Article
Health Care Sciences & Services
Mariana Angulo-Aguado, Karen Panche, Caroll Andrea Tamayo-Agudelo, Daniel-Armando Ruiz-Torres, Santiago Sambracos-Parrado, Maria Jose Nino-Orrego, Nathaly Paez, Laura B. Pineros-Hernandez, Luisa-Fernanda Castillo-Leon, Juan Mauricio Pardo-Oviedo, Katherine Parra Abaunza, Paul Laissue, Nora Contreras, Carlos Alberto Calderon-Ospina, Dora Janeth Fonseca-Mendoza
Summary: The study analyzed genetic variants in CYP2C19 gene in 166 patients with acute coronary syndrome treated with clopidogrel. New potentially pathogenic mutations, intronic variants with potential splicing effects, and a new haplotype in strong linkage disequilibrium were identified. Clinical outcomes showed adverse drug reactions in some patients, with a predominance of bleeding, particularly in carriers of polymorphic alleles.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
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)
Article
Cardiac & Cardiovascular Systems
Wenxing Peng, Yunnan Zhang, Yang Lin
Summary: This study mainly explored the effects of low-dose ticagrelor in Chinese ACS patients. The results showed that the platelet aggregation rates induced by ADP were comparable in the ticagrelor 60 mg and ticagrelor 90 mg groups, and both of these groups had significantly more potent antiplatelet activity compared to clopidogrel.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medicine, General & Internal
Alexandru Burlacu, Mariana Floria, Crischentian Brinza, Adrian Covic
Summary: This meta-analysis aimed to compare the efficacy and safety endpoints of ticagrelor and clopidogrel in end-stage kidney disease (ESKD) patients on chronic dialysis presenting with acute or chronic coronary syndromes (ACS or CCS). The results showed no significant difference in efficacy or safety outcomes between ticagrelor and clopidogrel. Further randomized controlled trials are needed to establish the optimal antiplatelet therapy in this population.
JOURNAL OF CLINICAL MEDICINE
(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
Yunnan Zhang, Yi Zhang, Xiujin Shi, Baidi Lin, Jialun Han, Yifan Wang, Jialin Yan, Wenxing Peng, Wenzheng Li, Ze Zheng, Yang Lin
Summary: This study found that in ACS patients without CYP2C19 loss-of-function alleles, clopidogrel was not associated with a higher risk of MACCEs compared to ticagrelor. This suggests that clopidogrel can be used as an alternative P2Y12 inhibitor in CYP2C19 LOF noncarriers, potentially reducing medical expenses and adverse reactions caused by more potent P2Y12 inhibitors in these patients.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Cardiac & Cardiovascular Systems
Amber L. Beitelshees, Cameron D. Thomas, Philip E. Empey, George A. Stouffer, Dominick J. Angiolillo, Francesco Franchi, Sony Tuteja, Nita A. Limdi, James C. Lee, Julio D. Duarte, Rolf P. Kreutz, Todd C. Skaar, James C. Coons, Jay Giri, Caitrin W. McDonough, Rachel Rowland, James M. Stevenson, Thuy Thai, Mark R. Vesely, Jacob T. Wellen, Julie A. Johnson, Almut G. Winterstein, Larisa H. Cavallari, Craig R. Lee
Summary: The clinical implementation of CYP2C19-guided antiplatelet therapy after PCI has shown better outcomes compared to clopidogrel treatment. For patients with a CYP2C19 loss-of-function variant, alternative therapy significantly reduces the risk of major atherothrombotic events.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Cardiac & Cardiovascular Systems
Yang Zhang, Xiliang Zhao, Yicong Ye, Quan Li, Yong Zeng
Summary: This study investigated the association between CYP2C19 gene polymorphisms and the risk of cardiovascular events in patients who received clopidogrel after percutaneous coronary intervention (PCI). The results showed that patients with two copies of loss-of-function (LOF) alleles had a higher risk of ischemic events at 3 months post-PCI, but this difference was not sustained for 12 months.
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Sawsan AlMukdad, Hazem Elewa, Salaheddin Arafa, Daoud Al-Badriyeh
Summary: This study evaluated the cost-effectiveness of CYP2C19 genotype-guided therapy, universal ticagrelor, and universal clopidogrel post-PCI, with genotype-guided therapy being the preferred strategy due to its cost-effectiveness and long-term effectiveness.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2021)
Article
Pharmacology & Pharmacy
Ismail Mouhrach, Laila Bouguenouch, Adil Kamal, Abbassi Meriame, Nada El Khorb, Mohammed El Azami El Idrissi, Hafid Akoudad, Hicham Bekkari
Summary: This study investigated the association between genetic polymorphisms in CYP genes and ABCB1 gene and clopidogrel responsiveness in Moroccan ACS patients. The results showed that the studied genetic variations and demographic factors had no effect on the platelet activity of clopidogrel.
PHARMACOGENOMICS & PERSONALIZED MEDICINE
(2023)
Article
Pharmacology & Pharmacy
Shanshan Nie, Kaifeng Chen, Chengxian Guo, Qi Pei, Chan Zou, Liangyuan Yao, Hongbo Yuan, Xia Zhao, Ran Xie, Xu He, Jie Huang, Guoping Yang
Summary: This study reveals the impact of CYP4F2 rs2074900 SNP on ticagrelor pharmacokinetics (PK) and provides new insights into the pharmacogenetics of ticagrelor.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Clinical Neurology
Changqing Li, Weihua Jia, Jian Li, Fangfei Li, Jing Ma, Lichun Zhou
Summary: This retrospective analysis of elderly stroke patients aged over 75 years receiving 75 mg clopidogrel showed that a CYP2C19 genotype-guided strategy could reduce the occurrence of composite of stroke and myocardial infarction compared to a non-genotype-guided strategy.
Article
Respiratory System
Wenwen Qian, Liang Chen, Lizhu Zhang, Mingzhu Gao, Chunxia Wang, Xi Qian, Chengjian Yang, Yahui Lin, Zhijun Han
Summary: This study found that CYP2C19 genotype is associated with the prognosis of patients with coronary heart disease receiving clopidogrel antiplatelet therapy. Patients carrying CYP2C19*2 and/or CYP2C19*3 mutations have a higher risk of poor prognosis, while patients undergoing PCI or carrying a single CYP2C19 deletion allele have a better prognosis with ticagrelor as replacement therapy.
JOURNAL OF THORACIC DISEASE
(2022)
Article
Cardiac & Cardiovascular Systems
J. J. Coughlan, Alp Aytekin, Shqipdona Lahu, Gjin Ndrepepa, Maurizio Menichelli, Katharina Mayer, Jochen Wohrle, Isabell Bernlochner, Senta Gewalt, Bernhard Witzenbichler, Willibald Hochholzer, Dirk Sibbing, Salvatore Cassese, Dominick J. Angiolillo, Rayyan Hemetsberger, Christian Valina, Arne Mueller, Sebastian Kufner, Christoph Liebetrau, Erion Xhepa, Alexander Hapfelmeier, Hendrik B. Sager, Michael Joner, Massimiliano Fusaro, Gert Richardt, Karl Ludwig Laugwitz, Franz Josef Neumann, Heribert Schunkert, Stefanie Schuepke, Adnan Kastrati
Summary: This study compared the safety and efficacy of ticagrelor and prasugrel hydrochloride for patients with ACS treated with PCI. Results showed that the incidence of the primary composite end point was lower in the prasugrel group compared to the ticagrelor group, while bleeding events were similar between the two groups.
Article
Cardiac & Cardiovascular Systems
Daniel M. F. Claassens, Thomas O. Bergmeijer, Gerrit J. A. Vos, Renicus S. Hermanides, Arnoud W. J. van 't Hof, Pim van der Harst, Emanuele Barbato, Carmine Morisco, Richard M. Tjon Joe Gin, Folkert W. Asselbergs, Arend Mosterd, Jean-Paul R. Herrman, Willem J. M. Dewilde, Paul W. A. Janssen, Johannes C. Kelder, Bakhtawar K. Mahmoodi, Vera H. M. Deneer, Jurrien M. ten Berg
Summary: In patients with primary PCI not carrying a CYP2C19 loss-of-function allele, the use of clopidogrel compared with ticagrelor or prasugrel was associated with lower bleeding rates, without an increase in thrombotic events. No effect on clinical outcomes was found for the CYP2C19*17 polymorphism.
CIRCULATION-CARDIOVASCULAR INTERVENTIONS
(2021)
Article
Cardiac & Cardiovascular Systems
Isabelle Durand-Zaleski, Gregory Ducrocq, Maroua Mimouni, Jerome Frenkiel, Cristina Avendano-Sola, Jose R. Gonzalez-Juanatey, Emile Ferrari, Gilles Lemesle, Etienne Puymirat, Laurence Berard, Marine Cachanado, Joan Albert Arnaiz, Manuel Martinez-Selles, Johanne Silvain, Albert Ariza-Sole, Gonzalo Calvo, Nicolas Danchin, Sandra Paco, Elodie Drouet, Helene Abergel, Alexandra Rousseau, Tabassome Simon, Philippe Gabriel Steg
Summary: This study assessed the cost-effectiveness and cost-utility ratios of restrictive vs. liberal transfusion strategy in acute myocardial infarction patients. The results showed that the restrictive strategy was dominant at 30 days, saving costs and improving outcomes, but it no longer maintained non-inferiority on MACE at 1 year.
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2023)
Article
Hematology
Tobias Geisler, Sven Poli, Kurt Huber, Dominik Rath, Parwez Aidery, Steen D. Kristensen, Robert F. Storey, Alex Ball, Jean-Philippe Collet, Jurrien ten Berg
Summary: This article discusses major bleeding as a common complication in patients undergoing antiplatelet therapy and the challenges in resuming the therapy. Understanding the patient's bleeding risk and weighing it against the thrombotic risk is crucial in preventing adverse events. The article focuses on the most life-threatening bleeding events, such as intracranial hemorrhage and gastrointestinal bleeding, and discusses the evidence for resumption of antiplatelet therapy based on individual risk assessment in high-risk cardiovascular disease patients.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Cardiac & Cardiovascular Systems
Michael Miller, Deepak L. Bhatt, Ph Gabriel Steg, Eliot A. Brinton, Terry A. Jacobson, Lixia Jiao, Jean-Claude Tardif, Christie M. Ballantyne, Matthew Budoff, R. Preston Mason
Summary: The study found that the use of IPE can reduce the risk of cardiovascular disease in smokers to the level observed in non-smokers.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2023)
Article
Cardiac & Cardiovascular Systems
Jeremie Abtan, Deepak L. Bhatt, Yedid Elbez, Gregory Ducrocq, Shinya Goto, Sidney C. Smith, E. Magnus Ohman, Kim A. Eagle, Kim Fox, Robert A. Harrington, Lawrence A. Leiter, Shamir R. Mehta, Tabassome Simon, Ivo Petrov, Peter R. Sinnaeve, Prem Pais, Eli Lev, Hector Bueno, Peter Wilson, Philippe Gabriel Steg
Summary: This study aimed to describe the proportion of eligible and ineligible patients for the THEMIS trial in a population with diabetes and stable coronary artery disease. 64.1% of patients did not meet THEMIS eligibility criteria, mainly due to prior myocardial infarction and use of oral anticoagulation. 28.1% of patients were eligible for the trial.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Endocrinology & Metabolism
Ramzi A. Ajjan, Simon R. Heller, Colin C. Everett, Armando Vargas-Palacios, Ruchi Higham, Linda Sharples, Diana A. Gorog, Alice Rogers, Catherine Reynolds, Catherine Fernandez, Pedro Rodrigues, Thozhukat Sathyapalan, Robert F. Storey, Deborah D. Stocken
Summary: This study analyzed the impact of modern glucose-monitoring strategies on glycemic and patient-related outcomes in individuals with type 2 diabetes (T2D) and recent myocardial infarction (MI). The results showed that compared with self-monitoring of blood glucose (SMBG), intermittently scanned continuous glucose monitoring (isCGM) marginally increased time in range and significantly reduced hypoglycemic exposure in T2D individuals with MI, while equally improving HbA(1c). These findings explain the cost effectiveness of isCGM.
Review
Cardiac & Cardiovascular Systems
Felicita Andreotti, Tobias Geisler, Jean-Philippe Collet, Bruna Gigante, Diana A. Gorog, Sigrun Halvorsen, Gregory Y. H. Lip, Joao Morais, Eliano Pio Navarese, Carlo Patrono, Bianca Rocca, Andrea Rubboli, Dirk Sibbing, Robert F. Storey, Freek W. A. Verheugt, Gemma Vilahur
Summary: This study aims to provide a concise yet comprehensive tool for understanding the bases of antithrombotic therapy in older patients, considering the complexities of comorbidities, comedications, and the uncertain balance between ischemic and bleeding risks.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Emmanuelle Vidal-Petiot, Yedid Elbez, Jules Mesnier, Gregory Ducrocq, Ian Ford, Michal Tendera, Roberto Ferrari, Jean-Claude Tardif, Kim M. Fox, Philippe Gabriel Steg
Summary: This study compared the benefits of strict vs. standard control of blood pressure with the potential benefits of controlling other modifiable risk factors in patients with chronic coronary syndromes. The results showed that the benefit associated with strict blood pressure control was marginal and driven only by the diastolic component, while uncontrolled other risk factors were associated with a gradually increasing risk. Therefore, optimizing other risk factors should be prioritized over further reduction of systolic blood pressure. The optimal blood pressure target in chronic coronary syndromes may be <=139/79 mmHg.
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Guillaume Marquis-Gravel, Laurie-Anne Boivin-Proulx, Zhen Huang, Steven L. Zelenkofske, A. Michael Lincoff, Roxana Mehran, P. Gabriel Steg, Christoph Bode, John H. Alexander, Thomas J. Povsic
Summary: This study compared the effectiveness of vascular closure devices (VCDs) with manual compression in reducing bleeding after transfemoral percutaneous coronary intervention. The results showed that there was no significant difference in bleeding rate between the two groups, but the VCD group had shorter recovery time. Further investigation is needed for high-bleeding risk populations.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Robert F. Storey, William A. E. Parker
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Pharmacology & Pharmacy
William A. E. Parker, Dominick J. Angiolillo, Fabiana Rollini, Francesco Franchi, Marc P. Bonaca, Deepak L. Bhatt, Ph. Gabriel Steg, Rachel C. Orme, Mark R. Thomas, Heather M. Judge, Marc S. Sabatine, Robert F. Storey
Summary: This study investigated the influence of body mass on the response to ticagrelor treatment in patients with chronic coronary syndromes. The results showed that body weight was positively correlated with P2Y12 reactivity units before drug administration, but not after. The dosage of 60 mg ticagrelor was significantly correlated with body mass index. However, body mass did not affect the chance of high platelet reactivity. Overall, the currently-used regimens are adequate across different body weights and body mass index in this patient population.
VASCULAR PHARMACOLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Christopher W. Baugh, Yonathan Freund, Philippe Gabriel Steg, Richard Body, David J. Maron, Maame Yaa A. B. Yiadom
Summary: Emergency department (ED) crowding is a global problem caused by hospital capacity and other health system challenges. Patients with cardiovascular emergencies are particularly vulnerable due to the crowding, which may lead to avoidance of the ED, premature departure, or delays in receiving care. This paper discusses the causes of crowding, its impact on cardiovascular emergencies, and potential solutions.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
Article
Cardiac & Cardiovascular Systems
Stefan James, David Erlinge, Robert F. Storey, Darren K. Mcguire, Mark de Belder, Ida Bjoerkgren, Peter A. Johansson, Anna Maria Langkilde, Wilhelm Ridderstrale, Ehsan Parvaresh Rizi, John Deanfield, Jonas Oldgren
Summary: The DAPA-MI trial aims to study therapies that could prevent heart failure and other cardiovascular events in patients with recent myocardial infarction. The trial design includes a multicenter, randomized, double-blind, placebo-controlled approach, and utilizes national clinical registries for data collection. The results will help improve outcomes for patients after myocardial infarction.
AMERICAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Diana A. Gorog, Jose Luis Ferreiro, Ingo Ahrens, Junya Ako, Tobias Geisler, Sigrun Halvorsen, Kurt Huber, Young-Hoon Jeong, Eliano P. Navarese, Andrea Rubboli, Dirk Sibbing, Jolanta M. Siller-Matula, Robert F. Storey, Jack W. C. Tan, Jurrien M. ten Berg, Marco Valgimigli, Christophe Vandenbriele, Gregory Y. H. Lip
Summary: Dual antiplatelet therapy (DAPT) reduces the risk of ischaemic events but increases bleeding risk in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Strategies to reduce bleeding include de-escalation of DAPT intensity or abbreviation of DAPT duration, which both require individual assessment of ischaemic and bleeding risks.
NATURE REVIEWS CARDIOLOGY
(2023)
Meeting Abstract
Medicine, General & Internal
Kambiz Hassan, Matthias Thielmann, Andreas Liebold, Stephan Geidel, Nandor Marzin, Daniel Wendt, Efthymios Deliargyris, Michael Schmoeckel, Robert Storey
SWISS MEDICAL WEEKLY
(2023)
Article
Cardiac & Cardiovascular Systems
Kang-Ling Wang, Mohammed N. Meah, Anda Bularga, Katherine Oatey, Rachel O'Brien, Jason E. Smith, Nick Curzen, Attila Kardos, Liza Keating, Dirk Felmeden, Robert F. Storey, Steve Goodacre, Carl Roobottom, David E. Newby, RAPID CTCA Investigators
Summary: This study investigated the influence of early CTCA on preventative treatment in patients with suspected acute coronary syndrome. The results showed that early CTCA facilitated targeted individualization of these therapies based on the extent of coronary artery disease.
AMERICAN HEART JOURNAL
(2023)