scholarly journals Clopidogrel: An Original Drug or a Generic?

Doctor Ru ◽  
2020 ◽  
Vol 19 (11) ◽  
pp. 17-21
Author(s):  
A.V. Andreeva ◽  
◽  
E.V. Filippov ◽  
◽  
Keyword(s):  
Myocardial Infarction ◽  
Observational Studies ◽  
Therapeutic Equivalence ◽  
Key Points ◽  
Final Confirmation

Objective: To analyse studies assessing the therapeutic equivalence of the original Clopidogrel and its generics. Key Points. Most studies assessing the therapeutic equivalence (impact on the platelets aggregation and the risk of myocardial infarction) of the original Clopidogrel and its generics demonstrated their interchangeability. Still, most of the results were generated in small observational studies, therefore they are not reliable enough. Conclusion. For the final confirmation of the therapeutic equivalence of the Clopidogrel and its generics, larger studies are required. Keywords: Clopidogrel, original drug, generic, therapeutic equivalence.

scholarly journals Clinical and pathogenetic features of myocardial infarction in patients with atrial fibrillation

2020 ◽  
pp. 31-39
Author(s):  
S.Y. Borodashkina ◽  
◽  
K.V. Protasov ◽  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Observational Studies ◽  
Risk Group ◽  
Clinical Manifestations ◽  
High Risk Group ◽  
Short Term ◽  
Invasive Treatment ◽  
Long Term Prognosis

Patients with myocardial infarction (MI) and atrial fibrillation (AF), the number of which is progressively increasing every year, make up a high-risk group for both recurrent cardiovascular events and bleeding; they require special attention from clinicians. The literature review provides data on features of pathogenesis and clinical manifestations of MI in patients with AF. The analysis of data on AF effect observational studies on short-term and long-term prognosis in patients with myocardial infarction was carried out. Mechanisms of occurrence, clinical features and prognostic value of postinfarction AF are considered. From the standpoint of modern clinical guidelines, information is presented on features of MI invasive treatment in combination with AF. Algorithms of anticoagulant and antiarrhythmic therapy in patients of this category are considered.

scholarly journals Actual Role of Platelet Glycoprotein IIb/IIIa Receptor Inhibitors as Adjunctive Pharmacological Therapy to Primary Angioplasty in Acute Myocardial Infarction: In the Light of Recent Randomized Trials and Observational Studies with Bivalirudin

2010 ◽  
Vol 4 (1) ◽  
pp. 135-145 ◽  
Author(s):  
Osmar Antonio Centurión
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Unfractionated Heparin ◽  
Observational Studies ◽  
Randomized Trials ◽  
Pharmacological Therapy ◽  
Bleeding Complications ◽  
Primary Pci ◽  
Therapeutic Benefits ◽  
Ischemic Complications

Strategies for preventing ischemic complications during percutaneous coronary interventions (PCI) in the setting of acute myocardial infarction (AMI) have focused on the platelet surface-membrane glycoprotein (GP) IIb/IIIa receptor. The platelet GP IIb/IIIa receptor inhibitors, by blocking the final common pathway of platelet aggregation, have become a breakthrough in the management of acute coronary syndromes. Current adjuvant pharmacological therapy of AMI with aspirin, clopidogrel, unfractionated heparin (UH), and platelet GP IIb/IIIa inhibitors provides useful therapeutic benefits. Although the use of more potent antithrombin and antiplatelet agents during PCI in AMI has reduced the rate of ischemic complications, in parallel, the rate of bleeding has increased. Several studies have reported an association between bleeding after PCI and an increase in morbidity and mortality. Therefore, investigational studies have focused in pharmacological agents that would reduce bleeding complications without compromising the rate of major adverse cardiovascular events. Based on the results of several randomized trials, abciximab with UH, aspirin and clopidogrel have become a standard adjunctive therapy with primary PCI for AMI. However, some of the trials were done before the use of stents and the widespread use of thienopyridines. In addition, GP IIb/IIIa inhibitors use have been associated with thrombocytopenia, high rates of bleeding, and the need for transfusions, which increase costs, length of hospital stay, and mortality. On the other hand, in the stent era, bivalirudin, a semi-synthetic direct thrombin inhibitor, has recently been shown to provide similar efficacy with less bleeding compared with unfractionated heparin plus platelet GP IIb/IIIa inhibitors in AMI patients treated with primary PCI. The impressive results of this recent randomized trial and other observational studies make a strong argument for the use of bivalirudin rather than heparin plus GP IIb/IIIa inhibitors for the great majority of patients with AMI treated with primary PCI. However, some controversial results and limitations in the studies with bivalirudin exert some doubts in the future widespread use of this drug.

Association between blood vitamin D and myocardial infarction: A meta-analysis including observational studies

2017 ◽  
Vol 471 ◽  
pp. 270-275 ◽  
Author(s):  
Jizhen Huang ◽  
Zhiwei Wang ◽  
Zhipeng Hu ◽  
Wanli Jiang ◽  
Bowen Li
Keyword(s):  
Myocardial Infarction ◽  
Vitamin D ◽  
Observational Studies ◽  
Meta Analysis

scholarly journals Efficacy and Safety of Direct Oral Anticoagulants in Patients with Diabetes and Nonvalvular Atrial Fibrillation: Meta-Analysis of Observational Studies

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Bo Cao ◽  
Xingcan Yao ◽  
Lifang Zhang ◽  
Xiaobo Hu ◽  
Min Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Observational Studies ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Nonvalvular Atrial Fibrillation ◽  
Patients With Diabetes

Background. This meta-analysis was performed to compare the efficacy and safety of direct oral anticoagulants (DOACs) with vitamin K antagonists (VKAs) for stroke prevention in real-world patients with diabetes and nonvalvular atrial fibrillation (NVAF) through observational studies. Methods. PubMed, Embase, and Web of Science databases were searched up to August 2020 for eligible studies. Outputs were presented as risk ratios (RRs) and corresponding 95% confidence intervals (CIs) by using a random-effect model. Results. Seven observational studies involving 249,794 diabetic NVAF patients were selected. Compared with VKAs, the use of DOACs was associated with significantly reduced risks of stroke ( RR = 0.56 , 95% CI 0.45-0.70; p < 0.00001 ), ischemic stroke ( RR = 0.61 , 95% CI 0.48-0.78; p < 0.0001 ), stroke or systemic embolism (SSE) ( RR = 0.81 , 95% CI 0.68-0.95; p = 0.01 ), myocardial infarction ( RR = 0.69 , 95% CI 0.55-0.88; p = 0.002 ), major bleeding ( RR = 0.75 , 95% CI 0.63-0.90; p = 0.002 ), intracranial hemorrhage ( RR = 0.50 , 95% CI 0.44-0.56; p < 0.00001 ), and major gastrointestinal bleeding ( RR = 0.77 , 95% CI 0.62-0.95; p = 0.02 ), and a borderline significant decrease in major adverse cardiac events ( RR = 0.87 , 95% CI 0.75-1.00; p = 0.05 ) in NVAF patients with diabetes. Conclusion. For patients with NVAF and diabetes in real-world clinical settings, DOACs showed superior efficacy and safety profile over VKAs and significantly reduced risks of stroke, ischemic stroke, SSE, myocardial infarction, major bleeding, intracranial hemorrhage, and major gastrointestinal bleeding.

scholarly journals A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

2020 ◽  
Author(s):  
Debmalya Barh ◽  
Sandeep Tiwari ◽  
Bruno Silva Andrade ◽  
Marianna E. Weener ◽  
Aristóteles Góes-Neto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Observational Studies ◽  
Congenital Disorders ◽  
Comorbid Conditions ◽  
Short Term ◽  
Bidirectional Relationship ◽  
Long Term Consequences ◽  
Clinical Pictures ◽  
Kidney Liver

ABSTRACTTill date the comprehensive clinical pictures, comorbid conditions, and long-term complications of COVID-19 are not known. Recently using a multi-omics-based strategy, we have predicted the drugs for COVID-19 management with ∼70% accuracy. Here, using a similar multi-omics-based bioinformatics approach and three-ways of analysis, we identified the symptoms, comorbid conditions, and short, mid and possible long-term complications of COVID-19 with ∼90% precision. In our analysis (i) we identified 27 parent, 170 child, and 403 specific conditions associated with COVID-19. (ii) Among the specific conditions, 36 are viral and 53 short-term, 62 short to mid to long-term, 194 mid to long-term, and 57 are congenital conditions. (iii) At a cut off “count of occurrence” of 4, we found ∼ 90% of the enriched conditions are associated with COVID-19. (iv) Except the dry cough and loss of taste, all other COVID-19 associated mild and severe symptoms are enriched. (v) Cardiovascular, pulmonary, metabolic, musculoskeletal, neuropsychiatric, kidney, liver, and immune system disorders are found as top comorbid conditions. (vi) Specific diseases such as myocardial infarction, hypertension, COPD, lung injury, diabetes, cirrhosis, mood disorders, dementia, macular degeneration, chronic kidney disease, lupus, arthritis etc. along with several other diseases are also enriched as top candidates. (vii) Interestingly, many cancers and congenital disorders associated with COVID-19 severity are also identified. (viii) Arthritis, dermatomyositis, glioma, diabetes, psychiatric disorder, cardiovascular diseases having bidirectional relationship with COVID-19 are also found as top ranked conditions. Based on the accuracy (∼90%) of this analysis, long presence of SARS-CoV-2 RNA in human, and our previously proposed “genetic remittance” assumption, we hypothesize that all the identified comorbid conditions including the short-long-mid and mid-long non-communicable diseases (NCDs) could also be long-term consequences in COVID-19 survivors and warrants long-term observational studies.

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