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Tag Archives: aspirin

October 2017

ESC 2017: COMPASS steers on anticoagulation in stable cardiovascular disease

Chris Allen

Abstract

Over a mean follow-up of 23 months, there was a marked decrease in the primary composite end point of cardiovascular death, stroke, or myocardial infarction in the combination therapy group by 24% (hazard ration [HR] 0.76; 95% CI 0.66-0.86; p<0.001) over aspirin monotherapy, and improved survival by 18%. The trial terminated prematurely by the data monitoring committee due to due to overwhelming efficacy. Rivaroxaban monotherapy showed no efficacy benefit. The anticipated trade-off was apparent with increased major bleeding in the combination therapy arm (HR 1.70, 95% CI 1.40–2.05; p<0.001), although fatal and intracranial bleeds wer

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October 2017

ESC 2017: RE-DUAL PCI shows benefits for dabigatran

BJC staff

Abstract

Approximately 20–30% of patients with AF, who are continuously taking an oral anticoagulant to reduce their risk of AF-related stroke, have coexisting coronary artery disease and may require PCI. The current practice of administering triple therapy with warfarin and two antiplatelet agents in patients with AF after a PCI is associated with high rates of major bleeding. RE-DUAL PCI tested an alternative treatment strategy: dual therapy with dabigatran and a single antiplatelet agent (P2Y12 inhibitor). Selected for one of the meeting’s hotline sessions and simultaneously published in the New England Journal of Medicine (https://doi.org/10.

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August 2017 Br J Cardiol 2017;24:97

In brief

BJCardio Staff

Abstract

A new gene therapy that targets the heart and requires only one treatment session, has been found safe for patients with coronary artery disease, according to a successful trial carried out in Finland (doi: 10.1093/eurheartj/ehx352). The treatment enhances circulation in ischaemic heart muscle and the effects were still visible one year after treatment. The randomised, blinded, placebo-controlled phase 1/2a trial was carried out in collaboration between the University of Eastern Finland, Kuopio University Hospital and Turku PET Centre. The biological bypass is based on gene transfer in which a natural human growth factor, AdVEGF-DΔNΔC, a ne

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November 2012 Br J Cardiol 2012;19:152

News from the ESC Congress 2012

BJCardio Staff

Abstract

WOEST: aspirin not required for stent patients on oral anticoagulants  A strategy of using clopidogrel as a single antiplatelet drug for patients receiving a drug-eluting stent who are also taking an oral anticoagulant appears safe and can reduce bleeding, the results of the WOEST study suggest. How to treat patients on anticoagulation when they receive a stent is fraught with difficulty as giving the normal dual antiplatelet therapy with aspirin and clopidogrel means they will be taking three anti-clotting agents which could increase bleeding complications to a dangerous level. But no randomised clinical trials have ever investigated whethe

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March 2012 Br J Cardiol 2012;19:10

Aspirin in primary prevention: new meta-analysis

News from the world of cardiology

Abstract

The authors, led by Professor Kausik Ray (St George’s University of London) conclude that the modest benefits and the significant increase in risk of bleeding do not justify routine use of aspirin in primary prevention, but that aspirin may be considered in certain higher-risk groups. The recently published meta-analysis (Arch Intern Med 2012;172:209–16), included nine randomised placebo-controlled trials with a total of 100,000 participants. Results (table 1) showed that during a mean follow-up of six years, aspirin treatment reduced total cardiovascular events by 10%, driven primarily by a reduction in non-fatal myocardial infarction (M

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Aspirin taking in a south Wales county

October 2011 Br J Cardiol 2011;18:238-240 doi:10.5837/bjc.2011.006

Aspirin taking in a south Wales county

Peter Elwood, Gareth Morgan, James White, Frank Dunstan, Janet Pickering, Clive Mitchell, David Fone

Abstract

Introduction Daily low-dose aspirin (75–100 mg per day) substantially reduces the risk of subsequent vascular events, such as myocardial infarction and ischaemic stroke.1 Evidence from primary prevention trials has indicated a reduction in the risk of a first vascular event,2 but the benefit–risk balance for this is open to debate.3 The prevalence of aspirin taking by patients at increased vascular risk and by the general population is unknown in the UK. The following reports a survey to determine the taking of regular aspirin within a representative community sample of adult individuals in the south Wales county of Caerphilly. Methods T

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Clopidogrel and proton-pump inhibitor interaction: viewpoint and practical clinical approach

April 2011 Br J Cardiol 2011;18:84−7

Clopidogrel and proton-pump inhibitor interaction: viewpoint and practical clinical approach

Mohaned Egred

Abstract

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‘Time is muscle’: aspirin taken during acute coronary thrombosis

July 2010 Br J Cardiol 2010;17:185-9

‘Time is muscle’: aspirin taken during acute coronary thrombosis

Peter C Elwood, Gareth Morgan, Malcolm Woollard, Andrew D Beswick 

Abstract

Introduction Aspirin, used in vascular disease prophylaxis, is probably the most cost-effective drug available in clinical practice and daily low-dose aspirin is now a standard item in the long-term management of vascular disease. Within a public health context, the provision of aspirin to individuals at increased vascular risk has been judged to be the preventive activity of greatest benefit and at the lowest cost (by far), apart from smoking cessation.1 Patients with known vascular disease are clearly at increased vascular risk, and a recent US Task Force judged that ‘individuals at increased risk’ includes males aged over about 45 and

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News from the 59th Annual Scientific Session of the American College of Cardiology

May 2010 Br J Cardiol 2010;17:111-5

News from the 59th Annual Scientific Session of the American College of Cardiology

BJ Cardio Staff

Abstract

ACCORD/INVEST: do not aim for normal blood pressure in diabetes patients with CAD The results of two trials comparing intensive versus more conventional blood pressure lowering in patients with diabetes at high cardiovascular risk have suggested that intensive treatment is not necessary and may be harmful in this population. In the ACCORD BP (Action to Control Cardiovascular Risk in Diabetes – Blood Pressure) trial, while intensive blood pressure treatment did reduce the risk of stroke, it failed to reduce the overall risk of cardiovascular events in patients and was associated with an increase in adverse events due to antihypertensive ther

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March 2010 Br J Cardiol 2009;17(Suppl 1):S8-S9

Aspirin – scope and limitations

Paul A Gurbel

Abstract

Identifying targets in the thrombosis pathway Figure 1. Central role of platelets and interaction with coagulation in the genesis of thrombosis (1) Figure 1 summarises the central role of platelets in the genesis of thrombosis.1 The platelet is initially activated in response to shear stress, events such as percutaneous coronary intervention (PCI) or plaque rupture, and the release of local agonists and exposure of the subendothelial components to flowing blood. Tissue factor ‘lights the fire’ by producing minute quantities of thrombin which then amplify the process. Binding of platelets to collagen and von Willebrand

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