MedWorm: Aspirin

  Journal Scan: Duration of Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents (N Engl J Med 2010;Mar 15:[Epub ahead of print].)

In two trials, the investigators randomly assigned a total of 2,701 patients who had received DES and had been free of major adverse cardiac or cerebrovascular events and major bleeding for a period of at least 12 months to receive clopidogrel plus aspirin or aspirin alone. The primary endpoint was . . . (Source: Cardiosource)

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  Is Triple Antiplatelet Therapy After PCI the Way Forward?

Adding cilostazol to clopidogrel and aspirin did not significantly reduce event rates, but it did improve posttreatment platelet reactivity in the CILON-T trial, and the study was underpowered for hard clinical events. Heartwire (Source: Medscape Today Headlines)

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  Is triple antiplatelet therapy after PCI the way forward?

Adding cilostazol to clopidogrel and aspirin did not significantly reduce event rates, but it did improve posttreatment platelet reactivity in the CILON-T trial, and the study was underpowered for... For complete story visit theheart.org. (Source: theHeart.org)

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  New Analysis Assesses Impact Of Common Genetic Variation On Benefit Of Antiplatelet Therapy

A new analysis of the TRITON-TIMI 38 study evaluated response rates in patients with a common genetic variant in the ABCB1 gene. Patients enrolled in the TRITON-TIMI 38 study were treated with dual antiplatelet therapy with either Plavix® (clopidogrel) plus aspirin or Effient® (prasugrel) plus aspirin and managed with percutaneous coronary intervention (PCI) following an acute coronary syndrome (ACS) event. The results of this retrospective genetic sub-study were presented today at the American College of Cardiology annual meeting... (Source: Health News from Medical News Today)

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  Generic Drug For Type 2 Diabetes Passes Next Clinical Hurdle

Clinical studies of a generic drug called salsalate, widely prescribed for arthritis, now provide early promising results that it may be useful for the treatment of patients with type 2 diabetes as well. Salsalate is an atypical non-steroidal anti-inflammatory agent that is chemically similar to aspirin but a bit easier on the stomach. In a three-month trial of people with type 2 diabetes that was led by Joslin Diabetes Center researchers, those who took the drug showed significantly improved blood glucose levels... (Source: Health News from Medical News Today)

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  Generic Drug For Type 2 Diabetes Passes Next Clinical Hurdle

Clinical studies of a generic drug called salsalate, widely prescribed for arthritis, now provide early promising results that it may be useful for the treatment of patients with type 2 diabetes as well. Salsalate is an atypical non-steroidal anti-inflammatory agent that is chemically similar to aspirin but a bit easier on the stomach... (Source: Diabetes News From Medical News Today)

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  Aspirin Alone Works Best to Prevent Clots a Year After Stenting

Title: Aspirin Alone Works Best to Prevent Clots a Year After StentingCategory: Health NewsCreated: 3/15/2010 12:10:00 PMLast Editorial Review: 3/16/2010 (Source: MedicineNet Cholesterol General)

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  Aspirin Alone Works Best to Prevent Clots a Year After Stenting

Title: Aspirin Alone Works Best to Prevent Clots a Year After StentingCategory: Health NewsCreated: 3/15/2010 12:10:00 PMLast Editorial Review: 3/16/2010 (Source: MedicineNet Heart General)

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  Aspirin Alone Works Best to Prevent Clots a Year After Stenting

Title: Aspirin Alone Works Best to Prevent Clots a Year After StentingCategory: Health NewsCreated: 3/15/2010 12:10:00 PMLast Editorial Review: 3/16/2010 (Source: MedicineNet Senior Health General)

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  Long-term aspirin for coronary artery disease: are we being deceived by a biased presentation of the evidence?

Future Cardiology , March 2010, Vol. 6, No. 2, Pages 141-146. (Source: Future Cardiology)

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  Extended use of dual antiplatet therapy after stent implantation questioned

Extending the duration of dual antiplatelet therapy for more than 12 months after receipt of drug-eluting stents in patients with no prior bleeding does not appear to be more effective than aspirin monotherapy for reducing the rate of myocardial infarction or cardiovascular death, researchers report. (Source: MedWire News - Cardiology)

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  Oral antiplatelet agents - are they safe in breastfeeding?

Source: Trent Medicines Information Service Area: Evidence > Medicines Q & A Limited data and pharmacokinetics indicate that low dose aspirin and dipyridamole pass into breast milk in small amounts, although there is not enough information to accurately establish the milk:plasma ratio.  There is no information regarding excretion of clopidogrel into breast milk but the pharmacokinetics of the drug would suggest that the amount would be very small. There have been no adverse reports described in infants exposed to low dose aspirin, clopidogrel or dipyridamole via breast milk, however, they should be used with caution in breastfeeding mothers. Infant monitoring of adverse effects described with therapeutic doses should be undertaken especially signs of bruising and bleeding, which ...

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  Extended use of dual antiplatet therapy after stent implantation questioned

Extending the duration of dual antiplatelet therapy for more than 12 months after receipt of drug-eluting stents in patients with no prior bleeding does not appear to be more effective than aspirin monotherapy for reducing the rate of myocardial infarction or cardiovascular death, researchers report. (Source: MedWire News - Thrombosis)

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  Dual antiplatelet therapy beyond 12 months after stent placement not beneficial?

Source: N Engl J Med Area: News Analysis of data from two controlled trials found no clear benefit from continuing dual antiplatelet therapy for nearly three years after placement of a drug-eluting stent; serious cardiovascular events were more frequent in the dual therapy group, although the differences did not reach statistical significance.   Drug-eluting coronary stents give better short-term outcomes than bare metal stents, however they require prolonged dual antiplatelet therapy to avoid stent thrombosis and there is some evidence suggesting a long-term increased risk of serious events. As this may be linked to discontinuation of dual antiplatelet therapy, the authors of this paper used outcome data from two randomised controlled trials of similar design to examine cardiova...

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  Drug Helps Diabetics, Trial Finds

A generic anti-inflammatory drug from the aspirin family helped patients in a clinical trial lower their blood sugar. (Source: NYT > Health)

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  Rhinosinusitis and Comorbidities

Abstract  A variety of systemic conditions impact the incidence, severity, prognosis, and treatment approach in patients with chronic rhinosinusitis (CRS). The controversy surrounding the impact of allergic rhinitis on CRS continues, but it is reasonable to consider and treat allergic sources of inflammation in any patient with CRS. CRS is more severe in patients with aspirin sensitivity but improves—at least temporarily—to the same degree as in non-aspirin-sensitive patients, given appropriate therapy. Polypoid rhinosinusitis in cystic fibrosis patients is characterized by compromised mucociliary clearance and infection with staphylococcal and pseudomonal organisms. Affected individuals require frequent antibiotic treatment, saline lavage, and repeated surgeries. Rhino...

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  Aspirin Alone Works Best to Prevent Clots a Year After Stenting

Adding Plavix didn't boost outcomes after 12 months, new study finds Source: HealthDay Related MedlinePlus Pages: Angioplasty, Blood Thinners, Pain Relievers (Source: MedlinePlus Health News)

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  Outcomes after middle turbinate resection: Revisiting a controversial topic

To evaluate differences in endoscopy exam, olfactory function, and quality-of-life (QOL) status after endoscopic sinus surgery (ESS) for patients with and without bilateral middle turbinate (BMT) resection.Open, prospective, multi-institutional cohort.Subjects completing enrollment interviews, computed tomography (CT), and endoscopy exam were asked to provide pre- and postoperative responses to the Smell Identification Test (SIT), Rhinosinusitis Disability Index (RSDI), Chronic Sinusitis Survey (CSS), and the Medical Outcomes Study Short Form-36 Health Survey (SF-36). Bivariate and multivariate analyses were performed at the .05 alpha level.Forty-seven subjects with BMT resection were compared to 195 subjects without BMT resection with a mean follow-up of 17.4 months postoperatively. Patie...

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  ACC: Aspirin as Effective as Dual Antiplatelet Therapy for Stents

In patients who have received drug-eluting stents, dual antiplatelet therapy longer than 12 months is no more effective than aspirin monotherapy in decreasing the rate of heart attack or death from cardiovascular causes, according to a study published online March 15 in the New England Journal of Medicine The study was released to coincide with the Annual Scientific Session of the American College of Cardiology, held from March 14 to 16 in Atlanta. (Source: Modern Medicine)

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  Do Aspirin and Acetaminophen Affect Total Menstrual Loss?

Gynecol Obstet Invest 1984;18:129-133 (DOI:10.1159/000299067) (Source: Gynecologic and Obstetric Investigation)

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  ACC: Plavix+aspirin, for those who can’t take warfarin, doesn't increase costs

ATLANTA—In high-risk patients with atrial fibrillation who can’t tolerate standard blood thinners, such as warfarin, a combination treatment of aspirin and the more expensive clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis) is clinically effective for preventing stroke as well as being cost-effective, according to an ACTIVE-A economic substudy presented Sunday at the American College of Cardiology’s (ACC) 59th annual scientific session.  Slides» (Source: Cardiovascular Business News)

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  Effects of glucosamine and celadrin on platelet function.

CONCLUSION: Glucosamine and celadrin may inhibit platelet aggregation in some individuals via aspirin-like effects as well as inhibition of ADP receptor P2Y1 but not P2Y12. PMID: 20218092 [PubMed - in process] (Source: Clinical Laboratory Science : Journal of the American Society for Medical Technology)

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  Adverse effects of drugs on the esophagus

Given the function of the esophagus to transport orally ingested solids and liquids into the stomach there are several medications with adverse effect on esophageal structures and function. Various pharmacologic agents can induce esophageal injury, promote gastroesophageal reflux by decreasing lower esophageal sphincter tone or affect esophageal perception and motility. The risks of bisphosphonates, doxycycline, ferrous sulfate, ascorbic acid, aspirin/NSAIDs and chemotherapeutic agents to induce esophageal lesions have been documented in case reports and short series. In addition to direct mucosal injury, many commonly used medications including nitroglycerins, anticholinergics, β-adrenergic agonists, aminophyllines, and benzodiazepines promote/facilitate gastroesophageal reflux by reduci...

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  Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most widely prescribed medication in the world. Their main benefit derives from their anti-inflammatory and analgesic effect, but the use of these agents is not innocuous since they mainly increase the risk of gastrointestinal (GI) and cardiovascular complications compared with non-NSAID users. NSAIDs injures the upper and lower gut by depleting COX-1 derived prostaglandins and causing topical injury to the mucosa. The risk of upper GI complications varies, depending on the presence of one or more risk factors. Among them, the three main risk factors are prior history of peptic ulcer, the single most important risk factor, age, the most common, and concomitant aspirin use, due to their GI and cardiovascular implications. Those i...

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  Tomato seeds promise new way to fight heart disease more safely

A TOMATO extract has been hailed as a safer alternative to aspirin when used to prevent heart attacks and strokes. (Source: Scotsman.com News - Health)

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  [Evaluation of unresponsiveness to standard high-dose gamma globulin therapy in Kawasaki disease.]

CONCLUSION: The incidence of unresponsiveness to treatment was markedly high in KD patients who had coronary artery involvement on admission. PMID: 20215838 [PubMed - as supplied by publisher] (Source: Turk Kardiyoloji Dernegi arsivi)

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  Blood pressure changes before stroke

Conclusion Professor Rothwell has presented a compelling argument in support of his theory that fluctuations in blood pressure may help to predict the risk of vascular events such as stroke. As mentioned in an accompanying editorial, it is important to point out that Professor Rothwell is not questioning the validity of using average blood pressure to predict risk, but is advocating also using variable blood pressure as a supplementary indicator of increased risk. As with all narrative reviews the research methods that the author used to identify evidence to support his theories are not definitively laid out. It is therefore not possible to carry out a full appraisal of this evidence. However, the systematic appraisal of data on blood pressure and stroke is a robust and standardised way of...

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  Development of various arrhythmias and conduction disturbances following corticosteroid therapy for systemic lupus erythematosus with antiphospholipid syndrome

Abstract  A 45-year-old Chinese woman with active systemic lupus erythematosus, lupus anticoagulant positive, was admitted to our hospital. Electrocardiography on admission was normal. Though anti-Sjögren’s syndrome A (anti SS-A/Ro) antibodies were negative and ultrasound cardiographic findings were normal, she developed various arrhythmias/conduction disturbances shortly after starting corticosteroid. Nearly all were resolved with continuous corticosteroid and aspirin therapy before discharge. Vasculitis, the presence of antiphospholipid antibodies, and platelet aggregation due to corticosteroid were possible mechanisms underlying the arrhythmias/conduction disturbances. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10165-010-0283-9Authors Yu Kasama...

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  Interview with Dr. Fausto Feres: Is Three Months of Antiplatelet Therapy After the Endeavor Zotarolimus-Eluting Stent Enough?

In this exclusive interview, Dr. Feres explains the novel nature of this 3,000 patient trial which is measuring patient outcomes after only three months of dual antiplatelet therapy when used with Medtronic's Endeavor ZES. OPTIMIZE is unique because, due to concerns over late stent thrombosis, other trials are testing periods of one to three years -- Dr. Feres' hypothesis is that the Endeavor zotarolimus-eluting stent heals more quickly and therefore patients do not need to be taking aspirin plus Plavix for more than three months. If borne out, these finding could have important implications for cost-savings as well as patient safety. (Source: News from Angioplasty.Org)

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  Studies examine effects of variation in blood pressure on cardiovascular and stroke risk

Source: Lancet, Lancet Neurology Area: News Five papers published in the Lancet and Lancet Neurology focus on the variability in blood pressure (BP) and the effects on cardiovascular and stroke risk. Readers with a more in depth interest in the management of hypertension are advised to view the complete papers (subscription required) for more detailed information.   In the first paper, the authors carried out a cohort study to establish the prognostic significance of visit-to-visit variability in blood pressure, maximum blood pressure reached, untreated episodic hypertension, and residual variability in treated patients. They studied a large cohort of patients with previous transient ischaemic attack (TIA) from the UK-TIA aspirin trial with validation in three similar cohorts and...

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  Synthesis of piperazino and morpholino derivatives of aryloxypropane with potential analgesic and possible antimigraine activities

Abstract  Modeling studies demonstrate that aryl piperazines (I), aryloxyalkylamines (II), phenylalkykamines (III) and indolylalkylamines (VI) may interact at 5-HT receptors in a similar manner. Examination of these structures (I–VI) reveals that all possess an aromatic moiety and terminal amine binding sites (Glennon et al., J Med Chem 32(8):1921–1926, 1989). In the present investigation a new series of aryloxyalkylamines (4, 5, 8, and 9) was designed and synthesized, in which the aromatic moiety is a phenyl group substituted at the 2,3-, 2,4-, 2,5-, or 2,6-positions by halogens and the terminal amine is N-methylpiperazine, or morpholine. In addition, the alkyl side chain is ethyl, or substituted ethyl at the α- or β-carbon by a methyl group. The length of the alkyl chai...

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  Regular Analgesic Use May Increase Risk for Hearing Loss

Regular use of aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs may increase the risk for hearing loss in men, particularly those younger than 60 years. Medscape Medical News (Source: Medscape Today Headlines)

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  Serum Thromboxane B2 Compared to Five Other Platelet Function Tests for the Evaluation of Aspirin Effect in Stable Cardiovascular Disease

Background: To assess the role of serum thromboxane B2 (TXB2) measurements and the correlation between platelet function studies, in patients with stable cardiovascular disease on aspirin or clopidogrel.Methods: 76 patients (47 on aspirin, 16 clopidogrel, 13 both) underwent assessment of TXB2, whole blood aggregometry (WBA) after stimulation with (i) arachidonic acid (0.5mM), (ii) ADP (5μM), (iii) collagen (1 and 5μg/ml), PFA-100®, and Cone and Plate Analyzer. Clopidogrel patients were additionally assessed by the VerifyNow® System.Results: TXB2 values ranged between 0.2 and 56.2ng/ml, with significant separation between those taking aspirin, clopidogrel and controls (0.45ng/ml vs 6.85ng/ml vs 12.97ng/ml, p (Source: Heart, Lung & Circulation)

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  Impact of Chronic Kidney Disease on Platelet Function Profiles in Diabetes Mellitus Patients With Coronary Artery Disease Taking Dual Antiplatelet Therapy

Conclusions: In DM patients with coronary artery disease taking maintenance aspirin and clopidogrel therapy, impaired renal function is associated with reduced clopidogrel-induced antiplatelet effects and a greater prevalence of HPPR. (Source: Journal of the American College of Cardiology)

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  PPIs linked to reduced platelet function in patients with CAD

Proton pump inhibitors may reduce the benefits of aspirin in patients with coronary artery disease, researchers from Denmark report. (Source: MedWire News - Cardiology)

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  Minocycline with aspirin: a therapeutic approach in the treatment of diabetic neuropathy

Abstract  Enhanced production of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in diabetes leads to degradation of extracellular matrix in blood vessels and leads to complications of diabetes. In the present study, we have targeted MMP-2 and MMP-9 overactivation in diabetic neuropathy using a known MMP-2 and MMP-9 inhibitor, minocycline, with a non-selective COX inhibitor, aspirin. Streptozotocin-induced diabetic neuropathy was carried out in male Wistar rats and monitored by measuring the sensory nerve conduction velocity (SNCV), motor nerve conduction velocity (MNCV), tail flick latency and hot plate latency. Three weeks of treatment with a combination of minocycline and aspirin showed significant improvement in SNCV, MNCV, hot plate latency an...

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  Novel Conjugates of Aspirin with Phenolic Acid as Anti-inflammatory Agents Having Significantly Reduced Gastrointestinal Toxicity

A series of novel conjugates of aspirin with natural phenolic acid antioxidants connected through a diol linker were designed and synthesized as potential bifunctional agents combining antioxidant and anti-inflammatory activity for reducing gastrointestinal toxicity. In general, the conjugates were found to be efficient antioxidants and many of them demonstrated much more potent anti-inflammatory activity than aspirin. Among them, 5a and 5b which bear the best anti-inflammatory activity exhibited significantly reduced ulcerogenic potency and toxicity compared to aspirin. However, it is evident that the anti-inflammatory activity of these dual-acting molecules in vivo, was not simply consistent with their antioxidant ability in vitro. (Source: Archiv der Pharmazie)

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  Systematic Review of Observational Research Studying the Long-Term use of Antithrombotic Medicines Following Intracerebral Hemorrhage

Patients with intracerebral hemorrhage frequently have indications for antithrombotic therapy. This represents a therapeutic dilemma as intracerebral hemorrhage is considered a contraindication to antithrombotic medication. Previous systematic reviews have revealed no long-term randomised studies addressing this issue. Our objective was to review observational studies describing the long-term follow-up of patients receiving antithrombotic therapy following intracerebral hemorrhage. Searches were conducted in MEDLINE and EMBASE from 1984 to 2008 for any observational studies detailing use of antithrombotic treatments in patients with intracerebral hemorrhage. Included studies must have had follow-up extending beyond discharge. The primary endpoint was recurrent intracerebral hemorrhage. Sec...

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  Regular Analgesic Use Linked to Hearing Loss in Men

The regular use of aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs may increase the risk of hearing loss in men, especially younger men, according to research published in the March issue of the American Journal of Medicine. (Source: Modern Medicine)

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  Increased Incidence of Gastrointestinal Bleeding Following Implantation of the HeartMate II LVAD

Conclusions: Although definitive source identification remains elusive, we believe that the majority of bleeding arises in the small bowel, possibly due to angiodysplasias, similar to the pathophysiology encountered in patients with aortic stenosis and GI bleeding. As we move toward wider use of the HMII and other axial continuous-flow devices in both bridge-to-transplant patients and for destination therapy, more studies will be necessary to understand the mechanisms of this obscure GI bleeding and develop treatment strategies to minimize its development. (J Card Surg ****;**:**-**) (Source: Journal of Cardiac Surgery)

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  Cilostazol Trumps Aspirin in Secondary Stroke Prevention

A large randomized controlled trial suggests that the phosphodiesterase inhibitor cilostazol is more effective for the prevention of secondary stroke and has a superior safety profile. Medscape Medical News (Source: Medscape Today Headlines)

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  Aspirin resistance in Indian patients with coronary artery disease and cardiovascular events

Conclusion : The incidence of aspirin resistance in the cohort of patients with documented heart disease was 38.1%. Patients with elevated absolute urinary dehydrothomboxane levels (>320 pg/ml) on chronic aspirin therapy constitute a high risk subset for recurrent vascular events. (Source: Journal of Postgraduate Medicine)

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  Accumetrics To Host Industry-Expert Theater Presentation At 59th Annual American College Of Cardiology 2010 Scientific Sessions

Accumetrics, Inc., a privately-held developer and marketer of the VerifyNow® System, the first rapid and easy-to-use diagnostic system for measuring platelet reactivity to multiple antiplatelet agents (e.g. Plavix® and aspirin), announced that the company will host an industry expert theater presentation on Monday, March 15, during the 59th annual American College of Cardiology Meeting. The ACC industry expert theater presentation will focus on a rapidly evolving and exciting topic: assessing patient response to antiplatelet therapies and the impact on clinical outcomes... (Source: Health News from Medical News Today)

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  Accumetrics To Host Industry-Expert Theater Presentation At 59th Annual American College Of Cardiology 2010 Scientific Sessions

Accumetrics, Inc., a privately-held developer and marketer of the VerifyNow® System, the first rapid and easy-to-use diagnostic system for measuring platelet reactivity to multiple antiplatelet agents (e.g. Plavix® and aspirin), announced that the company will host an industry expert theater presentation on Monday, March 15, during the 59th annual American College of Cardiology Meeting... (Source: Cardiovascular / Cardiology News From Medical News Today)

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  Letter by Doraiswamy Regarding Article, "Intensifying Platelet Inhibition With Tirofiban in Poor Responders to Aspirin, Clopidogrel, or Both Agents Undergoing Elective Coronary Intervention: Results From the Double-Blind, Prospective, Randomized Tailoring Treatment With Tirofiban in Patients Showing Resistance to Aspirin and/or Resistance to Clopidogrel Study".

Authors: Doraiswamy VA PMID: 20212290 [PubMed - in process] (Source: Circulation)

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  Potential Use of 10-Year and Lifetime Coronary Risk Information for Preventive Cardiology Prescribing Decisions: A Primary Care Physician Survey [Original Investigation]

Conclusions  Providing 10-year coronary risk information improved some hypothetical aspirin-prescribing decisions and improved lipid management when the short-term risk was moderately high. High lifetime risk sometimes led to more intensive prescription of aspirin or lipid-lowering medication. This outcome suggests that, to maximize the benefits of risk-calculating tools, specific guideline recommendations should be provided along with risk estimates. (Source: Archives of Internal Medicine)

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  Wine and women's weight

Conclusion This large cohort study that followed middle-aged women for almost 13 years found that there was an association between greater alcohol consumption and slightly slower weight gain over this period. Despite the tone of press coverage, it should be remembered that this type of study can only show associations between factors, and cannot say how or whether alcohol directly causes the slower weight gain. There are also a number of limitations to this research, some of which the researchers have highlighted: The participants self-reported their weights and alcohol consumption, which may have resulted in a misclassification or underestimation of these values. The study used a single measurement of alcohol consumption taken at the start of the study. It is likely that the partici...

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  Health Headlines: Keeping an Eye on Dementia, Aspirin and Heart Health, Chocolate and Stroke Prevention, Exercising Teens

Source: HealthDay - Related MedlinePlus Pages: Alzheimer's Disease, Exercise for Children, Nutrition, Obesity in Children, Pain Relievers (Source: MedlinePlus Health News)

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  Nitric oxide, derived from inducible nitric oxide synthase, decreases hypoxia inducible factor-1α in macrophages during aspirin-induced mesenteric inflammation

Conclusions and implications: NO, associated with acute gut inflammation induced by aspirin, diminished HIF-1[alpha] stabilization in macrophages. Early inhibition of iNOS-derived NO synthesis, by increasing the activity of HIF-1 in these cells, may accelerate the clearance of leucocytes. (Source: British Journal of Pharmacology)

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  Combination of Aspirin with Telmisartan suppress the augmented TGF-beta/smad signaling during the development of Streptozotocin induced type I diabetic nephropathy.

Authors: Shrikant M, Gaikwad AB, Tikoo K Diabetic nephropathy (DN) is the most common indication for the development of end stage renal diseases. Inflammation is increasingly seen as the core process in the development in diabetes. Inflammatory markers e.g. NFkappaB (p65 levels), TNFalpha, COX-2 and TGFbeta-smad signaling are the key elements in the development of DN. Renin-Angiotensin system suppressors like Telmisartan have been used to treat DN, but they are not able to prevent completely because of development of resistance against them. Anti-inflammatory agents like, Aspirin acts through both COX dependent and COX independent pathways. Hence, we thought that combining Aspirin with Telmisartan will be better therapeutic option in preventing the progression of nephropathy in diabete...

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  Factors influencing intercellular spaces in the rat esophageal epithelium.

CONCLUSION: Acute stress and aspirin can induce DIS of the esophageal epithelium in rats, and it is not correlated with acid reflux. PMID: 20205275 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

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  The Levels of Inflammatory Markers in the Treatment of Stroke study (LIMITS): inflammatory biomarkers as risk predictors after lacunar stroke

Inflammation is increasingly recognised as playing a central role in atherosclerosis, and peripheral blood markers of inflammation have been associated with incident and recurrent cardiac events. The relationship of these potentially modifiable risk markers to prognosis after ischaemic stroke is less clear. The Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) study will address hypotheses related to the role of inflammatory markers in secondary stroke prevention in an efficient manner using the well-established framework of the Secondary Prevention of Small Subcortical Strokes (SPS3) trial (NCT00059306). SPS3 is an ongoing Phase III multicentre secondary prevention trial focused on preventing recurrent stroke in patients with small vessel ischaemic stroke, or lacunes. In ...

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  Painkillers may increase risk of hearing loss

In a study, men who regularly use analgesics reported hearing loss. Perhaps it wasn't those years of listening to rock 'n' roll that damaged my hearing after all; regular use of aspirin, acetaminophen and other analgesics appears to substantially increase the risk of hearing loss, especially in men younger than 50. (Source: L.A. Times - Health)

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  Comparison of Different Antithrombotic Regimens for Patients With Atrial Fibrillation Undergoing Drug-Eluting Stent Implantation.

Conclusions: The cardiovascular benefits of triple antithrombotic therapy were confirmed by reducing the MACCE rate, and its major bleeding risk might be acceptable if the INR is closely monitored. PMID: 20208381 [PubMed - as supplied by publisher] (Source: Circulation Journal)

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  Too much of a good thing: Long-term treatment with salicylate strengthens outer hair cell function but impairs auditory neural activity.

Authors: Chen GD, Kermany MH, D'Elia A, Ralli M, Tanaka C, Bielefeld EC, Ding D, Henderson D, Salvi R Aspirin has been extensively used in clinical settings. Its side effects on auditory function, including hearing loss and tinnitus, are considered as temporary. A recent promising finding is that chronic treatment with high-dose salicylate (the active ingredient of aspirin) for several weeks enhances expression of the outer hair cell (OHC) motor protein (prestin), resulting in strengthened OHC electromotility and enhanced distortion product otoacoustic emissions (DPOAE). To follow up on these observations, we carried out two studies, one planned study of age-related hearing loss restoration and a second unrelated study of salicylate-induced tinnitus. Rats of different strains and ages ...

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  Major Bleeding Uncommon After Imaging-Guided Percutaneous Core Needle Biopsy

A study shows an overall low incidence of major bleeding after imaging-guided percutaneous core needle biopsy, with little effect of recent aspirin therapy. Medscape Medical News (Source: Medscape Hematology-Oncology Headlines)

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  Regular painkillers and hearing loss

Conclusion This study found an association between regular use of three types of painkiller and a small increased risk in hearing loss. This type of study can only find associations, it cannot demonstrate that these painkillers caused the hearing loss. The researchers highlight some limitations of their study: Men were categorised as having hearing loss based on their own admission in the questionnaire on whether it had been diagnosed by a professional. Participants who did not report hearing loss were considered to not be impaired. The best way to assess hearing would have been through standard pure-tone audiometry, but this could not be performed due to cost and logistics reasons. The researchers did not have information on the participants’ lifetime noise exposure or the reasons...

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  New blow for aspirin use in CVD prevention

The role of aspirin in the prevention of cardiovascular events has been dealt another blow by the results of a randomised controlled trial by Scottish researchers. (Source: Pulse)

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  Health Buzz: New Prostate Cancer Screening Guidelines

COBRA insurance subsidy is extended to March job-losers; the benefits (and risks) of popping an aspirin (Source: U.S. News - Health)

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  No Benefit from Aspirin in Low ABI (CME/CE)

Prophylactic aspirin had no effect on the risk of vascular events in patients with a low ankle-brachial index and no evidence of cardiovascular disease, data from a randomized clinical trial showed. (Source: MedPage Today Cardiovascular)

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  Aspirin Use Does Not Significantly Reduce Vascular Events Among Individuals Identified By Certain Screening Method As Being At Higher Risk

Individuals who were identified as being at increased risk of cardiovascular or cerebrovascular events based on screening for low ankle brachial index, a type of pressure measurement used in the diagnosis of peripheral artery disease, did not significantly reduce their risk of these events with the use of aspirin, according to a study in the March 3 issue of JAMA. "The ankle brachial index (ABI), which is the ratio of systolic pressure at the ankle to the arm, is used in the diagnosis of peripheral artery disease affecting the legs... (Source: Health News from Medical News Today)

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  Journal Scan: Warfarin and Aspirin Use in Atrial Fibrillation Among Practicing Cardiologists (From the AFFECTS Registry) (Am J Cardiol 2010;Feb 22:[Epub ahead of print].)

This was an analysis of 1,461 patients (mean age 66 years) who had AF (paroxysmal in 80%) without structural heart disease and who were enrolled in a multicenter registry. Participating cardiologists were trained in the practice guidelines of the American College of Cardiology/American Heart Associa. . . (Source: Cardiosource)

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  JAMA: Aspirin use does not significantly reduce vascular events

Individuals who were identified as being at increased risk of cardiovascular or cerebrovascular events based on screening for low ankle brachial index did not significantly reduce their risk of these events with the use of aspirin, according to a randomized, controlled trial in the March 3 issue of Journal of the American Medical Association. (Source: Cardiovascular Business News)

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  DTB: Using NSAIDs in cardiovascular disease

Source: Drug and Therapeutics Bulletin Area: Evidence > Medication Safety In this review in the Drug and Therapeutics Bulletin (DTB) on the use of NSAIDs in cardiovascular disease, the authors consider the evidence in the context of other unwanted effects of NSAIDs, and offer practical advice on their use of in this setting. The following topics are addressed:   . COX enzymes . Cardiovascular effects of NSAIDs . Evidence from RCTs and other studies . Effects on blood pressure . Use in hypertension, ischaemic heart disease, heart failure, patients treated with low dose aspirin . Gastrointestinal and renal effects of NSAID . National prescribing advice (Source: NeLM - Patient Safety)

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  An Aspirin A Day?

Source: HealthDay - Related MedlinePlus Pages: Heart Attack, Pain Relievers, Stroke (Source: MedlinePlus Health News)

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  Daily aspirin 'not for the healthy'

Conclusion This trial has tried to answer an important question regarding who should be given aspirin to prevent a heart attack or stroke. It used a systematic method to screen people and followed a reasonably large group of patients for up to 10 years in some cases. The finding of “no statistical significance” can be an important result, and in this case suggests that any benefits from taking aspirin for this group of people are likely to be small. The risk of bleeding was also small and not technically of statistical significant. There is a non-significant trend in the results towards aspirin being harmful. As there is also a suggestion that the study may have been underpowered (planned for too few people), this implies that a larger study may have detected a significant increase ...

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  Aspirin Fails to Prevent Cardiovascular Events in Patients with a Low Ankle-Brachial Index

(Source: Physician's First Watch current issue)

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  Aspirin a day may HARM your health and 'does not cut heart attack risk in worried well'

They may be doing more harm than good because the risks of internal bleeding can outweigh the potential benefits, a study found. (Source: the Mail online | Health)

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  ASPIRIN BOLUS (Acetylsalicylic Acid) Tablet [Sparhawk Laboratories, Inc.]

Updated Date: Mar 3, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Aspirin fails to prevent cardiovascular events in patients with subclinical CVD

Results of the Aspirin for Asymptomatic Atherosclerosis trial show that aspirin does not reduce the risk for cardiovascular events in individuals with subclinical atherosclerosis as identified by a low ankle brachial index. (Source: MedWire News - Cardiology)

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  Could long-term analgesic use increase risk of deafness?

Source: Am J Med Area: News A large epidemiological study from the US found an increased risk of hearing loss associated with long-term use of analgesics (aspirin, NSAID, and paracetamol). The increases in risk are small, however, and should be taken with caution.   There is some experimental evidence that various analgesics (salicylates, NSAID, paracetamol) may be ototoxic, however there is also evidence that low-dose aspirin may protect hearing. The authors of this study used data from a pre-existing large cohort, the Health Professionals Follow-up Study. Participants are US male health professionals who were aged between 40 to 75 years in 1986 when the study started: at this point, they provided details on diet, health and medication history by mailed questionnaire. He...

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  Low-dose aspirin primary prevention study published

Source: JAMA Area: News The Aspirin for Asymptomatic Atherosclerosis (AAA) study, which was initially presented at a conference last year, has now been published in full.   AAA examined whether primary prevention using low-dose aspirin was beneficial in people identified as being at increased cardiovascular risk by having a low ankle-brachial index (ABI). The ABI is the ratio of systolic BP at the ankle to that in the arm and is considered to be an indicator of sub-clinical atherosclerosis.   As noted in the report of the conference presentation, carried on NHS Choices, the study did not show any significant benefit from low-dose aspirin in this group.   The original report and link to NHS Choices can be found at the link below. (Source: NeLM - ...

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  Basic Principles of Platelet Biology and Clinical Implications.

Authors: Angiolillo DJ, Ueno M, Goto S Platelet activation and subsequent accumulation at sites of vascular injury are the first steps in hemostasis. Excessive platelet activation after atherosclerotic plaque rupture or endothelial cell erosion may also lead to the formation of occlusive thrombi, which are responsible for acute ischemic events. Multiple pathways are involved in platelet activation, including those activated by adenosine diphosphate (ADP), thromboxane A(2) (TXA(2)), serotonin, collagen, and thrombin. Antiplatelet agents used for prevention of atherothrombosis have focused on blocking the formation of TXA(2) (eg, aspirin) and interfering with ADP stimulation mediated by the P2Y(12) receptor (eg, clopidogrel). These agents, used alone or in combination, significantly decr...

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  Platelet tissue factor synthesis in type 2 diabetes patients is resistant to inhibition by insulin.

Discussion We characterized the extra- and intracellular mechanisms that couple surface activation to TF-synthesis in adhering platelets. In healthy individuals, TF-synthesis is inhibited by insulin but in patients with type 2 diabetes inhibition is impaired. This leads to the novel finding that platelets from type 2 diabetes patients produce more TF than platelets from matched controls. PMID: 20200314 [PubMed - as supplied by publisher] (Source: Diabetes)

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  AAA: Aspirin Not Warranted in Healthy Subjects With Low ABI, Based on Population Screening

Authors of the study say their study does not rule out a role for ankle/brachial index screening in the clinic or for other CVD drugs to reduce risk in asymptomatic subjects. But for aspirin and for populationwide screening, the study raises some questions. Heartwire (Source: Medscape Today Headlines)

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  The Benefits of Popping an Aspirin (and Some Risks)

Daily aspirin appears not to improve the odds for people with very early peripheral artery disease. (Source: U.S. News - Health)

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  AAA: Aspirin not warranted in healthy subjects with low ABI, based on population screening

Authors of the study say their study does not rule out a role for ankle/brachial index screening in the clinic or for other CVD drugs to reduce risk in asymptomatic subjects. But for aspirin and for... For complete story visit theheart.org. (Source: theHeart.org)

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  Study Questions Value of Test for Peripheral Artery Disease

Ankle-brachial index, and resulting aspirin therapy, may not be needed for healthier patients Source: HealthDay Related MedlinePlus Pages: Blood Thinners, Peripheral Arterial Disease (Source: MedlinePlus Health News)

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  Aspirin for Prevention of Cardiovascular Events in a General Population Screened for a Low Ankle Brachial Index: A Randomized Controlled Trial [Original Contribution]

Conclusion  Among participants without clinical cardiovascular disease, identified with a low ABI based on screening a general population, the administration of aspirin compared with placebo did not result in a significant reduction in vascular events. Trial Registration  isrctn.org Identifier: ISRCTN66587262 (Source: JAMA)

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  Aspirin as Preventive Therapy in Patients With Asymptomatic Vascular Disease [Editorial]

(Source: JAMA)

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  Clinical Trial Summary: Aspirin for Asymptomatic Atherosclerosis (AAA)

The goal of the trial was to evaluate treatment with aspirin compared with placebo for primary prevention among patients with a low ankle brachial index (ABI). (Source: Cardiosource)

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  The antiplatelet effect of aspirin is reduced by proton pump inhibitors in patients with coronary artery disease

Conclusions Patients with CAD treated with PPIs had a reduced platelet response to aspirin, as shown by increased residual platelet aggregation and platelet activation, compared with patients with CAD not taking PPIs. Concomitant use of aspirin and PPIs might reduce the cardiovascular protection by aspirin. (Source: Heart)

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  Hearing Loss In Men Increased By Regular Analgesic Use

In a study published in the March 2010 issue of The American Journal of Medicine, researchers determined that regular use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of hearing loss in men, particularly in younger men, below age 60. Hearing loss is the most common sensory disorder in the US, afflicting over 36 million people... (Source: Hearing / Deafness News From Medical News Today)

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  Hearing Loss In Men Increased By Regular Analgesic Use

In a study published in the March 2010 issue of The American Journal of Medicine, researchers determined that regular use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of hearing loss in men, particularly in younger men, below age 60. Hearing loss is the most common sensory disorder in the US, afflicting over 36 million people. Not only is hearing loss highly prevalent among the elderly, but approximately one third of those aged 40-49 years already suffer from hearing loss... (Source: Health News from Medical News Today)

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  Aspirin Could Fight Fat's Heart Threat

What if you could be fat but avoid heart disease or diabetes? Some scientists say inflammation is the key. (Source: WDSU.com - Health)

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  Aspirin advice

Daily dose risky for people without heart disease (Source: BHF National News)

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  Aspirin advice

Daily dose risky for people without heart disease (Source: BHF National News)

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  Can Aspirin Blur Line Between Fat, Healthy?

What if you could be fat but avoid heart disease or diabetes? Scientists trying to break the fat-and-disease link increasingly say inflammation is the key. (Source: WDSU.com - Health)

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  Fecal Occult Blood Test in Patients on Low-Dose Aspirin, Warfarin, Clopidogrel, or Non-steroidal Anti-inflammatory Drugs

Conclusion  Anticoagulants and antiplatelet medications lower the positive-predictive-value of FOBT for advance colonic neoplasia and should be stopped if clinically feasible prior to stool collection. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-010-1150-4Authors Mandeep S. Sawhney, Minneapolis Veterans Affairs Medical Center Division of Gastroenterology Minneapolis MN USAHeather McDougall, Minneapolis Veterans Affairs Medical Center Division of Gastroenterology Minneapolis MN USADouglas B. Nelson, Minneapolis Veterans Affairs Medical Center Division of Gastroenterology Minneapolis MN USAJohn H. Bond, Minneapolis Veterans Affairs Medical Center Division of Gastroenterology Minneapolis MN USA Journal Digestive Diseases and SciencesOnl...

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  Aspirin, Acetaminophen and NSAID's Increase Risk of Male Hearing Loss

Regular analgesic use increases hearing loss in men - According to new study published in the American Journal of Medicine... (Source: Disabled World)

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  Painkillers linked to hearing loss

BOSTON, March 1 (UPI) -- Regular use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs increases the risk of hearing loss in men, U.S. researchers found. (Source: Health News - UPI.com)

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  Defining Patients at High Risk for Gastrointestinal Hemorrhage after Drug-Eluting Stent Placement: A Cost Utility Analysis

Conclusion: In average-risk patients, the risk of GI bleeding from DAT can be substantial without affecting the cost-effectiveness of DES. However, DES are unlikely to be cost-effective in patients with two or more risk factors for GI bleeding. (J Interven Cardiol 2010;**:1[ndash]9) (Source: Journal of Interventional Cardiology)

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  Aspirin Benefit Not Seen With Low Ankle Brachial Index

The use of aspirin may not lead to fewer vascular events in middle-aged and older individuals with a low ankle brachial index, according to research published in the March 3 issue of the Journal of the American Medical Association. (Source: Modern Medicine)

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  Aspirin Benefit Not Seen With Low Ankle Brachial Index

The use of aspirin may not lead to fewer vascular events in middle-aged and older individuals with a low ankle brachial index, according to research published in the March 3 issue of the Journal of the American Medical Association. (Source: Modern Medicine)

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  Thrombosis Prevention After Total Hip Arthroplasty: A Prospective, Randomized Trial Comparing a Mobile Compression Device with Low-Molecular-Weight Heparin

Conclusions: When compared with low-molecular-weight heparin, use of the mobile compression device for prophylaxis against venous thromboembolic events following total hip arthroplasty resulted in a significant decrease in major bleeding events. Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence. (Source: JBJS [Am])

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  Regular analgesic use increases hearing loss in men

(Elsevier Health Sciences) In a study published in the March 2010 issue of the American Journal of Medicine, researchers determined that regular use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs increases the risk of hearing loss in men, particularly in younger men, below age 60. (Source: EurekAlert! - Medicine and Health)

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  Dispatch: PLoS, Obama's Smoking, Infections, Aspirin, and Kristof

ACSH& rsquo;s Jeff Stier got the last word in the Los Angeles Times & rsquo; report on PLoS Medicine & rsquo;s recent announcement that they will no longer review studies that are funded by the tobacco industry. (Source: Health Facts and Fears)

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  Prescriptions for selective cyclooxygenase-2 inhibitors, non-selective non-steroidal anti-inflammatory drugs, and risk of breast cancer in a population-based case-control study

IntroductionNon-steroidal anti-inflammatory drugs (NSAIDs) prevent the growth of mammary tumours in animal models. Two population-based case-control studies suggest a reduced risk of breast cancer associated with selective cyclooxygenase-2 (sCox-2) inhibitor use, but data regarding the association between breast cancer occurrence and use of non-selective NSAIDs are conflicting. Methods: We conducted a population-based case-control study using Danish healthcare databases to examine if use of NSAIDs, including sCox-2 inhibitors, was associated with a reduced risk of breast cancer. We included 8,195 incident breast cancer cases diagnosed 1991 through 2006 and 81,950 population controls. Results: Overall, we found no reduced breast cancer risk in ever users (>2 prescriptions) of sCox-2 inhibit...

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  Regular Analgesic Use Increases Hearing Loss in Men

Researchers determined that regular use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of hearing loss in men, particularly in younger men, below age 60. (Source: BWH for Journalists)

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  Regular Analgesic Use Increases Hearing Loss in Men

Researchers determined that regular use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of hearing loss in men, particularly in younger men, below age 60. (Source: BWH News)

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  Effects of aspirin, carprofen, deracoxib, and meloxicam on platelet function and systemic prostaglandin concentrations in healthy dogs.

Conclusions and Clinical Relevance-Oral administration of commonly used NSAIDs at therapeutic dosages in healthy dogs did not alter plasma TXB(2) and 6-keto PGF(1alpha) concentrations. Deracoxib administration resulted in a minor abnormality in platelet aggregation. Anti-inflammatory doses of aspirin did not affect platelet function as measured by use of optical aggregometry and a platelet-function analyzer. Further evaluation of the effects of aspirin and cyclooxygenase-2-selective inhibitors on hemostasis should be performed. PMID: 20187838 [PubMed - in process] (Source: American Journal of Veterinary Research)

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  The development of new analgesics over the past 50 years: a lack of real breakthrough drugs.

Authors: Kissin I Fifty-nine drugs identified as analgesics were introduced from 1960 to 2009 and remain in use. Seven can be regarded as having novel molecular targets; however, only one, sumatriptan, was sufficiently effective to motivate the introduction of many similar drugs acting at the same target (triptans). Publication productivity in the area of pain grew exponentially during this period. Pain-related publications on morphine were dominant among other analgesics. Very intensive research efforts directed at diverse molecular targets related to pain mechanisms produced thousands of publications, but those efforts have not yet yielded new analgesics with sufficient effectiveness to change the share of publications on opioids or nonsteroidal antiinflammatory drugs. Morphine and a...

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  Patients under anti-platelet therapy

Interruption or maintenance of anti-platelet agents (APAs) during surgical or invasive procedures is associated with an increase in cardiovascular or haemorrhagic complications, respectively. The pharmacology and indications of aspirin, clopidogrel and prasugrel are summarised. The utility and risks of interruption, the optimal delay between stent implantation and surgery, the appropriate window of preoperative interruption, the potential usefulness of bridging, the safest delay between the end of surgery and resumption of APA are detailed in this review. Some non- evidence-based suggestions are given to help the physicians in their daily clinical practice. (Source: Best Practice and Research. Clinical Anaesthesiology)

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  Analgesic Use and the Risk of Hearing Loss in Men

We examined the independent association between self-reported professionally diagnosed hearing loss and regular use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen in 26,917 men aged 40-74 years at baseline in 1986. Study participants completed detailed questionnaires at baseline and every 2 years thereafter. Incident cases of new-onset hearing loss were defined as those diagnosed after 1986. Cox proportional hazards multivariate regression was used to adjust for potential confounding factors.Results: During 369,079 person-years of follow-up, 3488 incident cases of hearing loss were reported. Regular use of each analgesic was independently associated with an increased risk of hearing loss. Multivariate-adjusted hazard ratios of hearing loss in regular users (2+...

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  Long-term Effect of Chronic Oral Anticoagulation with Warfarin after Acute Myocardial Infarction

Abstract: Background: Antiplatelet therapy is the principal component of the antithrombotic regimen after acute myocardial infarction. It remains unclear whether additional chronic oral anticoagulation (OAC) improves outcomes. We set out to evaluate the risk and benefit of long-term OAC after myocardial infarction.Methods: We pooled 10 randomized clinical trials comparing warfarin-containing regimens (OAC) with or without aspirin with non-OAC regimens with or without aspirin (No OAC) for patients with recent infarction. The primary endpoint was all-cause mortality. Other endpoints included recurrent infarction, stroke, and major bleeding. We calculated the odds ratio (OR) (fixed effect, OR (Source: The American Journal of Medicine)

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  Nocturia: An Uncommon Presentation of Lower-Limb Lymphedema

We report a case of nocturia as an uncommon presentation of lower-limb lymphedema in a 56-year-old man. To our knowledge, this is the first case reported in the literature. A 56-year-old man was admitted to the Department of Internal Medicine, University of Genova, on May 2008 for progressively worsening edema of the lower limbs. He had a history of nocturia (6-7 voids per night) since February 2007. Laboratory examination showed normal serum creatinine (0.7 mg/dL), urea nitrogen (13 mg/dL), and glucose (68 mg/dL). Urinalysis revealed normal urine pH (5.5), specific gravity (1.020), and osmolarity (750 mOsm/kg), and absence of proteinuria. Microalbuminuria, serum total protein, and albumin levels were in the normal range (20 mg/24 h, 7.2 g/dL, and 4.2 g/dL, respectively). Serum levels of ...

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  Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin.

CONCLUSIONS: When compared with low-molecular-weight heparin, use of the mobile compression device for prophylaxis against venous thromboembolic events following total hip arthroplasty resulted in a significant decrease in major bleeding events. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence. PMID: 20194309 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

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  Response to Ticagrelor in Clopidogrel Nonresponders and Responders and Effect of Switching Therapies. The RESPOND Study.

Conclusions-Ticagrelor therapy overcomes nonresponsiveness to clopidogrel, and its antiplatelet effect is the same in responders and nonresponders. Nearly all clopidogrel nonresponders and responders treated with ticagrelor will have platelet reactivity below the cut points associated with ischemic risk. Clinical Trial Registration-http://www.clinicaltrials.gov. Unique Identifier: NCT00642811. PMID: 20194878 [PubMed - as supplied by publisher] (Source: Circulation)

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  Combination Antiplatelet Therapy for Secondary Stroke Prevention: Enhanced Efficacy or Double Trouble?

Conclusion: Aspirin and clopidogrel combined are associated with more bleeding than aspirin or clopidogrel alone. Summary: Aspirin is effective as an antithrombotic agent for secondary stroke prevention. It reduces the risk of secondary stroke 15% to 20% compared with placebo (BMJ 1994;308:81-106) but fails to prevent many events; therefore, other antithrombotic agents have been investigated for secondary stroke prevention. All antithrombotic agents, however, carry a bleeding risk, and some bleeding episodes are fatal; for example, bleeding associated with antithrombotic agents for secondary prevention leads to higher mortality in patients with acute coronary syndromes (Circulation 2006;114:774-82). In this report the authors sought to compare bleeding risk associated with secondary strok...

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  Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP)—A randomized, open-label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events

Conclusion: The JPPP is the largest primary prevention trial of aspirin in a Japanese population that is investigating whether the benefit of aspirin in reducing risk of vascular events outweighs any bleeding risk in elderly patients with multiple risk factors. (Source: American Heart Journal)

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  Evidence of disparity in the application of quality improvement efforts for the treatment of acute myocardial infarction: The American College of Cardiology's Guidelines Applied in Practice Initiative in Michigan

Conclusions: The GAP program led to significant increases in rates of evidence-based care in both white and nonwhite Medicare patients. However, nonwhite patients received less quality improvement discharge tool and smoking cessation counseling. Policies designed to reduce racial disparities in health care must address disparity in the delivery of quality improvement programs. (Source: American Heart Journal)

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  Clinical relevance of clopidogrel unresponsiveness during elective coronary stenting: Experience with the point-of-care Platelet Function Assay–100 C/ADP

Conclusions: Unresponsiveness to clopidogrel as assessed by the point-of-care test PFA-100C/ADP is an independent major risk factor for thrombotic complications after coronary intervention. (Source: American Heart Journal)

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  The life of patients with thalassemia major.

Authors: Borgna-Pignatti C Andrea wakes up late, because the night before he went to a party with his girlfriend. He disconnects the needle and puts his desferal pump in the drawer. Then he rushes to work: he's a computer designer and his job is quite safe, because it was granted under the law protecting thalassemia patients and other people with medical problems. Nevertheless he does not want to irritate his boss. Besides, in a few days, he will be absent, and work will pile up, as he needs to go to the hospital for his regular blood transfusion. Salvatore does not sleep well. He has a cast on his leg, which makes sleeping difficult. Playing football with his friends he broke a tibia, and it is not a first. Last time it was a rib, jumping from a wall in the countryside. He lost his jo...

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  Pitfalls in salicylate toxicity

We read with great interest the report by Drs Herres, Ryan, and Salzman entitled “Delayed Salicylate Toxicity With Undetectable Initial Levels After Large-dose Aspirin Ingestion” . The authors have uncovered many of the pitfalls that have plagued treatment of aspirin-poisoned patients and make it such a difficult ingestion to treat appropriately. It also brings home the point that salicylate intoxication, like acetaminophen, may seem relatively innocuous in the face of worsening toxicity. (Source: The American Journal of Emergency Medicine)

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  Pancreatic cholangiocarcinoma as an ST-elevation myocardial infarction with thrombolytic therapy

We report the case of a 46-year-old patient who presented a chest pain with ST-segment elevation in precordial leads V1 (2 mm), V2 (4 mm), and V3 (3 mm). Thrombolytic therapy was initiated with the combination tenecteplase tissue plasminogene activator, aspirin, and heparin. Further electrocardiogram and cardiac enzymes measured every 2 hours during the first 24 hours remained normal, and after a computed tomography of the abdomen, the patient was taken to surgery for an exploratory abdominal operation that revealed pancreatic cholangiocarcinoma. No adverse effects were attributed to the initial thrombolytic therapy. Finally, myocardial ischemia was excluded because the electrocardiogram, cardiac enzymes, and a 1-month later cardiac stress test remained normal and because no coronary event...

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  Prescriptions for selective cyclooxygenase-2 inhibitors, non-selective non-steroidal anti-inflammatory drugs, and risk of breast cancer in a population-based case-control study

IntroductionNon-steroidal anti-inflammatory drugs (NSAIDs) prevent the growth of mammary tumours in animal models. Two population-based case-control studies suggest a reduced risk of breast cancer associated with selective cyclooxygenase-2 (sCox-2) inhibitor use, but data regarding the association between breast cancer occurrence and use of non-selective NSAIDs are conflicting. Methods: We conducted a population-based case-control study using Danish healthcare databases to examine if use of NSAIDs, including sCox-2 inhibitors, was associated with a reduced risk of breast cancer. We included 8,195 incident breast cancer cases diagnosed 1991 through 2006 and 81,950 population controls. Results: Overall, we found no reduced breast cancer risk in ever users (>2 prescriptions) of sCox-2 inhibit...

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  ASA: Antiplatelet Tops Aspirin for Secondary Stroke Prevention (CME/CE)

Cilostazol, an antiplatelet agent used in the U.S. to treat intermittent claudication, was better than aspirin at preventing recurrent stroke from noncardiogenic sources, a randomized trial conducted in Japan showed. (Source: MedPage Today Cardiovascular)

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  Resveratrol May Replace Aspirin As Heart Protector; Longevinex® First Branded Resveratrol Pill Successfully Tested During Heart Attack

With the realization that half of the people experiencing a sudden mortal heart attack were taking aspirin on the day of their demise, researchers have begun to search for a more reliable alternative, and they may have found it in a red wine molecule called resveratrol (rez-vair-ah-trawl)... (Source: Cardiovascular / Cardiology News From Medical News Today)

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  Resveratrol May Replace Aspirin As Heart Protector; Longevinex® First Branded Resveratrol Pill Successfully Tested During Heart Attack

With the realization that half of the people experiencing a sudden mortal heart attack were taking aspirin on the day of their demise, researchers have begun to search for a more reliable alternative, and they may have found it in a red wine molecule called resveratrol (rez-vair-ah-trawl). Researchers at the University of Connecticut induced heart attacks in animals and found resveratrol significantly reduces damage to heart muscle. Scarring and fibrosis were limited and the animals survived an otherwise mortal event. Dipak Das, Ph.D., Sc.D... (Source: Health News from Medical News Today)

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  Antiplatelet Drug May Be Better Than Aspirin In Preventing Recurrent Strokes

This study demonstrated for the first time that cilostazol significantly reduces the risk of recurrent ischemic [blood-clot caused] stroke and the incidence of serious cerebral hemorrhage, compared to aspirin," said Yukito Shinohara, M.D... (Source: Health News from Medical News Today)

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  Antiplatelet Drug May Be Better Than Aspirin In Preventing Recurrent Strokes

The antiplatelet drug cilostazol used in the United States to treat leg pain associated with peripheral vascular disease was more effective and safer than aspirin at preventing recurrent strokes in a Japanese trial presented as late-breaking science at the American Stroke Association's International Stroke Conference 2010... (Source: Stroke / Neuroprotection News From Medical News Today)

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  Advisers alter aspirin recommendations

ROCKVILLE, Md., Feb. 26 (UPI) -- U.S. health advisers have altered their advice on using low-dose aspirin to reduce cardiovascular risk, officials said. (Source: Health News - UPI.com)

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  This Day in Science History - February 27 - Aspirin

February 27th could be considered aspirin's birthday. The process to make aspirin was patented in 1900 by Felix Hoffman on behalf of the German pharmaceutical company, Bayer. Hoffman's aspirin was a stable form of acetylsalicylic acid and named in three parts for this active ingredient. The 'A' was from acetyl, 'spir' was from the source of slaicin, the spirea plant, and 'in' was tacked on the end to give it a good pharmacological sounding name. Find out how to make your own aspirin and what else occurred on this day in science history.This Day in Science History - February 27 - Aspirin originally appeared on About.com Chemistry on Saturday, February 27th, 2010 at 00:05:24.Permalink | Comment | Email this (Source: About.com Chemistry)

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  Current Blood Thinners Face Tough Competition

Studies provide more evidence that newcomers hold mettle against warfarin, aspirin Source: HealthDay Related MedlinePlus Pages: Blood Thinners, Stroke (Source: MedlinePlus Health News)

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  Prothrombinase formation at the site of microvascular injury and aspirin resistance: The effect of simvastatin

The production of thrombin is determined by the formation of the prothrombinase complex, which assembles predominantly on activated platelets. Aspirin that suppresses the synthesis of thromboxane A2 (TXA2) has been shown to reduce thrombin formation at the site of injury . We have reported that impaired platelet sensitivity to aspirin, called aspirin resistance, is associated with faster thrombin generation following injury . (Source: Thrombosis Research)

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  The effect of the long term aspirin administration on the progress of atherosclerosis in apoE-/- LDLR-/- double knockout mouse

Conclusion: Our results suggest that endothelial dysfunction with low dose aspirin improved, reduced progression of atherosclerosis in apoE-/- and LDLR-/- double deficient mice and provides a pathophysiological basis for the beneficial effects of aspirin in atherosclerosis, and low doses appeared to be more efficient than high doses. (Source: Thrombosis Research)

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  Cardiologists Comment on Aspirin Versus Resveratrol

FT. LEE, N.J., Feb. 26 /PRNewswire/ -- With the realization that half of the people experiencing a sudden mortal heart attack were taking aspirin on the day of their demise, and the fact that higher-than-recommended doses of aspirin are needed to... (Source: Drugs.com - Clinical Trials)

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  Methylphenidate (Ritalin) and acute myocardial infarction

3 out of 5 stars Acute Myocardial Infarction Related to Methylphenidate for Adult Attention Deficit Disorder.  Thompson J et al.  J Emerg Med 2010;38:18-21. Abstract This case report describes at 27-year-old man who presented to the emergency department with an acute anterolateral myocardial infarction after taking several extra doses of methylphenidate (Ritalin®) prescribed for adult attention deficit disorder, along with pseudoephedrine.  Cardiac catheterization showed normal coronary arteries, inferolateral hypokinesis, and an ejection fraction of 50%.  He was discharged after two days, at which time an echocardiogram showed an ejection fraction of 55% and no wall motion abnormalities.  The authors make the following points: • methylphenidate is a psychostimulant with effects si...

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  Daily aspirin therapy: Understand benefits, risks

Daily aspirin therapy can be lifesaving or life-threatening. Discover if you're a good candidate. (Source: MayoClinic.com Full Feed)

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  Group CBT has sustained benefits for back pain

Group CBT is a low-cost therapy for low-back pain with year-long benefitsRelated items from OnMedicaFalls prevention services are not evidence-basedWomen with small babies can safely wait for labourPay more heed to parent concern over sick childrenPreventative role of aspirin questionedGPs not prescribing enough beta blockers (Source: OnMedica Latest News)

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  Heart failure

New evidence; conclusions changed for: Angiotensin II receptor blockers for diastolic heart failure One RCT added comparing irbesartan versus placebo found no significant difference between irbesartan and placebo in all-cause mortality or in hospital admission for cardiovascular causes at a mean follow-up of 49.5 months. Evidence for effect of irbesartan on hospital admission for cardiovascular disease differs from evidence previously reported for candesartan for this outcome. Effects of angiotensin II receptor blockers as a class in treatment of diastolic heart failure is unclear. Categorisation changed from Likely to be beneficial to Unknown effectiveness. New evidence; conclusion confirmed for: Multidisciplinary intervent...

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  Risk of Venous Thromboembolism in Long-Term Care Residents: What Do We Know Now?

The article by Barbara Zarowitz and colleagues on the risk of venous thromboembolism (VTE) in long-term care (LTC) is a brave attempt to stratify thrombotic risk in LTC. Their systematic review of more than 8 years of data identified a total of 1165 publications relating to VTE and immobility. Rating these publications according to accepted quality criteria resulted in selection of 4 articles relating to thrombotic risk, and 1 article (1 of these 4, actually) relating to immobility. Eight mobility-related statements and 30 VTE risk statements were derived from these articles. The authors' final recommendations (reached by modified Delphi method of analysis of the mobility and VTE risk statements) include baseline thrombotic risk screening on admission; prophylaxis for up to 35 days if high...

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  Resveratrol May Replace Aspirin As Heart Protector; Longevinex® First Branded Resveratrol Pill Successfully Tested During Experimental Heart Attack

With the realization that half of the people experiencing a sudden mortal heart attack were taking aspirin on the day of their demise, researchers have begun to search for a more reliable alternative, and they may have found it in a red wine molecule called resveratrol (rez-vair-ah-trawl). (Source: Pharmaceutical Online News)

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  Aspirin Use in Vascular Disease Patients Assessed

About 70 percent of vascular disease patients take aspirin, mainly for secondary prevention. While some non-aspirin users take other antithrombotic agents, almost 15 percent of patients take no antithrombotic agent at all, according to research published in the Feb. 15 American Journal of Cardiology. (Source: Modern Medicine)

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  Cilostazol in the Management of Atherosclerosis.

Authors: Sallustio F, Rotondo F, Di Legge S, Stanzione P The burden of atherosclerosis is particularly high in western countries in terms of mortality and disability. The cerebral arteries (stroke or transient ischemic attack [TIA]), coronary arteries (myocardial infarction [MI]) and peripheral arteries (intermittent claudication [IC], ischemic limb) can be affected. Atherosclerosis may involve different mechanisms such as inflammation, platelet activation, endothelial damage, balance between proliferation and apoptosis of smooth muscle cells and oxidative stress. Research is focused to counteract each of these aspects. Many antithrombotic drugs are currently available and most of them act as inhibitors of platelet function. Aspirin, ticlopidine, clopidogrel and the combination of aspi...

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  Rethinking an Aspirin-a-Day

New Federal Guidelines Say Many Now Taking It Daily to Try to Lower Cardiac Risk Shouldn't, Due to Intestinal Bleeding Risk (Source: Health News: CBSNews.com)

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  Treatment of Coagulopathy in Intracranial Hemorrhage

Opinion statement  Intracranial hemorrhage (ICH) complicated by coagulopathy is a medical emergency, which can delay neurosurgical intervention, lead to larger hematoma size, and increase mortality until the coagulopathy is corrected. Prompt recognition of coagulopathy during ICH is essential for correct, rapid treatment to reduce ongoing bleeding and improve survival. The proper treatment of a coagulopathic ICH patient is centered on rapid identification of the coagulopathic defect and correction of the underlying coagulopathy to stop acute bleeding. Patients with coagulopathic ICH require admission to a neuro-intensive unit care with management of airway, oxygenation, and systemic arterial and cerebral perfusion pressure; optimization of serum glucose; aggressive treatmen...

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  EXCEDRIN (Acetaminophen, Aspirin (Nsaid) And Caffeine) Tablet, Film Coated [Novartis Consumer Health, Inc.]

Updated Date: Feb 24, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  EXCEDRIN (Acetaminophen, Aspirin And Caffeine) Tablet, Film Coated [Novartis Consumer Health, Inc.]

Updated Date: Feb 24, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Drug Interaction Between Clopidogrel and Proton Pump Inhibitors

Pharmacotherapy 30(3): 275-289 Abstract Proton pump inhibitors (PPIs) have been recommended for reducing the risk of gastrointestinal bleeding associated with dual antiplatelet therapy (aspirin plus clopidogrel). However, studies have found decreased efficacy of clopidogrel when concurrently administered with a PPI. To determine the mechanism of and evidence for the potential interaction between clopidogrel and PPIs, along with the clinical implications of this drug interaction, we reviewed recently published reports of trials that examined the interaction. A MEDLINE database search (1966-September 2009) for English-language reports of clinical trials in human subjects was performed, supplemented by a manual search of reference lists. Four trials that examined surrogate outcomes and eight ...

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  Dilated Cardiomyopathy and Role of Antithrombotic Therapy.

CONCLUSIONS:: To date, there is no agreement on appropriate antithrombotic treatment (if any) for primary thromboembolism prophylaxis in patients with dilated cardiomyopathy with sinus rhythm. In recent years, several promising prospective trials were terminated prematurely due to inadequate enrollment. The Warfarin Aspirin-Reduced Cardiac Ejection Fraction trial may provide evidence regarding the use of anticoagulation for patients with decreased myocardial function. PMID: 20186041 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

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  Effect of Combined Aspirin and Extended-Release Dipyridamole Versus Clopidogrel on Functional Outcome and Recurrence in Acute, Mild Ischemic Stroke. PRoFESS Subgroup Analysis.

CONCLUSIONS: Treatment with combined Asp/ER-DP vs clopidogrel in 1360 patients with acute, mild ischemic stroke did not differ in terms of effects on functional outcome, recurrence, death, bleeding, or serious adverse events. Both treatments were practical to administer. PMID: 20181679 [PubMed - as supplied by publisher] (Source: Stroke)

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  Antithrombotic activity of F 16618, a new PAR1 antagonist evaluated in extracorporeal arterio-venous shunt in the rat.

In conclusion, F 16618 exerted a potent antithrombotic activity by intravenous and oral routes, without affecting bleeding time. Furthermore, the antithrombotic activity was potentiated when combined with aspirin or clopidogrel. PMID: 20188709 [PubMed - as supplied by publisher] (Source: Biochemical Pharmacology)

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  Cleveland Medical Malpractice Attorney Obtains Settlement in Wrongful Death Case

NASA engineer dies after instructions to stop taking Plavix® and Aspirin for elective colonoscopy. Cleveland medical malpractice attorney (http://medical-malpractice.spanglaw.com/) nets settlement for widow. (PRWeb Feb 23, 2010) Read the full story at http://www.prweb.com/releases/top-medical-malpractice/attorneys-cleveland-ohio/prweb3611524.htm (Source: PRWeb: Medical Pharmaceuticals)

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  Women Warned Aspirin Reports May Be Misleading

Recent research from the US suggests women who have been diagnosed with breast cancer may benefit from taking aspirin but the National Prescribing Service (NPS) warns people to talk to their health professional before self-medicating. The study, published in the Journal of Clinical Oncology, has received significant media attention, with some reports suggesting aspirin could be a miracle treatment... (Source: Health News from Medical News Today)

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  Women Warned Aspirin Reports May Be Misleading

Recent research from the US suggests women who have been diagnosed with breast cancer may benefit from taking aspirin but the National Prescribing Service (NPS) warns people to talk to their health professional before self-medicating... (Source: Breast Cancer News From Medical News Today)

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  Herbal products may pose danger for heart patients

3 out of 5 stars Use of Herbal Products and Potential Interactions in Patients with Cardiovascular Diseases. Tachjian A et al.  J Am Coll Cardiol Feb 9, 2010;55:515-25. Abstract Use of unregulated herbal remedies is common and increasing dramatically among patients also taking prescription medicines. Unfortunately, these herbal products can have detrimental effects of their own, as well as potential interactions with other medications.  This review, form the Mayo Clinic, searched PubMed and Medline databases for the years 1966 to 2009 to identify medical literature related to herbs and cardiovascular disease. Among the authors’ findings: • Many herbal products can potentially increase bleeding, especially in patients on warfarin, aspirin, and anti-platelet drugs.  Such herbal pr...

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  Baseline Characteristics of the Nateglinide and Valsartan Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial Population: Comparison with Other Diabetes Prevention Trials

In conclusion, the NAVIGATOR study comprises prediabetic subjects who typically have concurrent BP and metabolic disturbances and an enhanced risk of CVD, and are thus at higher risk for cardiovascular events than subjects in previous DM prevention trials. (Source: Cardiovascular Therapeutics)

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  Modulation of stress genes expression profile by nitric oxide-releasing aspirin in Jurkat T leukemia cells.

In this study, DNA oligo arrays with 263 genes were used to examine the gene expression profiles relating to stress and drug metabolism, and characterize the stress responses at IC(50) and subIC(50) concentrations of p-NO-ASA (20 and 10muM, respectively) in Jurkat T cells. A total of 22 genes related to heat shock response, apoptosis signaling, detoxifiers and Phase II enzymes, and regulators of cell growth were altered in expression by array analysis based on the expression fold change criteria of >/=1.5-fold or </= 0.65 -fold. Real time quantitative RT-PCR confirmed that 20muM p-NO-ASA strongly upregulated the mRNA levels of two heat shock genes HSPA1A (41.5+/-7.01-fold) and HSPA6 (100.4+/-8.11-fold), and FOS (16.2+/-3.2-fold), moderately upregulated HSPH1 (1.71+/-0.43-fold), FMO4 ...

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  Why every man should carry a giant chewy aspirin

When Chris Atkinson felt a searing pain in his chest, he knew straight away what was wrong. Then Chris remembered he had an aspirin in his car. (Source: the Mail online | Health)

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