The use of aspirin and clopidogrel as effective antiplatelet therapy in preventing secondary thromboembolic events is well-established. However, there is controversy among dentists and physicians regarding the appropriate dental management of patients receiving dual antiplatelet therapy due to the lack of clinical studies about hemorrhagic risk in these patients. Indications for modifying dual antiplatelet therapy--whether it is done by altering doses, switching to monotherapy, or discontinuing it completely--occur infrequently, as most patients can be treated in a dental office setting. In all cases, patients must be managed jointly by the dentist and physician, taking into account the patient's medical and dental history. This article reviews the current use of aspirin and clopidogrel as combination therapy, examining their effect on platelet function, the associated hemorrhagic risk during dental procedures for patients using this therapy, and how oral health care providers can manage these patients safely and effectively.
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In Tanzania, acute myocardial infarction (AMI) is under-diagnosed, and uptake of evidence-based care is sub-optimal. Using an implementation science approach, an intervention was developed to address local barriers to care: the Multicomponent Intervention for Improving Myocardial Infarction Care in Tanzania (MIMIC). This single-arm pre-post trial was conducted in a northern Tanzanian emergency department (ED).
View Article and Find Full Text PDFAm Heart J
December 2024
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China; Department of Cardiology, Shanghai Geriatric Medical Center, Shanghai, China. Electronic address:
Background: It remains unclear whether indobufen-based dual antiplatelet therapy (DAPT) preserves ischemic protection while limiting bleeding risk in patients with multivessel coronary disease (MVD). This study aimed to investigate the efficacy and safety of indobufen-based DAPT in patients with MVD.
Methods: Patients in the OPTION trial were stratified based on the presence of MVD.
J Evid Based Med
December 2024
Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Objective: The optimal low-dose antiplatelet agents in patients with coronary heart disease (CHD) had not been determined. The objective of this study was to compare the impact of different low-dose antiplatelet agents on cardiovascular outcomes and bleeding risks in patients with CHD.
Methods: We searched PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, VIP, WanFang Data, and China Biology Medicine.
Stroke
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.Z., X.W., Y.G., W.C., H.Y., T.W., Y.Y., Q.Z., M.W., J.J., C.W., Yongjun Wang, Yilong Wang, Y.P.).
Background: Risk profile of recurrence may influence the effect of antiplatelet therapy. This study aimed to evaluate the efficacy and safety of clopidogrel-aspirin initiated within 72 hours after symptom onset for acute mild stroke or high-risk transient ischemic attack stratified by risk profile.
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Interv Cardiol Clin
October 2024
Division of Cardiology, University of Florida College of Medicine-Jacksonville, ACC Building 5th Floor, 655 West 8th Street, Jacksonville, FL 32209, USA.
Antiplatelet therapy involving aspirin and a P2Y receptor inhibitor is fundamental in managing patients with atherothrombotic disease. Switching between P2Y inhibitors is frequently observed in clinical settings for various reasons, such as safety, efficacy, patient adherence, or cost concerns. Although it occurs often, the optimal method for switching remains a concern owing to potential drug interactions, which can result in either inadequate platelet inhibition and subsequent thrombotic events or low platelet reactivity and increased bleeding risks due to therapy overlap.
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