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81. Bioresorbable Stents in cardiovascular indications (coronary artery disease)

with an immunosuppressant or cytotoxic drug. A polymer coating is usually used for drug loading and control of elution kinetics. Sustained release of the drug reduces neointimal hyperplas- ia, leading to a reduction in the rate of restenosis. However, because stent implantation can also lead to stent thrombosis with potentially deleterious consequences, it necessitates potent antiplate- let therapy with a combination of aspirin and P2Y12 inhibitors, thus leading to potential bleeding complications. A consequence

2019 EUnetHTA

84. Achieving Health Equity in Preventive Services

screening Women age 40 years and older a Cervical cancer screening Women age 21 to 65 years Lung cancer screening Adults age 55 to 80 years with a smoking history Tobacco smoking cessation: behavioral and pharmacotherapy interventions b Adults Cardiovascular disease Aspirin use to prevent cardiovascular disease and colorectal cancer: preventive medication Adults age 50 to 59 years with >10% 10-year CVD risk Healthful diet and physical activity for CVD prevention in adults with risk factors: behavioral (...) screening 0 0 0 0 1 Tobacco smoking cessation 0 3 1 2 0 Cardio- vascular disease Aspirin to prevent CVD and CRC 0 0 0 0 0 Healthful diet and physical activity for CVD prevention 0 0 0 0 0 High blood pressure screening 0 0 0 0 1 Diabetes Abnormal blood glucose and type 2 diabetes screening 0 0 0 0 0 Obesity screening and management 0 0 1 d 2 7 Abbreviations: CRC = colorectal cancer; CVD = cardiovascular disease; KQ = Key Question Note: Some studies are included for multiple Key Questions or preventive

2019 Effective Health Care Program (AHRQ)

85. Secondary prevention of recurrent venous thromboembolism after initial oral anticoagulation therapy in patients with unprovoked venous thromboembolism. Full Text available with Trip Pro

Secondary prevention of recurrent venous thromboembolism after initial oral anticoagulation therapy in patients with unprovoked venous thromboembolism. Currently, little evidence is available on the length and type of anticoagulation used for extended treatment for prevention of recurrent venous thromboembolism (VTE) in patients with unprovoked VTE who have completed initial oral anticoagulation therapy.To compare the efficacy and safety of available oral therapeutic options (aspirin, warfarin (...) studies, assessed quality, and extracted data. We resolved disagreements by discussion.Six studies with a combined total of 3436 participants met the inclusion criteria. Five studies compared extended prophylaxis versus placebo: three compared warfarin versus placebo, and two compared aspirin versus placebo. One study compared one type of extended prophylaxis (rivaroxaban) versus another type of extended prophylaxis (aspirin). For extended prophylaxis versus placebo, we downgraded the quality

2017 Cochrane

86. Corticosteroids for the treatment of Kawasaki disease in children. Full Text available with Trip Pro

Corticosteroids for the treatment of Kawasaki disease in children. Kawasaki disease (KD), or mucocutaneous syndrome, is the leading cause of childhood-acquired heart disease in the developed world. There is much controversy on how best to treat children with KD and in particular who may benefit from additional treatment beyond the standard intravenous immunoglobulin (IVIG) and aspirin, such as the addition of corticosteroids.To assess the impact of corticosteroid use on the incidence

2017 Cochrane

87. Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents. Full Text available with Trip Pro

% of aspirin participants (low-quality evidence). Secondary outcomesAll seven studies reported adverse events. Participants reporting an adverse event (one or more per person) by drug were: aspirin 85/202; fenoprofen 28/49; ibuprofen 40/45; indomethacin 9/30; ketoprofen 9/30; meloxicam 18/47; naproxen 44/202; and rofecoxib 47/209 (very low-quality evidence).All seven studies reported withdrawals due to adverse events. Participants withdrawn due to an adverse event by drug were: aspirin 16/120; celecoxib 10 (...) /159; fenoprofen 0/49; ibuprofen 0/45; indomethacin 0/30; ketoprofen 0/30; meloxicam 10/147; naproxen 17/285; and rofecoxib 3/209 (very low-quality evidence).All seven studies reported serious adverse events. Participants experiencing a serious adverse event by drug were: aspirin 13/120; celecoxib 5/159; fenoprofen 0/79; ketoprofen 0/30; ibuprofen 4/45; indomethacin 0/30; meloxicam 11/147; naproxen 10/285; and rofecoxib 0/209 (very low-quality evidence).There were few or no data for our remaining

2017 Cochrane

90. Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update

risk among patients on warfarin a 83 Table 31. C-statistics from studies comparing scores of interest for prediction of major bleeding risk among patients on aspirin alone a 85 Table 32. C-statistics from studies comparing scores of interest for prediction of major bleeding risk among patients off antithrombotic therapy a 85 Table 33. Net reclassification improvement from studies comparing scores of interest for predicting major bleeding risk among patients on warfarin (except as indicated) 86 (...) Table 34. Bleeding risk instruments and strength of evidence domains for prediction of bleeding risk a 89 Table 35. Number and study design of specific comparisons within included studies 94 Table 36. Strength of evidence—aspirin vs. warfarin 97 Table 37. Strength of evidence—warfarin+aspirin vs. warfarin alone 99 Table 38. Strength of evidence—clopidogrel+aspirin vs. aspirin alone 102 Table 39. Strength of evidence—clopidogrel vs. warfarin 104 Table 40. Strength of evidence—clopidogrel+aspirin vs

2018 Effective Health Care Program (AHRQ)

91. Management of Antiplatelet Therapy among Patients on Antiplatelet Therapy for Coronary or Cerebrovascular Disease

therapy (aspirin plus a P2Y12 inhibitor) for a shorter time (such as 30 days, if a bare metal stent was placed) or a longer time (such as 6 months or a year or indefinitely, if a drug-eluting stent was placed); followed by indefinite single antiplatelet therapy (almost always aspirin). Historically, clopidogrel and aspirin has been prescribed. But use of newer agents such as ticagrelor and prasugrel are increasing. Patients undergoing non-cardiac surgery with prior history of percutaneous coronary (...) , and both antiplatelet agents were stopped 5 days prior to surgery “in 85% of cases, with the remainder continuing aspirin through surgery,” and then reported major adverse cardiac events and serious bleeding, would be excluded since there was no way to know whether the adverse events happened in the patients who had both APT agents stopped or in the few patients who were continued on aspirin. Ergo, unless we could match the reported outcomes to the exact preoperative and perioperative APT, we were

2017 Veterans Affairs Evidence-based Synthesis Program Reports

93. Implantable loop recorders for diagnosis of atrial fibrillation in cryptogenic stroke

QALYs Methods used to generate results Markov cohort analysis Health states Primarily defined by with / without AF; AF detected / undetected; OAC / aspirin. Cycle length 3 months Discount rate 5% Software packages used TreeAge Abbreviations: AF, atrial fibrillation The result for the base case economic evaluation is shown in Table 5, the ICER is estimated to be $29,570. 8 Table 5 Base case cost-effectiveness results for ILR vs SoC estimated in the model Treatment arms Cost Incremental cost QALYs (...) ; ? the assumed constant risk of stroke throughout the duration of the model. ESC considered stratifying the Gage (2004) estimated risk by CHADS-Score was appropriate and was evaluated appropriately in sensitivity analyses; ? uncertainty regarding the efficacy of the non-vitamin K antagonist oral anticoagulants (NOACs) compared with aspirin in reducing recurrent stroke in this patient population. ESC considered that the submission approach is clinically justified; ? wide confidence intervals for the hazard

2017 Medical Services Advisory Committee

96. Mechanical thrombectomy

therapy with antiplatelet agents (aspirin) or anticoagulants. 10. Comparative safety Five randomised trials of MT plus usual care and usual care alone were identified which met the PICO-defined inclusion criteria: ESCAPE; EXTEND-IA; MR CLEAN; REVASCAT and SWIFT PRIME. 6 Death and symptomatic intracerebral haemorrhage outcomes were consistently reported across the five trials and thus analysed in the meta-analysis by Goyal et al. 2016. In the meta- analysis of the individual patient data from the five

2017 Medical Services Advisory Committee

98. NOACs for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation

-LY or ARISTOTLE; and a lower proportion of patients in the apixaban study (ARISTOTLE) took concomitant aspirin compared to those in RE-LY or ROCKET-AF. 3.6 The Committee considered that the differences in baseline characteristics between study populations could lead to difficulties in interpreting the results of any indirect treatment comparison. 3.7 The Committee concluded that the NOACs could be considered comparable with no clinically important differences in outcomes. Cost-effectiveness Point (...) to fall in the range of $3 to $5 million at the prices proposed by the manufacturers. It was noted that, given the ageing population, the prevalence of AF, and the risk for AF-associated stroke increasing with age, patient numbers would increase in time. 5.2 The Committee also noted cost estimates were based on various assumptions. The exact rate of people switching from warfarin, aspirin, or no treatment to a NOAC can be difficult to predict as clinical knowledge evolves and new technologies

2018 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

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