• Title/Summary/Keyword: Antiplatelet drugs

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Effect of Antiplatelets in Diabetic Peripheral Vasculopathy: Comparison by Ankle-Brachial Index and Peak Wave Velocity (당뇨병성 말초혈관병증에서 항혈소판제의 효과: 발목상완지수 및 맥파전달속도를 통한 비교)

  • Park, Se-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.159-164
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    • 2014
  • Purpose: The purpose of this study is to confirm the effect of antiplatelet drugs in diabetic peripheral vasculopathy in diabetic foot patients. Materials and Methods: We designed a retrospective study in diabetic foot patients with diabetic peripheral vasculopathy. From October 2007 to December 2013, 278 cases in 139 patients who took antiplatelet drugs over at least a six-month period were included in this study. We categorized these patients according to the type of drug used. The efficacy of antiplatelet drugs was evaluated using anklebrachial index (ABI) and pulse wave velocity (PWV). Results: Only the aspirin group showed a statistically significant increase of ABI after antiplatelet therapy ($1.10{\pm}0.12$ to $1.12{\pm}0.11$). In addition, only the cilostazol group showed a statistically significant decrease of PWV after antiplatelet therapy ($1,701.20{\pm}396.56$ to $1,627.42{\pm}324.98$). Conclusion: Aspirin and cilostazol may be used in treatment of diabetic peripheral vasculopathy, whereas dual antiplatelet therapy with aspirin and clopidogrel has no specific benefits in diabetic peripheral vasculopathy.

Evaluation of Bleeding After Denal Extraction in Patients Taking Single Antiplatelet Treatment

  • Kim, Jae Jin;Kim, Hak Kyun
    • International Journal of Oral Biology
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    • v.40 no.3
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    • pp.147-150
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    • 2015
  • The purpose of this study was to evaluate the effect of single antiplatelet treatment on delayed bleeding, in patients undergoing dental extraction. A total of 154 teeth were extracted in 94 patients with ongoing antiplatelet treatment, who were taking single antiplatelet of either aspirin or clopidogrel. All patients underwent simple dental extraction; local hemostasis was performed with gauze-biting, suturing, and/or application of a local hemostatic agent. Delayed bleeding was recorded in 5 teeth out of a total of 154 teeth after extraction, the incidence of postoperative delayed bleeding being 3.2%. The bleeding was controlled by the patients themselves, through application of pressure with additional gauze-biting. No one visited the doctor or emergency room for hemostasis. These results confirmed that patients taking single antiplatelet drugs may have teeth extracted safely without interruption of the antiplatelet treatment.

Clinical Outcomes of Antiplatelets Combined with Statins in Patients with Ischemic Heart Disease (허혈성 심장질환 환자에서 스타틴과 병용하는 항혈소판제 종류에 따른 임상결과)

  • Kim, Chungsoo;Lee, Jimin;Park, Rae Woong;Lee, Sukhyang
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.4
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    • pp.254-266
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    • 2019
  • Background: Patients with cardiovascular risks are recommended to use statins and antiplatelet agents to prevent major cerebro-cardiovascular events (MACCE). Antiplatelet agents also possess anti-inflammatory and antioxidant effects, in addition to their inhibitory activity on platelets. The differences in clinical outcomes in ischemic heart disease (IHD) based on the type of antiplatelet therapy combined with statin treatment were investigated in this study. Methods: We conducted a retrospective cohort study using electronic medical records of IHD patients from January 2010 to December 2014 at Ajou University Hospital. Patients on combination therapy of antiplatelet drugs and statins were grouped based on antiplatelet drug types: clopidogrel, cilostazol, or sarpogrelate. Propensity score matching was applied to balance the baseline of the groups of clopidogrel vs. cilostazol and the groups of clopidogrel vs. sarpogrelate. The incidence and risk of MACCE as primary outcomes were assessed between the groups of antiplatelet drugs. Results: Among the approximately 128,500 patients with IHD, 1,049 patients had taken a combination therapy of statin and antiplatelet agents. The cohorts of patients administered clopidogrel, cilostazol, or sarpogrelate were 906, 79, and 64, respectively. The incidence of MACCE was not significantly different among the cohorts (p=0.58), and there were no differences between clopidogrel vs. cilostazol (p=0.72) or clopidogrel vs. sarpogrelate (p=1.00) after propensity score matching. Conclusion: There was no difference in the incidence of MACCE based on the type of antiplatelet drug (clopidogrel, cilostazol, or sarpogrelate) in combination with a statin in patients with IHD.

Variability of Platelet Reactivity on Antiplatelet Therapy in Neurointervention Procedure

  • Yi, Ho Jun;Hwang, Gyojun;Lee, Byoung Hun
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.3-9
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    • 2019
  • As more intracranial aneurysms and other cerebrovascular pathologies are treated with neurointervention procedure, thromboembolic events that frequently lead to serious neurological deficit or fatal outcomes are increasing. In order to prevent the thromboembolic events, antiplatelet therapy is used in most procedures including coil embolization, stenting, and flow diversion. However, because of variable individual pharmacodynamics responses to antiplatelet drugs, especially clopidogrel, it is difficult for clinicians to select the adequate antiplatelet regimen and its optimal dose. This article reviews the neurointervention literature related to antiplatelet therapy and suggests a strategy for tailoring antiplatelet therapy in individual patients undergoing neurointervention based on the results of platelet function testing.

A Comparative Study the USA, Europe and Korea Guidelines of Antiplatelet Therapy for Patients with Acute Coronary Syndrome (급성관상동맥 증후군 치료를 위한 국내·외 항혈소판제 약물요법 가이드라인 비교 연구)

  • Jung, Eun-Joo;Lee, Chae-Won;Baek, In-Hwan
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.200-208
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    • 2015
  • Objective: Patients with acute coronary syndrome (ACS) are typically managed with dual antiplatelet therapy of acetylsalicylic acid (aspirin) and $P2Y_{12}$ receptor inhibitor. In this study, we discussed current and previous antiplatelet therapy guidelines and compared with guidelines of the USA (ACC/AHA), Europe (ESC) and Korea (KSC). Method: This study investigated from ACC/AHA Joint Guidelines (the USA), ESC Clinical Practice Guidelines (Europe) and Korea Society of Interventional Cardiology (Korea) web site, respectively. Results: It is significant that difference between the current and the previous guidelines was integration of terminology from clopidogrel to $P2Y_{12}$ receptor inhibitors since prasugrel and ticagrelor, new antiplatelet drugs, has been added. The other difference was all three guidelines has differences in dose of aspirin. The most notable difference was class of recommendation(COR) in $P2Y_{12}$ receptor inhibitors. ACC/AHA and Korean guidelines recommend clopidogrel, prasugrel, and ticagrelor with COR IB; whereas, ESC recommend prasugrel and ticagrelor with IB which is higher than clopidogrel with IC. Conclusion: This research addresses important movement to revise the Korean existing guideline recommendations. New Korean antiplatelet therapy guideline should be avoiding obvious differences in ACC/AHA and ESC guidelines and harmonizing international guidelines.

Updates in the Management of Coronary Artery Disease (관동맥질환 치료의 최신 지견)

  • Yang, Dong-Heon;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.87-93
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    • 2005
  • Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary Intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCI. In the management of patients with 57 segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but mote complete. Recently published evidences in the pharmacologic therapy including antiplatelet and stalin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

Anti-platelet role of Korean ginseng and ginsenosides in cardiovascular diseases

  • Irfan, Muhammad;Kim, Minki;Rhee, Man Hee
    • Journal of Ginseng Research
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    • v.44 no.1
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    • pp.24-32
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    • 2020
  • Cardiovascular diseases prevail among modern societies and underdeveloped countries, and a high mortality rate has also been reported by the World Health Organization affecting millions of people worldwide. Hyperactive platelets are the major culprits in thrombotic disorders. A group of drugs is available to deal with such platelet-related disorders; however, sometimes, side effects and complications caused by these drugs outweigh their benefits. Ginseng and its nutraceuticals have been reported to reduce the impact of thrombotic conditions and improve cardiovascular health by antiplatelet mechanisms. This review provides (1) a comprehensive insight into the available pharmacological options from ginseng and ginsenosides (saponin and nonsaponin fractions) for platelet-originated cardiovascular disorders; (2) a discussion on the impact of specific functional groups on the modulation of platelet functions and how structural modifications among ginsenosides affect platelet activation, which may further provide a basis for drug design, optimization, and the development of ginsenoside scaffolds as pharmacological antiplatelet agents; (3) an insight into the synergistic effects of ginsenosides on platelet functions; and (4) a perspective on future research and the development of ginseng and ginsenosides as super nutraceuticals.

Safety of Acupuncture Therapy for Patients Undergoing Anticoagulants / antiplatelet-Hwalhyeolgeoeo Herbal Medication: Retrospective Casecontrol Study (항응고제 또는 항혈전제와 활혈거어 한약 병용환자에서 침치료 안전성에 대한 후향적 환자-대조군 연구)

  • Lee, Min Jun;Im, Se Hoon;Lee, Seung Min;Kim, Eun Seok;Lee, Seung Hoon;Kang, Jung Won;Lee, Jae Dong
    • Journal of Acupuncture Research
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    • v.31 no.4
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    • pp.71-79
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    • 2014
  • Objectives : The aim of this study is to evaluate the safety of acupuncture therapy when applied to patients who are undergoing anticoagulants / antiplatelet medication therapy combined with herbal medicine using a retrospective, case-control study. Methods : 428 charts of patients were reviewed in this study. Odds ratio between case of bleeding-related adverse event and control was calculated as main analysis. Exposures were anticoagulants / antiplatelet medication, Hwalhyeolgeoeo herbal medicine and combination of both drugs. Additionally, odds ratios were calculated according to the severity of bleeding-related adverse events. Results : The results were as following: 1. Analysis of all bleeding-related adverse events showed there was no increased risk of combined therapy compared with other exposures and control group. 2. Analysis of only clinically significant adverse events showed there was no increased risk of combined therapy compared with other exposure and control group. 3. Hwalhyeolgeoeo herbal medicine group showed a tendency of increased risk of bleeding-related adverse events in all analysis but was not statistically significant. Conclusions : The results suggest that Hwalhyeolgeoeo herbal medicine-anticoagulant / antiplatelet medication combined therapy may not increase risk of bleeding-related adverse events in acupuncture therapy. By executing various modules of analysis, it was possible to acquire useful data for possible future studies. Further research is needed to confirm such results.

Bleeding after Taking Dual Antiplatelets and NSAID Concurrently (항혈소판제와 비스테로이드성소염진통제의 동시 투약으로 인한 출혈 사례)

  • Seo, Jeongmin;Choi, Joonghyuk;Son, Pyoungwoo;Lee, Seungmin;Chae, Hyunwoo;Kang, Geunhyung;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.250-253
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    • 2018
  • When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

Development of PK/PD Model for the Antiplatelet and Cardiovascular Effects of Cilostazol using the Results of Bioequivalence Study

  • Kwon, Kwang-Il
    • Proceedings of the PSK Conference
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    • 2003.04a
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    • pp.88-89
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    • 2003
  • In recent days, the bioequivalence(BE) study of domestic drugs on original drug are quite, activated in Korea. This BE study provide not only the bioequivalence of test and reference drug but also produce the population pharmacokinetic(PK) parameters in normal healthy Korean. The BE study can also make it possible to establish a PK/PD model of the drug when the additional pharmacodynamic(PD) data are available. (omitted)

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