Clear evidence supports the value of oral anticoagulation (OAC) with vitamin K antagonists in preventing stroke and thromboembolism in patients with atrial fibrillation (AF) who have well-established risk factors. For this indication, vitamin K antagonists have been shown to be superior to single or dual antiplatelet agents in reducing thromboembolic complications (1). Yet, up to 30% of patient...

Letter by Meves and Neubauer Regarding Article “Clinical Outcomes Using a Platelet FunctionGuided Approach for Secondary Prevention in Patients With Ischemic Stroke or Transient Ischemic Attack” To the Editor: Depta et al reported that platelet functionguided modification of antiplatelet therapy in patients with stroke may be associated with higher rates of adverse clinical outcomes. Platelet f...

OBJECTIVES Intracranial hemorrhage (ICH) after acute stroke thrombolysis is associated with poor outcomes. Previous investigations of the relationship between preexisting antiplatelet use and the safety of intravenous (IV) thrombolysis have been limited by low event rates. The objective of this study was to determine whether preexisting antiplatelet therapy increased the risk of ICH following a...

Platelets play an important role in atherothrombotic disease. The currently available antiplatelet drugs target key steps of platelet activation including thromboxane A(2) synthesis, ADP-mediated signaling, and glycoprotein IIb/IIIa-mediated platelet aggregation. The improvement of our understanding on the pharmacokinetic and pharmacodynamic characteristics of these drugs enables the tailoring ...

Dual antiplatelet therapy with aspirin and a thienopyridine has been shown to reduce cardiac events after coronary stenting. However, many patients and healthcare providers prematurely discontinue dual antiplatelet therapy, which greatly increases the risk of stent thrombosis, myocardial infarction, and death. This advisory stresses the importance of 12 months of dual antiplatelet therapy after...

Acute coronary syndrome (ACS) is still a serious condition associated with decreased quality of life, increased healthcare expenditures, and premature death. The prevalence of ACS is expected to increase with aging of the population and with the epidemics of obesity and diabetes. The shortand long-term mortality after an ACS has been dramatically reduced by the development of revascularization ...

Atrial fibrillation (AF) is the most frequent indication for oral anticoagulation. Dual antiplatelet treatment with aspirin and clopidogrel is an antithrombotic treatment recommended after acute coronary syndrome and/or coronary artery stenting. The evidence for optimal antiplatelet therapy for patients who underwent a long-term treatment based on oral anticoagulation is strong. A direct thromb...

Stent thrombosis is rare but can lead to potential severe consequence. The incidence is relative higher in drug-eluting sent than bare-metal stent implantation. Dual antiplatelet therapy is the major treatment to avoid early and late stent thrombosis. Simultaneous two stents thrombosis is rare. Although mechanical or/and procedure factors may predispose to stent thrombosis occurred, simultaneou...

Patients receiving long-term anticoagulant and antiplatelet medications pose a clinical challenge when therapy needs intraocular surgery, including cataract surgery and vitrectomy [1-3]. Maintaining antiplatelet and anticoagulation places them at risk for serious bleeding complications, whereas discontinuing these medications puts them at risk of thromboembolic complications [4-6]. Currently, t...

Aggressive intravenous and oral dual antiplatelet therapy has established primary percutaneous coronary intervention (PCI) as the standard of care for acute myocardial infarction. Clopidogrel is currently the thienopyridine of choice for dual antiplatelet therapy in patients treated with PCI. The dose regime and duration of therapy of clopidogrel has undergone multiple refinements. Recently, 2 ...