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Antiplatelet therapy is extensively used in the primary and secondary prophylaxis of arterial thrombotic disorders. Aspirin, the most commonly used antiplatelet agent, is a cyclooxygenase-1 inhibitor and considered a mild to moderate inhibitor of platelet function. Therefore, often a second antiplatelet agent is necessary in certain clinical conditions requiring greater inhibition of platelet function. An adenosine diphosphate (ADP) receptor, P2Y12, is an important target for this purpose; several agents inhibit this receptor providing potent antiplatelet effect. One of the side effects of these agents is bleeding, which in some patients may require reversal of antiplatelet effect. Similarly, patients undergoing emergent surgeries may benefit from reversal of antiplatelet effect to avoid excessive surgical bleeding. This article reviews current literature on this topic.
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http://dx.doi.org/10.1016/j.tmrv.2019.01.002 | DOI Listing |
Heart
September 2025
Department of Cardiology, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
Objective: The impact of off-label underdosing of direct oral anticoagulants (DOACs) on clinical outcomes in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) remains unclear.
Methods: The EPIC-CAD trial (Edoxaban vs Edoxaban with antiPlatelet agent In patients with atrial fibrillation and Chronic stable Coronary Artery Disease) randomised patients with AF and stable CAD to receive either edoxaban monotherapy or dual antithrombotic therapy (edoxaban plus single antiplatelet agent). Off-label underdosing was defined as low-dose edoxaban (30 mg once daily) without standard criteria for dose reduction.
Aim To analyze the efficacy and cost-effectiveness of various options of antithrombotic therapy in patients with type 2 diabetes mellitus (T2DM) after acute coronary syndrome (ACS), based on the results of a one-year follow-up.Material and methods The article presents features of various antithrombotic therapies in patients with T2DM after ACS from the standpoint of efficacy and cost-effectiveness in real clinical practice based on the materials of the ORACLE II open prospective observational study (2014-2017). The data of 368 patients were divided into three groups based on the selected antithrombotic therapy.
View Article and Find Full Text PDFDrug Des Devel Ther
September 2025
Department of Anesthesiology, The Affiliated Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China.
Background: Emergence delirium (ED) is a common postoperative complication during the recovery period in pediatric anesthesia. Continuous intravenous infusion of remimazolam can effectively prevent the occurrence of ED. However, the optimal dose for preventing ED in pediatric patients remains unclear.
View Article and Find Full Text PDFBMC Pulm Med
September 2025
Division of Cellular Pneumology, Priority Area Infections, Research Center Borstel, Leibniz Lung Center, Borstel, 23845, Germany.
Background: Volatile anesthetics are gaining recognition for their benefits in long-term sedation of mechanically ventilated patients with bacterial pneumonia and acute respiratory distress syndrome. In addition to their sedative role, they also exhibit anti-bacterial and anti-inflammatory properties, though the mechanisms behind these effects remain only partially understood. In vitro studies examining the prolonged impact of volatile anesthetics on bacterial growth, inflammatory cytokine response, and surfactant proteins - key to maintaining lung homeostasis - are still lacking.
View Article and Find Full Text PDFFew reports exist in dentistry about the use of general anesthesia in children after liver transplant. In this paper, we report our experience utilizing general anesthesia for oral surgery in a 9-year-old girl who had undergone living donor liver transplantation. She was diagnosed with hepatoblastoma at 4 months of age and underwent a living donor liver transplant at 7 months of age.
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