European journal of internal medicine
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Eur. J. Intern. Med. · Jan 2025
Aspirin-free strategies after percutaneous coronary intervention: Old habits, consolidated evidence and future perspectives.
For almost two decades, dual antiplatelet therapy (DAPT) has been considered the cornerstone of pharmacological treatment in patients undergoing percutaneous coronary intervention (PCI). DAPT composition and duration have considerably evolved in the last decade moving from fixed treatment durations to tailored strategies based on the individual ischemic and bleeding risks. ⋯ These findings suggest that aspirin-free strategies at short and long-term after PCI might be associated with net benefit in presence of potent P2Y12 receptor inhibition. In this Viewpoint, we provide a contemporary overview of available evidence on aspirin-free strategies, moving from the latest guidelines recommendations to future perspectives on modulation of antiplatelet therapy after PCI.
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Eur. J. Intern. Med. · Jan 2025
What is the impact of thiamine deficiency on cognitive function in patients with alcohol use disorder? - A systematic review.
Cognitive impairments are frequently observed in patients with Alcohol Use Disorder (AUD). Thiamine deficiency is often found in AUD patients and has been suggested as a possible cause of cognitive impairments. While thiamine deficiency is not consistently present in all AUD patients with cognitive deficits, thiamine is traditionally prescribed to patients with AUD to treat or prevent cognitive impairment. ⋯ This review indicates that there is a relationship between thiamine levels and cognitive function in AUD patients, even in the absence of thiamine deficit. The cognitive domains particularly affected are visuospatial/executive ability, abstraction, attention, verbal fluency, and memory scores, notably delayed memory. Additionally, studies have demonstrated that thiamine supplementation in AUD patients, even in the absence of thiamine deficit, leads to improvements in cognitive function.