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Latest & greatest articles for clopidogrel
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Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events. Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease. This is an update to a previously published review from 2011.To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular (...) trials comparing over 30 days use of aspirin plus clopidogrel with aspirin plus placebo or aspirin alone in people with coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or at high risk of atherothrombotic disease. We excluded studies including only people with coronary drug-eluting stent (DES) or non-DES, or both.We collected data on mortality from cardiovascular causes, all-cause mortality, fatal and non-fatal myocardial infarction, fatal and non-fatal ischaemic
Clopidogrel and Proton Pump Inhibitor Use: A Review of the Evidence on Safety Clopidogrel and Proton Pump Inhibitor Use: A Review of the Evidence on Safety | CADTH.ca Find the information you need Clopidogrel and Proton Pump Inhibitor Use: A Review of the Evidence on Safety Clopidogrel and Proton Pump Inhibitor Use: A Review of the Evidence on Safety Published on: March 14, 2017 Project Number: RC0874-000 - RD0036-000 Product Line: Research Type: Drug Report Type: Summary with Critical (...) Appraisal Result type: Report Question What are the harms of proton pump inhibitors used concomitantly with clopidogrel for patients requiring antiplatelet therapy following percutaneous coronary intervention? Key Message Although the findings across the studies were mixed, overall, the evidence favours clopidogrel antiplatelet therapy without PPIs. The evidence suggests that there are still some serious safety risks associated with the use of proton pump inhibitors (PPIs) with clopidogrel antiplatelet
Adverse cardiovascular effects of concomitant use of proton pump inhibitors and clopidogrel in patients with coronary artery disease: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Predictors of Mortality in Patients With Atrial Fibrillation (from the Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events [ACTIVE A]) The mortality rate of most patients with atrial fibrillation (AF) exceeds the stroke rate, but predictors of mortality have not been well defined. The Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events (ACTIVE A) recruited patients with AF who were unsuitable to receive vitamin K (...) -antagonists and were randomized to aspirin alone versus aspirin plus clopidogrel. We investigated independent predictors of all-cause mortality by multivariable Cox regression analysis and explored interactions with assigned antiplatelet therapy. Of the 7,554 patients enrolled with a mean age of 71 years, 1,687 (22%) patients died during the median follow-up of 3.7 years (annualized mortality rate 6.4%/year). Assignment to dual antiplatelet therapy had no effect on mortality (hazard ratio [HR] 0.99, 95
Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C19 Genotype and Clopidogrel Therapy CPIC UPdate nature publishing group Cytochrome P450 (CYP)2C19 catalyzes the bioactivation of the antiplatelet prodrug clopidogrel, and CYP2C19 loss- of-function alleles impair formation of active metabolites, resulting in reduced platelet inhibition. In addition, CYP2C19 loss-of-function alleles confer increased risks for serious adverse cardiovascular (CV) events among clopidogrel (...) , diabetes mellitus, obesity, smoking, and concomitant use of other drugs that may influence clopidogrel efficacy and clinical decision making. The CPIC of the National Institutes of Health’s Pharmacogenomics Research Network and PharmGKB develops peer-reviewed gene/drug guidelines that are published and updated on www.pharmgkb. org every 2 years or as needed based on significant developments in the field. 2 FOCUSED LITERATURE REVIEW A systematic literature review was conducted on CYP2C19 geno- type
Cost-effectiveness of clopidogrel plus aspirin for stroke prevention in patients with atrial fibrillation in whom warfarin is unsuitable Cost-effectiveness of clopidogrel plus aspirin for stroke prevention in patients with atrial fibrillation in whom warfarin is unsuitable Cost-effectiveness of clopidogrel plus aspirin for stroke prevention in patients with atrial fibrillation in whom warfarin is unsuitable Coleman CI, Straznitskas AD, Sobieraj DM, Kluger J, Anglade MW 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 assessed the cost-effectiveness of clopidogrel plus aspirin, compared with aspirin alone, for the prevention of stroke in patients with uncomplicated atrial fibrillation. The authors concluded
Comparison of 1-Year Outcomes of Triple (Aspirin + Clopidogrel + Cilostazol) Versus Dual Antiplatelet Therapy (Aspirin + Clopidogrel + Placebo) After Implantation of Second-Generation Drug-Eluting Stents into One or More Coronary Arteries: from the DECREA This study sought to evaluate the impact of triple antiplatelet therapy on clinical outcomes in patients treated with second-generation drug-eluting stents (DES) for coronary artery disease. There are limited data regarding the impact (...) of triple antiplatelet therapy in patients who underwent implantation of second-generation DES. We planned to randomly assign 2,110 patients treated with second-generation DES to triple (aspirin, clopidogrel, and cilostazol) and dual (aspirin, clopidogrel, and placebo) antiplatelet therapy groups. The primary end point was a composite of death, myocardial infarction, ischemic stroke, or target vessel revascularization (TVR) at 1 year since randomization. The study was stopped early owing to slow
Network meta-analysis of prasugrel, ticagrelor, high- and standard-dose clopidogrel in patients scheduled for percutaneous coronary interventions Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Concomitant use of clopidogrel and proton pump inhibitors: impact on platelet function and clinical outcome ? a systematic review Concomitant use of clopidogrel and proton pump inhibitors: impact on platelet function and clinical outcome – a systematic review Concomitant use of clopidogrel and proton pump inhibitors: impact on platelet function and clinical outcome – a systematic review Jaspers Focks J, Brouwer MA, van Oijen MG, Lanas A, Bhatt DL, Verheugt FW CRD summary This review concluded (...) that the evidence for the clinical consequences of clopidogrel given with proton-pump inhibitors was controversial. Prospective clinical studies did not support any adverse effects. These conclusions reflect the evidence and seem reliable; the limitations of the evidence should be borne in mind. Authors' objectives To evaluate the impact of clopidogrel plus proton-pump inhibitors on platelet function and cardiovascular outcomes for patients with acute coronary syndrome or stents for stable coronary disease
Drug Interaction Between Clopidogrel and Ranitidine or Omeprazole in Stable Coronary Artery Disease: A Double-Blind, Double Dummy, Randomized Study. Proton-pump inhibitors (PPIs) are often prescribed to patients receiving dual antiplatelet therapy (DAPT). However, this class of medication, especially omeprazole, has been associated with a reduction in clopidogrel efficacy, leading many clinicians to substitute omeprazole with ranitidine.Our objective was to compare the antiplatelet effect (...) of clopidogrel before and after the addition of omeprazole or ranitidine.We measured platelet aggregability at baseline and after 1 week of clopidogrel 75 mg daily. Subjects were then randomized in a double-blinded, double-dummy fashion to omeprazole 20 mg twice daily (bid) or ranitidine 150 mg bid. We repeated aggregability tests after 1 additional week, using VerifyNow P2Y12™ (Accumetrics; San Diego, CA, USA), depicting aggregability as percent inhibition of platelet aggregation (IPA).We enrolled 41
Ticagrelor versus clopidogrel after fibrinolytic therapy in patients with ST-elevation myocardial infarction: Rationale and design of the ticagrelor in patients with ST elevation myocardial infarction treated with thrombolysis (TREAT) trial. The safety and efficacy of ticagrelor in patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolytic therapy remain uncertain.The primary objective of the TicagRElor in pAtients with ST elevation myocardial infarction treated (...) with Thrombolysis (TREAT) trial is to evaluate the short-term safety of ticagrelor when compared with clopidogrel in STEMI patients treated with fibrinolytic therapy. Key secondary objectives are to assess the safety and efficacy of ticagrelor compared with clopidogrel at 12-months.The TREAT trial is a multicenter, randomized, phase III, Prospective randomized open blinded end-point (PROBE) study that enrolled 3,799 patients in 152 sites from 10 countries. Following administration of fibrinolytic therapy
Clopidogrel (Plavix) and Proton Pump Inhibitors: An Update on the Potential Drug Interaction Clopidogrel (Plavix®) and Proton Pump Inhibitors: An Update on the Potential Drug Interaction – Clinical Correlations Search Clopidogrel (Plavix®) and Proton Pump Inhibitors: An Update on the Potential Drug Interaction July 28, 2010 5 min read By Antony Q. Pham, Pharm.D. and Reena M. Tejura, Pharm.D. Faculty Peer Reviewed Recent publications have described a potential drug interaction between (...) clopidogrel (Plavix®) and proton pump inhibitors (PPIs). Several retrospective studies have concluded that the use of PPIs can lower the effectiveness of clopidogrel and as a result, increase the possibility of cardiovascular events. Limited data from prospective trials have yet to show a clinical significance from this potential interaction. The Food and Drug Administration (FDA) released an early communication about the ongoing safety review of clopidogrel and omeprazole on January 26, 2009. Over
Effect of proton-pump inhibitors on the risk of lower gastrointestinal bleeding associated with NSAIDs, aspirin, clopidogrel, and warfarin. We investigated the effects of proton-pump inhibitors (PPIs) on lower gastrointestinal bleeding (LGIB) and of their interactions with nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, clopidogrel, and warfarin on LGIB risk.We prospectively studied 355 patients emergently hospitalized for LGIB and 8,221 nonbleeding patients. All patients (...) underwent colonoscopy. Smoking, alcohol drinking, drug exposure, and the Charlson comorbidity index score were assessed before colonoscopy. Adjusted odds ratios (AOR) of LGIB were estimated.LGIB was significantly associated with older age, higher comorbidity index, and NSAID, aspirin, clopidogrel, or warfarin use. PPI use was significantly associated with older age, male sex, being a current alcohol drinker, higher comorbidity index, and NSAID, aspirin, clopidogrel, warfarin, acetaminophen
Recurrent Ischemic Lesions After Acute Atherothrombotic Stroke: Clopidogrel Plus Aspirin Versus Aspirin Alone In patients with acute ischemic stroke caused by large artery atherosclerosis, clopidogrel plus aspirin versus aspirin alone might be more effective to prevent recurrent cerebral ischemia. However, there is no clear evidence.In this multicenter, double-blind, placebo-controlled trial, we randomized 358 patients with acute ischemic stroke of presumed large artery atherosclerosis origin (...) within 48 hours of onset to clopidogrel (75 mg/d without loading dose) plus aspirin (300-mg loading followed by 100 mg/d) or to aspirin alone (300-mg loading followed by 100 mg/d) for 30 days. The primary outcome was new symptomatic or asymptomatic ischemic lesion on magnetic resonance imaging within 30 days. Secondary outcomes were 30-day functional disability, clinical stroke recurrence, and composite of major vascular events. Safety outcome was any bleeding.Of 358 patients enrolled, 334 (167
Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-la We hypothesised that ticagrelor, in combination with aspirin for 1 month, followed by ticagrelor alone, improves outcomes after percutaneous coronary intervention compared with standard antiplatelet regimens.GLOBAL LEADERS was a randomised (...) , open-label superiority trial at 130 sites in 18 countries. Patients undergoing percutaneous coronary intervention with a biolimus A9-eluting stent for stable coronary artery disease or acute coronary syndromes were randomly assigned (1:1) to 75-100 mg aspirin daily plus 90 mg ticagrelor twice daily for 1 month, followed by 23 months of ticagrelor monotherapy, or standard dual antiplatelet therapy with 75-100 mg aspirin daily plus either 75 mg clopidogrel daily (for patients with stable coronary
Randomised controlled trial: Percutaneous coronary intervention for acute coronary syndromes: no difference in 30-day efficacy or safety of high- and low-dose aspirin; double-dose clopidogrel reduces 30-day risk of cardiovascular death, myocardial infarct Percutaneous coronary intervention for acute coronary syndromes: no difference in 30-day efficacy or safety of high- and low-dose aspirin; double-dose clopidogrel reduces 30-day risk of cardiovascular death, myocardial infarction or stroke (...) For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Percutaneous coronary intervention for acute coronary syndromes: no difference in 30-day efficacy or safety of high- and low-dose aspirin; double-dose clopidogrel reduces 30-day risk of cardiovascular death, myocardial infarction or stroke compared with … Article Text Therapeutics Randomised controlled trial Percutaneous coronary intervention for acute coronary syndromes: no difference
Impact of clopidogrel and potent P2Y12-inhibitors on mortality and stroke in patients with acute coronary syndrome or undergoing percutaneous coronary intervention: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Prasugrel versus clopidogrel for patients with unstable angina or non-ST-segment elevation myocardial infarction with or without angiography: a secondary, prespecified analysis of the TRILOGY ACS trial. Treatment with prasugrel and aspirin improves outcomes compared with clopidogrel and aspirin for patients with acute coronary syndrome who have had angiography and percutaneous coronary intervention; however, no clear benefit has been shown for patients managed first with drugs only. We assessed (...) outcomes from the TRILOGY ACS trial based on whether or not patients had coronary angiography before treatment was chosen.TRILOGY ACS (ClinicalTrials.gov number NCT00699998) was a randomised controlled trial, done at more than 800 sites worldwide. Patients with non-ST-elevation acute coronary syndrome who were selected for management without [corrected] revascularisation were randomly assigned to clopidogrel or prasugrel.The primary endpoint was cardiovascular death, myocardial infarction, or stroke
Omeprazole and Pantoprazole Antiplatelet Effect of Clopidogrel Clinical Trials(OPEN) Omeprazole and Pantoprazole Antiplatelet Effect of Clopidogrel Clinical Trials(OPEN) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Omeprazole and Pantoprazole Antiplatelet Effect of Clopidogrel Clinical Trials(OPEN) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01735227 Recruitment Status : Unknown Verified November 2012 by Yaling Han, Shenyang Northern Hospital. Recruitment status was: Not yet recruiting First