Is There a Need for “Triple Therapy”? Role of Anticoagulation with Dual Antiplatelet Therapy in Acute Coronary Syndromes (ATLAS Study &amp; TRAP Study)

Patrick, William L.; Patel, Charmaine; Guddeti, Raviteja; Narayan, Aarti; Maddaleni, Michael; Kumar, Shankar; Dolma, Kalsang; Serla, Vishnu Vardhan; Sangha, Maheep; Govindavarjhulla, Aditya; Saddala, Prashanth; Singh, Priyamvada; Halaby, Rim; Gibson, C. Michael

doi:10.1007/s11886-013-0411-1

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…Besides, the major risk factor for fatal cardiovascular disease is elevated blood cholesterol. Therefore, dual antiplatelet therapy (DAPT) and hypolipemic drugs provided evidence to be a good therapeutic option for patients with ACS 9 . Several advantages have been demonstrated for the use of fixed‐dose combination (FDC) in cardiovascular diseases, such as reduction in cost, adverse effects and dose, improved patient compliance, and medication adherence.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, dual antiplatelet therapy (DAPT) and hypolipemic drugs provided evidence to be a good therapeutic option for patients with ACS. 9 Several advantages have been demonstrated for the use of fixed-dose combination (FDC) in cardiovascular diseases, such as reduction in cost, adverse effects and dose, improved patient compliance, and medication adherence. Multidrug therapy with ASP, CLP, and ATV or ROS has been suggested as a therapeutic strategy to reduce cardiovascular risk.…”

Section: Introductionmentioning

confidence: 99%

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A novel eco‐friendly methods for simultaneous determination of aspirin, clopidogrel, and atorvastatin or rosuvastatin in their fixed‐dose combination using chemometric techniques and artificial neural networks

AlSawy¹,

Elkady

Mostafa

2023

Journal of Chemometrics

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In this study, the simultaneous determination of aspirin, clopidogrel, and either atorvastatin or rosuvastatin in their fixed‐dose combination (FDC) formulations has been reported. As a straightforward substitute for employing distinct models for each component, UV spectrophotometry was applied with chemometric approaches and artificial neural networks to achieve this. Three chemometric techniques, including principal component regression (PCR), partial least‐squares (PLS), and classical least‐squares (CLS), were applied in addition to the radial basis function‐artificial neural network (RBF‐ANN). The validation of a set of laboratory‐prepared combinations of aspirin, clopidogrel, and atorvastatin in one ternary mixture and aspirin, clopidogrel, and rosuvastatin in a second ternary mixture was assessed, and the results from the use of these approaches were recorded and compared. The absorbance data matrix matching the concentration data matrix in CLS, PCR, and PLS was created using measurements of absorbances in the range of 250–280 nm at intervals of 0.2 nm in their zero‐order spectra. Then, in order to forecast the unknown concentrations, calibration or regression was created utilizing the concentration and absorbance data matrices. Using RBF‐ANN for the simultaneous determination of aspirin, clopidogrel, and atorvastatin or rosuvastatin in their formulations was achieved by providing the input layer with 151 neurons; there are 2 hidden layers and 3 output neurons were obtained. The green profile of the developed methods has been assessed and compared with previously reported spectrophotometric methods. The suggested techniques were effectively applied to FDC dosage forms that contained the cited medications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A novel eco‐friendly methods for simultaneous determination of aspirin, clopidogrel, and atorvastatin or rosuvastatin in their fixed‐dose combination using chemometric techniques and artificial neural networks

AlSawy¹,

Elkady

Mostafa

2023

Journal of Chemometrics

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“…Patients treated with dual antiplatelet therapy, as well as anticoagulation (so-called "triple therapy"), have an excess risk of major bleeding beyond 10 % per year, 56,57 While there is guidance from multiple groups on the management of these patients, until recently, there have been little randomized, controlled data. [58][59][60] Warfarin is effective post-ACS at decreasing recurrent myocardial infarction from a meta-analysis of nearly 6,000 patients treated without stents, but at an increased rate of bleeding. 61 to a P2Y12 inhibitor versus standard triple therapy.…”

Section: How To Address Triple Therapymentioning

confidence: 99%

Controversies in Antiplatelet and Anticoagulation Therapy in Patients Presenting with Acute Coronary Syndrome

Phillips¹,

Gavin²

2017

US Cardiology Review

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Multiple, large-scale pharmaceutical and device trials have greatly improved the outcomes of patients with acute coronary syndrome (ACS). The expanding arsenal of antiplatelets, anticoagulants, and coronary stents has simultaneously generated debate over how to best optimize ischemic outcomes while mitigating bleeding risk for individual patients. This manuscript reviews the data supporting current practice, and highlights areas where the data are weak and controversies abound. After introducing the background and pathophysiology of patients presenting with ACS, five clinical controversies relevant to the everyday care of the ACS patient are discussed: (1) choice initial antiplatelet and anticoagulant combination; (2) decision to start second oral antiplatelet before or after coronary angiography; (3) transition between antiplatelets; (4) duration of dual antiplatelet therapy; and (5) management of patients on oral anticoagulants.

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“…Несмотря на соблюдение оптимальной двойной антиагрегантной терапии и вазопротекции, у 10-12 % пациентов в течение года после ЧКВ случается атеротроматоз. Эта ситуация в литературе названа «клиническая резистентность к антиагрегантам» [8,15,24]. Проблема резистентности определяется рядом факторов, включая гиперреактивность тромбоцитов, которая ставит вопрос о необходимости введении третьего антиагреганта [9,24].…”

Section: Introductionunclassified

“…Эта ситуация в литературе названа «клиническая резистентность к антиагрегантам» [8,15,24]. Проблема резистентности определяется рядом факторов, включая гиперреактивность тромбоцитов, которая ставит вопрос о необходимости введении третьего антиагреганта [9,24]. Одним из способов решения проблемы резистентности является поиск нового соединения, обладающего широким спектром действия на различные типы рецепторов тромбоцитов.…”

Section: Introductionunclassified

Effect of Notrombel on systemic hemodynamics and thrombin tolerance in the in vivo experiment

Sonin

Dement’eva

Чефу

2017

Regional blood circulation and microcirculation

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Objectives. The aim of the study was to investigate of the effect of administration of Notrombel, (one of the representatives of a new class of compounds, N,N'-substituted piperazines), on systemic hemodynamics and thrombin tolerance. Material and methods. The effect of daily intragastric administration for 14 days of Notrombel (0.01 mM/kg) and ASA (0.01 mM/kg) on the risk of spontaneous hemorrhages and thrombin tolerance (intravenous bolus thrombin administration at a dose of 50 units NIH/kg) was studied in male Wistar rats. The number of circulating platelets was determined before and 5 minutes after thrombin administration. The concentration of fibrinogen after 30 min was determined by the gravimetric method according to Rutberg R. A. Results. With the daily intragastric administration of Notrombel and ASA, spontaneous hemorrhages and increased bleeding were not observed. Blood pressure and heart rate did not differ from the control animals. Intravenous administration of thrombin caused thrombocytopenia and hypofibrinogenemia in all experimental animals. The severity of hypofibrinogenemia after thrombin administration was significantly less in rats treated with Notrombel (0.01 mM/kg) and ASA (0.01 mM/kg) than in the control group. There were no differences between Notreblel and ASA groups. Conclusions. Daily intragastric administration of Notrombel and ASA for 14 days did not cause spontaneous hemorrhages and were not associated with any adverse hemodynamic effect. Both Notrombel and ASA increased tolerance to thrombin. These data broaden the currently available knowledge related to the antithrombotic action of Notrombel.

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Is There a Need for “Triple Therapy”? Role of Anticoagulation with Dual Antiplatelet Therapy in Acute Coronary Syndromes (ATLAS Study & TRAP Study)

Cited by 7 publications

References 26 publications

A novel eco‐friendly methods for simultaneous determination of aspirin, clopidogrel, and atorvastatin or rosuvastatin in their fixed‐dose combination using chemometric techniques and artificial neural networks

A novel eco‐friendly methods for simultaneous determination of aspirin, clopidogrel, and atorvastatin or rosuvastatin in their fixed‐dose combination using chemometric techniques and artificial neural networks

Controversies in Antiplatelet and Anticoagulation Therapy in Patients Presenting with Acute Coronary Syndrome

Effect of Notrombel on systemic hemodynamics and thrombin tolerance in the in vivo experiment

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