Search results for "Clopidogrel"

Prevalence of older in-patients at risk of clopidogrel resistance according to the STIB score. Results from REPOSI registry

2017

The phenomenon of resistance to copidogrel catches the attention of a growing number of clinicians because of its frequency and the severity of adverse events related to it. The identification of patients with high platelet reactivity (HPR may help to improve their therapy applying the concept of personalized medicine, most important in the older people treated with polypharmacy. The existece of such a simple clinical method as the STIB score, that allows to predict the possible resistace to clopidogrel at the bedside without using expensive laboratory investigations, provides an attractive approach to the problem.

LE VARIANTI DEL GENE CYP2C19 NELLA FARMACO-GENOMICA DEL CLOPIDOGREL

2010

Il clopidogrel per espletare la propria funzione di antiaggregante piastrinica necessita l’intervento di diversi citocromi epatici. Le varianti del gene CYP2C19 sembrano influenzarne sensibilmente l’attivazione e pertanto l’azione farmacologica. Sono stati identificati tre alleli principali. L’allele CYP2C19*1 è il wild type e codifica per un enzima costituzionalmente attivo. Gli alleli CYP2C9*2 e CYP2C9*3 codificano invece per forme enzimatiche parzialmente funzionanti e sono responsabili sia in eterozigosi che in omozigosi della variazione di attività farmacologica. La valutazione delle varianti è stata eseguita mediante le metodiche PCR-RFLP e sequenziamento diretto. Abbiamo allestito du…

Role of genetic factors on the effect of additional loading doses and two maintenance doses used to overcome clopidogrel hyporesponsiveness.

2014

Background and objective: Additional loading doses and higher maintenance doses (MDs) have been used to overcome hyporesponsiveness of clopidogrel. We aimed to investigate whether genetic polymorphisms of two cytochromes (CYP2C19 and CYP2C9) and ABCB1 modify effect of such dose-adjustment strategy.Materials and methods: We enrolled 118 patients undergoing elective or acute percutaneous coronary intervention (PCI) with drug eluting stent (DES). Platelet reactivity index (PRI) was measured using the vasodilator-stimulated phosphoprotein (VASP) index and a cut-off value of ≥60% was defined as hyporesponsiveness. Polymorphism of two cytochromes (CYP2C19, CYP2C9) and gene ABCB1 were determined. …

Management of Patients with Asymptomatic and Symptomatic Carotid Artery Disease: Update on Anti-Thrombotic Therapy

2019

AbstractThe most common causes of ischaemic stroke are represented by carotid artery atherosclerotic disease (CAAD) and atrial fibrillation. While oral anticoagulants substantially reduce the incidence of thromboembolic stroke (< 1%/year), the rate of ischaemic stroke and other cardiovascular disease events in patients with CAAD remains high, ranging from 8.4 to 18.1 events per 100 patient-years. Similar to any other atherosclerotic disease, anti-thrombotic therapies are proposed for CAAD to reduce stroke and other cardiovascular events. The 2017 European Society of Cardiology (ESC)/European Society for Vascular Surgery (ESVS) guidelines recommend for patients with asymptomatic CAAD ≥60%…

RE: Risk of Postpolypectomy Bleeding With Uninterrupted Clopidogrel Therapy in an Industry-Independent, Double-Blind, Randomized, Trial

2019

Tendencia en la utilización de antiagregantes en la Comunidad Valenciana (2000-2005)

2007

Beatriz Román Llamosí, Rocío Broseta Solaz, Joan Quiles Izquierdo y Amalia Úbeda Pascual (Amalia.Ubeda@uv.es) Los antiagregantes plaquetarios son fármacos básicos para la prevención de enfermedades isquémicas arteriales. El objetivo de este trabajo es conocer la evolución de su utilización en Atención Primaria en la Comunidad Valenciana durante el periodo 2000-2005. Métodos: Estudio descriptivo del consumo de los antiagregantes plaquetarios (código ATC: B01AC) dispensados con cargo al Sistema Nacional de Salud en la Comunidad Valenciana en el ámbito de Atención Primaria. Datos expresados en dosis diarias definidas (DDD) por 1.000 habitantes y día. Resultados: En 2005 tres fármacos represent…

Is Aspirin a Worthy Candidate in Preventing Intracranial Aneurysm Rupture?

2020

Subarachnoid hemorrhage (SAH) usually occurs with a thunderclap headache or the worst headache of a patient's life, leading to a neurologic emergency. Among cases of nontraumatic SAH, 80%–85% are caused by ruptured intracranial aneurysms (IAs) and comprise 3% of all strokes in high-income countries In the years 2000–2008, the incidence of SAH was 4–7 per 100,000 person-years in high-income and low-to middle-income countries. Outcome after aneurysmal SAH depends on several factors, including severity of the initial hemorrhage, rebleeding, perioperative medical management, and timing and technical success for vascular malformation exclusion from the cerebral circulation. It has been estimated…

Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized C…

2020

Our aim is to assess whether following a Mediterranean Diet (MedDiet) decreases the risk of initiating antithrombotic therapies and the cardiovascular risk associated with its use in older individuals at high cardiovascular risk. We evaluate whether participants of the PREvenci&oacute

Gene therapy with iNOS enhances regional contractility and reduces delayed contrast enhancement in a model of postischemic congestive heart failure

2012

Aims: The purpose of this study was to evaluate the effect of transient local myocardial gene transfer of iNOS on cardiac function in a large mammal animal model of heart failure induced by chronic ischemia. Methods: Chronic myocardial ischemia was induced using a minimally invasive model in 16 landrace pigs. Upon demonstration of heart failure, eight animals were treated with liposome-mediated iNOS-gene-transfer by local intramyocardial injection; eight animals received a sham procedure to serve as control. Results: The transmurality of late enhancement (control: 46.4%, iNOS: 35.9%; p < 0.05) was significantly decreased in the ischemic area in the iNOS-treated group. Wall thickness at end-…

Bridge to Operation with the GPIIb/IIIa Inhibitor Abciximab in High-Risk Coronary Patients

2006

BACKGROUND Glycoprotein-IIb/IIIa inhibitors are now frequently used in the cardiological treatment of high-risk coronary patients even if the patient is considered suitable for surgical intervention. However, there is no consensus whether GPIIb/IIIa inhibitors should be stopped before operation because of an increased risk of bleeding or if surgery should even be delayed until the anticoagulating effect subsides. METHODS From June 2002 to August 2003 140 patients who had to undergo primary aorto-coronary bypass for ongoing myocardial ischemia were enrolled in the present study. The patients received either clopidogrel, aspirin and heparin or additionally abciximab until operation. RESULTS A…