Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high...Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high risk of bleeding.Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo,especially following next-generation DES implantation,for cost-effectiveness.However,the clinical results are inconsistent and the data regarding next-generation DESs limited.In this report,recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized.展开更多
Background Stroke is the most common neurological disease in China, and antiplatelet treatment is important for primary and secondary prevention. This study aimed to describe the current status of antiplatelet treatme...Background Stroke is the most common neurological disease in China, and antiplatelet treatment is important for primary and secondary prevention. This study aimed to describe the current status of antiplatelet treatment before, immediately after, and 1 month after ischemic stroke in the Qingdao area of China, and to determine the factors and potential barriers influencing use. Methods A total of 1114 patients with acute ischemic stroke were enrolled from 11 hospitals in the Qingdao area. Patient demographic data, clinical data, and treatment before and after the stroke were recorded. Univariate analysis （two sample t-test or Mann-Whitney U test, and chi-square test） and multivariate Logistic regression analysis were used to determine the frequency of antiplatelet treatment, and factors associated with treatment, at three time points： before the stroke, in hospital after the stroke, and at 1-month follow-up. Results The frequency of antiplatelet treatment was 6.4% before the stroke, 91.5% in hospital, and 77.2% at 1 month. Aspirin pretreatment was independently associated with higher education level, higher income level, history of hyperlipidemia, and history of cerebral vascular disease. Antiplatelet treatment in hospital was independently associated with treatment in an urban hospital, National Institutes of Health Stroke Scale at onset, and statin use in hospital. Antiplatelet treatment at 1-month follow-up was independently associated with higher income level, diagnosis of transient ischemic attack, antiplatelet treatment in hospital, large artery atherosclerosis according to the Trial of Org 10172 in Acute Stroke Treatment classification, and statin use at follow-up. Modified Rankin Scale ≥4 at 1-month follow-up and history of coronary heart disease were negatively associated with antiplatelet treatment at follow-up. Conclusions This study documents the current status of antiplatelet treatment in primary and early secondary prevention of ischemic stroke in China. Further education of clinicians and the public about stroke prevention is important.展开更多
Antiplatelet therapy with aspirin or clopidogrel or both is the standard care for patients with proven coronary or peripheral arterial disease,especially those undergoing endovascular revascularization procedures. How...Antiplatelet therapy with aspirin or clopidogrel or both is the standard care for patients with proven coronary or peripheral arterial disease,especially those undergoing endovascular revascularization procedures. However,despite the administration of the antiplatelet regiments,some patients still experience recurrent cardiovascular ischemic events. So far,it is well documented by several studies that in vitro response of platelets may be extremely variable. Poor antiplatelet effect of clopidogrel or high on-treatment platelet reactivity(HTPR) is under investigation by numerous recent studies. This review article focuses on methods used for the ex vivo evaluation of HTPR,as well as on the possible underlying mechanisms and the clinical consequences of this entity. Alternative therapeutic options and future directions are also addressed.展开更多
文摘Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high risk of bleeding.Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo,especially following next-generation DES implantation,for cost-effectiveness.However,the clinical results are inconsistent and the data regarding next-generation DESs limited.In this report,recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized.
文摘Background Stroke is the most common neurological disease in China, and antiplatelet treatment is important for primary and secondary prevention. This study aimed to describe the current status of antiplatelet treatment before, immediately after, and 1 month after ischemic stroke in the Qingdao area of China, and to determine the factors and potential barriers influencing use. Methods A total of 1114 patients with acute ischemic stroke were enrolled from 11 hospitals in the Qingdao area. Patient demographic data, clinical data, and treatment before and after the stroke were recorded. Univariate analysis （two sample t-test or Mann-Whitney U test, and chi-square test） and multivariate Logistic regression analysis were used to determine the frequency of antiplatelet treatment, and factors associated with treatment, at three time points： before the stroke, in hospital after the stroke, and at 1-month follow-up. Results The frequency of antiplatelet treatment was 6.4% before the stroke, 91.5% in hospital, and 77.2% at 1 month. Aspirin pretreatment was independently associated with higher education level, higher income level, history of hyperlipidemia, and history of cerebral vascular disease. Antiplatelet treatment in hospital was independently associated with treatment in an urban hospital, National Institutes of Health Stroke Scale at onset, and statin use in hospital. Antiplatelet treatment at 1-month follow-up was independently associated with higher income level, diagnosis of transient ischemic attack, antiplatelet treatment in hospital, large artery atherosclerosis according to the Trial of Org 10172 in Acute Stroke Treatment classification, and statin use at follow-up. Modified Rankin Scale ≥4 at 1-month follow-up and history of coronary heart disease were negatively associated with antiplatelet treatment at follow-up. Conclusions This study documents the current status of antiplatelet treatment in primary and early secondary prevention of ischemic stroke in China. Further education of clinicians and the public about stroke prevention is important.
文摘Antiplatelet therapy with aspirin or clopidogrel or both is the standard care for patients with proven coronary or peripheral arterial disease,especially those undergoing endovascular revascularization procedures. However,despite the administration of the antiplatelet regiments,some patients still experience recurrent cardiovascular ischemic events. So far,it is well documented by several studies that in vitro response of platelets may be extremely variable. Poor antiplatelet effect of clopidogrel or high on-treatment platelet reactivity(HTPR) is under investigation by numerous recent studies. This review article focuses on methods used for the ex vivo evaluation of HTPR,as well as on the possible underlying mechanisms and the clinical consequences of this entity. Alternative therapeutic options and future directions are also addressed.
