Letter
Medicine, General & Internal
John A. Bittl
Summary: The article discusses the preference for antithrombotic therapy in patients with acute coronary syndromes and the difference between preference and actual practice. It also mentions a new study, but does not explicitly state whether this new study can explain the discrepancy.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Review
Medicine, General & Internal
Clara Bonanad, Francisca Esteve-Claramunt, Sergio Garcia-Blas, Ana Ayesta, Pablo Diez-Villanueva, Jose-Angel Perez-Rivera, Jose Luis Ferreiro, Joaquim Canoves, Francisco Lopez-Fornas, Albert Ariza Sole, Sergio Raposerias, David Vivas, Regina Blanco, Daznia Bompart Berroteran, Alberto Cordero, Julio Nunez, Lorenzo Facila, Ivan J. Nunez-Gil, Jose Luis Gorriz, Vicente Bodi, Manuel Martinez-Selles, Juan Miguel Ruiz Nodar, Francisco Javier Chorro
Summary: The treatment of acute coronary syndrome (ACS) in elderly patients is challenging due to their characteristics and lack of specific recommendations. This review summarizes the current evidence on oral antithrombotic therapy in elderly patients, discussing peculiarities of dual antiplatelet therapy (DAPT) in ACS management and analyzing antithrombotic strategies in patients with atrial fibrillation (AF) and coronary artery disease (CAD).
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Multidisciplinary Sciences
Zhi-Jiang Xie, Shuan-Li Xin, Chao Chang, Hai-Jing Zhou, Xiu-Feng Zhao, Feng-Hui Jiao, Chuan Chen, Tao Li
Summary: The study comparing combined GPI and ticagrelor therapy with ticagrelor alone in patients with acute coronary syndrome found that the combination therapy increased the risk of major cardiovascular events and various types of bleeding. Propensity score-matched analysis further supported these findings.
Review
Medicine, General & Internal
Hassan Kamran, Hani Jneid, Waleed T. Kayani, Salim S. Virani, Glenn N. Levine, Vijay Nambi, Umair Khalid
Summary: Dual antiplatelet therapy is beneficial for patients with acute coronary syndrome, and the specific combination and duration should be based on patient characteristics and bleeding risk.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Shqipdona Lahu, Gjin Ndrepepa, Franz-Josef Neumann, Maurizio Menichelli, Isabell Bernlochner, Gert Richardt, Jochen Wohrle, Bernhard Witzenbichler, Rayyan Hemetsberger, Katharina Mayer, Ibrahim Akin, Salvatore Cassese, Senta Gewalt, Erion Xhepa, Sebastian Kufner, Christian Valina, Hendrik B. Sager, Michael Joner, Tareq Ibrahim, Karl-Ludwig Laugwitz, Heribert Schunkert, Stefanie Schupke, Adnan Kastrati
Summary: Pre-admission treatment with aspirin and/or clopidogrel does not affect the efficacy and safety of ticagrelor and prasugrel in patients with acute coronary syndromes.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Guiomar Mendieta, Shamir Mehta, Usman Baber, Dominick J. Angiolillo, Carlo Briguori, David Cohen, Timothy Collier, George Dangas, Dariusz Dudek, Javier Escaned, Robert Gil, Birgit Vogel, Davide Cao, Alessandro Spirito, Kurt Huber, Adnan Kastrati, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Vijay Kunadian, David J. Moliterno, E. Magnus Ohman, Gennaro Sardella, Samantha Sartori, Samin Sharma, Richard Shlofmitz, P. Gabriel Steg, Ya-Ling Han, Stuart Pocock, C. Michael Gibson, Roxana Mehran
Summary: In high-risk patients, ticagrelor monotherapy reduces bleeding events without increasing the risk of ischemic events compared to dual antiplatelet therapy. The benefit of ticagrelor monotherapy is consistent across different bleeding and ischemic risk levels.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Pharmacology & Pharmacy
Arun Kumar, Pamela L. Lutsey, Wendy L. St. Peter, Jon C. Schommer, Jeremy R. Van't Hof, Abhijeet Rajpurohit, Joel F. Farley
Summary: In acute coronary syndrome following percutaneous coronary intervention, newer P2Y12 inhibitors (ticagrelor and prasugrel) reduce cardiovascular outcomes compared to clopidogrel, but have a higher bleeding risk. This study examines the safety of each inhibitor in a real-world population.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Pharmacology & Pharmacy
Georg Gelbenegger, Ummahan Erari-Canyurt, Jurgen Grafeneder, Bernd Jilma, Maciej Lesiak, Anna Komosa, Raffaele de Caterina, Marek Postula, Jolanta M. Siller-Matula
Summary: This study suggests that very short-term DAPT after PCI does not increase the risk of MACE, while any longer-term DAPT can significantly reduce the risk of MACE, but may increase the risk of major bleeding.
VASCULAR PHARMACOLOGY
(2021)
Article
Medicine, Research & Experimental
Dandan Li, Yang Sun, Xiaoran Ye, Lanting Li, Yundai Chen, Daowen Wang
Summary: In Chinese ACS patients undergoing PCI with second-generation DESs, outpatient use of clopidogrel dual antiplatelet therapy was associated with a reduction in NACCE and bleeding compared to ticagrelor therapy.
ADVANCES IN THERAPY
(2022)
Article
Pharmacology & Pharmacy
Alexandru-George Cotoban, Cristian Alexandru Udroiu, Dragos Vinereanu
Summary: In Romania, invasively managed NSTE-ACS patients commonly receive DAPT, P2Y12 inhibitor pretreatment, and single vessel PCI, while the introduction of full reimbursement for ticagrelor since November 2017 has doubled its usage rate.
AMERICAN JOURNAL OF THERAPEUTICS
(2021)
Article
Medicine, General & Internal
Hiroyoshi Mori, Takuya Mizukami, Atsuo Maeda, Kazuki Fukui, Yoshihiro Akashi, Junya Ako, Yuji Ikari, Toshiaki Ebina, Kouichi Tamura, Atsuo Namiki, Ichiro Michishita, Kazuo Kimura, Hiroshi Suzuki
Summary: The 1-year rates of ischemic and bleeding events were similar in Japanese patients with AMI treated with prasugrel or clopidogrel.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Dominick J. Angiolillo, Davide Cao, Samantha Sartori, Usman Baber, George Dangas, Zhongjie Zhang, Birgit Vogel, Vijay Kunadian, Carlo Briguori, David J. Cohen, Timothy Collier, Dariusz Dudek, Michael Gibson, Robert Gil, Kurt Huber, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Alfonso Ielasi, Giulio G. Stefanini, Carlo A. Pivato, Shamir Mehta, David J. Moliterno, E. Magnus Ohman, Javier Escaned, Gennaro Sardella, Samin K. Sharma, Richard Shlofmitz, Giora Weisz, Bernhard Witzenbichler, P. Gabriel Steg, Stuart Pocock, Roxana Mehran
Summary: This study found that nearly 10% of patients receiving ticagrelor therapy experienced dyspnea-related discontinuation of treatment. Asian race, smoking, prior PCI, and other factors were identified as predictors of dyspnea-related ticagrelor discontinuation. Ticagrelor monotherapy after discontinuation did not increase the risk of subsequent cardiovascular events.
JACC-CARDIOVASCULAR INTERVENTIONS
(2023)
Review
Medicine, General & Internal
Brian A. Bergmark, Njambi Mathenge, Piera A. Merlini, Marilyn B. Lawrence-Wright, Robert P. Giugliano
Summary: Although progress has been made in diagnosing and treating acute coronary syndromes, cardiovascular disease remains a leading cause of death globally. High-sensitivity troponin assays have allowed for rapid diagnosis in suspected cases. Dual antiplatelet therapy and additional preventive measures are recommended. The diagnosis and management of acute coronary syndromes continue to evolve, especially in response to the COVID-19 pandemic.
Article
Hematology
Freek W. A. Verheugt, Kurt Huber, Peter Clemmensen, Jean-Philippe Collet, Thomas Cuisset, Felicita Andreotti
Summary: Antiplatelet therapy is crucial for preventing secondary ischemic heart disease. After PCI, temporary DAPT, which consists of aspirin and an oral P2Y12 receptor blocker, is recommended. However, long-term DAPT increases the risk of bleeding compared to aspirin monotherapy. To reduce bleeding, shorter DAPT duration or switching to P2Y12 inhibitor monotherapy have been suggested. This survey reviews the evidence and provides clinical guidance on the use of P2Y12 inhibitor monotherapy after DAPT cessation following PCI.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Hematology
Chor-Cheung Frankie Tam, Yap-Hang Chan, Yuen-Kwun Wong, Zhen Li, Xiurui Zhu, Kuo-Jung Su, Anindita Ganguly, Kuoyuan Hwa, Xuefeng B. Ling, Hung-Fat Tse
Summary: This study compared the effects of ticagrelor and aspirin monotherapy on vascular endothelial function in patients with prior acute coronary syndrome. The results showed that ticagrelor significantly improved brachial flow-mediated dilation compared with aspirin, but had no significant effect on platelet activation markers and endothelial progenitor cell count. The analysis of multi-omics pathways also found associations between ticagrelor treatment and changes in metabolism and lipid levels.
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
(2022)
Review
Hematology
Oliver Buchhave Pedersen, Erik Lerkevang Grove, Steen Dalby Kristensen, Peter H. Nissen, Anne-Mette Hvas
Summary: A systematic review identified a total of 45 miRs associated with platelet function or maturity in patients with CVD, with miR-223 and miR-126 being the most frequently investigated. However, the majority of miRs were only investigated in one study, indicating the need for more data to validate their potential use as biomarkers for platelet function and maturity in CVD patients.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Biochemistry & Molecular Biology
Gina Perrella, Samantha J. Montague, Helena C. Brown, Lourdes Garcia Quintanilla, Alexandre Slater, David Stegner, Mark Thomas, Johan W. M. Heemskerk, Steve P. Watson
Summary: The study shows that Syk tyrosine kinase regulates the stability of thrombus under flow conditions, and this process involves pathways additional to activation of GPVI by collagen.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Cardiac & Cardiovascular Systems
Paul F. Brady, Winnie Chua, Frantisek Nehaj, Derek L. Connolly, Alya Khashaba, Yanish J. Purmah, Muhammad J. Ul-Qamar, Mark R. Thomas, Chetan Varma, Renate B. Schnabel, Tanja Zeller, Larissa Fabritz, Paulus F. Kirchhof
Summary: This study found that elevated NT-proBNP concentrations predict future heart failure events in patients with atrial fibrillation, regardless of the presence of heart failure.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Critical Care Medicine
Benjamin A. Fisher, Tonny Veenith, Daniel Slade, Charlotte Gaskell, Matthew Rowland, Tony Whitehouse, James Scriven, Dhruv Parekh, Madhu S. Balasubramaniam, Graham Cooke, Nick Morley, Zoe Gabriel, Matthew P. Wise, Joanna Porter, Helen McShane, Ling-Pei Ho, Philip N. Newsome, Anna Rowe, Rowena Sharpe, David R. Thickett, Julian Bion, Simon Gates, Duncan Richards, Pamela Kearns
Summary: This study aimed to evaluate the efficacy of two drugs in hospitalized patients with COVID-19. The results showed that namilumab was able to reduce the inflammatory response, while infliximab did not show significant efficacy compared to usual care. Although there were some differences in adverse events and mortality rates, these differences were not significant.
LANCET RESPIRATORY MEDICINE
(2022)
Article
Biochemistry & Molecular Biology
Maan H. Harbi, Christopher W. Smith, Fawaz O. Alenazy, Phillip L. R. Nicolson, Alok Tiwari, Steve P. Watson, Mark R. Thomas
Summary: The study investigates the effect of Syk inhibitor fostamatinib as an antiplatelet drug, showing that it mildly inhibits platelet responses induced by atherosclerotic plaque and that this effect is amplified by aspirin and ticagrelor.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Hematology
Natalie J. Jooss, Christopher W. Smith, Alexandre Slater, Samantha J. Montague, Ying Di, Christopher O'Shea, Mark R. Thomas, Yvonne M. C. Henskens, Johan W. M. Heemskerk, Steve P. Watson, Natalie S. Poulter
Summary: This study emphasizes the critical difference in GPVI-mediated platelet activation by plaque and collagen, highlighting the importance of GPVI clustering for downstream signaling and thrombus formation. Labeled Nb28 is a novel tool for providing mechanistic insight into this process, and the data suggest Nb2 warrants further investigation as a potential anti-thrombotic agent.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Hematology
Oliver Buchhave Pedersen, Erik Lerkevang Grove, Peter H. Nissen, Sanne Bojet Larsen, Leonardo Pasalic, Steen Dalby Kristensen, Anne-Mette Hvas
Summary: This study aimed to investigate whether the expression of selected candidate miRNAs can predict cardiovascular events in stable CAD patients. Among 749 patients, adding miR-223-3p expression to traditional cardiovascular risk factors improved the predictive value of ST, the primary composite endpoint, and the secondary endpoint of the composite of nonfatal MI and ST. Clinical trials are needed to confirm these findings.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Biochemical Research Methods
Oliver Buchhave Pedersen, Leonardo Pasalic, Erik Lerkevang Grove, Steen Dalby Kristensen, Anne-Mette Hvas, Peter H. Nissen
Summary: Newly produced immature platelets are larger, contain higher amounts of residual RNA, and are more reactive than mature platelets. Flow cytometry using the SYTO-13 dye can differentiate between immature and mature platelets based on labeling of intracellular platelet RNA, allowing for investigation of the reactivity of each platelet population. The presented flow cytometry protocol provides detailed information on platelet physiology and can be used to analyze platelet reactivity in relation to platelet maturity.
METHODS AND PROTOCOLS
(2023)
Article
Cell Biology
Oliver Buchhave Pedersen, Sanne Bojet Larsen, Steen Dalby Kristensen, Anne-Mette Hvas, Erik Lerkevang Grove
Summary: Immature platelet markers cannot predict cardiovascular events in stable CAD patients.
Article
Cardiac & Cardiovascular Systems
Troels Thim, Lars Jakobsen, Rebekka Vibjerg Jensen, Nicolaj Stottrup, Ashkan Eftekhari, Erik Lerkevang Grove, Sanne Bojet Larsen, Jacob Thorsted Sorensen, Steen Carstensen, Sahar Amiri, Karsten Tange Veien, Evald Hoj Christiansen, Christian Juhl Terkelsen, Michael Maeng, Steen Dalby Kristensen
Summary: This retrospective observational study aimed to describe the real-world use of cangrelor in acute percutaneous coronary intervention (PCI) and evaluate patient outcomes. The majority of patients with acute procedures were treated for STEMI, and the use of oral P2Y12 inhibitors prior to PCI was uncommon. While cangrelor showed advantages in clinical management, randomized trials are needed to assess its benefits, risks, and patient outcomes.
CARDIOLOGY RESEARCH AND PRACTICE
(2023)
Article
Hematology
Oliver Buchhave Pedersen, Anne-Mette Hvas, Leonardo Pasalic, Steen Dalby Kristensen, Erik Lerkevang Grove, Peter H. Nissen
Summary: This study explored the association between miRNA expression and platelet function and maturity in patients with acute STEMI and healthy individuals. The expression of miR-26b-5p showed the most consistent association with platelet function in STEMI patients and may potentially influence the effect of antiplatelet therapy.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Cardiac & Cardiovascular Systems
Mia Ravn Jacobsen, Reza Jabbari, Thomas Engstrom, Erik Lerkevang Grove, Charlotte Glinge, Frants Pedersen, Lene Holmvang, Lars Kober, Christian Torp-Pedersen, Michael Maeng, Karsten Veien, Phillip Freeman, Mette Gitz Charlot, Henning Kelbaek, Rikke Sorensen
Summary: The aim of this study was to characterize and follow patients with ST-segment elevation myocardial infarction (STEMI) at high bleeding risk (HBR) according to the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score, and to examine the use of P2Y12 inhibitors and the subsequent risk of major adverse cardiovascular events (MACE) and bleeding. The results showed that one-third of PCI-treated all-comer patients with STEMI were at HBR according to the PRECISE-DAPT score and were more often treated with potent P2Y12 inhibitors instead of clopidogrel. The risk of MACE was lower in ticagrelor- and prasugrel-treated patients than in clopidogrel-treated patients without differences in major bleeding.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2023)
Article
Hematology
Foteini-Nafsika Damaskinaki, Natalie J. Jooss, Eleyna M. Martin, Joanne C. Clark, Mark R. Thomas, Natalie S. Poulter, Jonas Emsley, Barrie Kellam, Steve P. Watson, Alexandre Slater
Summary: This study investigates the binding sites of three high-affinity nanobodies, Nb2, Nb21, and Nb35, on the platelet-signaling receptor GPVI. The researchers found that all three nanobodies can bind to the D1 domain of GPVI and inhibit collagen-induced GPVI signaling. They also identified common target residues, Arg46, Tyr47, and Ala57, on GPVI for these nanobodies. Additionally, the study negates the idea that GPVI dimerization induces a conformational change required for ligand binding.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Hematology
Fawaz O. Alenazy, Maan H. Harbi, Dean P. Kavanagh, Joshua Price, Paul Brady, Oscar Hargreaves, Paul Harrison, Alexandre Slater, Alok Tiwari, Phillip L. R. Nicolson, Derek L. Connolly, Paulus Kirchhof, Neena Kalia, Martine Jandrot-Perrus, Pierre H. Mangin, Steve P. Watson, Mark R. Thomas
Summary: This study investigated the additional antithrombotic effects of combining glenzocimab, a GPVI inhibitor, with aspirin and ticagrelor. The results showed that glenzocimab enhanced platelet inhibition and reduced atherosclerotic plaque-induced platelet aggregation, adhesion, and activation. Compared to a GPIIb/IIIa inhibitor, glenzocimab exhibited similar antithrombotic effects but with less inhibition of general hemostasis.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Hematology
Anne Gulbech Ording, Mette Sogaard, Flemming Skjoth, Erik Lerkevang Grove, Gregory Y. H. Lip, Torben Bjerregaard Larsen, Peter Bronnum Nielsen
Summary: There is a similar risk of hematuria associated with DOAC and warfarin treatment in patients with AF and urologic cancer.
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2022)