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| http://dx.doi.org/10.1016/j.jacc.2016.02.023 | DOI Listing |
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PCISOS Risk Profiles Stratify Heterogeneous Outcomes in Minor Posterior Circulation Ischemic Stroke: A Post Hoc Analysis of the CHANCE-2 Trial.
Stroke
September 2025
Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University.
Background: Risk stratification in posterior circulation ischemic stroke (PCIS) is challenging. Although the Posterior Circulation Ischemic Stroke Outcome Score (PCISOS) was developed to address this, its utility in minor PCIS and in identifying homogeneous populations for clinical trials or treatment-responsive subgroups remains uncertain.
Methods: CHANCE-2 (Clopidogrel in High-Risk Patients With Acute Non-disabling Cerebrovascular Events-II) was a multicenter, randomized trial that enrolled patients with minor stroke or high-risk transient ischemic attack who carried CYP2C19 loss-of-function alleles.
Myocardial infarction with nonobstructive coronary arteries associated with blood transfusion in a young woman: A case report.
Medicine (Baltimore)
September 2025
Department of Cardiology, Jining Key Laboratory of Metabolic Cardiovascular Diseases, Institute of Cardiovascular Diseases of Jining Medical Research Academy, Jining No. 1 People's Hospital, Jining, Shandong, China.
Rationale: Myocardial infarction with nonobstructive coronary arteries (MINOCA) has diverse ischemic etiologies and has been defined by the absence of angiographically significant obstructive coronary artery disease. Blood transfusion has seldom been reported as a precipitating factor for MINOCA. Here, we present a rare case of transfusion-associated MINOCA in a young woman without underlying chronic conditions, aiming to raise clinical awareness of this uncommon yet important phenomenon and to explore its potential pathophysiological mechanisms.
View Article and Find Full Text PDFImproved Platelet Inhibition with Ticagrelor when compared to Clopidogrel in Peripheral Artery Disease Patients.
J Vasc Surg
August 2025
Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:
Background: Clopidogrel and Ticagrelor are well-known antiplatelet drugs that inhibit P2Y12 receptors. Though Clopidogrel is currently the standard of care for Peripheral Artery Disease (PAD), 25% of patients are known to exhibit drug resistance due to genetic variability. Ticagrelor presents an alternative with reduced susceptibility to genetic variations and has demonstrated superior outcomes in Acute Coronary Syndromes.
View Article and Find Full Text PDFBackground: Based on the landmark PLATO (Platelet Inhibition and Patient Outcomes) and TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction) trials, current guidelines recommend ticagrelor and prasugrel over clopidogrel for acute coronary syndrome. However, subsequent studies have failed to replicate the reported benefits of ticagrelor, raising concerns about the validity of the PLATO trial's findings.
Methods: Randomized trials published until January 2025 were searched on PubMed and Embase and included if they compared 2 of the 3 standard dual antiplatelet therapies: 12 months aspirin plus clopidogrel, prasugrel, or ticagrelor.
Antiplatelet Monotherapies for Long-Term Secondary Prevention Following Percutaneous Coronary Intervention.
J Clin Med
August 2025
Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
In patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), antiplatelet therapy is the cornerstone of treatment for secondary prevention. Although dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y inhibitor is the current standard of care, being, respectively, recommended for 6 and 12 months in patients with chronic and acute coronary syndrome without a need for oral anticoagulation, the continuous improvement in PCI technology and pharmacology have significantly reduced the need for long-term DAPT. Mounting evidence supports the administration of P2Y inhibitor monotherapy, particularly ticagrelor, after a short period of DAPT following PCI as a strategy to reduce bleeding without a trade-off in ischemic events compared to standard DAPT.
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