clopidogrel/aspirin / Generic mfg. - LARVOL DELTA

Clinical outcomes with the use of aspirin versus clopidogrel as a combination therapy with direct oral anticoagulant after coronary stent implantation in patients with atrial fibrillation. (PubMed, Eur Heart J Cardiovasc Pharmacother) - "In patients with AF receiving double antithrombotic therapy after PCI, aspirin and clopidogrel showed similar efficacy and safety when used in combination with DOAC."

Clinical data • Journal • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Ischemic stroke • Myocardial Infarction

Safety of Ticagrelor Use in Elective Endovascular Treatment of Unruptured Intracranial Aneurysms. (PubMed, Neurosurgery) - "The use of DAPT with aspirin and ticagrelor seems to be a safe alternative to clopidogrel for unruptured aneurysm embolization using intracranial stent."

Journal • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Vascular Neurology

Aspirin Plus Clopidogrel Reduces Infection Risk Compared With Aspirin or Clopidogrel Alone in Acute Ischemic Stroke. (PubMed, Clin Ther) - "Dual antiplatelet therapy with aspirin and clopidogrel is associated with decreased infection after stroke compared with aspirin or clopidogrel monotherapy. The findings support the net protective effect of aspirin and clopidogrel against poststroke infection."

Journal • Cardiovascular • Infectious Disease • Ischemic stroke • Pneumonia • Respiratory Diseases

Dual antiplatelets therapy prescription trends and mortality outcomes among senior citizens with acute coronary syndrome: insights from the Malaysian National Cardiovascular Disease Database. (PubMed, J Geriatr Cardiol) - "Despite the optimal prescription rate and variation of DAPT in the older Malaysian population, there is room for investigation and improvement in the prescription of newer DAPT combinations that have been suggested to improve patient survival."

Journal • Acute Coronary Syndrome • Cardiovascular • Hypertension • Obesity • Pulmonary Disease • Respiratory Diseases

Evaluation of Bleeding Time after Dental Extractions during Uninterrupted Single or Dual Antiplatelet Treatment - A Comparative Study. (PubMed, Ann Maxillofac Surg) - "The antiplatelet agents assessed were aspirin, clopidogrel, ticagrelor and a combination of aspirin with clopidogrel and ticagrelor. Simple extraction can be undertaken safely in patients under single antiplatelet therapy, considering that local haemostatic measures are available for use in the setup to control bleeding if necessary. Patients under DAPT are better managed if the therapy is altered, as there was a definite increase in bleeding time in patients under DAPT after extraction."

Journal

The Prevalence of CYP2C19 Polymorphism in Patients with Symptomatic Intracranial Atherosclerosis. (PubMed, Cerebrovasc Dis Extra) - "Almost one-half of Thai symptomatic intracranial stenosis patients were intermediate or poor metabolizers. Usage of combination of aspirin and clopidogrel might not be effective in this group of patients."

Journal • Atherosclerosis • Cardiovascular • Ischemic stroke • CYP2C19

Selective Serotonin Reuptake Inhibitors and Bleeding Risk in the Geriatric Population. (PubMed, Innov Clin Neurosci) - "This risk is accentuated when SSRIs are combined with antiplatelet drugs and nonsteroidal anti-inflammatory drugs (NSAIDs), the highest risk being observed with use of a combination of aspirin, clopidogrel, and SSRIs. These findings emphasize the need for tailored medication management, vigilant monitoring, and a patient-centered approach in prescribing antidepressants to geriatric patients. Balancing mental healthcare with potential bleeding risks is paramount in the evolving landscape of geriatric mental health."

Journal • Review • CNS Disorders • Depression • Gastroenterology • Gastrointestinal Disorder • Geriatric Disorders • Psychiatry

A comparison of the effects of ticagrelor and clopidogrel in patients with acute ST-segment elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials. (PubMed, BMC Pharmacol Toxicol) - "Ticagrelor decreased the chance of mortality, re-infarction, stroke, and MACE in post-STEMI patients compared to clopidogrel. But there was no difference in the chance of major bleedings (BARC ≥ 3) and improvement in TIMI grade flow between these two drugs. However, none of these findings were statistically significant, and more studies are needed to reach definitive results."

Clinical • Journal • Retrospective data • Review • Acute Coronary Syndrome • Atherosclerosis • Cardiovascular • Myocardial Infarction

Assessing the Utility of the DAPT Score and PRECISE-DAPT Score in Determining the Appropriateness of Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction/Percutaneous Coronary Intervention. (PubMed, Cardiol Res Pract) - "The widely prescribed DAPT combination was aspirin with clopidogrel (72.3% at discharge and 46% on current use). The incidence of bleeding events was observed to be 7.23%, among which 5.1% had Type 1 bleeding according to BARC. Both DAPT and PRECISE-DAPT scores could be used to determine the appropriateness of the recommendations of DAPT in patients with AMI or undergoing PCI."

Journal • Cardiovascular • Diabetes • Hematological Disorders • Hypertension • Metabolic Disorders • Myocardial Infarction

Aspirin-clopidogrel combination therapy for ischemic stroke patients: Clinical efficacy and cost-effectiveness analyses in low-resource setting. (PubMed, Narra J) - "These results suggest that combination therapy might be a favorable alternative for managing ischemic stroke, presenting a viable option for consideration in clinical practice. The findings underscore the potential economic and clinical advantages of employing the aspirin-clopidogrel combination in routine stroke management protocols."

Combination therapy • Cost effectiveness • HEOR • Journal • Observational data • Cardiovascular • Ischemic stroke

Aspirin and Ticagrelor Versus Aspirin and Clopidogrel or Pasugrel and the Effect on Staphylococcal-Associated Infections: A Real-world Study. (PubMed, Clin Ther) - "A combination of aspirin and ticagrelor is associated with a lower rate of a variety of bacterial infections. This combination warrants further investigation in in-vitro studies to tease out mechanisms and through clinical randomized trials in groups who have ACS and are at high infection risk."

Journal • Real-world • Real-world evidence • Acute Coronary Syndrome • Cardiovascular • Dermatology • Immunology • Infectious Disease • Pneumonia • Respiratory Diseases • Rheumatology • Septic Shock • Thrombosis

Effect of Clopidogrel combined with aspirin in the treatment of acute progressive cerebral infarction: A retrospective single-center analysis. (PubMed, Pak J Med Sci) - "Our results indicate that compared with aspirin alone or clopidogrel alone, the combination of aspirin and clopidogrel is more effective for the treatment of APCI. The combination regimen effectively lowers serum inflammatory factors (IL-8, TNF-α, and IL-1β), as well as the VILIP-1 and Cav-1 levels."

Journal • Retrospective data • Cardiovascular • CNS Disorders • CAV1 • CXCL8 • IL1B • TNFA • VSNL1

Comparison of Effectiveness and Safety of Dual Antiplatelet Therapy (DAPT) With Clopidogrel and Aspirin Versus Aspirin Monotherapy in Patients With Mild-to-Moderate Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis. (PubMed, Cureus) - "The aim of this meta-analysis was to assess the effectiveness and safety of the combination of clopidogrel and aspirin in patients with mild ischemic stroke or transient ischemic attack (TIA). The methodologies employed in this meta-analysis strictly followed the commonly used reporting formats for systematic reviews and meta-analyses. These findings highlight the importance of carefully weighing the potential benefits against the risks, especially in clinical decision-making for patients with TIA or ischemic stroke. Further research is warranted to elucidate optimal strategies for balancing stroke prevention with bleeding risk mitigation in this patient population."

Journal • Monotherapy • Retrospective data • Review • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Ischemic stroke • Myocardial Infarction

TIME INTERVAL OF ESOMEPRAZOLE AND DUAL ANTIPLATELET THERAPY IN PATIENTS WITH CARDIOCEREBROVASCULAR DISEASES (ESOC 2024) - "Background and aims: Dual antiplatelet therapy (DAPT) with the combination of clopidogrel and aspirin is recommended for secondary prevention in patients with acute coronary syndrome (ACS) or acute ischemic stroke (AIS). There was no significant difference in the occurrence of MACCEs and bleeding issues within 6 months according to the medication administration interval. The majority of patients with DAPT were taking PPIs simultaneously in real-world practice."

Clinical • Acute Coronary Syndrome • Cardiovascular • Ischemic stroke

Cilastazole in secondary prevention of recurrent stroke (CONy 2024) - "Aspirin and clopidogrel or ticagrelor dual therapy has been proven to be beneficial in preventing stroke recurrence but increases the risk of major bleeding complications beyond a month... Cilastazole appears promising in prevention of recurrent stroke , with least risk of intracranial bleed . Further studies are needed to confirm the results."

Cardiovascular • Ischemic stroke • Peripheral Arterial Disease

Time interval of esomeprazole and dual antiplatelet therapy in patients with cardiocerebrovascular diseases. (PubMed, Medicine (Baltimore)) - "Dual antiplatelet therapy (DAPT) with the combination of clopidogrel and aspirin is recommended for preventing secondary ischemic events in patients with acute coronary syndrome (ACS) or acute ischemic stroke (AIS). This multicenter, prospective, observational study that enrolled patients with ACS or AIS demonstrated that there was no significant difference in the occurrence of MACCEs and bleeding issues within 6 months according to the medication administration interval. The majority of patients with DAPT were taking PPIs simultaneously in real-world practice."

Journal • Acute Coronary Syndrome • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Ischemic stroke

Dual Antiplatelet Therapy for the Acute Management and Long-term Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack, An Updated Review. (PubMed, J Cardiovasc Dev Dis) - "For minor ischemic stroke and high-risk transient ischemic attack, the aspirin-clopidogrel combination is now recommended for acute short-term treatment, whereas aspirin-ticagrelor combination may be considered in selected patients, especially those with resistance to clopidogrel. For long-term stroke prevention, aspirin-dipyridamole combination has been used as an alternative to antiplatelet monotherapy, and aspirin or clopidogrel combined with cilostazole may be prescribed for added protection in high-risk patients. In this paper, we review the development of DAPT from a historical perspective and describe the findings from major clinical trials published up until the end of 2023. Using the 2021 American Heart Association guideline for secondary stroke prevention as a basis for our recommendations, we further discuss areas of controversy and more recent developments to provide an updated review for clinicians to consider in their daily practice."

Journal • Review • Cardiovascular • Ischemic stroke

Dual Antiplatelet Therapy and Immediate Intensive Statin in Mild Ischemic Stroke or Transient Ischemic Attack: The INSPIRES Randomized Clinical Trial (ISC 2024) - P3 | "Among patients with mild ischemic stroke or high-risk TIA of presumed atherosclerotic cause, combination of clopidogrel-aspirin and immediate intensive statin initiated within 72 hours after symptom onset was superior to aspirin plus delayed intensive statin in reducing the risk of new stroke and improving functional outcome at 90 days with a low but increased risk of moderate-to-severe bleeding. (ClinicalTrials.gov Identifiers: NCT03635749)"

Clinical • Late-breaking abstract • Atherosclerosis • Cardiovascular • Dyslipidemia • Ischemic stroke

Efficacy and Safety of Cilostazol in Mild Cognitive Impairment: A Randomized Clinical Trial (ISC 2024) - P2 | "Importance: Cilostazol, a selective type-3 phosphodiesterase inhibitor, was shown to prevent recurrent stroke in combination with aspirin or clopidogrel in patients with high-risk noncardioembolic ischemic stroke in the CSPS.com trial and to suppress cognitive decline in combination with isosorbide mononitrate in patients with lacunar stroke in the LACI-2 trial. The full analysis set included 159 patients who received placebo or cilostazol at least once (66 [41.5%] male; mean age [standard deviation], 75.6 [5.2] years). The least-squares mean changes in the Mini-Mental State Examination scores (standard error) in patients receiving placebo and cilostazol were -0.1 (0.3) and -0.6 (0.3), -0.8 (0.3) and -1.0 (0.3), -1.2 (0.4) and -1.1 (0.4), and -1.3 (0.4) and -1.8 (0.4) at the 24-, 48-, 72-, and 96-week visits, respectively. Other cognitive battery tests also demonstrated no beneficial effects of cilostazol."

Clinical • Late-breaking abstract • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Dementia • Ischemic stroke

Outcomes of Platelet Infusion for the Reversal of Antiplatelet Medications in Traumatic Brain Injury (SCCM 2024) - "Our findings suggest that there is no benefit associated with platelet administration for the reversal of aspirin or the combination of aspirin and clopidogrel in the setting of tICH. Clinical judgment should be used to determine the possible risks and benefits of platelet therapy in this population."

Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Thrombocytopenia • Vascular Neurology

Bleeding and thrombotic risk of different antiplatelet regimens posttranscatheter edge-to-edge mitral valve repair in patients with an indication for oral anticoagulation: Results from an all-comers national registry. (PubMed, Catheter Cardiovasc Interv) - "In patients with an indication for OACs, withholding of antiplatelet therapy post-TEER with Mitraclip was associated with a 45% reduction in bleeding and without a signal of increased thrombotic risk."

Journal • Cardiovascular • Hematological Disorders • Myocardial Infarction • Thrombosis

Economic Evaluation of Single Pill Combination Clopidogrel: Aspirin Versus Free Combination Clopidogrel Plus Aspirin for Prevention of Cardiovascular Events After Acute Coronary Syndrome in China (ISPOR-EU 2023) - "Compared to free combo, SPC (Clopidogrel-aspirin, tab in tab) was a dominant choice for ACS patients in China by preventing cardiovascular events and saving costs."

HEOR • Acute Coronary Syndrome • Cardiovascular

Single-center experience of endovascular treatment for patients with progressive posterior circulation cerebral infarction exceeding 24 h. (PubMed, Asian Biomed (Res Rev News)) - "The conditions of patients worsened despite receiving intravenous thrombolysis or combination therapy with clopidogrel and aspirin. There were no significant differences in age, gender, clinical characteristics, and stroke subtype between patients with mRS scores ≤2 and >2. In patients with progressive posterior circulation cerebral infarction caused by vertebral basilar artery occlusion, ET is effective and safe even if the time from onset to puncture exceeds 24 h."

Journal • Cardiovascular • CNS Disorders • Hematological Disorders • Infectious Disease • Respiratory Diseases

Body Mass Index and Association With Unguided De-Escalation From Ticagrelor to Clopidogrel in the TALOS-AMI Trial (AHA 2022) - "The combination of clopidogrel plus aspirin compared with ticagrelor plus aspirin reduced in the primary outcome led by bleeding events reduction, in 18.5 ≤BMI <25 kg/m2. For 18.5 ≤BMI <25 kg/m2: 4.3% vs. 7.9%; hazard ratio (HR): 0.516 (95% confidential interval [CI]: 0.334 to 0.797); 25 ≤ BMI <30 kg/m2: 4.9% vs. 7.1%; HR: 0.674 (95% CI: 0.389 to 1.166); BMI ≥30 kg/m2: 1.2% vs. 4.2%; HR: 0.284 (95% CI: 0.029 to 2.792).Conclusion In conclusion, our results suggest that in the patients of 18.5 kg/m2 ≤BMI <25 kg/m2, with acute myocardial infarction after index PCI, de-escalation strategy is better net clinical outcome, mainly by reducing the bleeding events. But, there are no differences between two groups BMI ≥25 kg/m2."

Cardiovascular • Myocardial Infarction

Impact of Atrial Fibrillation on Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI): The K-TAVI Registry. (PubMed, Yonsei Med J) - "AF was an independent predictor of 1-year mortality and new pacemaker insertion in Korean patients undergoing TAVI."

Journal • Atrial Fibrillation • Cardiovascular