Angelos Perperis
University of Patras
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Publication
Featured researches published by Angelos Perperis.
Journal of the American College of Cardiology | 2013
Dimitrios Alexopoulos; Vassilios Gkizas; Sotirios Patsilinakos; Ioanna Xanthopoulou; Christos Angelidis; Prodromos Anthopoulos; George Makris; Angelos Perperis; Stavros Karanikas; Nikolaos Koutsogiannis; Periklis Davlouros; Spyridon Deftereos; John Chiladakis; George Hahalis
To the Editor: Early and strong platelet inhibition is highly desirable in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Ticagrelor, which has direct action on the P2Y12 receptor and no need for previous metabolic
Journal of the American College of Cardiology | 2013
Dimitrios Alexopoulos; Vassilios Gkizas; Sotirios Patsilinakos; Ioanna Xanthopoulou; Christos Angelidis; Prodromos Anthopoulos; George Makris; Angelos Perperis; Stavros Karanikas; Nikolaos Koutsogiannis; Periklis Davlouros; Spyridon Deftereos; John Chiladakis; George Hahalis
To the Editor: Early and strong platelet inhibition is highly desirable in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Ticagrelor, which has direct action on the P2Y12 receptor and no need for previous metabolic
Circulation-cardiovascular Interventions | 2014
Dimitrios Alexopoulos; George Makris; Ioanna Xanthopoulou; Sotirios Patsilinakos; Spyridon Deftereos; Vassilios Gkizas; Angelos Perperis; Stavros Karanikas; Christos Angelidis; Grigorios Tsigkas; Nikolaos Koutsogiannis; George Hahalis; Periklis Davlouros
Background—In patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention, a suboptimal degree of platelet inhibition for the first 2 hours after the standard 60 mg loading dose of prasugrel has been described. Methods and Results—In a prospective, 3-center, nonrandomized, controlled study, 2 sequential groups of P2Y12 inhibitor-naive consecutive patients were loaded with either 100 mg (n=47) or 60 mg (n=35) of prasugrel. Platelet reactivity was assessed by VerifyNow at hours 0, 0.5, 1, 2, and 4. At hour 2, there was a strong trend for the primary end point of platelet reactivity (in P2Y12 reaction units) to be lower (least squares estimates of the mean difference [95% confidence interval], −45.5 [−91.2 to 0.3]; P=0.051), whereas platelet reactivity percentage inhibition (median, first to third quartile) was higher (75.5% [24%–91.8%] versus 23.5% [0%–78.3%]; P=0.02) in the 100-mg compared with 60-mg loading dose group. At hour 2, prasugrel 100 mg over 60 mg loading dose significantly reduced high platelet reactivity rates from 28.6% to 8.5% (≥230 P2Y12 reaction units threshold; P=0.036) and from 31.4% to 10.6% (≥208 P2Y12 reaction units threshold; P=0.024), whereas resulted in lower rate of ⩽20% platelet inhibition (23.4% versus 51.4%; P=0.009). Conclusions—In patients with ST-segment–elevation myocardial infarction treated with primary percutaneous coronary intervention, a higher (100 mg) than the standard loading dose of prasugrel results in greater and more consistent platelet inhibition, yet this will need to be further validated in additional studies. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01835353.
Current Pharmaceutical Design | 2013
Dimitrios Alexopoulos; Ioanna Xanthopoulou; Angelos Perperis; Argyro Siapika; Katerina Stavrou; Evropi Tsoni; Periklis Davlouros; George Hahalis
Identification of factors affecting platelet reactivity (PR) and high PR (HPR) or high platelet inhibition (HPI) rates while on prasugrel maintenance dose (MD) might be helpful in avoiding ischemic or bleeding complications. We retrospectively analyzed all patients (n=233) treated in our institution between April 2010 and November 2012 who had platelet function assessment pre-prasugrel and following prasugrel 10 mg MD for at least 5 days, using the Verify Now P2Y12 platelet function assay. Multiple linear regression and logistic regression models were applied to identify independent factors affecting post-prasugrel PR level, HPR and HPI status. The amount of variance in PR under prasugrel MD that could be explained by the model was 25.9% (adjusted R²), p<0.001. Pre-prasugrel treatment PR, acute coronary syndrome (ACS), prasugrel loading and smoking uniquely accounted for 10.8%, 1.3%, 3.5% and 1.2% of the observed variance, respectively. HPR and HPI were observed in 7.7% and 13.7% of the cases, respectively. On multivariate analysis, pre-prasugrel PR in the upper quartile (>313 PRU) was the only independent factor associated with HPR under prasugrel MD. In contrast, pre-prasugrel PR in the lower quartile (<242 PRU) and prasugrel loading emerged as the only independent predictors of HPI. In patients under different clinical settings receiving prasugrel 10 mg MD a significant amount of the PR variability in response to prasugrel may be explained by pre- treatment PR level, ACS, prasugrel loading and smoking status. A high pre- treatment PR is associated with HPR, while a low pre-treatment PR and prasugrel loading predict HPI.
Platelets | 2017
Dimitrios Alexopoulos; Ioanna Xanthopoulou; Angelos Perperis; John A. Goudevenos; Michalis Hamilos; George Sitafidis; Ioannis Kanakakis; Manolis Vavouranakis; George Giannopoulos; Nikolaos Barampoutis; Spyridon Deftereos; John Lekakis
Abstract In ‘real life’ acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and receiving contemporary antiplatelet treatment, data on dyspnea occurrence and impact on persistence with treatment are scarce. In a prospective, multicenter, cohort study, ACS patients undergoing PCI were recruited into the GReekAntiPlatElet (GRAPE) registry. During 1-year follow up, overall, 249/1989 (12.5%) patients reported dyspnea, more frequently at 1-month and decreasing thereafter. Multivariate analysis showed that ticagrelor administration (n = 738) at discharge was associated with the occurrence of dyspnea: Odds ratio 2.46 (95% confidence interval, CI, 1.87–3.25), p < 0.001. Older age, lower hematocrit, and prior bleeding event were also associated with dyspnea reports. Persistence, switching, and cessation rates were 68.3%, 20.9%, and 10.8% vs 76.7%, 12.5%, and 10.9% among patients reporting dyspnea compared with those who did not, p for trend = 0.002. In conclusion, in ACS patients undergoing PCI and treated with a P2Y12 receptor antagonist, dyspnea occurs commonly, particularly when ticagrelor is administered. Non-persistence with antiplatelet agents at discharge is more frequently observed among dyspnea-reporters.
Platelets | 2018
Karolina Akinosoglou; Angelos Perperis; Spyridoula Theodoraki; Dimitrios Alexopoulos; Charalambos Gogos
Abstract High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study. Patients were assessed for their PR on presentation and following septic syndrome, using the VerifyNow point-of-care P2Y12 assay. Patients were excluded in the presence of evidence of noncompliance to antiplatelet regimen or in need of discontinuation during this study. Twenty-two septic patients on clopidogrel were included in this study (Supplemental Figure S1). Clopidogrel was administered for previous stroke, coronary, and peripheral artery disease in 27.3, 40.9, and 31.8% of patients, respectively. The main site of infection was respiratory tract followed by urinary tract, while the same amounts of gram-negative and -positive pathogens were isolated. HPR was noted in 77% and 29% of patients during sepsis and recovery, respectively, presenting a significant decrease in P2Y12 reaction units values during follow-up [240.7 ± 58.3 versus 179.5 ± 58.4, 95% CI (–102.7, –39.76), p = 0.0002]. Five patients died of infection, while no adverse cardiovascular events were noted in our study. Our study shows that sepsis may favor HPR, which is reversed when recovery occurs. This finding may underlie the adverse cardiovascular events in patients admitted with sepsis, possibly requiring alteration of antiplatelet regimen during the inflammation period.
Journal of the American College of Cardiology | 2014
Ioanna Xanthopoulou; Angelos Perperis; Stavros Karanikas; Ioanna Koniari; Sotirios Patsilinakos; Periklis Davlouros; George Hahalis; Dimitrios Alexopoulos
No data exist on high platelet reactivity (HPR) rate following standard clopidogrel treatment in patients with ST elevation myocardial infarction (STEMI) post thrombolysis and ticagrelors pharmacodynamic effect in these patients. This was a prospective, 2-center, randomized study of parallel
Journal of the American College of Cardiology | 2013
Ioanna Xanthopoulou; Katerina Stavrou; Eleni Mavronasiou; Vasileios Gizas; Angelos Perperis; Michalis Hamilos; Filippos Triposkiadis; Ioannis Goudevenos; Dimitrios Alexopoulos
Few comparative data exist on in-hospital bleeding events with the concurrent use of clopidogrel, prasugrel and ticagrelor in real-life patients with ACS undergoing percutaneous coronary intervention (PCI). We performed detailed recording of bleeding events (Bleeding Academic Research Consortium -
Journal of Thrombosis and Thrombolysis | 2015
Dimitrios Alexopoulos; Angelos Perperis; Ioanna Koniari; Haralambos Karvounis; Sotirios Patsilinakos; Antonios Ziakas; Nikolaos Barampoutis; Theofilos Panagiotidis; Karolina Akinosoglou; George Hahalis; Ioanna Xanthopoulou
Diagnostic Microbiology and Infectious Disease | 2012
Karolina Akinosoglou; Angelos Perperis; Dimitrios Siagris; Panagiota Goutou; Irida Spiliopoulou; Charalambos Gogos; Markos Marangos