Latest & greatest articles for clopidogrel

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Top results for clopidogrel

161. Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study.

Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study. BACKGROUND: Clopidogrel and low-dose aspirin have become the mainstay oral antiplatelet regimen to prevent recurrent ischaemic events after acute coronary syndromes or stent placement. The frequent genetic functional variant 681 G>A (*2) of cytochrome P450 2C19 (CYP2C19) is an important contributor to the wide variability between individuals of the antiplatelet effect (...) of clopidogrel. We assessed whether the CYP2C19*2 polymorphism affected long-term prognosis of patients who were chronically treated with clopidogrel. METHODS: Between April 1, 1996, and April 1, 2008, 259 young patients (aged <45 years) who survived a first myocardial infarction and were exposed to clopidogrel treatment for at least a month, were enrolled in a multicentre registry and underwent CYP2C19*2 determination. The primary endpoint was a composite of death, myocardial infarction, and urgent

Lancet2008

162. Cytochrome P-450 Polymorphisms and Response to Clopidogrel.

Cytochrome P-450 Polymorphisms and Response to Clopidogrel. BACKGROUND: Clopidogrel requires transformation into an active metabolite by cytochrome P-450 (CYP) enzymes for its antiplatelet effect. The genes encoding CYP enzymes are polymorphic, with common alleles conferring reduced function. METHODS: We tested the association between functional genetic variants in CYP genes, plasma concentrations of active drug metabolite, and platelet inhibition in response to clopidogrel in 162 healthy (...) subjects. We then examined the association between these genetic variants and cardiovascular outcomes in a separate cohort of 1477 subjects with acute coronary syndromes who were treated with clopidogrel in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel-Thrombolysis in Myocardial Infarction (TRITON-TIMI) 38. RESULTS: In healthy subjects who were treated with clopidogrel, carriers of at least one CYP2C19 reduced-function allele (approximately 30

NEJM2008

163. Reduction in recurrent cardiovascular events with prasugrel compared with clopidogrel in patients with acute coronary syndromes from the TRITON-TIMI 38 trial

Reduction in recurrent cardiovascular events with prasugrel compared with clopidogrel in patients with acute coronary syndromes from the TRITON-TIMI 38 trial 18682445 2008 10 15 2009 01 30 2015 11 19 1522-9645 29 20 2008 Oct European heart journal Eur. Heart J. Reduction in recurrent cardiovascular events with prasugrel compared with clopidogrel in patients with acute coronary syndromes from the TRITON-TIMI 38 trial. 2473-9 10.1093/eurheartj/ehn362 In the TRITON-TIMI 38 trial, greater platelet (...) inhibition with prasugrel reduced the first occurrence of the primary endpoint (cardiovascular death, MI, or stroke) compared with clopidogrel in patients with an acute coronary syndrome (ACS) undergoing planned percutaneous coronary intervention. We hypothesized that prasugrel would reduce not only first events but also recurrent primary endpoint events and therefore total events compared with clopidogrel. Poisson regression analysis was performed to compare the number of occurrences of the primary

EvidenceUpdates2008 Full Text: Link to full Text with Trip Pro

165. Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFE

Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFE 18757238 2008 10 13 2008 12 18 2016 12 15 1474-4422 7 10 2008 Oct The Lancet. Neurology Lancet Neurol Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent (...) telmisartan were investigated in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial. Patients who had had an ischaemic stroke were randomly assigned in a two by two factorial design to receive either 25 mg aspirin (ASA) and 200 mg extended-release dipyridamole (ER-DP) twice a day or 75 mg clopidogrel once a day, and either 80 mg telmisartan or placebo once per day. The predefined endpoints for this substudy were disability after a recurrent stroke, assessed with the modified

EvidenceUpdates2008 Full Text: Link to full Text with Trip Pro

166. Cardiovascular outcomes after a change in prescription policy for clopidogrel.

Cardiovascular outcomes after a change in prescription policy for clopidogrel. BACKGROUND: Drug-reimbursement policies may have an adverse effect on patient outcomes if they interfere with timely access to efficacious medications for acute medical conditions. Clopidogrel in combination with aspirin is the recommended standard of care for patients receiving coronary stents to prevent thrombosis. We examined the population-level effect of a change by a Canadian provincial government in a pharmacy (...) -benefits program from a prior-authorization policy to a less restrictive, limited-use policy on access to clopidogrel among patients undergoing percutaneous coronary intervention (PCI) with stenting after acute myocardial infarction. METHODS: We conducted a population-based, retrospective, time-series analysis from April 1, 2000, to March 31, 2005, of all patients 65 years of age or older with acute myocardial infarction who underwent PCI with stenting in Ontario, Canada. The primary outcome

NEJM2008

168. Comparison of higher clopidogrel loading and maintenance dose to standard dose on platelet function and outcomes after percutaneous coronary intervention using drug-eluting stents

Comparison of higher clopidogrel loading and maintenance dose to standard dose on platelet function and outcomes after percutaneous coronary intervention using drug-eluting stents 18678295 2008 08 05 2008 09 19 2013 11 21 0002-9149 102 4 2008 Aug 15 The American journal of cardiology Am. J. Cardiol. Comparison of higher clopidogrel loading and maintenance dose to standard dose on platelet function and outcomes after percutaneous coronary intervention using drug-eluting stents. 401-3 10.1016 (...) /j.amjcard.2008.03.073 Adequate antiplatelet therapy is paramount for good clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). The purpose of this study was to determine whether a high-dose regimen of clopidogrel in patients undergoing PCI is superior to standard dosing. A total of 119 patients undergoing PCI were blindly randomized in 2:1 fashion to receive clopidogrel loading 600 mg on the table immediately before PCI and 75 mg 2 times/day for 1 month (high-dose group

EvidenceUpdates2008

169. Relation of Low Response to Clopidogrel Assessed With Point-of-Care Assay to Periprocedural Myonecrosis in Patients Undergoing Elective Coronary Stenting for Stable Angina Pectoris

Relation of Low Response to Clopidogrel Assessed With Point-of-Care Assay to Periprocedural Myonecrosis in Patients Undergoing Elective Coronary Stenting for Stable Angina Pectoris 18549843 2008 06 13 2008 07 15 2014 11 20 0002-9149 101 12 2008 Jun 15 The American journal of cardiology Am. J. Cardiol. Relation of low response to clopidogrel assessed with point-of-care assay to periprocedural myonecrosis in patients undergoing elective coronary stenting for stable angina pectoris. 1700-3 10.1016 (...) /j.amjcard.2008.02.054 Impaired responses to antiplatelet therapy assessed by laboratory tests are associated with an increased risk of recurrent ischemic events after percutaneous coronary intervention (PCI). This study was designed to determine the relation between responses to aspirin and clopidogrel as assessed by a point-of-care assay (Verify Now, Accumetrics, San Diego, California) and periprocedural myocardial infarction (PMI) in patients undergoing elective PCI for stable angina. One hundred

EvidenceUpdates2008

170. Clopidogrel pre-treatment in stable angina: for all patients > 6 h before elective coronary angiography or only for angiographically selected patients a few minutes before PCI? A randomized multicentre trial PRAGUE-8

Clopidogrel pre-treatment in stable angina: for all patients > 6 h before elective coronary angiography or only for angiographically selected patients a few minutes before PCI? A randomized multicentre trial PRAGUE-8 18441320 2008 06 16 2008 11 12 2016 12 15 1522-9645 29 12 2008 Jun European heart journal Eur. Heart J. Clopidogrel pre-treatment in stable angina: for all patients > 6 h before elective coronary angiography or only for angiographically selected patients a few minutes before PCI? A (...) randomized multicentre trial PRAGUE-8. 1495-503 10.1093/eurheartj/ehn169 To compare two different clopidogrel regimens on the outcomes of patients undergoing elective coronary angiography (CAG)+/-ad hoc percutaneous coronary intervention (PCI). Open-trial randomized 1028 patients with stable angina to group A ('non-selective'-clopidogrel 600 mg > 6 h before CAG; n = 513) or group B ('selective'-clopidogrel 600 mg in the cath-lab after CAG, only in case of PCI; n = 515). Combined primary endpoint

EvidenceUpdates2008 Full Text: Link to full Text with Trip Pro

171. Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting

Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting 18294117 2008 02 25 2008 06 03 2013 11 21 0277-0008 28 3 2008 Mar Pharmacotherapy Pharmacotherapy Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting. 376-92 10.1592/phco.28.3.376 To determine if clopidogrel use before coronary artery bypass grafting (CABG) is associated with an increase in major bleeding, hemorrhage (...) -related complications, or transfusion requirements. A structured literature search of English-language articles was conducted by using MEDLINE, EMBASE, and the Cochrane Collaboration Database for the period of January 1, 1990-April 30, 2007. Studies were included if they met the following criteria: randomized controlled trials, prospective observational trials, or retrospective trials; characteristics and outcomes of patients who were exposed to clopidogrel within 7 days before CABG were analyzed; at

EvidenceUpdates2008

172. One-year clinical outcomes with abciximab vs. placebo in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention after pre-treatment with clopidogrel

One-year clinical outcomes with abciximab vs. placebo in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention after pre-treatment with clopidogrel 18158289 2008 02 15 2008 08 04 2013 11 21 0195-668X 29 4 2008 Feb European heart journal Eur. Heart J. One-year clinical outcomes with abciximab vs. placebo in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention after pre-treatment (...) with clopidogrel: results of the ISAR-REACT 2 randomized trial. 455-61 The aim of this study is to investigate whether the benefit of abciximab in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) undergoing percutaneous coronary intervention (PCI) after pre-treatment with 600 mg clopidogrel is sustained at 1 year. We performed 1-year follow-up of 2022 high-risk patients with NSTE-ACS undergoing urgent PCI, who were randomized to abciximab or placebo after pre-treatment with 600 mg

EvidenceUpdates2008

173. Incidence of death and acute myocardial infarction associated with stopping clopidogrel after acute coronary syndrome.

Incidence of death and acute myocardial infarction associated with stopping clopidogrel after acute coronary syndrome. CONTEXT: It is unknown whether patients are at increased short-term risk for adverse events following clopidogrel cessation. OBJECTIVE: To assess the rates of adverse events after stopping treatment with clopidogrel in a national sample of patients with acute coronary syndrome (ACS). DESIGN, SETTING, AND PATIENTS: Retrospective cohort study of 3137 patients with ACS discharged (...) from 127 Veterans Affairs hospitals between October 1, 2003, and March 31, 2005, with posthospital treatment with clopidogrel. MAIN OUTCOME MEASURE: Rate of all-cause mortality or acute myocardial infarction (AMI) after stopping treatment with clopidogrel. RESULTS: Mean (SD) follow-up after stopping treatment with clopidogrel was 196 (152) days for medically treated patients with ACS without stents (n = 1568) and 203 (148) days for patients with ACS treated with percutaneous coronary intervention

JAMA2008

174. Meta-analysis of the efficacy and safety of clopidogrel plus aspirin as compared to antiplatelet monotherapy for the prevention of vascular events

Meta-analysis of the efficacy and safety of clopidogrel plus aspirin as compared to antiplatelet monotherapy for the prevention of vascular events Meta-analysis of the efficacy and safety of clopidogrel plus aspirin as compared to antiplatelet monotherapy for the prevention of vascular events Meta-analysis of the efficacy and safety of clopidogrel plus aspirin as compared to antiplatelet monotherapy for the prevention of vascular events Bowry A D, Brookhart M A, Choudhry N K CRD summary (...) The authors concluded that combined clopidogrel and aspirin reduced the likelihood of major cardiovascular events associated with acute coronary syndrome or percutaneous coronary intervention compared with monotherapy, but increased the likelihood of major bleeding. Although the review had limitations, in particular the restriction to published studies in English, in most respects it was well conducted and the conclusions appeared reliable. Authors' objectives To evaluate the role of dual antiplatelet

DARE.2008

175. Clopidogrel versus aspirin in patients with atherothrombosis: CAPRIE-based calculation of cost-effectiveness for Germany

Clopidogrel versus aspirin in patients with atherothrombosis: CAPRIE-based calculation of cost-effectiveness for Germany Clopidogrel versus aspirin in patients with atherothrombosis: CAPRIE-based calculation of cost-effectiveness for Germany Clopidogrel versus aspirin in patients with atherothrombosis: CAPRIE-based calculation of cost-effectiveness for Germany Berger K, Hessel F, Kreuzer J, Smala A, Diener H C Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness of clopidogrel versus aspirin as secondary prevention for patients who had experienced myocardial infarction or ischaemic stroke or were diagnosed with peripheral arterial disease. The authors concluded that clopidogrel was a cost

NHS Economic Evaluation Database.2008

176. Cost-effectiveness of clopidogrel treatment in percutaneous coronary intervention: a European model based on a meta-analysis of the PCI-CURE, CREDO and PCI-CLARITY trials

Cost-effectiveness of clopidogrel treatment in percutaneous coronary intervention: a European model based on a meta-analysis of the PCI-CURE, CREDO and PCI-CLARITY trials Cost-effectiveness of clopidogrel treatment in percutaneous coronary intervention: a European model based on a meta-analysis of the PCI-CURE, CREDO and PCI-CLARITY trials Cost-effectiveness of clopidogrel treatment in percutaneous coronary intervention: a European model based on a meta-analysis of the PCI-CURE, CREDO and PCI (...) -CLARITY trials Berg J, Fidan D, Lindgren P Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The objective was to conduct a cost-effectiveness analysis of pre-treatment and long-term treatment with clopidogrel in percutaneous coronary

NHS Economic Evaluation Database.2008

177. Impact of pretreatment with clopidogrel on initial patency and outcome in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review

Impact of pretreatment with clopidogrel on initial patency and outcome in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review Impact of pretreatment with clopidogrel on initial patency and outcome in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review Impact of pretreatment with clopidogrel on initial patency and outcome in patients (...) treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review Vlaar PJ, Svilaas T, Damman K, De Smet BJ, Tijssen JG, Hillege HL, Zijlstra F CRD summary The review concluded that pre-treatment with clopidogrel before primary percutaneous coronary intervention for ST-segment elevation myocardial infarction significantly improved initial coronary artery patency and reduced mortality and combined death/reinfarction. The limitations

DARE.2008

178. Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting

Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting Pickard A S, Becker R C, Schumock G T, Frye C B CRD summary The authors concluded that exposure to clopidogrel in the seven days before coronary (...) artery bypass grafting was associated with an increase in bleeding-related complications. Due to reliance on potentially biased retrospective studies and because of differences between studies, the authors’ conclusions may not be reliable. Authors' objectives To determine if clopidogrel given prior to coronary artery bypass grafting (CABG) increased bleeding-related events. Searching MEDLINE, EMBASE (both 1990 to April 2007) and the Cochrane Database of Systematic Reviews were searched for studies published

DARE.2008

179. Effects of glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention after pretreatment with clopidogrel: a meta-analysis of randomized trials

Effects of glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention after pretreatment with clopidogrel: a meta-analysis of randomized trials Effects of glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention after pretreatment with clopidogrel: a meta-analysis of randomized trials Effects of glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention after pretreatment with clopidogrel: a meta (...) -analysis of randomized trials Pannu R, Andraws R CRD summary The authors concluded that the use of glycoprotein IIb/IIa in patients pre-treated with clopidogrel did not reduce death, post-procedural myocardial infarction or TVR and significantly increased the risk of bleeding. Due to the inadequate reporting of study quality, questionable pooling of data and flaws with the review process, the authors' conclusions should be interpreted with caution. Authors' objectives To evaluate the efficacy

DARE.2008