual anti-platelet therapy for secondary prevention in intracranial atherosclerotic disease: a network meta-analysis." Therapeutic Advances in Neurological Disorders 15 (January 2022): 175628642211147. http://dx.doi.org/10.1177/17562864221114716.

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Background: Intracranial arterial stenosis (ICAS) is a non-marginal cause of stroke/transient ischemic attacks (TIAs) and is associated with high stroke recurrence rate. Some studies have investigated the best secondary prevention ranging from antithrombotic therapy to endovascular treatment (ET). However, no direct comparison between all the possible treatments is currently available especially between single and dual anti-platelet therapies (SAPT and DAPT). Aim: To establish whether DAPT is more effective than SAPT in preventing the recurrence of ICAS-related stroke, by means of a network meta-analysis (NMA). Design: Systematic review and NMA in accordance to PRISMA guidelines. Data sources and methods: We performed a systematic review of trials investigating secondary prevention (SAPT or DAPT, anticoagulant treatment or ET) in patients with symptomatic ICAS available in MEDLINE, Scopus and Web of Science from January 1989 to May 2021. We defined our primary efficacy outcome as the recurrence of ischemic stroke/TIA. We analysed the extracted data with Bayesian NMA approach. Results: We identified 815 studies and included 5 trials in the NMA. Sequence generation was adequate in all the selected studies while the allocation concealment method was described in one study. All the included studies reported the pre-specified primary outcomes, and outcome assessment was blinded in all the studies. We used the fixed-effect approach as the heterogeneity was not significant ( p > 0.1) according to the Cochran’s Q statistic. DAPT was superior to SAPT and DAPT + ET in preventing stroke/TIA recurrence [respectively, odds ratio (OR), 0.59; confidence interval (CI), 0.39–0.9; and OR, 0.49, CI, 0.26–0.88], while no difference was found between DAPT and oral anticoagulant therapy (OAC). DAPT was safer than OAC (OR, 0.48; CI, 0.26–0.89) and DAPT + ET (OR, 0.50; CI, 0.35–0.71), while no difference was found between DAPT and SAPT. Conclusion: DAPT is more effective than SAPT for secondary stroke prevention in patients with symptomatic ICAS, without increasing the risk of haemorrhage. Registration: Prospero/CRD42019140033.

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Greco, Antonio, Davide Capodanno, and Dominick Angiolillo. "The Conundrum Surrounding Racial Differences on Ischaemic and Bleeding Risk with Dual Anti-Platelet Therapy." Thrombosis and Haemostasis 119, no. 01 (December 31, 2018): 009–13. http://dx.doi.org/10.1055/s-0038-1676612.

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Dhindsa, Mandeep, and Fernando Boccalandro. "DO WE NEED SYSTEMIC ANTICOAGULATION AND DUAL ANTI-PLATELET THERAPY FOR FRACTIONAL FLOW RESERVE CALCULATION?" Journal of the American College of Cardiology 65, no. 10 (March 2015): A1943. http://dx.doi.org/10.1016/s0735-1097(15)61943-x.

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Grodzinsky, Anna, Suzanne V. Arnold, Tracy Y. Wang, Praneet Sharma, Kensey Gosch, Philip G. Jones, Deepak L. Bhatt, et al. "Bleeding risk following percutaneous coronary intervention in patients with diabetes prescribed dual anti-platelet therapy." American Heart Journal 182 (December 2016): 111–18. http://dx.doi.org/10.1016/j.ahj.2016.09.010.

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