Antiplatelet therapy including aspirin and thienopyridine agents (such as clopidogrel, prasugrel and ticagrelor) are often used in patients with coronary disease. Pulmonary hemorrhage due to antiplatelet therapy although very rare, when excessive, is a life-threatening event. So far, there is lack of specific guidelines for the management of these patients. We report a case series of 5 patients receiving antiplatelet therapy who were admitted to the hospital due to pulmonary hemorrhage related to antiplatelet therapy. We also propose an algorithm on the management of these patients taking into consideration the balance between thrombotic and bleeding risk and the severity of the hemorrhage.
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http://dx.doi.org/10.1016/j.rmcr.2022.101782 | DOI Listing |
BMJ Open
January 2025
Cardiologie, Trousseau Hospital, Chambray-les-Tours, France.
Introduction: Several cardiovascular outcome trials have been conducted to assess the cardiovascular safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RAs) on cardiorenal outcomes in patients with type-2 diabetes (T2D). However, the strict requirements of randomised controlled trials to avoid most confounding factors are at the expense of external validity. Using national real-world data, we aimed to evaluate the effectiveness of GLP-1RAs in association with metformin especially on cardiovascular events, hospitalisation for heart failure and all-cause death in comparison with other diabetes treatment schemes using dipeptidyl peptidase IV inhibitors, sulfonylureas/glinides or insulin also associated with metformin.
View Article and Find Full Text PDFStroke
January 2025
Population Health Research Institute, University of British Columbia, Vancouver, Canada. (M.A.S., J.W.E., A.H.K., A. Shoamanesh, A.T., R.G.H., A.C., R.Z.).
Background: Stroke secondary to intracranial atherosclerotic disease (ICAD) is associated with high recurrence risk despite currently available secondary prevention strategies. In patients with systemic atherosclerosis, a significant reduction of stroke risk with no increase in intracranial or fatal hemorrhage was seen when rivaroxaban 2.5 mg twice daily was added to aspirin.
View Article and Find Full Text PDFJTCVS Open
December 2024
Heart & Vascular Program, Baystate Health, University of Massachusetts Chan Medical School-Baystate, Springfield, Mass.
Objective: The management of preoperative medications is an essential component of perioperative care for the cardiac surgical patient. This turnkey order set is part of a series created by the Enhanced Recovery After Surgery Cardiac Society, first presented at the Annual Meeting of The American Association for Thoracic Surgery in 2023. Numerous guidelines and expert consensus documents have been published to provide guidance in preoperative medication management.
View Article and Find Full Text PDFZhonghua Wei Zhong Bing Ji Jiu Yi Xue
December 2024
Department of CCU, Chest Hospital, Tianjin University, Tianjin 300222, China.
Objective: To explore the prognosis and influencing factors of ST-segment elevation myocardial infarction (STEMI) due to late stent thrombosis (LST) and very late stent thrombosis (VLST).
Methods: Patients who underwent percutaneous coronary intervention (PCI) for STEMI caused by LST and VLST at Tianjin Chest Hospital from January 2016 to June 2021 were selected as the study subjects, and long-term follow-up was conducted. The baseline clinical features, laboratory examination indicators, echocardiography results, coronary angiography and intervention treatment characteristics, and antiplatelet treatment status of patients were collected.
JMIR Cardio
January 2025
Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Background: Stroke is a major cause of death and disability worldwide. Identifying individuals who would benefit most from preventative interventions, such as antiplatelet therapy, is critical for personalized stroke prevention. However, traditional methods for estimating treatment effects often focus on the average effect across a population and do not account for individual variations in risk and treatment response.
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