Scholars@Duke
Paul Alfred Gurbel

Paul Alfred Gurbel

Adjunct Professor in the Department of Medicine
Medicine, Clinical Pharmacology

Selected Publications

Utility of VerifyNow to assess the immediate pharmacodynamic response of chewed and swallowed aspirin: comparison with aggregometry.

Journal Article Platelets · December 2024 VerifyNow (VN) test is a less laborious method to assess pharmacodynamics (PD) compared to light transmittance aggregometry (LTA). VN assay has not been used to study the immediate PD effects of acetylsalicylic acid (ASA). Ten healthy volunteers were rando ... Full text Link to item Cite

Meta-Analysis of Physiology-Guided Complete or Culprit Lesion-Only Percutaneous Coronary Interventions in Myocardial Infarction.

Journal Article Am J Cardiol · December 1, 2024 Whether physiology-guided complete revascularization of nonculprit lesions is superior to culprit lesion-only percutaneous coronary intervention (PCI) in patients with myocardial infarction (MI) and multivessel disease remains debated. Online databases wer ... Full text Link to item Cite

New interest in fibrinogen as an ischemic risk factor.

Journal Article J Thromb Thrombolysis · October 2024 Platelet-fibrin clot formation is a key process in acute arterial thrombosis. The relationship between thrombin-induced platelet-fibrin clot strength (P-FCS) and fibrinogen levels in patients with cardiovascular disease (CVD) and COVID-19 has not been stud ... Full text Link to item Cite

Can CYP2C19 genotyping improve antiplatelet therapy efficacy in real-life practice? Recent advances.

Journal Article Kardiol Pol · August 14, 2024 Clopidogrel remains the most widely used P2Y₁₂ receptor inhibitor worldwide and is often used in combination with aspirin for secondary prevention in patients with arterial disease. The drug is associated with a wide response variability with one on three ... Full text Link to item Cite

Efficacy and Safety of P2Y12 monotherapy vs standard DAPT in patients undergoing percutaneous coronary intervention: meta-analysis of randomized trials.

Journal Article Curr Probl Cardiol · August 2024 BACKGROUND: Debates persist regarding the optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in coronary artery disease (CAD). Recent trials have introduced a novel approach involving P2Y12 inhibitor monothe ... Full text Link to item Cite

P2Y12 Inhibitor Monotherapy After Short-Term Dual Antiplatelet Therapy in Acute Coronary Syndrome.

Journal Article Am J Cardiol · August 1, 2024 Recent studies have shown similar safety and efficacy of short-term dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor (P2Y12i) monotherapy when compared with standard DAPT. However, the optimal DAPT duration and regimen in acute coronary syndrom ... Full text Link to item Cite

Platelet-fibrin clot strength and platelet reactivity predicting cardiovascular events after percutaneous coronary interventions.

Journal Article Eur Heart J · July 9, 2024 BACKGROUND AND AIMS: Platelet-fibrin clot strength (PFCS) is linked to major adverse cardiovascular event (MACE) risk. However, the association between PFCS and platelet reactivity and their prognostic implication remains uncertain in patients undergoing p ... Full text Link to item Cite

Milvexian: evaluating the factor XIa inhibitor for the treatment of acute coronary syndrome.

Journal Article Expert Opin Pharmacother · July 2024 INTRODUCTION: Balancing the prevention of thrombosis with bleeding risk when combining anticoagulants and platelet antagonists remains a concern among clinicians, particularly in patients with acute coronary syndrome (ACS) who are treated with potent antip ... Full text Link to item Cite

The Effect of the COVID-19 Pandemic on Post-PCI Outcomes: A Study of First Event Occurrences

Journal Article Iranian Heart Journal · July 1, 2024 Background: Previous studies have reported a higher incidence of ischemic events in African Americans (AAs) than in non-AAs following percutaneous coronary intervention (PCI). Moreover, AAs are known to experience worse COVID-19-related outcomes. However, ... Cite

Systemic hypertension with VEGFR inhibitor (axitinib) therapy in cancer patients: A meta-analysis and systematic review of randomized controlled trials

Journal Article IJC Heart and Vasculature · June 1, 2024 Vascular endothelial growth factor receptor inhibitors (VEGFRi), namely axitinib, are commonly used chemotherapeutic agents in patients with cancer; however, this medication has a significant cardiovascular side effect profile, such as high-grade hypertens ... Full text Cite

Cardiovascular Outcomes With Empagliflozin and Dapagliflozin in Patients Without Diabetes.

Journal Article Am J Cardiol · May 1, 2024 Although the cardiovascular (CV) benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with diabetes mellitus (DM) are well known, their effects in patients without DM continue to be explored. We provide a meta-analysis of the availabl ... Full text Link to item Cite

Development of a routine bedside CYP2C19 genotype assessment program for antiplatelet therapy guidance in a community hospital catheterization laboratory.

Journal Article J Thromb Thrombolysis · April 2024 Genotype based personalized antiplatelet therapy in the setting of percutaneous coronary intervention (PCI) has been studied in clinical trials. Despite the demonstrated risk associated with CYP2C19 loss-of-function (LoF) carriage in clopidogrel-treated PC ... Full text Link to item Cite

Meta-analysis of immediate complete vs staged complete revascularization in patients with acute coronary syndrome and multivessel disease.

Journal Article Cardiovasc Revasc Med · March 2024 BACKGROUND: Randomized controlled trials (RCTs) have shown varying results between immediate and staged complete percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and multivessel disease (MVD). We conducted a meta-anal ... Full text Link to item Cite

Outcomes of Clostridioides difficile infection in acute heart failure hospitalizations: insights from the National Inpatient Database.

Journal Article J Hosp Infect · March 2024 BACKGROUND: Heart failure (HF) patients are at a greater risk for nosocomial infections due to their higher prevalence of comorbidities, readmission rates, and prolonged hospital stays. Clostridioides difficile infection (CDI) remains a common nosocomial i ... Full text Link to item Cite

Safety and efficacy of glucagon-like peptide-1 receptor agonists on cardiovascular events in overweight or obese non-diabetic patients.

Journal Article Curr Probl Cardiol · March 2024 BACKGROUND: Randomized controlled trials (RCTs) have shown variable cardiovascular (CV) outcomes in overweight or obese patients without diabetes mellitus (DM) who are treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) vs. placebo. We condu ... Full text Link to item Cite

Meta-Analysis of the Performance of AI-Driven ECG Interpretation in the Diagnosis of Valvular Heart Diseases.

Journal Article Am J Cardiol · February 15, 2024 Valvular heart diseases (VHDs) significantly impact morbidity and mortality rates worldwide. Early diagnosis improves patient outcomes. Artificial intelligence (AI) applied to electrocardiogram (ECG) interpretation presents a promising approach for early V ... Full text Link to item Cite

An overview of the utility of prasugrel hydrochloride as a treatment option for ischemic stroke.

Journal Article Expert Rev Neurother · February 2024 INTRODUCTION: Prasugrel, a potent P2Y12 receptor inhibitor, is not currently recommended in patients with stroke due to a higher rate of recurrent stroke. Prasugrel was associated with comparable efficacy to clopidogrel in reducing the risk of ischemic str ... Full text Link to item Cite

Early assessment of the pharmacokinetic and pharmacodynamic effects following acetylsalicylic acid loading: toward a definition for acute therapeutic response.

Journal Article J Thromb Thrombolysis · January 2024 Despite decades of investigations, the optimal assessment of the "therapeutic response" to early after loading dose of acetylsalicylic acid (ASA) remains unclear. Limited information is available on the relation between pharmacodynamic (PD) and pharmacokin ... Full text Link to item Cite

Genetics in the diagnosis and treatment of cardiovascular diseases

Journal Article Journal of Translational Genetics and Genomics · January 1, 2024 Cardiovascular diseases (CVDs) remain one of the leading causes of morbidity and mortality worldwide, with genetics being a major risk factor. Genetic cardiovascular disease can occur either because of single variant (Mendelian) or polygenic influences and ... Full text Cite

Long-term prognostic implications of brachial-ankle pulse wave velocity in patients undergoing percutaneous coronary intervention

Journal Article Frontiers in Medicine · January 1, 2024 Objective: The long-term clinical effect of arterial stiffness in high-risk disease entities remains unclear. The prognostic implications of brachial-ankle pulse wave velocity (baPWV) were assessed using a real-world registry that included patients who und ... Full text Cite

The COVID-19 thrombus: distinguishing pathological, mechanistic, and phenotypic features and management

Journal Article Journal of Thrombosis and Thrombolysis · January 1, 2024 A heightened risk for thrombosis is a hallmark of COVID-19. Expansive clinical experience and medical literature have characterized small (micro) and large (macro) vessel involvement of the venous and arterial circulatory systems. Most events occur in pati ... Full text Cite

Low-Dose Aspirin for Primary Prevention of Cardiovascular Events Comparing East Asians With Westerners: A Meta-Analysis

Journal Article JACC: Asia · December 1, 2023 Background: East Asians have shown different risk profiles for both thrombophilia and bleeding than Western counterparts. Objectives: The authors sought to evaluate the effect of low-dose aspirin for primary prevention between these populations. Methods: W ... Full text Cite

Role of Intravascular Imaging in Complex Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials.

Journal Article Am J Cardiol · December 1, 2023 Intravascular imaging (IVI) during percutaneous coronary intervention (PCI) has been shown to improve clinical outcomes. However, data is limited in complex PCI and the adoption remains low. We aimed to conduct a meta-analysis of all available randomized c ... Full text Link to item Cite

High Platelet Reactivity Combined with CYP2C19 Genotype in Predicting Outcomes in East Asian Patients Undergoing Percutaneous Coronary Intervention.

Journal Article Clin Pharmacol Ther · November 2023 Loss-of-function (LoF) alleles of cytochrome P450 2C19 (CYP2C19), which are prevalent in East Asians, are linked to high platelet reactivity (HPR) phenotype and poor prognosis. We aimed to investigate the incremental predictive value of HPR combined with C ... Full text Link to item Cite

Effect of Furosemide Versus Torsemide on Hospitalizations and Mortality in Patients With Heart Failure: A Meta-Analysis of Randomized Controlled Trials.

Journal Article The American journal of cardiology · November 2023 Loop diuretics are essential in the treatment of patients with heart failure (HF) who develop congestion. Furosemide is the most commonly used diuretic; however, some randomized controlled trials (RCTs) have shown varying results associated with torsemide ... Full text Cite

Oxygen Targets After Cardiac Arrest: A Meta-analysis of Randomized Controlled Trials.

Journal Article Am J Ther · November 2023 BACKGROUND: Optimal oxygen saturation target in patients resuscitated after cardiac arrest is unknown. Previous randomized controlled trials (RCTs) comparing restrictive oxygen therapy with liberal therapy have shown conflicting results. STUDY QUESTION: We ... Full text Link to item Cite

Safety and Effectiveness of Adjunctive Posterior Wall Isolation in Atrial Fibrillation Patients: An Updated Meta-Analysis.

Journal Article Am J Cardiol · September 15, 2023 As the atrial fibrillation (AF) recurrence rate remains high after pulmonary vein isolation (PVI), additional left atrial posterior wall isolation (PWI) has been studied in randomized controlled trials, however, the results are conflicting. We performed an ... Full text Link to item Cite

Post-PCI Risk Assessment by Inflammation Activity According to Disease Acuity and Time from Procedure.

Journal Article Thromb Haemost · June 2023 BACKGROUND:  High-sensitivity C-reactive protein (hs-CRP) has been proposed as an indicator of inflammation and cardiovascular risk. However, little is known of the comparative temporal profile of hs-CRP and its relation to outcomes according to the diseas ... Full text Link to item Cite

Prognostic impact of hypercoagulability and impaired fibrinolysis in acute myocardial infarction.

Journal Article Eur Heart J · May 14, 2023 AIMS: Atherothrombotic events are influenced by systemic hypercoagulability and fibrinolytic activity. The present study evaluated thrombogenicity indices and their prognostic implications according to disease acuity. METHODS AND RESULTS: From the consecut ... Full text Link to item Cite

Urinary L-Type Fatty Acid-Binding Protein Predicts Oxygen Demand of COVID-19 in Initially Mild Cases

Journal Article Critical Care Explorations · March 9, 2023 IMPORTANCE: Early detection of illness trajectory in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients is crucial for patients and healthcare workers. An effective, noninvasive approach, with simple measurement for decision-mak ... Full text Cite

PCSK9 Inhibition During the Inflammatory Stage of SARS-CoV-2 Infection.

Journal Article J Am Coll Cardiol · January 24, 2023 BACKGROUND: The intensity of inflammation during COVID-19 is related to adverse outcomes. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is involved in low-density lipoprotein receptor homeostasis, with potential influence on vascular inflammation a ... Full text Link to item Cite

An update on novel therapies for treating patients with arterial thrombosis.

Journal Article Expert Rev Hematol · 2023 INTRODUCTION: Antithrombotic therapy field is undergoing rapid and significant changes during the past decade. In addition to new therapeutic strategies with existing targets, investigators are exploring the potential use of new targets to address unmet ne ... Full text Link to item Cite

An evaluation of the AggreGuide A-100 ADP Assay for measuring the effect of antiplatelet agents targeting the P2Y12 receptor.

Journal Article Expert Rev Mol Diagn · 2023 INTRODUCTION: Currently available platelet function assays largely ignore the important characteristics of in vivo thrombus generation, such as flow conditions and shear. The AggreGuide A-100 ADP Assay detects platelet aggregation in whole blood using ligh ... Full text Link to item Cite

Sex-related differences in clinical outcomes among patients with myocardial infarction with nonobstructive coronary artery disease: A systematic review and meta-analysis.

Journal Article Int J Cardiol · December 15, 2022 BACKGROUND: Among patients who present with acute myocardial infarction (MI), 2-6% are found to have non-obstructive coronary arteries (NOCA). Patients with MINOCA are more commonly women and present at a younger age (51-59 years). The influence of sex on ... Full text Link to item Cite

Prevalence of adverse events during ticagrelor versus clopidogrel treatment and its association with premature discontinuation of dual antiplatelet therapy in East Asian patients with acute coronary syndrome

Journal Article Frontiers in Cardiovascular Medicine · December 12, 2022 Background: Clinical evidence raises the issues regarding the high risk of adverse events and serious bleeding in East Asian patients receiving standard-dose ticagrelor treatment. We sought to evaluate the association between adverse events and their assoc ... Full text Cite

Bleeding and Ischemic Outcomes With Ticagrelor Monotherapy According to Body Mass Index.

Journal Article JACC Cardiovasc Interv · October 10, 2022 BACKGROUND: There is a paucity of data regarding the safety and efficacy of different antiplatelet regimens according to standardized body mass index (BMI) categories. OBJECTIVES: The aim of this study was to investigate bleeding and ischemic outcomes acco ... Full text Link to item Cite

Serial assessment of thrombogenicity and hemodynamics in patients with type II diabetes in a clinical research unit: Evidence for circadian variations in clot formation.

Journal Article J Thromb Thrombolysis · October 2022 BACKGROUND: Circadian fluctuations in thrombogenicity and hemostasis play a role in acute cardiovascular thrombotic events occurring in the early morning hours. There is a lack of data assessing thrombogenicity, platelet function, and hemodynamics to inves ... Full text Link to item Cite

Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens.

Journal Article J Thromb Thrombolysis · August 2022 Tirofiban is a glycoproteine (GP) IIb/IIIa receptor antagonist, which inhibits platelet-platelet aggregation and is a potential adjunctive antithrombotic treatment in patients with acute coronary syndromes (ACS) or high-risk percutaneous coronary intervent ... Full text Link to item Cite

Current and novel biomarkers of thrombotic risk in COVID-19: a Consensus Statement from the International COVID-19 Thrombosis Biomarkers Colloquium.

Journal Article Nat Rev Cardiol · July 2022 Coronavirus disease 2019 (COVID-19) predisposes patients to thrombotic and thromboembolic events, owing to excessive inflammation, endothelial cell activation and injury, platelet activation and hypercoagulability. Patients with COVID-19 have a prothrombot ... Full text Link to item Cite

Residual Inflammatory Risk and its Association With Events in East Asian Patients After Coronary Intervention

Journal Article JACC: Asia · June 1, 2022 Background: East Asian population has a low level of inflammation compared with Western population. The prognostic implication of residual inflammatory risk (RIR) remains uncertain in East Asians. Objectives: This study sought to provide an analysis to est ... Full text Cite

The Prognostic Role of ST2L and sST2 in Patients Who Underwent Carotid Plaque Endarterectomy: A Five-Year Follow-Up Study

Journal Article Journal of Clinical Medicine · June 1, 2022 Soluble suppressor of tumorigenicity (sST)-2 plasma concentration is related to athero-sclerosis. The aim of this study was to assess the prognostic impact of sST2 and its mem-brane-associated form (ST2L) in patients with carotid atherosclerotic plaque who ... Full text Cite

The role of viscoelastic testing in assessing peri-interventional platelet function and coagulation.

Journal Article Platelets · May 19, 2022 We carried out a literature search in MEDLINE (PubMed) and EMBASE literature databases to provide a concise review of the role of viscoelastic testing in assessing peri-interventional platelet function and coagulation. The search identified 130 articles th ... Full text Link to item Cite

Metformin use in patients hospitalized with COVID-19: lower inflammation, oxidative stress, and thrombotic risk markers and better clinical outcomes.

Journal Article Journal of thrombosis and thrombolysis · February 2022 Diabetes mellitus (DM) is associated with a greater risk of COVID-19 and an increased mortality when the disease is contracted. Metformin use in patients with DM is associated with less COVID-19-related mortality, but the underlying mechanism behind this a ... Full text Cite

Further evidence for the use of aspirin in COVID-19.

Journal Article Int J Cardiol · January 1, 2022 Full text Link to item Cite

Thrombogenicity markers for early diagnosis and prognosis in COVID-19: a change from the current paradigm?

Journal Article Blood Coagul Fibrinolysis · December 1, 2021 Standard biomarkers have been widely used for COVID-19 diagnosis and prognosis. We hypothesize that thrombogenicity metrics measured by thromboelastography will provide better diagnostic and prognostic utility versus standard biomarkers in COVID-19 positiv ... Full text Link to item Cite

Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis.

Journal Article Eur Heart J · December 1, 2021 AIMS: The value of elective coronary revascularisation plus medical therapy over medical therapy alone in managing stable patients with coronary artery disease is debated. We reviewed all trials comparing the two strategies in this population. METHODS AND ... Full text Link to item Cite

Pharmacodynamic Profile and Prevalence of Bleeding Episode in East Asian Patients with Acute Coronary Syndromes Treated with Prasugrel Standard-Dose versus De-escalation Strategy: A Randomized A-MATCH Trial.

Journal Article Thromb Haemost · October 2021 Compared with Caucasian patients, East Asian patients have the unique risk-benefit trade-off and different responsiveness to antithrombotic regimens. The aim of this study was to compare pharmacodynamic profile in East Asian patients with acute coronary sy ... Full text Link to item Cite

Association Between Thrombogenicity Indices and Coronary Microvascular Dysfunction in Patients With Acute Myocardial Infarction

Journal Article JACC: Basic to Translational Science · September 1, 2021 The association between thrombogenicity and coronary microvascular dysfunction (CMD) has been poorly explored in patients with acute myocardial infarction (AMI). In our real-world clinical practice (N = 116), thrombogenicity was evaluated with thromboelast ... Full text Cite

Clinical validation of AggreGuide A-100 ADP, a novel assay for assessing the antiplatelet effect of oral P2Y12 antagonists.

Journal Article J Thromb Thrombolysis · July 2021 In this prospective, 3-arm, repeated-measure multicenter investigation in 280 patients with cardiovascular risk factors, platelet aggregation was measured with the novel AggreGuide A-100 ADP (A-100 ADP) and VerifyNow (VN)-PRU assays at baseline, and after ... Full text Link to item Cite

Platelet Reactivity and Coagulation Markers in Patients with COVID-19.

Journal Article Adv Ther · July 2021 INTRODUTION: COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in ... Full text Link to item Cite

First Experience Addressing the Prognostic Utility of Novel Urinary Biomarkers in Patients with COVID-19

Journal Article Open Forum Infectious Diseases · July 1, 2021 Urine 11-dehydro-thromboxane B2 (u11-dh-TxB2), 8-hydroxy-2'-deoxyguanosine (8-OHdG), and liver-type fatty acid binding protein levels (L-FABP) at the time of hospitalization were higher in coronavirus disease 2019 (COVID-19) patients with adverse events vs ... Full text Cite

Effects of monotherapy with clopidogrel vs. Aspirin on vascular function and hemostatic measurements in patients with coronary artery disease: The prospective, crossover i-love-mono trial

Journal Article Journal of Clinical Medicine · June 2, 2021 Objectives: To evaluate the effect of clopidogrel vs. aspirin monotherapy on vascular function and hemostatic measurement. Background: Monotherapy with P2Y12 receptor inhibitor vs. aspirin can be a useful alterative to optimize clinical efficacy and safety ... Full text Cite

The East Asian Paradox: An Updated Position Statement on the Challenges to the Current Antithrombotic Strategy in Patients with Cardiovascular Disease.

Journal Article Thromb Haemost · April 2021 East Asian patients have reduced anti-ischemic benefits and increased bleeding risk during antithrombotic therapies compared with Caucasian patients. As potent P2Y12 receptor inhibitors (e.g., ticagrelor and prasugrel) and direct oral anticoagulants are co ... Full text Link to item Cite

Platelet Reactivity in Patients With Acute Coronary Syndromes Awaiting Surgical Revascularization.

Journal Article J Am Coll Cardiol · March 16, 2021 BACKGROUND: Dual antiplatelet therapy is recommended for patients with acute coronary syndromes (ACS). Approximately 10% to 15% of these patients will undergo coronary artery bypass graft (CABG) surgery for index events, and current guidelines recommend st ... Full text Link to item Cite

Efficacy and safety of intracoronary epinephrine versus conventional treatments alone in STEMI patients with refractory coronary no-reflow during primary PCI: The RESTORE observational study.

Journal Article Catheter Cardiovasc Interv · March 2021 OBJECTIVES: We aimed to compare intracoronary (IC) epinephrine versus conventional treatments alone in patients with ST-elevation myocardial infarction and refractory coronary no-reflow during primary percutaneous coronary intervention (PPCI). METHODS: Thi ... Full text Link to item Cite

Viscoelastic properties of clot formation and their clinical impact in East Asian versus Caucasian patients with stable coronary artery disease: a COMPARE-RACE analysis.

Journal Article J Thromb Thrombolysis · February 2021 Compared with Caucasian patients, East Asian patients with coronary artery disease (CAD) have demonstrated better clinical outcomes. We sought to compare the viscoelastic properties of clot formation and their impact on clinical outcomes in East Asian vs. ... Full text Link to item Cite

Defining platelet response to acetylsalicylic acid: the relation between inhibition of serum thromboxane B2 and agonist-induced platelet aggregation.

Journal Article J Thromb Thrombolysis · February 2021 Arachidonic acid (AA)-induced platelet aggregation (PA) and serum thromboxane B2 (TxB2) inhibition are widely used to indicate cyclooxygenase-1 activity and the antiplatelet effect of acetylsalicylic acid (ASA). Despite decades of investigations, the relat ... Full text Link to item Cite

Ethnic difference of thrombogenicity in patients with cardiovascular disease: A pandora box to explain prognostic differences

Journal Article Korean Circulation Journal · February 1, 2021 Arterial and venous atherothrombotic events are finely regulated processes involving a complex interplay between vulnerable blood, vulnerable vessel, and blood stasis. Vulnerable blood ('thrombogenicity') comprises complex interactions between cellular com ... Full text Cite

An Ex Vivo Study to Evaluate the Effect of Tegaserod on Platelet Activation and Aggregation.

Journal Article J Cardiovasc Pharmacol Ther · January 2021 INTRODUCTION: Tegaserod, an orally active, potent 5-hydroxytryptamine-4 serotonin receptor agonist, was previously indicated for irritable bowel syndrome but was voluntarily withdrawn due to potential cardiovascular side effects. In vitro studies suggested ... Full text Link to item Cite

Aspirin as an Adjunctive Pharmacologic Therapy Option for COVID-19: Anti-Inflammatory, Antithrombotic, and Antiviral Effects All in One Agent

Journal Article Journal of Experimental Pharmacology · January 1, 2021 Introduction: Pharmacologic therapy options for COVID-19 should include antiviral, anti-inflammatory, and anticoagulant agents. With the limited effectiveness, currently available virus-directed therapies may have a substantial impact on global health due ... Full text Cite

Quantification of antibody avidities and accurate detection of SARS-CoV-2 antibodies in serum and saliva on plasmonic substrates.

Journal Article Nat Biomed Eng · December 2020 Accurate assays for the detection of antibodies to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) are essential for the control of the COVID-19 (coronavirus disease 2019) pandemic. Here, we report antibody and antibody-avidity assays, relying ... Full text Link to item Cite

PAR1 (Protease-Activated Receptor 1) Pepducin Therapy Targeting Myocardial Necrosis in Coronary Artery Disease and Acute Coronary Syndrome Patients Undergoing Cardiac Catheterization: A Randomized, Placebo-Controlled, Phase 2 Study.

Journal Article Arterioscler Thromb Vasc Biol · December 2020 OBJECTIVE: Arterial thrombosis leading to ischemic injury worsens the prognosis of many patients with cardiovascular disease. PZ-128 is a first-in-class pepducin that reversibly inhibits PAR1 (protease-activated receptor 1) on platelets and other vascular ... Full text Link to item Cite

The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease.

Journal Article J Thromb Thrombolysis · November 2020 Patients with peripheral artery disease (PAD) have shown the increased risk of cardiovascular (CV) morbidity and mortality. This study sought to evaluate the impact of clot strength on prevalence and major adverse CV events (MACE) of PAD in high-risk patie ... Full text Link to item Cite

Genomewide Association Study of Platelet Reactivity and Cardiovascular Response in Patients Treated With Clopidogrel: A Study by the International Clopidogrel Pharmacogenomics Consortium.

Journal Article Clin Pharmacol Ther · November 2020 Antiplatelet response to clopidogrel shows wide variation, and poor response is correlated with adverse clinical outcomes. CYP2C19 loss-of-function alleles play an important role in this response, but account for only a small proportion of variability in r ... Full text Link to item Cite

Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease.

Journal Article Adv Ther · November 2020 INTRODUCTION: Lipoprotein (a) [Lp(a)] is a risk factor for coronary artery disease (CAD). To the best of our knowledge, this is the first study addressing the relationship between Lp(a) and platelet reactivity in primary and secondary prevention. METHODS: ... Full text Link to item Cite

Meta-Analysis of the Usefulness of Therapeutic Hypothermia After Cardiac Arrest.

Journal Article Am J Cardiol · October 15, 2020 Despite current guidelines recommending therapeutic hypothermia (TH) for post cardiac arrest comatose patient, its use remains limited. Randomized controlled trials (RCTs) have also reported conflicting results on the efficacy of TH. Therefore, we conducte ... Full text Link to item Cite

TEG®6s system measures the contributions of both platelet count and platelet function to clot formation at the site-of-care.

Journal Article Platelets · October 2, 2020 Knowledge of platelet count and function is key to ensuring appropriate hemostatic management. We hypothesized that the novel, portable TEG®6s coagulation assessment system could evaluate the contribution of both platelet count and function to clot formati ... Full text Link to item Cite

Detailed thrombogenicity phenotyping and 1 year outcomes in patients undergoing WATCHMAN implantation: (TARGET-WATCHMAN) a case-control study.

Journal Article J Thromb Thrombolysis · October 2020 The relation of device related thrombosis (DRT) and major bleeding after left atrial appendage closure (LAAC) to laboratory thrombosis and hemostasis markers has not been studied. We performed a prospective case control study to identify clinical character ... Full text Link to item Cite

Targeted pharmacotherapy for ischemia reperfusion injury in acute myocardial infarction.

Journal Article Expert Opin Pharmacother · October 2020 INTRODUCTION: Achieving reperfusion immediately after acute myocardial infarction improves outcomes; despite this, patients remain at a high risk for mortality and morbidity at least for the first year after the event. Ischemia-reperfusion injury (IRI) has ... Full text Link to item Cite

Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS.

Journal Article Eur Heart J · October 1, 2020 AIMS: The aim of this study was to determine the effect of ticagrelor monotherapy on clinically relevant bleeding and major ischaemic events in relation to clinical presentation with and without non-ST elevation acute coronary syndromes (NSTE-ACS) among pa ... Full text Link to item Cite

Bioprosthetic Valve Thrombosis: Insights from Transcatheter and Surgical Implants

Journal Article Structural Heart · September 2, 2020 Although aortic valve replacement with implantation of a bioprosthesis has been widely performed for more than 50 years, appreciation of the development of bioprosthetic leaflet thrombosis has increased recently with the emergence of transcatheter aortic v ... Full text Cite

Pharmacodynamics, pharmacokinetics, and safety of single-dose subcutaneous administration of selatogrel, a novel P2Y12 receptor antagonist, in patients with chronic coronary syndromes.

Journal Article Eur Heart J · September 1, 2020 AIMS: To study the pharmacodynamics and pharmacokinetics of selatogrel, a novel P2Y12 receptor antagonist for subcutaneous administration, in patients with chronic coronary syndromes (CCS). METHODS AND RESULTS: In this double-blind, randomized study of 345 ... Full text Link to item Cite

Vorapaxar in the treatment of cardiovascular diseases.

Journal Article Future Cardiol · September 2020 Vorapaxar specifically and effectively inhibits protease activated receptor-1 and may reduce thrombin-mediated ischemic events without interfering primary hemostasis. In the TRA-2P-TIMI 50 trial, vorapaxar reduced the risk of primary ischemic outcome but w ... Full text Link to item Cite

Can an Old Ally Defeat a New Enemy?

Journal Article Circulation · July 28, 2020 Full text Link to item Cite

Comparative Efficacy and Safety of Oral P2Y12 Inhibitors in Acute Coronary Syndrome: Network Meta-Analysis of 52 816 Patients From 12 Randomized Trials.

Journal Article Circulation · July 14, 2020 BACKGROUND: New randomized, controlled trials have become available on oral P2Y12 inhibitors in acute coronary syndrome. We aimed to evaluate current evidence comparing the efficacy and safety profile of prasugrel, ticagrelor, and clopidogrel in acute coro ... Full text Link to item Cite

Pharmacogenetic considerations in antiplatelet therapy

Journal Article Expert Review of Precision Medicine and Drug Development · July 3, 2020 Full text Cite

Pharmacogenomic polygenic response score predicts ischaemic events and cardiovascular mortality in clopidogrel-treated patients.

Journal Article Eur Heart J Cardiovasc Pharmacother · July 1, 2020 AIMS: Clopidogrel is prescribed for the prevention of atherothrombotic events. While investigations have identified genetic determinants of inter-individual variability in on-treatment platelet inhibition (e.g. CYP2C19*2), evidence that these variants have ... Full text Link to item Cite

Circulating MicroRNA Profiling in Non-ST Elevated Coronary Artery Syndrome Highlights Genomic Associations with Serial Platelet Reactivity Measurements.

Journal Article Sci Rep · April 10, 2020 Changes in platelet physiology are associated with simultaneous changes in microRNA concentrations, suggesting a role for microRNA in platelet regulation. Here we investigated potential associations between microRNA and platelet reactivity (PR), a marker o ... Full text Open Access Link to item Cite

Effect of Smoking Cessation on the Pharmacokinetics and Pharmacodynamics of Clopidogrel after PCI: The Smoking Cessation Paradox Study.

Journal Article Thromb Haemost · March 2020 BACKGROUND:  Cigarette smoking is associated with enhanced clopidogrel effect and platelet inhibition. However, the effect of smoking cessation on clopidogrel pharmacokinetics (PK) and pharmacodynamics (PD) is unknown. We aimed to determine the effect of s ... Full text Link to item Cite

Synergistic influence of rivaroxaban on inflammation and coagulation biomarkers in patients with coronary artery disease and peripheral artery disease on aspirin therapy.

Journal Article Future Cardiol · March 2020 COMPASS study demonstrated efficacy of dual pathway inhibition with 2.5 mg twice daily rivaroxaban and aspirin in patients with polyvascular disease (coronary artery disease, peripheral arterial disease or both), the underlying mechanism of which is not cl ... Full text Link to item Cite

Direct oral anticoagulants: a review on the current role and scope of reversal agents.

Journal Article J Thromb Thrombolysis · February 2020 New guideline recommendations prefer direct oral anticoagulants (DOACs) over warfarin in DOAC-eligible patients with atrial fibrillation and patients with venous thromboembolism. As expected with all antithrombotic agents, there is an associated increased ... Full text Link to item Cite

Effects of vorapaxar on clot characteristics, coagulation, inflammation, and platelet and endothelial function in patients treated with mono- and dual-antiplatelet therapy.

Journal Article J Thromb Haemost · January 2020 BACKGROUND: Vorapaxar is indicated with standard antiplatelet therapy (APT) in patients with a history of myocardial infarction (MI) or peripheral arterial disease (PAD). OBJECTIVES: To evaluate the comparative effects of vorapaxar on platelet-fibrin clot ... Full text Link to item Cite

Investigational drugs in phase II clinical trials for acute coronary syndromes.

Journal Article Expert Opin Investig Drugs · January 2020 Introduction: Despite current guideline-based, secondary prevention strategies in patients with the acute coronary syndrome, the residual ischemic risk is still at an unacceptable rate, and there is a concomitant high bleeding event rate. These observation ... Full text Link to item Cite

Safety and efficacy of antiplatelet regimens after percutaneous coronary intervention using drug eluting stents: A network meta-analysis of randomized controlled trials.

Journal Article Prog Cardiovasc Dis · 2020 AIMS: We aimed to determine the efficacy and safety of different anti-platelet regimens after percutaneous coronary intervention (PCI) with drug eluting stent (DES) implantation using a network meta-analysis of randomized controlled trials (RCTs). METHODS: ... Full text Link to item Cite

Prolonged antithrombotic therapy in patients after acute coronary syndrome: A critical appraisal of current European Society of Cardiology guidelines.

Journal Article Cardiol J · 2020 The increased risk of non-cardiovascular death in patients receiving clopidogrel or prasugrel in comparison with the placebo group in the Dual Antiplatelet Therapy (DAPT) trial in contrast to the decreased risk of cardiovascular death and all-cause death s ... Full text Link to item Cite

Assessing platelet reactivity after drug eluting stent implantation: state of the art.

Journal Article Expert Rev Cardiovasc Ther · January 2020 Introduction: Platelets play a pivotal role in the occurrence of recurrent ischemic events in coronary artery disease patients who are treated with drug-eluting stents and are on dual antiplatelet therapy (DAPT).Areas covered: High platelet reactivity (HPR ... Full text Link to item Cite

Ticagrelor with or without Aspirin in High-Risk Patients after PCI.

Journal Article N Engl J Med · November 21, 2019 BACKGROUND: Monotherapy with a P2Y12 inhibitor after a minimum period of dual antiplatelet therapy is an emerging approach to reduce the risk of bleeding after percutaneous coronary intervention (PCI). METHODS: In a double-blind trial, we examined the effe ... Full text Link to item Cite

Smoking and cardiovascular diseases: paradox greater than expected?

Journal Article Pol Arch Intern Med · October 30, 2019 Cardiovascular diseases, including acute coronary syndromes, are a major cause of death among tobacco smokers. Epidemiological studies have demonstrated that long‑term prognosis is worse in smokers with acute coronary syndromes than in nonsmokers. However, ... Full text Link to item Cite

Gender differences in thrombogenicity among patients with angina and non-obstructive coronary artery disease.

Journal Article J Thromb Thrombolysis · October 2019 Women more often present with angina and non-obstructive coronary artery disease (ANOCA) and have poorer clinical outcomes than men. These findings may be related to sex associated differences in inflammation and thrombogenicity. Consecutive patients (n =  ... Full text Link to item Cite

Combination Antiplatelet and Oral Anticoagulant Therapy in Patients With Coronary and Peripheral Artery Disease.

Journal Article Circulation · April 30, 2019 Antiplatelet therapy is the mainstay for the treatment of acute and chronic arterial disease involving the coronary and peripheral beds. However, questions remain about optimal antithrombotic therapy for long-term treatment of chronic vascular disease. The ... Full text Link to item Cite

2018 update of expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI

Journal Article Science Bulletin · February 15, 2019 East Asians are the most populous race in the world and their health status is an important global issue. Compared with Caucasian populations, East Asian patients have a different benefit/risk ratio when using antithrombotic treatment. Despite this observa ... Full text Cite

Pharmacokinetic-pharmacodynamic modelling of platelet response to ticagrelor in stable coronary artery disease and prior myocardial infarction patients.

Journal Article Br J Clin Pharmacol · February 2019 AIMS: To characterize ticagrelor exposure-response relationship for platelet inhibition in patients with stable coronary artery disease (CAD) and a history of myocardial infarction (MI), using nonlinear mixed effects modelling and simulation. METHODS: Plat ... Full text Link to item Cite

Influence of Amlodipine on Haemostatic Measurements during Clopidogrel Treatment in Patients with Coronary Artery Disease.

Journal Article Thromb Haemost · February 2019 Amlodipine has a potential to reduce clopidogrel bioactivation through the cytochrome P450 3A4 enzyme in vivo, but the clinical impact of this interaction remains controversial. This randomized, open-label, two-period, crossover study was performed to eval ... Full text Link to item Cite

"Blueprinting" thrombogenicity and antithrombotic drug response at the bedside in patients presenting emergently with symptoms of acute stroke.

Journal Article J Thromb Thrombolysis · February 2019 Early assessment of thrombogenicity and antithrombotic drug effects may be important for therapeutic decision making in patients presenting with acute stroke. In this prospective, single center, pilot study, a bedside thrombelastography assay (TEG6s) was u ... Full text Link to item Cite

A narrative review of the cardiovascular risks associated with concomitant aspirin and NSAID use.

Journal Article J Thromb Thrombolysis · January 2019 The concomitant use of low-dose aspirin for cardioprotection and non-steroidal anti-inflammatory agents for pain relief is prevalent, particularly in the elderly for whom cardiovascular disease and pain are common co-morbidities. Non-selective non-steroida ... Full text Link to item Cite

High Residual Platelet Reactivity during Aspirin Therapy in Patients with Non-St Segment Elevation Acute Coronary Syndrome: Comparison Between Initial and Late Phases.

Journal Article Arq Bras Cardiol · 2019 BACKGROUND: High platelet reactivity (HPR) during therapy with acetylsalicylic acid (ASA) is a poor prognostic factor in acute coronary syndromes (ACS). The prevalence of HPR during ACS is greater than that reported in stable diseases. However, it is uncle ... Full text Link to item Cite

Phosphodiesterase inhibitors

Chapter · January 1, 2019 In addition to the inhibition of the cyclooxygenase-1 enzyme by acetylsalicylic acid and the ADP-P2Y12 receptor by P2Y12 inhibitors, inhibition of the phosphodiesterase enzyme (PDE) by cilostazol and dipyridamole provides another strategy to prevent platel ... Full text Cite

Is There a Role for Preoperative Platelet Function Testing in Patients Undergoing Cardiac Surgery During Antiplatelet Therapy?

Journal Article Circulation · November 6, 2018 Up to 11% of patients presenting with acute coronary syndromes undergo coronary artery bypass grafting. Guidelines largely recommend a one-size-fits-all preoperative discontinuation period for P2Y12 receptor blockers to avoid bleeding. These recommendation ... Full text Link to item Cite

The potential of genotype-guided antiplatelet therapy: promises and challenges

Journal Article Expert Review of Precision Medicine and Drug Development · November 2, 2018 Introduction: Presence of loss-of-function (LoF) allele of CYP2C19 gene has been associated with poor clopidogrel active metabolite generation, poor antiplatelet response, and elevated risk for cardiovascular events in patients treated with coronary stenti ... Full text Cite

Antithrombotic Strategies and Device Thrombosis.

Journal Article Cardiol Clin · November 2018 Despite improvements in left ventricular assist device (LVAD) technology, bleeding and thrombotic complications are major concerns that adversely influence morbidity and mortality. Current antithrombotic therapy recommendations for LVAD thrombosis prophyla ... Full text Link to item Cite

Dual vs single antiplatelet therapy in patients with lower extremity peripheral artery disease - A meta-analysis.

Journal Article Int J Cardiol · October 15, 2018 AIMS: Peripheral artery disease (PAD) is associated with increased risk of cardiovascular events. The benefits of dual antiplatelet therapy (DAPT) vs single antiplatelet therapy (SAPT) with aspirin in patients with PAD remain subject of ongoing debate. MET ... Full text Link to item Cite

Outcomes of Patients Receiving Downstream Revascularization After Initial Medical Management for Non-ST-Segment Elevation Acute Coronary Syndromes (From the TRILOGY ACS Trial).

Journal Article Am J Cardiol · October 15, 2018 Patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) are sometimes treated with medical management alone rather than an invasive strategy. Among those medically managed without revascularization and discharged, a proportion will requi ... Full text Link to item Cite

Prediction of Ischemic and Bleeding Events Using the Dual Antiplatelet Therapy Score in an Unrestricted Percutaneous Coronary Intervention Population.

Journal Article Circ Cardiovasc Interv · October 2018 BACKGROUND: The dual antiplatelet therapy (DAPT) risk score was developed from the DAPT trial to inform the optimal duration of DAPT after percutaneous coronary intervention. We assessed the performance of the DAPT score in the ADAPT-DES (Assessment of Dua ... Full text Link to item Cite

Cangrelor for the treatment of patients with Arterial Thrombosis.

Journal Article Expert Opin Pharmacother · August 2018 All oral P2Y12 receptor blockers are associated with some degree of delayed onset and offset of pharmacodynamic (PD) effects in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Although intravenous glycoprot ... Full text Link to item Cite

Platelet Reactivity and Risk of Ischemic Stroke After Coronary Drug-Eluting Stent Implantation: From the ADAPT-DES Study.

Journal Article JACC Cardiovasc Interv · July 9, 2018 OBJECTIVES: The authors sought to investigate the association between P2Y12 reaction units (PRU) and the risk of ischemic stroke (IS) after successful coronary drug-eluting stents (DES) implantation. BACKGROUND: The association between platelet reactivity ... Full text Link to item Cite

Thromboembolism after WATCHMANTM in a clopidogrel non-responder: A case for concern?

Journal Article Catheter Cardiovasc Interv · July 2018 Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMANTM left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we presen ... Full text Link to item Cite

Role of proprotein convertase subtilisin/kexin type 9 inhibitors in patients with coronary artery disease undergoing percutaneous coronary intervention.

Journal Article Expert Rev Cardiovasc Ther · June 2018 Although novel therapies have improved outcomes in PCI patients, a sizeable number of patients still remain at high cardiovascular risk for recurrent event. There is therefore an unmet need for novel therapies that can improve clinical outcomes, with an as ... Full text Link to item Cite

Noncanonical Matrix Metalloprotease 1-Protease-Activated Receptor 1 Signaling Drives Progression of Atherosclerosis.

Journal Article Arterioscler Thromb Vasc Biol · June 2018 OBJECTIVE: Protease-activated receptor-1 (PAR1) is classically activated by thrombin and is critical in controlling the balance of hemostasis and thrombosis. More recently, it has been shown that noncanonical activation of PAR1 by matrix metalloprotease-1 ... Full text Link to item Cite

Evaluation of potential antiplatelet effects of CSL112 (Apolipoprotein A-I [Human]) in patients with atherosclerosis: results from a phase 2a study.

Journal Article J Thromb Thrombolysis · May 2018 CSL112 (Apolipoprotein A-I [Human]), an infusible, plasma-derived apolipoprotein A-I, is being developed to reduce cardiovascular events following acute myocardial infarction (AMI). A predecessor compound (CSL111) demonstrated a potential antiplatelet effe ... Full text Link to item Cite

Combination oral antithrombotic therapy for the treatment of myocardial infarction: recent developments.

Journal Article Expert Opin Pharmacother · May 2018 INTRODUCTION: There have been significant new developments in the treatment of patients with myocardial infarction with respect to oral antithrombotic agents over the past decade. Recent studies have explored the potential utility of targeting the dual pat ... Full text Link to item Cite

Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis.

Journal Article JAMA · April 17, 2018 IMPORTANCE: Effects on specific fatal and nonfatal end points appear to vary for low-density lipoprotein cholesterol (LDL-C)-lowering drug trials. OBJECTIVE: To evaluate whether baseline LDL-C level is associated with total and cardiovascular mortality ris ... Full text Link to item Cite

Genome-wide and candidate gene approaches of clopidogrel efficacy using pharmacodynamic and clinical end points-Rationale and design of the International Clopidogrel Pharmacogenomics Consortium (ICPC).

Journal Article Am Heart J · April 2018 RATIONALE: The P2Y12 receptor inhibitor clopidogrel is widely used in patients with acute coronary syndrome, percutaneous coronary intervention, or ischemic stroke. Platelet inhibition by clopidogrel shows wide interpatient variability, and high on-treatme ... Full text Link to item Cite

Selection of P2Y12 Inhibitor in Percutaneous Coronary Intervention and/or Acute Coronary Syndrome.

Journal Article Prog Cardiovasc Dis · 2018 The P2Y12 receptor plays a critical role in the amplification of platelet aggregation in response to various agonists and stable thrombus generation at the site of vascular injury leading to deleterious ischemic complications. Therefore, treatment with a P ... Full text Link to item Cite

Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians?

Journal Article Curr Vasc Pharmacol · 2018 With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothromb ... Full text Link to item Cite

Acetylsalicylic acid and clopidogrel hyporesponsiveness following acute coronary syndromes.

Journal Article Kardiol Pol · 2018 This review discusses the response variability to acetylsalicylic acid (ASA) and particularly to clopidogrel, and their relation to adverse recurrent ischaemic events in patients with arterial diseases. The higher rate of ASA resistance reported in the lit ... Full text Link to item Cite

Bleeding and thrombosis associated with ventricular assist device therapy.

Journal Article J Heart Lung Transplant · November 2017 Over the past decade, continuous-flow rotary pumps have dramatically improved survival for patients with advanced systolic heart failure. Bleeding and thrombosis, however, continue to be the Achilles heel of left ventricular assist device (LVAD) therapy. T ... Full text Link to item Cite

Low-density lipoprotein 4: a novel predictor of coronary artery disease severity.

Journal Article Curr Med Res Opin · November 2017 BACKGROUND: Hyperlipidemia is a well established risk factor for coronary artery disease (CAD). Severe CAD has been observed in patients with normal levels of total and low-density lipoprotein (LDL) cholesterol. Small dense LDL particle subtypes (LDL3 and ... Full text Link to item Cite

Advocating cardiovascular precision medicine with P2Y12 receptor inhibitors.

Journal Article Eur Heart J Cardiovasc Pharmacother · October 1, 2017 Antiplatelet therapy with P2Y12-receptor inhibitors has become the cornerstone of medical treatment in patients with acute coronary syndrome treated with percutaneous coronary intervention (PCI). With over 100 million prescriptions filled since its approva ... Full text Link to item Cite

Impact of Aspirin and Clopidogrel Hyporesponsiveness in Patients Treated With Drug-Eluting Stents: 2-Year Results of a Prospective, Multicenter Registry Study.

Journal Article JACC Cardiovasc Interv · August 28, 2017 OBJECTIVES: In this analysis of 2-year outcomes in the ADAPT-DES (Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents) study, the authors sought to examine the independent associations between platelet reactivity to both aspirin and clopidogre ... Full text Link to item Cite

More Evidence for Non-P2Y12-Mediated Effects of Ticagrelor.

Journal Article JACC Cardiovasc Interv · August 28, 2017 Full text Link to item Cite

Central aortic pulse pressure, thrombogenicity and cardiovascular risk.

Journal Article J Thromb Thrombolysis · August 2017 High central aortic pulse pressure (CPP) and thrombin-induced platelet-fibrin clot strength (TIP-FCS) have been associated with ischemic outcomes in patients with coronary artery disease in separate studies. But, the ischemic risk associated with these fac ... Full text Link to item Cite

Implantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic Cardiomyopathy: A Systematic Review and Meta-analysis.

Journal Article Ann Intern Med · July 18, 2017 BACKGROUND: Implantable cardioverter-defibrillators (ICDs) have a role in preventing cardiac arrest in patients at risk for life-threatening ventricular arrhythmias. PURPOSE: To compare ICD therapy with conventional care for the primary prevention of death ... Full text Link to item Cite

Novel role of platelet reactivity in adverse left ventricular remodelling after ST-segment elevation myocardial infarction: The REMODELING Trial.

Journal Article Thromb Haemost · May 3, 2017 The role of platelet-leukocyte interaction in the infarct myocardium still remains unveiled. We aimed to determine the linkage of platelet activation to post-infarct left ventricular remodelling (LVR) process. REMODELING was a prospective, observational, c ... Full text Link to item Cite

Determination of non-Vitamin K oral anticoagulant (NOAC) effects using a new-generation thrombelastography TEG 6s system.

Journal Article J Thromb Thrombolysis · May 2017 Non vitamin K oral anticoagulants (NOACs) do not require regular monitoring but information about their pharmacodynamic effect may be importantin situations like trauma, stroke oremergent surgery. Currently, no standardized point-of-care test is available ... Full text Link to item Cite

Mortality Following Cardiovascular and Bleeding Events Occurring Beyond 1 Year After Coronary Stenting: A Secondary Analysis of the Dual Antiplatelet Therapy (DAPT) Study.

Journal Article JAMA Cardiol · May 1, 2017 IMPORTANCE: Early cardiovascular and bleeding events after coronary stenting are associated with high risk of morbidity and mortality. OBJECTIVE: To assess the prognosis of cardiovascular and bleeding events occurring beyond 1 year after coronary stenting. ... Full text Link to item Cite

The Rationale for and Clinical Pharmacology of Prasugrel 5 mg.

Journal Article Am J Cardiovasc Drugs · April 2017 Prasugrel is a third-generation thienopyridine platelet P2Y12 adenosine diphosphate (ADP) receptor antagonist administered with aspirin for the treatment of patients with acute coronary syndrome (ACS) with planned percutaneous coronary intervention. Prasug ... Full text Link to item Cite

Monitoring of antiplatelet therapy

Chapter · March 8, 2017 The variability of response to antiplatelet agents and its potential relation to the occurrence of recurrent ischemic events have stimulated the concept of antiplatelet therapy monitoring over the last decade. This has been driven further by the developmen ... Full text Cite

Pharmacodynamic effects of a new fixed-dose clopidogrel-aspirin combination compared with separate administration of clopidogrel and aspirin in patients treated with coronary stents: The ACCEL-COMBO trial.

Journal Article Platelets · March 2017 Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin is a widely prescribed regimen to prevent ischemic events in patients undergoing percutaneous coronary intervention (PCI). A fixed-dose combination (FDC) capsule (HCP0911) has been developed to ... Full text Link to item Cite

Efficacy of aspirin (325 mg) + omeprazole (40 mg) in treating coronary artery disease.

Journal Article Expert Opin Pharmacother · January 2017 Aspirin is indicated for primary and secondary prevention of cardiovascular diseases (CVD) by major guidelines. However, its use may be associated with gastrointestinal (GI) toxicities, including, but not limited to, GI bleeding. This may lead to increased ... Full text Link to item Cite

Prevention of contrast-induced acute kidney injury in patients undergoing cardiovascular procedures-a systematic review and network meta-analysis.

Journal Article PLoS One · 2017 BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovasc ... Full text Link to item Cite

Antiplatelet Effect Durability of a Novel, 24-Hour, Extended-Release Prescription Formulation of Acetylsalicylic Acid in Patients With Type 2 Diabetes Mellitus.

Journal Article Am J Cardiol · December 15, 2016 High platelet reactivity and high platelet turnover have been implicated in incomplete platelet inhibition during immediate-release acetylsalicylic acid therapy in patients with type 2 diabetes mellitus (DM). An extended-release acetylsalicylic acid (ER-AS ... Full text Link to item Cite

Does Platelet Reactivity Predict Bleeding in Patients Needing Urgent Coronary Artery Bypass Grafting During Dual Antiplatelet Therapy?

Conference Ann Thorac Surg · December 2016 BACKGROUND: Up to 15% of patients require coronary artery bypass grafting (CABG) during dual antiplatelet therapy. Available evidence suggests an association between platelet reactivity and CABG-related bleeding. However, platelet reactivity cutoffs for bl ... Full text Link to item Cite

Coagulation Abnormalities in Heart Failure: Pathophysiology and Therapeutic Implications.

Journal Article Curr Heart Fail Rep · December 2016 Heart failure (HF) represents a heterogeneous condition characterized by vulnerabilities in the blood, vasculature, and impaired flow dynamics that predispose to both arterial and venous thrombosis. Despite evidence-based advances in the medical and device ... Full text Link to item Cite

Current controversies in the use of aspirin and ticagrelor for the treatment of thrombotic events.

Journal Article Expert Rev Cardiovasc Ther · December 2016 A P2Y12 inhibitor plus aspirin is the most widely used antiplatelet strategy to prevent adverse outcomes in the setting of atherothrombotic vascular disease. Areas covered: A paucity of robust evidence for an optimal dose, gastrointestinal toxicity, ineffe ... Full text Link to item Cite

Cigarette Smoking, Clopidogrel Responsiveness, and Hemoglobin Level.

Journal Article JACC Cardiovasc Interv · November 28, 2016 Full text Link to item Cite

Peri-procedural platelet function testing in risk stratification and clinical decision making

Chapter · November 21, 2016 Myocardial infarction (MI) and stent thrombosis are catastrophic events that occur in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). The clinical efficacy of dual antiplatelet therapy (DAPT) of aspirin and ... Full text Cite

Relationship of Platelet Reactivity With Bleeding Outcomes During Long-Term Treatment With Dual Antiplatelet Therapy for Medically Managed Patients With Non-ST-Segment Elevation Acute Coronary Syndromes.

Journal Article J Am Heart Assoc · November 4, 2016 BACKGROUND: The relationship between "on-treatment" low platelet reactivity and longitudinal risks of major bleeding dual antiplatelet therapy following acute coronary syndromes remains uncertain, especially for patients who do not undergo percutaneous cor ... Full text Open Access Link to item Cite

First report of the point-of-care TEG: A technical validation study of the TEG-6S system.

Journal Article Platelets · November 2016 Thrombelastography (TEG) measured by the TEG5000 Hemostasis Analyzer is an established but the labor-intensive method for assessing global hemostasis. The first true point-of-care TEG, the TEG6s system, uses resonance-frequency viscoelasticity measurements ... Full text Link to item Cite

Risk factors associated with plasma omega-3 fatty acid levels in patients with suspected coronary artery disease.

Journal Article Prostaglandins Leukot Essent Fatty Acids · October 2016 INTRODUCTION: We sought to determine the associations between plasma eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels and various cardiovascular risk factors and with the use of fish oil supplements (FOS). PATIENTS AND METHODS: Patients wi ... Full text Link to item Cite

Oxidized Low-Density Lipoprotein-β2-Glycoprotein I Complex But Not Free Oxidized LDL Is Associated With the Presence and Severity of Coronary Artery Disease.

Journal Article Am J Cardiol · September 1, 2016 Oxidized low-density lipoprotein (oxLDL) and β2-glycoprotein I (β2GPI) have been identified in human atherosclerotic lesions and when complexed have been implicated as a pro-atherothrombotic antigen. We examined the association of free oxLDL and oxLDL-β2GP ... Full text Link to item Cite

Extended-release acetylsalicylic acid for secondary prevention of stroke and cardiovascular events.

Journal Article Expert Rev Cardiovasc Ther · July 2016 INTRODUCTION: Aspirin has been the bedrock of antiplatelet treatment strategies for the secondary prevention of recurrent cardiovascular and cerebrovascular events for the last 3 decades. The limitations of standard aspirin therapy include bleeding, gastro ... Full text Link to item Cite

Impact of Anemia on Platelet Reactivity and Ischemic and Bleeding Risk: From the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents Study.

Journal Article Am J Cardiol · June 15, 2016 Anemic patients remain at increased risk of ischemic and bleeding events. Whether the effects of hemoglobin levels on thrombotic and bleeding risk are independent of platelet reactivity on clopidogrel, however, remains unknown. Patients from the Assessment ... Full text Link to item Cite

Timing of Coronary Bypass Surgery in Patients Receiving Clopidogrel: The Role of VerifyNow.

Journal Article Can J Cardiol · June 2016 We briefly report for the first time the association between a point of care platelet recovery test and the timing of coronary artery bypass grafting after clopidogrel withdrawal. We observe an association between suggested wait days and platelet recovery ... Full text Link to item Cite

Proprotein Convertase Subtilisin/Kexin Type 9 Monoclonal Antibodies for Acute Coronary Syndrome: A Narrative Review.

Journal Article Ann Intern Med · May 3, 2016 Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) are an emerging therapy for dyslipidemia. Acute coronary events induce a dynamic increase of PCSK9 levels that may play a role in plaque vulnerability of both culprit ... Full text Link to item Cite

Influence of platelet reactivity on BARC classification in East Asian patients undergoing percutaneous coronary intervention. Results of the ACCEL-BLEED study.

Journal Article Thromb Haemost · May 2, 2016 An increasing body of data suggests that East Asian patients have differing risk profiles for both thrombophilia and bleeding compared with Western population. This study was designed to evaluate the relationship of bleeding to platelet function in East As ... Full text Link to item Cite

Platelet-Mediated Thrombosis: From Bench to Bedside.

Journal Article Circ Res · April 29, 2016 The pivotal role that platelets play in thrombosis and resultant ischemic event occurrences in patients with high-risk coronary artery disease is well established. This role provides the fundamental basis for the current wide implementation of dual antipla ... Full text Link to item Cite

Markers of platelet function

Chapter · April 19, 2016 Cite

Association of weight gain with coronary artery disease, inflammation and thrombogenicity.

Journal Article J Thromb Thrombolysis · April 2016 Obese individuals, despite having increased cardiovascular (CV) risk factors experience adverse CV outcomes less frequently than non-obese. Little is known about association of long-term weight gain to development of coronary artery disease (CAD), inflamma ... Full text Link to item Cite

Thrombin-Induced Platelet-Fibrin Clot Strength Identified by Thrombelastography: A Novel Prothrombotic Marker of Coronary Artery Stent Restenosis.

Journal Article J Interv Cardiol · April 2016 BACKGROUND AND OBJECTIVE: In-stent restenosis (ISR) is a limitation of percutaneous coronary intervention and has been linked to specific clinical and angiographic variables. We aimed to simultaneously assess thrombosis biomarkers and lipid levels in patie ... Full text Link to item Cite

Vascular risk levels affect the predictive value of platelet reactivity for the occurrence of MACE in patients on clopidogrel. Systematic review and meta-analysis of individual patient data.

Journal Article Thromb Haemost · April 2016 Prior studies have shown an association between high on-clopidogrel platelet reactivity (PR) and the risk of major adverse cardiovascular events (MACE). However, large intervention trials on PR-tailored treatments have been neutral. The role and usefulness ... Full text Link to item Cite

Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel.

Journal Article J Am Coll Cardiol · March 1, 2016 BACKGROUND: Certain alleles of the CYP2C19 gene are associated with higher platelet reactivity and increased ischemic events among patients treated with clopidogrel. However, the relationship of CYP2C19 genotype and outcomes in medically managed patients w ... Full text Link to item Cite

Point-of-Care Technologies for Precision Cardiovascular Care and Clinical Research: National Heart, Lung, and Blood Institute Working Group

Journal Article JACC: Basic to Translational Science · February 1, 2016 Point-of-care technologies (POC or POCT) are enabling innovative cardiovascular diagnostics that promise to improve patient care across diverse clinical settings. The National Heart, Lung, and Blood Institute convened a working group to discuss POCT in car ... Full text Cite

Drug delivery and therapeutic impact of extended-release acetylsalicylic acid.

Journal Article Future Cardiol · January 2016 Current treatment guidelines recommend once-daily, low-dose acetylsalicylic acid (ASA; aspirin) for secondary prevention of cardiovascular events. However, the anti-thrombotic benefits of traditional ASA formulations may not extend over a 24-h period, espe ... Full text Link to item Cite

Cell-Penetrating Pepducin Therapy Targeting PAR1 in Subjects With Coronary Artery Disease.

Journal Article Arterioscler Thromb Vasc Biol · January 2016 OBJECTIVE: Pepducins are membrane-tethered, cell-penetrating lipopeptides that target the cytoplasmic surface of their cognate receptor. Here, we report the first human use of a protease-activated receptor-1-based pepducin, which is intended as an antiplat ... Full text Link to item Cite

Statin therapy and inflammation in patients with diabetes treated with high dose aspirin.

Journal Article J Diabetes Complications · 2016 BACKGROUND: Statin and aspirin form the therapeutic cornerstone in patients with coronary artery disease (CAD) and diabetes. Little is known about relationship of statins with blood thrombogenicity and inflammation in these patients. METHODS: Two hundred n ... Full text Link to item Cite

Vorapaxar in the secondary prevention of atherothrombosis.

Journal Article Expert Rev Cardiovasc Ther · December 2015 Dual antiplatelet therapy with aspirin, a platelet cyclooxygenase-1 inhibitor and P2Y12 receptor blockers, remains the major drug strategy to prevent ischemic event occurrence in patients with acute coronary syndromes and in patients undergoing coronary st ... Full text Link to item Cite

Infusion of Reconstituted High-Density Lipoprotein, CSL112, in Patients With Atherosclerosis: Safety and Pharmacokinetic Results From a Phase 2a Randomized Clinical Trial.

Journal Article J Am Heart Assoc · August 25, 2015 BACKGROUND: CSL112 is a new formulation of human apolipoprotein A-I (apoA-I) being developed to reduce cardiovascular events following acute coronary syndrome. This phase 2a, randomized, double-blind, multicenter, dose-ranging trial represents the first cl ... Full text Open Access Link to item Cite

Complete revascularisation in ST-elevation myocardial infarction and multivessel disease: meta-analysis of randomised controlled trials.

Journal Article Heart · August 2015 BACKGROUND: Current guidelines recommend culprit-only revascularisation (COR) in haemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) and multivessel (MV) disease. Contrarily, growing body of evidence available from rece ... Full text Link to item Cite

Bleeding and stent thrombosis on P2Y12-inhibitors: collaborative analysis on the role of platelet reactivity for risk stratification after percutaneous coronary intervention.

Journal Article Eur Heart J · July 14, 2015 AIMS: Although platelet reactivity during P2Y12-inhibitors is associated with stent thrombosis (ST) and bleeding, standardized and clinically validated thresholds for accurate risk stratification after percutaneous coronary intervention (PCI) are lacking. ... Full text Link to item Cite

Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia: A Systematic Review and Meta-analysis.

Journal Article Ann Intern Med · July 7, 2015 BACKGROUND: Guidelines recommend statins as first-line therapy for dyslipidemia. Monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new lipid-lowering approach. PURPOSE: To assess the efficacy and safety of PCSK9 ant ... Full text Link to item Cite

Novel antiplatelet agents in cardiovascular medicine.

Journal Article Curr Treat Options Cardiovasc Med · June 2015 Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker, particularly clopidogrel, has been the standard of therapy for secondary prevention in patients with acute coronary syndromes and patients treated with percutaneous coronary intervention. ... Full text Link to item Cite

P2Y12 receptor inhibitors for secondary prevention of ischemic stroke.

Journal Article Expert Opin Pharmacother · June 2015 INTRODUCTION: Ischemic stroke (IS) is a major cause of death and disability worldwide. The P2Y12 receptor plays a critical role in the formation of a stable thrombus leading to ischemic complications. Therefore, P2Y12 receptor inhibitors constitute a major ... Full text Link to item Cite

Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry.

Journal Article Circ Cardiovasc Interv · June 2015 BACKGROUND: Chronic kidney disease (CKD) is associated with increased rates of adverse events after percutaneous coronary intervention. We sought to determine the impact of CKD on platelet reactivity in clopidogrel-treated patients and whether high platele ... Full text Link to item Cite

Relation of fish oil supplementation to markers of atherothrombotic risk in patients with cardiovascular disease not receiving lipid-lowering therapy.

Journal Article Am J Cardiol · May 1, 2015 Fish oil supplementation (FOS) is known to have cardiovascular benefits. However, the effects of FOS on thrombosis are incompletely understood. We sought to determine if the use of FOS is associated with lower indices of atherothrombotic risk in patients w ... Full text Link to item Cite

Current antiplatelet treatment strategy in patients with diabetes mellitus.

Journal Article Diabetes Metab J · April 2015 Patients with diabetes mellitus (DM) have accelerated atherosclerosis with an increased risk for atherothrombotic cardiovascular complications. A state of high platelet reactivity and activation, hypercoagulability (prothrombotic state) and a subdued respo ... Full text Link to item Cite

Meta-analysis of direct and indirect comparison of ticagrelor and prasugrel effects on platelet reactivity.

Journal Article Am J Cardiol · March 15, 2015 Studies have linked on-treatment platelet reactivity (PR) to adverse clinical outcomes. Because new P2Y12 inhibitors (prasugrel and ticagrelor) have been predominantly tested against clopidogrel, data on pharmacodynamic comparisons between these 2 drugs ar ... Full text Link to item Cite

G-protein-coupled receptors signaling pathways in new antiplatelet drug development.

Journal Article Arterioscler Thromb Vasc Biol · March 2015 Platelet G-protein-coupled receptors influence platelet function by mediating the response to various agonists, including ADP, thromboxane A2, and thrombin. Blockade of the ADP receptor, P2Y12, in combination with cyclooxygenase-1 inhibition by aspirin has ... Full text Link to item Cite

What is the best anticoagulant therapy during primary percutaneous coronary intervention for acute myocardial infarction?

Journal Article Pol Arch Med Wewn · 2015 Both ST-segment elevation myocardial infarction and percutaneous coronary intervention (PCI) are associated with a highly prothrombotic state, and thrombin plays a critical role during occlusive clot generation and subsequent occurrence of an ischemic even ... Full text Link to item Cite

Graduated compression stockings to treat acute leg pain associated with proximal DVT. A randomised controlled trial.

Journal Article Thromb Haemost · December 2014 Acute deep venous thrombosis (DVT) causes leg pain. Elastic compression stockings (ECS) have potential to relieve DVT-related leg pain by diminishing the diameter of distended veins and increasing venous blood flow. It was our objective to determine whethe ... Full text Link to item Cite

Resistance to antiplatelet drugs: what progress has been made?

Journal Article Expert Opin Pharmacother · December 2014 INTRODUCTION: Despite well-documented efficacy, recurrent thrombotic event occurrences, particularly stent thrombosis, have been repeatedly demonstrated in stented patients treated with aspirin and clopidogrel. The latter observation stimulated the close s ... Full text Link to item Cite

Effect of adjunctive dipyridamole to DAPT on platelet function profiles in stented patients with high platelet reactivity. The result of the ACCEL-DIP Study.

Journal Article Thromb Haemost · December 2014 Adjunctive use of phosphodiesterase (PDE) inhibitor can enhance antiplatelet and vasoprotective properties in patients with cardiovascular disease. The aim of this study was to evaluate the impact of PDE5 inhibitor dipyridamole on platelet function in sten ... Full text Link to item Cite

Influence of race and sex on thrombogenicity in a large cohort of coronary artery disease patients.

Journal Article J Am Heart Assoc · October 20, 2014 BACKGROUND: It is uncertain whether sex and race affect thrombogenicity in patients with coronary artery disease. We evaluated the effects of sex and race on thrombogenicity in patients with coronary artery disease treated with aspirin. METHODS AND RESULTS ... Full text Link to item Cite

Platelet reactivity during ticagrelor maintenance therapy: a patient-level data meta-analysis.

Journal Article Am Heart J · October 2014 BACKGROUND: Factors associated with platelet reactivity (PR) during ticagrelor maintenance dose (MD) are not well defined. We aimed to examine factors that influence levels of PR during chronic ticagrelor therapy. METHODS: We performed individual participa ... Full text Link to item Cite

The effect of CYP2C19 gene polymorphisms on the pharmacokinetics and pharmacodynamics of prasugrel 5-mg, prasugrel 10-mg and clopidogrel 75-mg in patients with coronary artery disease.

Journal Article Thromb Haemost · September 2, 2014 CYP2C19 genotype has been shown to impact response to clopidogrel 75-mg but not prasugrel 10-mg. Here, we assessed effects of CYP2C19 metaboliser status on pharmacokinetics (PK) and pharmacodynamic (PD) responses to prasugrel 5-mg and 10-mg and clopidogrel ... Full text Link to item Cite

Review of pharmacokinetic and pharmacodynamic modeling and safety of proton pump inhibitors and aspirin.

Journal Article Expert Rev Clin Pharmacol · September 2014 The efficacy of aspirin in primary and secondary prevention of cardiovascular diseases has been convincingly demonstrated. Gastrointestinal (GI) adverse effects with aspirin may lead to poor adherence and/or discontinuation of treatment. Proton pump inhibi ... Full text Link to item Cite

Statin therapy and thromboxane generation in patients with coronary artery disease treated with high-dose aspirin.

Journal Article Thromb Haemost · August 2014 Aspirin and statin therapy are mainstay treatments in patients with coronary artery disease (CAD). The relation between statin therapy, in vivo thromboxane (Tx) generation; a marker of inflammation, and blood thrombogenicity has never been explored. Urinar ... Full text Link to item Cite

Impact of smoking status on platelet function and clinical outcomes with prasugrel vs. clopidogrel in patients with acute coronary syndromes managed without revascularization: Insights from the TRILOGY ACS trial.

Conference Am Heart J · July 2014 BACKGROUND: To further explore the impact of smoking on antiplatelet activity and treatment response, we evaluated time-dependent relationships between smoking status with on-treatment platelet reactivity and clinical outcomes for prasugrel vs. clopidogrel ... Full text Link to item Cite

Thrombelastography and Other Novel Techniques

Chapter · June 3, 2014 Recent implementation of user-friendly, point-of-care (POC) and near-POC platelet function assays in translational research studies enhanced interest in the personalized antiplatelet therapy concept. In addition to the measurement of platelet response to a ... Full text Cite

Platelet Pathophysiology and its Role in Thrombosis

Chapter · June 3, 2014 Multiple lines of evidence support the important role of platelets in thrombosis and subsequent clinical manifestations. Following platelet activation, the two agonists such as thromboxane A2 (TxA2) and adenosine diphosphate (ADP) generated at the site of ... Full text Cite

Antiplatelet Therapy in Cardiovascular Disease

Book · June 3, 2014 Begins with a concise but thorough discussion of platelet biology and pathophysiology so that readers understand how antiplatelet agents work and why they produce such a varied range of complications, from minor GI upset to potentially life-threatening con ... Full text Cite

Personalizing Antiplatelet Therapy

Chapter · June 3, 2014 Currently, the evidence indicates that high platelet reactivity (HPR) and CYP2C19 LoF carriage are associated with poorer clinical outcomes in high-risk clopidogrel-treated patients who have undergone percutaneous coronary intervention (PCI). Therefore, a ... Full text Cite

Clopidogrel Resistance

Chapter · June 3, 2014 A large body of data from observational studies indicates that clopidogrel therapy is associated with major pharmacodynamic (PD) limitations including wide response variability and nonresponsiveness (high on-treatment platelet reactivity (HPR) to adenosine ... Full text Cite

Light Transmission Aggregometry

Chapter · June 3, 2014 Laboratory evaluation of platelet function by a simple and reliable in vitro method is crucial to understand the critical role of platelets during hemostasis and thrombotic complications of cardiovascular disease. An in vitro quantitative determination of ... Full text Cite

Update: Acute coronary syndromes (V). Personalized antiplatelet therapy.

Journal Article Rev Esp Cardiol (Engl Ed) · June 2014 It is well established that high on-treatment platelet reactivity to adenosine diphosphate during clopidogrel therapy is an independent risk factor for ischemic event occurrences in a postpercutaneous coronary intervention patients. However, the precise ro ... Full text Link to item Cite

Clopidogrel metaboliser status based on point-of-care CYP2C19 genetic testing in patients with coronary artery disease.

Journal Article Thromb Haemost · May 5, 2014 We compared results obtained with the Nanosphere Verigene® System, a novel point-of-care (POC) genetic test capable of analysing 11 CYP2C19 variants within 3 hours, to an established, validated genotyping method (Affymetrix™ DMET+; reference assay) for ide ... Full text Link to item Cite

Cangrelor: an emerging therapeutic option for patients with coronary artery disease.

Journal Article Curr Med Res Opin · May 2014 OBJECTIVES: To perform a systematic up-to-date review and critical discussion of potential clinical applications of cangrelor based on its pharmacologic properties and the main findings from randomized clinical studies. METHODS: A database search (PubMed, ... Full text Link to item Cite

Pharmacodynamic evaluation of switching from ticagrelor to prasugrel in patients with stable coronary artery disease: Results of the SWAP-2 Study (Switching Anti Platelet-2).

Journal Article J Am Coll Cardiol · April 22, 2014 OBJECTIVES: The goal of this study was to evaluate the pharmacodynamic effects of switching patients from ticagrelor to prasugrel. BACKGROUND: Clinicians may need to switch between more potent P2Y12 inhibitors because of adverse effects or switch to the us ... Full text Link to item Cite

Thrombin-induced platelet-fibrin clot strength: relation to high on-clopidogrel platelet reactivity, genotype, and post-percutaneous coronary intervention outcomes.

Journal Article Thromb Haemost · April 1, 2014 The relationship between thrombin-induced platelet-fibrin clot strength (MATHROMBIN), genotype and high on-treatment platelet reactivity (HPR) is unknown. The aim of this study is to assess the influence of MATHROMBIN measured by thrombelastography on HPR ... Full text Link to item Cite

Antiplatelet treatment for prevention of cerebrovascular events in patients with vascular diseases: a systematic review and meta-analysis.

Journal Article Stroke · February 2014 BACKGROUND AND PURPOSE: The efficacy and safety of different antiplatelet regimes for prevention of stroke in patients at high risk were investigated in a systematic review and meta-analysis. METHODS: We searched the Cochrane Central Register of Controlled ... Full text Link to item Cite

Antiplatelet and anticoagulant agents in heart failure: current status and future perspectives.

Journal Article JACC Heart Fail · February 2014 There has been a 3-fold increase in hospital discharges for heart failure (HF) and also significantly increased mortality rate in HF patients in recent years. A major focus of HF research has been in the area of neurohormonal control and resynchronization ... Full text Link to item Cite

Personalized antiplatelet therapy

Journal Article Revista Espanola de Cardiologia · January 1, 2014 It is well established that high on-treatment platelet reactivity to adenosine diphosphate during clopidogrel therapy is an independent risk factor for ischemic event occurrences in a postpercutaneous coronary intervention patients. However, the precise ro ... Full text Cite

Pharmacodynamic effects of cilostazol versus clopidogrel in stented patients under proton pump inhibitor co-administration: the ACCEL-PARAZOL study.

Journal Article J Atheroscler Thromb · 2014 AIM: Proton pump inhibitor (PPI) therapy has been shown to attenuate the antiplatelet effects of clopidogrel. The aim of this study was to compare the antiplatelet effects of cilostazol versus clopidogrel in patients co-administered a PPI. METHODS: We enro ... Full text Link to item Cite

Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding.

Journal Article J Am Coll Cardiol · December 17, 2013 Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker is a key strategy to reduce platelet reactivity and to prevent thrombotic events in patients treated with percutaneous coronary intervention. In an earlier consensus document, we proposed ... Full text Link to item Cite

Pharmacology of antiplatelet agents.

Journal Article Curr Atheroscler Rep · December 2013 Pharmacotherapies with agents that inhibit platelet function have proven to be effective in the treatment of acute coronary syndromes, and in the prevention of complications during and after percutaneous coronary intervention. Because of multiple synergeti ... Full text Link to item Cite

Acute coronary syndromes

Chapter · November 1, 2013 Aspirin remains the bedrock oral antiplatelet agent in patients with acute coronary syndrome (ACS). Dual-antiplatelet therapy is the standard of care in patients with ACS, particularly in patients undergoing percutaneous coronary intervention. Both of the ... Full text Cite

PA tablets: investigational compounds combining aspirin and omeprazole for cardioprotection.

Journal Article Future Cardiol · November 2013 For most patients with prior cardiovascular events, preventing future secondary cardiovascular events requires life-long persistence with antiplatelet therapy. PA tablets (P: proton pump inhibitors; A: aspirin) are investigational compounds that were devel ... Full text Link to item Cite

Importance of measurement of platelet reactivity to ADP in patients with coronary artery disease: an historical account.

Journal Article Expert Rev Cardiovasc Ther · November 2013 The pivotal roles of platelets in physiological hemostasis and pathological thrombosis at the site of plaque rupture are well established. The latter roles provide the fundamental basis for the most widely implemented pharmacologic management of coronary a ... Full text Link to item Cite

The role of platelet function testing in risk stratification and clinical decision-making

Journal Article Interventional Cardiology Clinics · October 1, 2013 Clopidogrel (a widely used second-generation thienopyridine) therapy is associated with an unpredictable pharmacodynamic response whereby approximately 1 in 3 patients will have a high on-treatment platelet reactivity to adenosine diphosphate. High on-trea ... Full text Cite

Influence of platelet reactivity and inflammation on peri-procedural myonecrosis in East Asian patients undergoing elective percutaneous coronary intervention.

Journal Article Int J Cardiol · September 20, 2013 BACKGROUND AND OBJECTIVES: The contribution of multiple risk factors to peri-procedural myocardial infarction (PMI) in East Asians remains controversial. To assess the influence of clinical or laboratory covariates on PMI in these patients. METHODS: Stable ... Full text Link to item Cite

Potential role of oral anticoagulants in the treatment of patients with coronary artery disease: focus on dabigatran.

Journal Article Expert Rev Cardiovasc Ther · September 2013 The pharmacologic management of patients with high-risk coronary artery disease consists of aspirin and a P2Y12 receptor inhibitor. Chronic oral anticoagulation with warfarin is the major treatment strategy to attenuate thromboembolism or stroke in patient ... Full text Link to item Cite

Platelet reactivity and clinical outcomes after coronary artery implantation of drug-eluting stents (ADAPT-DES): a prospective multicentre registry study.

Journal Article Lancet · August 17, 2013 BACKGROUND: The relation between platelet reactivity and stent thrombosis, major bleeding, and other adverse events after coronary artery implantation of drug-eluting stents has been incompletely characterised. We aimed to determine the relation between pl ... Full text Link to item Cite

What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?

Journal Article Lancet · August 17, 2013 Acute ST-segment elevation myocardial infarction (STEMI) is a dynamic, thrombus-driven event. As understanding of its pathophysiology has improved, the central role of platelets in initiation and orchestration of this process has become clear. Key componen ... Full text Link to item Cite

Prasugrel 5 mg in the very elderly attenuates platelet inhibition but maintains noninferiority to prasugrel 10 mg in nonelderly patients: the GENERATIONS trial, a pharmacodynamic and pharmacokinetic study in stable coronary artery disease patients.

Journal Article J Am Coll Cardiol · August 13, 2013 OBJECTIVES: This study assessed pharmacodynamic (PD) response to the reduced prasugrel maintenance dose of 5 mg in very elderly (VE) patients (≥75 years of age). BACKGROUND: In the TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Opti ... Full text Link to item Cite

The influence of smoking status on the pharmacokinetics and pharmacodynamics of clopidogrel and prasugrel: the PARADOX study.

Journal Article J Am Coll Cardiol · August 6, 2013 OBJECTIVES: The goal of this study was to evaluate the effect of smoking on the pharmacokinetics and pharmacodynamics (PD) of clopidogrel and prasugrel therapy. BACKGROUND: Major randomized trial data demonstrated that nonsmokers experience less or no bene ... Full text Link to item Cite

Low-dose of oral factor Xa inhibitors in patients with a recent acute coronary syndrome: a systematic review and meta-analysis of randomized trials.

Journal Article Atherosclerosis · August 2013 BACKGROUND: Recently, randomized controlled trials (RCTs) have shown that therapy with new oral activated factor X (Xa) inhibitors in acute coronary syndrome (ACS) yielded a reduction of ischemic events. However, this therapy was associated with a dose-rel ... Full text Link to item Cite

Is bleeding a necessary evil? The inherent risk of antithrombotic pharmacotherapy used for stroke prevention in atrial fibrillation.

Journal Article Expert Rev Cardiovasc Ther · August 2013 Current European atrial fibrillation (AF) guidelines have assigned a strong recommendation for the initiation of antithrombotic therapy to prevent thromboembolism in all but those AF patients at low risk (or with contraindications). Furthermore, the select ... Full text Link to item Cite

The next 10 years in personalized medicine in cardiology.

Journal Article Expert Rev Cardiovasc Ther · August 2013 Full text Link to item Cite

Relation between the vasodilator-stimulated phosphoprotein phosphorylation assay and light transmittance aggregometry in East Asian patients after high-dose clopidogrel loading.

Journal Article Am Heart J · July 2013 OBJECTIVES: We analyzed the relation between platelet aggregation measured by light transmittance aggregometry (LTA) and platelet reactivity index (PRI) measured by vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) assay. BACKGROUND: It has be ... Full text Link to item Cite

P2Y12 Receptor Blockade and Myocardial Perfusion.

Journal Article JACC Cardiovasc Interv · July 2013 Full text Link to item Cite

Thienopyridine efficacy and cigarette smoking status.

Journal Article Am Heart J · May 2013 Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker is an established regimen to reduce the risk of ischemic event occurrence in patients with high-risk cardiovascular (CV) disease. Cigarette smoking is an important cardiovascular risk fact ... Full text Link to item Cite

Cigarette smoking and clopidogrel interaction.

Journal Article Curr Cardiol Rep · May 2013 Dual antiplatelet therapy (DAPT) with aspirin and an adenosine diphosphate receptor antagonist is central to the modern management of acute coronary syndromes and percutaneous revascularization. The most widely used adenosine diphosphate receptor antagonis ... Full text Link to item Cite

Evaluating the clinical usefulness of platelet function testing: considerations for the proper application and interpretation of performance measures.

Journal Article Thromb Haemost · May 2013 Various diagnostic and prognostic performance measures have been used to describe the clinical usefulness of platelet function testing in the evaluation and management of patients taking P2Y12 inhibitors, which reduce the risk for thrombosis due to their a ... Full text Link to item Cite

Influence of genetic polymorphisms on platelet function, response to antiplatelet drugs and clinical outcomes in patients with coronary artery disease.

Journal Article Expert Rev Cardiovasc Ther · April 2013 Platelet activation and aggregation play important roles in ischemic event occurrences in patients with coronary artery disease. In the absence of a disease state and drug administration, platelet reactivity has been shown to be stable over time, indicatin ... Full text Link to item Cite

Genetic variation in PEAR1 is associated with platelet aggregation and cardiovascular outcomes.

Journal Article Circ Cardiovasc Genet · April 2013 BACKGROUND- Aspirin or dual antiplatelet therapy with aspirin and clopidogrel is a standard therapy for patients who are at increased risk for cardiovascular events. However, the genetic determinants of variable response to aspirin (alone and in combinatio ... Full text Link to item Cite

Drug-coated balloons in treatment of in-stent restenosis: a meta-analysis of randomised controlled trials.

Journal Article Clin Res Cardiol · April 2013 BACKGROUND: Drug-coated balloons (DCBs) have been developed for the percutaneous treatment of coronary artery disease. An initial focus has been the management of in-stent restenosis (ISR) but randomised controlled trials (RCTs) have been small and powered ... Full text Link to item Cite

Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes: a systematic review and meta-analysis.

Journal Article Ann Intern Med · February 19, 2013 BACKGROUND: The optimal timing of coronary intervention in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) is a matter of debate. Conflicting results among published studies partly relate to different risk profiles of the studie ... Full text Link to item Cite

Spaced administration of PA32540 and clopidogrel results in greater platelet inhibition than synchronous administration of enteric-coated aspirin and enteric-coated omeprazole and clopidogrel.

Journal Article Am Heart J · February 2013 BACKGROUND: A common regimen for patients requiring dual-antiplatelet therapy who are at risk for gastrointestinal complications is the synchronous administration of enteric-coated (EC) aspirin, a proton pump inhibitor, and clopidogrel, although proton pum ... Full text Link to item Cite

Decrease in high on-treatment platelet reactivity (HPR) prevalence on switching from clopidogrel to prasugrel: insights from the switching anti-platelet (SWAP) study.

Journal Article Thromb Haemost · February 2013 The prevalence of high platelet reactivity (HPR) in patients who have switched from clopidogrel to prasugrel during maintenance phase after an acute coronary syndrome (ACS) event is unknown. Therefore, the effect of switching from clopidogrel to prasugrel ... Full text Link to item Cite

Antiplatelet drug resistance and variability in response: the role of antiplatelet therapy monitoring.

Journal Article Curr Pharm Des · 2013 Dual antiplatelet therapy of clopidogrel added aspirin is an established treatment strategy to prevent recurrent ischemic event occurrence in coronary artery disease patients. Generally, a one size fits all nonselective strategy is used without an assessme ... Full text Link to item Cite

The functional G143E variant of carboxylesterase 1 is associated with increased clopidogrel active metabolite levels and greater clopidogrel response.

Journal Article Pharmacogenet Genomics · January 2013 INTRODUCTION: Carboxylesterase 1 (CES1) is the primary enzyme responsible for converting clopidogrel into biologically inactive carboxylic acid metabolites. METHODS: We genotyped a functional variant in CES1, G143E, in participants of the Pharmacogenomics ... Full text Link to item Cite

Platelet reactivity and thrombogenicity in postmenopausal women.

Journal Article Menopause · January 2013 OBJECTIVE: Age-adjusted incidence of cardiovascular disease, including myocardial infarction, is significantly lower in premenopausal women than in men, which is thought to be caused by the cardioprotective effects of estrogen. However, there is a consiste ... Full text Link to item Cite

High-dose, but not low-dose, aspirin impairs anticontractile effect of ticagrelor following ADP stimulation in rat tail artery smooth muscle cells.

Journal Article Biomed Res Int · 2013 OBJECTIVE: To compare effects of low- versus high-dose aspirin coadministered with ticagrelor on the reactivity of vascular smooth muscle cells (VSMCs). METHODS: Wistar rats were orally administered ticagrelor (10 mg/kg) and/or aspirin (2 or 10 mg/kg) (n = ... Full text Link to item Cite

Platelet Function During Extended Prasugrel and Clopidogrel Therapy for Patients With ACS Treated Without Revascularization: The TRILOGY ACS Platelet Function Substudy.

Journal Article JAMA · November 4, 2012 CONTEXT The relationship of platelet function testing measurements with outcomes in patients with acute coronary syndromes (ACS) initially managed medically without revascularization is unknown. OBJECTIVE To characterize the differences and evaluate clinic ... Full text Link to item Cite

Pharmacodynamic effect of cilostazol plus standard clopidogrel versus double-dose clopidogrel in patients with type 2 diabetes undergoing percutaneous coronary intervention.

Journal Article Diabetes Care · November 2012 OBJECTIVE: To determine the effect of adding cilostazol (100 mg b.i.d.) to standard-dose clopidogrel (75 mg/d) (TRIPLE) compared with double-dose clopidogrel (150 mg/d) (DOUBLE) and the influence of the cytochrome P450 (CYP2C19*2/*3, CYP3A5*3)and ATP-bindi ... Full text Link to item Cite

Prasugrel versus clopidogrel for acute coronary syndromes without revascularization.

Journal Article N Engl J Med · October 4, 2012 BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, ... Full text Link to item Cite

Accelerated platelet inhibition by switching from atorvastatin to a non-CYP3A4-metabolized statin in patients with high platelet reactivity (ACCEL-STATIN) study.

Journal Article Eur Heart J · September 2012 AIMS: CYP3A4-metabolized statins can influence the pharmacodynamic effect of clopidogrel. We sought to assess the impact of switching to a non-CYP3A4-metabolized statin on platelet function among patients receiving clopidogrel and atorvastatin with high on ... Full text Link to item Cite

Role of genotype-based personalized antiplatelet therapy in the era of potent P2Y₁₂ receptor inhibitors.

Journal Article Expert Rev Cardiovasc Ther · August 2012 Therapy with clopidogrel and aspirin, commonly known as dual antiplatelet therapy, is a widely adapted secondary prevention strategy among coronary artery disease patients treated with percutaneous coronary intervention. However, in addition to response va ... Full text Link to item Cite

Importance of potent P2Y(12) receptor blockade in acute myocardial infarction: focus on prasugrel.

Journal Article Expert Opin Pharmacother · August 2012 INTRODUCTION: Prasugrel therapy is recommended in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). AREAS COVERED: This article reviews the efficacy and safety profile of prasugrel, cost considerations, and i ... Full text Link to item Cite

Influence of the paraoxonase-1 Q192R genetic variant on clopidogrel responsiveness and recurrent cardiovascular events: a systematic review and meta-analysis.

Journal Article J Thromb Haemost · July 2012 BACKGROUND: A poor biological response to clopidogrel is associated with an increased risk of major cardiovascular ischemic events (MACE). Paraoxonase 1 (PON1) enzyme activity is modulated by the PON1-Q192R variant (rs662) and was recently suggested to be ... Full text Link to item Cite

Translational platelet research in patients with coronary artery disease: what are the major knowledge gaps?

Journal Article Thromb Haemost · July 2012 Translational platelet function investigations performed in the percutaneous coronary intervention (PCI)-treated population receiving clopidogrel have identified high platelet reactivity to ADP (HPR) as a major risk factor for both acute as well as long-te ... Full text Link to item Cite

Usefulness of the VerifyNow P2Y12 assay to evaluate the antiplatelet effects of ticagrelor and clopidogrel therapies.

Journal Article Am Heart J · July 2012 OBJECTIVES: We analyzed the antiplatelet effects of different P2Y(12) receptor blockers with VerifyNow P2Y12 assay (VN-P2Y12) and light transmittance aggregometry (LTA). BACKGROUND: The point-of-care VN-P2Y12 has been used to assess the antiplatelet effect ... Full text Link to item Cite

Ticagrelor in the treatment of coronary artery disease patients

Journal Article Clinical Practice · July 1, 2012 Clopidogrel is a major P2Y 12 receptor blocker administered in addition to aspirin to reduce the ischemic event occurrence in a wide range of patients with arterial diseases particularly in patients treated with percutaneous coronary intervention (PCI). Ho ... Full text Cite

Pharmacokinetic and pharmacodynamic effects of elinogrel: results of the platelet function substudy from the intravenous and oral administration of elinogrel to evaluate tolerability and efficacy in nonurgent percutaneous coronary intervention patients (INNOVATE-PCI) trial.

Journal Article Circ Cardiovasc Interv · June 2012 BACKGROUND: Elinogrel is the only selective, competitive and reversible platelet P2Y(12) inhibitor available in both intravenous (IV) and oral formulations. METHODS AND RESULTS: This substudy of the Intravenous and Oral Administration of Elinogrel to Evalu ... Full text Link to item Cite

A randomized, double-blind, active-controlled phase 2 trial to evaluate a novel selective and reversible intravenous and oral P2Y12 inhibitor elinogrel versus clopidogrel in patients undergoing nonurgent percutaneous coronary intervention: the INNOVATE-PCI trial.

Journal Article Circ Cardiovasc Interv · June 2012 BACKGROUND: We evaluated the safety, efficacy, and tolerability of elinogrel, a competitive, reversible intravenous and oral P2Y(12) inhibitor that does not require metabolic activation, in patients undergoing nonurgent percutaneous coronary intervention. ... Full text Link to item Cite

Pharmacokinetics and pharmacodynamics of ticagrelor in patients with stable coronary artery disease: results from the ONSET-OFFSET and RESPOND studies.

Journal Article Clin Pharmacokinet · June 1, 2012 BACKGROUND AND OBJECTIVES: Ticagrelor, the first reversibly binding oral P2Y(12) receptor antagonist, improves outcomes in patients with acute coronary syndromes (ACS) compared with clopidogrel. In the ONSET-OFFSET study (parallel group trial) and the RESP ... Full text Link to item Cite

Adenosine improves post-procedural coronary flow but not clinical outcomes in patients with acute coronary syndrome: a meta-analysis of randomized trials.

Journal Article Atherosclerosis · May 2012 AIMS: Adjunctive therapy with adenosine has been shown to improve coronary flow in patients with acute coronary syndromes (ACS); it is unclear, however, whether adenosine can effectively reduce adverse clinical events. The aim of our study was to perform a ... Full text Link to item Cite

Platelet function measurement-based strategy to reduce bleeding and waiting time in clopidogrel-treated patients undergoing coronary artery bypass graft surgery: the timing based on platelet function strategy to reduce clopidogrel-associated bleeding related to CABG (TARGET-CABG) study.

Journal Article Circ Cardiovasc Interv · April 2012 BACKGROUND: Aspirin and clopidogrel therapy is associated with a variable bleeding risk in patients undergoing coronary artery bypass graft surgery (CABG). We evaluated the role of platelet function testing in clopidogrel-treated patients undergoing CABG. ... Full text Link to item Cite

Does gender have an influence on platelet function and the efficacy of oral antiplatelet therapy?

Journal Article Interventional Cardiology Clinics · April 1, 2012 The underlying pathophysiology of ischemic complications during acute coronary syndrome involves thrombus generation at sites of plaque rupture and endothelial erosion, in which platelet activation and aggregation play major roles. This review discusses wh ... Full text Cite

Antithrombotic therapies

Chapter · March 1, 2012 Full text Cite

Antiplatelet therapy beyond 2012: role of personalized medicine.

Journal Article Pol Arch Med Wewn · 2012 Since its first approval in 1997, clopidogrel has revolutionized interventional cardiology and transformed therapy for non‑ST‑segment elevation myocardial infarction (NSTEMI), STEMI, and percutaneous coronary intervention‑treated patients. It enjoyed a rem ... Link to item Cite

Updated evidence on intracoronary abciximab in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials.

Journal Article Cardiol J · 2012 BACKGROUND: Intracoronary (IC) abciximab administration remains a promising approach aimed to increase a drug concentration in the target area and possibly improve clinical outcomes in the setting of ST-segment elevation myocardial infarction (STEMI). The ... Full text Link to item Cite

Clinical efficacy and safety of intracoronary vs. intravenous abciximab administration in STEMI patients undergoing primary percutaneous coronary intervention: a meta-analysis of randomized trials.

Journal Article Platelets · 2012 Adjunctive therapy with abciximab has been proven to reduce mortality and reinfarction in patients with ST-elevation myocardial infarction (STEMI) referred to invasive management. Standard abciximab regimen consists of an intravenous (IV) bolus followed by ... Full text Link to item Cite

Pharmacodynamic evaluation of clopidogrel plus PA32540: the Spaced PA32540 With Clopidogrel Interaction Gauging (SPACING) study.

Journal Article Clin Pharmacol Ther · December 2011 PA32540 combines 325 mg enteric-coated (EC) aspirin (ASA) with 40 mg immediate-release omeprazole; its influence on the antiplatelet effect of clopidogrel (C) is unknown. In this randomized, open-label study, subjects (n = 30) were treated with (i) 300 mg ... Full text Link to item Cite

Effect of CYP2C19*2 and *3 loss-of-function alleles on platelet reactivity and adverse clinical events in East Asian acute myocardial infarction survivors treated with clopidogrel and aspirin.

Journal Article Circ Cardiovasc Interv · December 1, 2011 BACKGROUND: As compared with whites, East Asians more often carry the cytochrome P450 (CYP) 2C19 loss-of-function (LOF) allele with the CYP2C19*3 variant. The influence of the CYP2C19 LOF alleles (*2 and *3) on clopidogrel response and clinical outcomes in ... Full text Link to item Cite

Paraoxonase 1 (PON1) gene variants are not associated with clopidogrel response.

Journal Article Clin Pharmacol Ther · October 2011 A common functional variant in paraoxonase 1 (PON1), Q192R, was recently reported to be a major determinant of clopidogrel response. This variant was genotyped in 566 participants of the Amish Pharmacogenomics of Anti-Platelet Intervention (PAPI) study and ... Full text Link to item Cite

Vorapaxar: a novel protease-activated receptor-1 inhibitor.

Journal Article Expert Opin Investig Drugs · October 2011 INTRODUCTION: Platelet activation and reactivity are pivotal for both acute and chronic atherothrombotic event occurrences. AREAS COVERED: Only 20% relative risk (∼ 2% absolute risk) reduction associated with newer P2Y(12) receptor blocker therapy such as ... Full text Link to item Cite

Low-molecular-weight heparins vs. unfractionated heparin in the setting of percutaneous coronary intervention for ST-elevation myocardial infarction: a meta-analysis.

Journal Article J Thromb Haemost · October 2011 BACKGROUND: The aim of the current study was to perform two separate meta-analyses of available studies comparing low-molecular-weight heparins (LMWHs) vs. unfractionated heparin (UFH) in ST-elevation myocardial infarction (STEMI) patients treated (i) with ... Full text Link to item Cite

Earlier recovery of platelet function after discontinuation of treatment with ticagrelor compared with clopidogrel in patients with high antiplatelet responses.

Journal Article J Thromb Haemost · September 2011 BACKGROUND: The rate of recovery of platelet function after discontinuation of P2Y(12) inhibitors depends on the reversibility of the antiplatelet effect and the extent of the on-treatment response. P2Y(12) inhibition increases the bleeding risk in patient ... Full text Link to item Cite

Clopidogrel response variability and the advent of personalised antiplatelet therapy. A bench to bedside journey.

Journal Article Thromb Haemost · August 2011 Platelet-mediated thrombosis is a dreaded clinical event and is the primary cause of acute coronary syndromes and post-percutaneous intervention (PCI) ischaemic events. There has been a long standing interest in the ex vivo quantification of platelet react ... Full text Link to item Cite

Peri-operative platelet function testing: the potential for reducing ischaemic and bleeding risks.

Journal Article Thromb Haemost · August 2011 The pivotal role of platelet activation and reactivity during atherothrombotic event occurrence associated with acute coronary syndromes (ACS) or percutaneous coronary interventions (PCI) is well established. Numerous translational research studies have es ... Full text Link to item Cite

Assessment of oral antithrombotic therapy by platelet function testing.

Journal Article Nat Rev Cardiol · July 19, 2011 Dual antiplatelet therapy with clopidogrel and aspirin is recommended for the prevention of ischemic events in high-risk patients with coronary artery disease. In patients with atrial fibrillation, oral anticoagulant therapy with warfarin is the 'gold stan ... Full text Link to item Cite

The effect of ticagrelor versus clopidogrel on high on-treatment platelet reactivity: combined analysis of the ONSET/OFFSET and RESPOND studies.

Journal Article Am Heart J · July 2011 OBJECTIVES: The objective of the study was to determine the prevalence of high on-treatment platelet reactivity (HPR) in coronary artery disease patients enrolled in the ONSET/OFFSET and RESPOND studies. BACKGROUND: HPR has been linked to the occurrence of ... Full text Link to item Cite

Late-term clinical outcomes with zotarolimus- and sirolimus-eluting stents. 5-year follow-up of the ENDEAVOR III (A Randomized Controlled Trial of the Medtronic Endeavor Drug [ABT-578] Eluting Coronary Stent System Versus the Cypher Sirolimus-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions).

Journal Article JACC Cardiovasc Interv · May 2011 OBJECTIVES: This study sought to compare late safety and efficacy outcomes following percutaneous coronary revascularization with zotarolimus-eluting stents (ZES) and sirolimus-eluting stents (SES). BACKGROUND: Despite higher late lumen loss and binary res ... Full text Link to item Cite

Clopidogrel and proton pump inhibitors: influence of pharmacological interactions on clinical outcomes and mechanistic explanations.

Journal Article JACC Cardiovasc Interv · April 2011 Dual antiplatelet therapy with aspirin and clopidogrel is associated with a significant reduction in vascular ischemic events; however, gastrointestinal bleeding events are a major concern in high-risk and older patients. Clinical practice guidelines recom ... Full text Link to item Cite

The relation between CYP2C19 genotype and phenotype in stented patients on maintenance dual antiplatelet therapy.

Journal Article Am Heart J · March 2011 Both high platelet reactivity (HPR) and CYP2C19 genotyping have been proposed to stratify cardiovascular event risk and to personalize maintenance dual antiplatelet therapy (DAPT) in stented patients. However, how well CYP2C19 genotype correlates with HPR ... Full text Link to item Cite

Current options in oral antiplatelet strategies during percutaneous coronary interventions.

Journal Article Rev Cardiovasc Med · 2011 Dual antiplatelet therapy (DAPT) with aspirin and a P2Y(12) receptor blocker is the standard of care to prevent recurrent ischemic event occurrence in patients undergoing percutaneous intervention. Glycoprotein IIb/IIIa receptor inhibitors are used in addi ... Link to item Cite

The influence of CYP2C19 polymorphisms on the pharmacokinetics, pharmacodynamics, and clinical effectiveness of P2Y(12) inhibitors.

Journal Article Rev Cardiovasc Med · 2011 P2Y(12) antagonists, in combination with aspirin, significantly reduce thrombotic and ischemic events in patients presenting with an acute coronary syndrome and in patients undergoing percutaneous coronary intervention. The thienopyridine clopidogrel is a ... Full text Link to item Cite

The effect of St John's Wort on the pharmacodynamic response of clopidogrel in hyporesponsive volunteers and patients: increased platelet inhibition by enhancement of CYP3A4 metabolic activity.

Journal Article J Cardiovasc Pharmacol · January 2011 Clopidogrel is metabolically activated by cytochrome P450 (CYP) isoenzymes. We evaluated whether St. John's wort (SJW), a CYP2C19 and CYP3A4 inducer, enhances the pharmacodynamic response of clopidogrel. Volunteers (n = 45) were screened for clopidogrel hy ... Full text Link to item Cite

Platelet Function Testing in Clinical Practice - Experience and Views from Europe and the US

Journal Article European Cardiology · January 1, 2011 A 68-year-old male is admitted to our hospital because of a 50-minute episode of chest pain occurring during the night. On admission he is symptom-free. His electrocardiogram shows new negative T waves in the leads V1-V3. Troponin T, measured twice, with a ... Full text Cite

First analysis of the relation between CYP2C19 genotype and pharmacodynamics in patients treated with ticagrelor versus clopidogrel: the ONSET/OFFSET and RESPOND genotype studies.

Journal Article Circ Cardiovasc Genet · December 2010 BACKGROUND: The influence of cytochrome P450 (CYP) 2C19 genotype on platelet function in patients treated with ticagrelor versus clopidogrel is unknown. METHODS AND RESULTS: CYP2C19 (*1, *2, *3, *4, *5, *6, *7, *8, *17) genotyping was performed in patients ... Full text Link to item Cite

Antiplatelet effects of aspirin with phytosterols: comparison with non-enteric coated aspirin alone.

Journal Article Thromb Res · November 2010 The novel combination of aspirin and phytosterols may be a potential strategy to treat patients with cardiovascular disease. We sought to determine if the antiplatelet effects of a combination caplet of 81 mg aspirin with 400 mg phytosterols differed from ... Full text Link to item Cite

Elinogrel potassium: Receptor antagonist antiplatelet therapy

Journal Article Drugs of the Future · November 1, 2010 (Chemical Equation Presented) The pharmacological management of cardiovascular disease patients with antiplatelet therapy has undergone dramatic changes in recent years with the development of new and more potent P2Y 12 receptor antagonists. These agents h ... Full text Cite

Reduced-function CYP2C19 genotype and risk of adverse clinical outcomes among patients treated with clopidogrel predominantly for PCI: a meta-analysis.

Journal Article JAMA · October 27, 2010 CONTENT: Clopidogrel, one of the most commonly prescribed medications, is a prodrug requiring CYP450 biotransformation. Data suggest its pharmacologic effect varies based on CYP2C19 genotype, but there is uncertainty regarding the clinical risk imparted by ... Full text Link to item Cite

Increased platelet inhibition after switching from maintenance clopidogrel to prasugrel in patients with acute coronary syndromes: results of the SWAP (SWitching Anti Platelet) study.

Journal Article J Am Coll Cardiol · September 21, 2010 OBJECTIVES: The objective was to evaluate the pharmacodynamic response of switching patients on maintenance phase clopidogrel therapy after an acute coronary syndrome (ACS) to prasugrel. BACKGROUND: Prasugrel P2Y(12) receptor blockade is associated with gr ... Full text Link to item Cite

Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate.

Journal Article J Am Coll Cardiol · September 14, 2010 The addition of clopidogrel to aspirin treatment reduces ischemic events in a wide range of patients with cardiovascular disease. However, recurrent ischemic event occurrence during dual antiplatelet therapy, including stent thrombosis, remains a major con ... Full text Link to item Cite

Controversies in oral antiplatelet therapy in patients undergoing aortocoronary bypass surgery.

Journal Article Ann Thorac Surg · September 2010 Oral antiplatelet therapy with aspirin and clopidogrel is a major strategy to prevent thrombotic events in patients with acute coronary syndromes and patients undergoing percutaneous coronary interventions. Although this therapy is associated with both sho ... Full text Link to item Cite

Ticagrelor for the treatment of arterial thrombosis.

Journal Article Expert Opin Pharmacother · September 2010 IMPORTANCE OF THE FIELD: High platelet reactivity has been linked to recurrent ischemic events in patients treated with conventional dual antiplatelet therapy, in patients with arterial diseases and particularly in patients treated with coronary artery ste ... Full text Link to item Cite

Adenosine diphosphate-induced platelet-fibrin clot strength: a new thrombelastographic indicator of long-term poststenting ischemic events.

Journal Article Am Heart J · August 2010 BACKGROUND: Poststenting ischemic events occur despite dual-antiplatelet therapy, suggesting that a "one size fits all" antithrombotic strategy has significant limitations. Ex vivo platelet function measurements may facilitate risk stratification and perso ... Full text Link to item Cite

Incidence of dyspnea and assessment of cardiac and pulmonary function in patients with stable coronary artery disease receiving ticagrelor, clopidogrel, or placebo in the ONSET/OFFSET study.

Journal Article J Am Coll Cardiol · July 13, 2010 OBJECTIVES: We prospectively assessed cardiac and pulmonary function in patients with stable coronary artery disease (CAD) treated with ticagrelor, clopidogrel, or placebo in the ONSET/OFFSET (A Multi-Centre Randomised, Double-Blind, Double-Dummy Parallel ... Full text Link to item Cite

Genotyping: one piece of the puzzle to personalize antiplatelet therapy.

Journal Article J Am Coll Cardiol · July 6, 2010 The loss-of-function hepatic cytochrome P450 (CYP) 2C19*2 allele has been associated with reduced clopidogrel active metabolite generation and higher ex vivo platelet reactivity to adenosine diphosphate. Independently, in post hoc analyses, CYP2C19*2 has b ... Full text Link to item Cite

Hypothesis formulation from subgroup analyses: nonadherence or nonsteroidal anti-inflammatory drug use explains the lack of clinical benefit of aspirin on first myocardial infarction attributed to "aspirin resistance".

Journal Article Am Heart J · May 2010 BACKGROUND: "Aspirin resistance" has been defined as the occurrence of cardiovascular events despite regular intake of aspirin. One major analytic study suggesting that "aspirin resistance" is a clinical reality was unable to control for confounding by non ... Full text Link to item Cite

Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND study.

Journal Article Circulation · March 16, 2010 BACKGROUND: The antiplatelet effects of the Platelet Inhibition and Patient Outcomes (PLATO) trial dose of ticagrelor in patients nonresponsive to clopidogrel and after they switch agents are unknown. METHODS AND RESULTS: Patients with stable coronary arte ... Full text Link to item Cite

Aspirin - Scope and limitations

Journal Article British Journal of Cardiology · March 1, 2010 Cite

Platelet P2Y12 receptor antagonist pharmacokinetics and pharmacodynamics: A foundation for distinguishing mechanisms of bleeding and anticipated risk for platelet-directed therapies.

Journal Article Thromb Haemost · March 2010 The platelet P2Y12 receptor is involved in all aspects of arterial thrombosis, including adhesion, activation, aggregation, secretion and development of a stable aggregate on which coagulation proteins can assemble and fibrin strands can mesh. Inhibition o ... Full text Link to item Cite

Combination antithrombotic therapies.

Journal Article Circulation · February 2, 2010 Full text Link to item Cite

Hypercoagulability, platelet function, inflammation and coronary artery disease acuity: results of the Thrombotic RIsk Progression (TRIP) study.

Journal Article Platelets · 2010 The objective of the study was to determine the relation of platelet reactivity, hypercoagulability and inflammation in various stages of coronary artery disease acuity (CAD). Thrombin-induced platelet-fibrin clot strength (MA), time to initial platelet-fi ... Full text Link to item Cite

Interaction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases.

Journal Article Drug Healthc Patient Saf · 2010 Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin has been successful in reducing ischemic events in a wide range of patients with cardiovascular diseases. However, the anti-ischemic effects of DAPT may also be associated with gastrointestinal ... Full text Link to item Cite

The effect of elinogrel on high platelet reactivity during dual antiplatelet therapy and the relation to CYP2C19*2 genotype: first experience in patients.

Journal Article J Thromb Haemost · January 2010 UNLABELLED: To study the effect of a new direct acting reversible P2Y(12) inhibitor, elinogrel (PRT060128), and the relation to cytochrome P450 (CYP) polymorphisms in patients with high platelet reactivity (HPR) on standard dual antiplatelet therapy. METHO ... Full text Link to item Cite

Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study.

Journal Article Circulation · December 22, 2009 BACKGROUND: Ticagrelor is the first reversibly binding oral P2Y(12) receptor antagonist. This is the first study to compare the onset and offset of platelet inhibition (IPA) with ticagrelor using the PLATO (PLATelet inhibition and patient Outcomes) trial l ... Full text Link to item Cite

Platelet monitoring for PCI: is it really necessary?

Journal Article Hamostaseologie · November 2009 Percutaneous coronary intervention (PCI) has significantly improved clinical outcomes in coronary artery disease patients. Since PCI is associated with platelet activation, antiplatelet therapy with aspirin, clopidogrel and GPIIb/IIIa inhibitors comprise t ... Link to item Cite

The relation between platelet reactivity and glycemic control in diabetic patients with cardiovascular disease on maintenance aspirin and clopidogrel therapy.

Journal Article Am Heart J · November 2009 BACKGROUND: High platelet reactivity (HPR) during aspirin and clopidogrel therapy in patients with diabetes has been reported and may affect outcomes. However, the relation of platelet reactivity to glycemic control is less studied in patients on dual anti ... Full text Link to item Cite

Association of cytochrome P450 2C19 genotype with the antiplatelet effect and clinical efficacy of clopidogrel therapy.

Journal Article JAMA · August 26, 2009 CONTEXT: Clopidogrel therapy improves cardiovascular outcomes in patients with acute coronary syndromes and following percutaneous coronary intervention by inhibiting adenosine diphosphate (ADP)-dependent platelet activation. However, nonresponsiveness is ... Full text Link to item Cite

Prevalence of aspirin and clopidogrel resistance among patients with and without drug-eluting stent thrombosis.

Journal Article Am J Cardiol · August 15, 2009 Drug-eluting stent (DES) thrombosis has a multifactorial etiology. Variable responsiveness to antiplatelet therapy likely contributes to its pathogenesis. We aimed to determine whether patients who had experienced DES thrombosis compared with a cohort of p ... Full text Link to item Cite

Recent developments in clopidogrel pharmacology and their relation to clinical outcomes.

Journal Article Expert Opin Drug Metab Toxicol · August 2009 Oral antiplatelet therapy with clopidogrel and aspirin is an important and widely prescribed strategy to prevent ischemic events in patients with cardiovascular diseases. However, the occurrence of thrombotic events including stent thrombosis is still high ... Full text Link to item Cite

Effect of long-term clopidogrel treatment on platelet function and inflammation in patients undergoing coronary arterial stenting.

Journal Article Am J Cardiol · June 1, 2009 A clopidogrel loading dose administered during stenting attenuates inflammation marker release. However, less is known of the anti-inflammatory effect of clopidogrel maintenance therapy. Platelet reactivity to adenosine diphosphate and inflammation markers ... Full text Link to item Cite

The link between heightened thrombogenicity and inflammation: pre-procedure characterization of the patient at high risk for recurrent events after stenting.

Journal Article Platelets · March 2009 Heightened thrombogenicity and biomarker evidence of inflammation have been independently associated with ischemic risk in patients with coronary artery disease. However, a study examining their relation has not been reported. We analysed the relation betw ... Full text Link to item Cite

Bivalirudin and clopidogrel with and without eptifibatide for elective stenting: effects on platelet function, thrombelastographic indexes, and their relation to periprocedural infarction results of the CLEAR PLATELETS-2 (Clopidogrel with Eptifibatide to Arrest the Reactivity of Platelets) study.

Journal Article J Am Coll Cardiol · February 24, 2009 OBJECTIVES: The primary objective of this study was to compare the effect of therapy with bivalirudin alone versus bivalirudin plus eptifibatide on platelet reactivity measured by turbidometric aggregometry and thrombin-induced platelet-fibrin clot strengt ... Full text Link to item Cite

Advances in antiplatelet therapy: agents in clinical development.

Journal Article Am J Cardiol · February 2, 2009 Antiplatelet agents are the cornerstone of treatment for patients with acute coronary syndromes and patients undergoing percutaneous coronary intervention. The current "gold standard" consists of a combination of aspirin and clopidogrel administered orally ... Full text Link to item Cite

Selecting optimal antiplatelet therapy based on platelet function monitoring in patients with coronary artery disease.

Journal Article Curr Treat Options Cardiovasc Med · February 2009 Results from pharmacodynamic and translational research studies assessing platelet reactivity have highlighted the limitations of current oral antiplatelet therapy. The data from translational research studies present strong arguments against the "one-size ... Full text Link to item Cite

Antiplatelet resistance--fact or myth?

Journal Article Am Heart Hosp J · 2009 Full text Link to item Cite

Aspirin resistance.

Journal Article Prog Cardiovasc Dis · 2009 Full text Link to item Cite

Relationship between age and platelet activation in patients with stable and unstable angina.

Journal Article Arch Gerontol Geriatr · 2009 The objective of this study was to examine platelet reactivity and activation as a function of age in patients with both stable and unstable angina. This was a retrospective cohort study to compare platelet function in older patients with and without acute ... Full text Link to item Cite

The rationale for and comparisons of different antiplatelet treatments in acute coronary syndrome.

Journal Article J Interv Cardiol · December 2008 Fundamentally, acute coronary syndromes are platelet-centric diseases, resulting from platelet-rich thrombi that develop at the site of vessel wall injury. In addition to aggregation, platelets modulate a plethora of other important pathophysiologic proces ... Full text Link to item Cite

Platelet reactivity to adenosine diphosphate and long-term ischemic event occurrence following percutaneous coronary intervention: a potential antiplatelet therapeutic target.

Journal Article Platelets · December 2008 Platelets play a central role in the genesis of post-percutaneous coronary intervention (PCI) ischemic events. High post-procedural platelet reactivity to adenosine diphosphate (HPR(ADP)) may be a risk factor for ischemic events after PCI. The study was de ... Full text Link to item Cite

Dark chocolate effect on platelet activity, C-reactive protein and lipid profile: a pilot study.

Journal Article South Med J · December 2008 BACKGROUND: Dark chocolate (DC) is one of the richest sources of flavonoids. Since DC has been demonstrated to have beneficial effects on the cardiovascular system, our study examined its effect on platelet reactivity, inflammation, and lipid levels in hea ... Full text Link to item Cite

The association of cigarette smoking with enhanced platelet inhibition by clopidogrel.

Journal Article J Am Coll Cardiol · August 12, 2008 OBJECTIVES: The purpose of this study was to examine the effect of cigarette smoking on the platelet response to clopidogrel. BACKGROUND: Response variability to clopidogrel therapy has been demonstrated. Clopidogrel is metabolically activated by several h ... Full text Link to item Cite

Treatment strategies in non-ST-elevation acute coronary syndromes in patients undergoing percutaneous coronary intervention: an evidence-based review of clinical trial results and treatment guidelines: report on a roundtable discussion.

Journal Article J Interv Cardiol · August 2008 With the availability of new data and the recent release of new European and US guidelines, contemporary care paradigms for the treatment of patients with non-ST-elevation acute coronary syndromes (NSTE ACS), including those undergoing percutaneous coronar ... Full text Link to item Cite

Race and sex differences in thrombogenicity: risk of ischemic events following coronary stenting.

Journal Article Blood Coagul Fibrinolysis · June 2008 Race and sex affect thrombogenicity. We have demonstrated that platelet-fibrin clot characteristics can be used to stratify patients for risk of ischemic events following percutaneous coronary intervention. We investigated race and sex differences in throm ... Full text Link to item Cite

Antiplatelet treatment of cardiovascular disease: a translational research perspective.

Journal Article Pol Arch Med Wewn · May 2008 Platelet mediated thrombosis is the primary cause of ischemic event occurrence in patients with cardiovascular disease. The P2Y12 receptor plays a central role in thrombus generation and is therefore a major target for pharmacologic therapy. Although vario ... Link to item Cite

Peri-procedural platelet function and platelet inhibition in percutaneous coronary intervention.

Journal Article JACC Cardiovasc Interv · April 2008 Pre-procedural platelet reactivity has been correlated with adverse ischemic events following percutaneous coronary intervention. Patients with high pre-percutaneous coronary intervention platelet reactivity demonstrate a differential response to standard ... Full text Link to item Cite

Clinical considerations with the use of antiplatelet therapy in patients undergoing percutaneous coronary intervention.

Journal Article Clin Cardiol · March 2008 Despite the proven benefits of using antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI), a number of key questions remain to be answered. In recent years, clopidogrel dosing strategies among such patients have evolved cons ... Full text Link to item Cite

Antiplatelet strategies: evaluating their current role in the setting of acute coronary syndromes.

Journal Article Clin Cardiol · March 2008 Numerous clinical trials have established the value of antiplatelet therapies for acute coronary syndromes (ACS). Aspirin (ASA), thienopyridines (i.e., clopidogrel and ticlopidine) and GP IIb/IIIa antagonists comprise the major classes of antiplatelet ther ... Full text Link to item Cite

The problem of persistent platelet activation in acute coronary syndromes and following percutaneous coronary intervention.

Journal Article Clin Cardiol · March 2008 Platelets play a central role in the atherosclerotic inflammatory response, thrombotic vascular occlusion, microembolization, vasoconstriction, and plaque progression. Persistent platelet activation poses a serious problem among patients with acute coronar ... Full text Link to item Cite

Investigating the mechanisms of hyporesponse to antiplatelet approaches.

Journal Article Clin Cardiol · March 2008 Hyporesponsiveness, or resistance, to antiplatelet therapy may be a major contributor to poorer outcomes among cardiac patients and may be attributed to an array of mechanisms--both modifiable and unmodifiable. Recent evidence has uncovered clinical, cellu ... Full text Link to item Cite

Assessing the current role of platelet function testing.

Journal Article Clin Cardiol · March 2008 In vitro platelet function tests are commonly applied in research and offer justification for using antiplatelet therapy. However, studies assessing the ability of standardized platelet function tests to predict patients' clinical response to aspirin or cl ... Full text Link to item Cite

Prasugrel, a third generation thienopyridine and potent platelet inhibitor.

Journal Article Curr Opin Investig Drugs · March 2008 Eli Lilly & Co and Daiichi Sankyo Co Ltd are developing prasugrel, a third generation thienopyridine derivative. Prasugrel is in phase III clinical trials in Western Europe and Japan, and is awaiting regulatory approval in the US for the treatment of throm ... Link to item Cite

Diagnostics for aspirin resistance.

Journal Article Mol Diagn Ther · 2008 Full text Link to item Cite

Biomarker analysis by fluorokine multianalyte profiling distinguishes patients requiring intervention from patients with long-term quiescent coronary artery disease: a potential approach to identify atherosclerotic disease progression.

Journal Article Am Heart J · January 2008 BACKGROUND: The study rationale was to compare the biomarker profile of metalloproteinases (MMPs) and inflammation markers (IMs) in patients requiring revascularization with that of patients with long-term, clinically quiescent coronary artery disease (CAD ... Full text Link to item Cite

Inflammatory changes during the 'common cold' are associated with platelet activation and increased reactivity of platelets to agonists.

Journal Article Blood Coagul Fibrinolysis · December 2007 Epidemiologic studies have shown increased rates of myocardial infarction after upper respiratory tract infections. We hypothesized that changes in platelet activation and reactivity and inflammation occur during the 'common cold'. Previously healthy indiv ... Full text Link to item Cite

The effect of aspirin dosing on platelet function in diabetic and nondiabetic patients: an analysis from the aspirin-induced platelet effect (ASPECT) study.

Journal Article Diabetes · December 2007 OBJECTIVE: Diabetic patients may have a higher prevalence of platelet aspirin resistance than nondiabetic patients. Our goal was to analyze platelet aspirin responsiveness to various aspirin doses in diabetic and nondiabetic patients. RESEARCH DESIGN AND M ... Full text Link to item Cite

Platelet function monitoring in patients with coronary artery disease.

Journal Article J Am Coll Cardiol · November 6, 2007 Studies focused on patient responsiveness to antiplatelet therapies, particularly aspirin and clopidogrel, have increased in recent years. However, the relations of in vivo platelet function and adverse clinical events to results of ex vivo platelet functi ... Full text Link to item Cite

Inhibition of platelet aggregation by AZD6140, a reversible oral P2Y12 receptor antagonist, compared with clopidogrel in patients with acute coronary syndromes.

Journal Article J Am Coll Cardiol · November 6, 2007 OBJECTIVES: In a substudy of DISPERSE (Dose confIrmation Study assessing anti-Platelet Effects of AZD6140 vs. clopidogRel in non-ST-segment Elevation myocardial infarction)-2, we compared the antiplatelet effects of AZD6140 and clopidogrel and assessed the ... Full text Link to item Cite

Antiplatelet therapy after implantation of drug-eluting stents: duration, resistance, alternatives, and management of surgical patients.

Journal Article Am J Cardiol · October 22, 2007 The routine off-label use of drug-eluting stents (DESs) has been associated with a higher prevalence of stent thrombosis in clinical practice than was suggested in US Food and Drug Administration (FDA) preapproval studies. Consequently, the early identific ... Full text Link to item Cite

Platelet function measured by VerifyNow identifies generalized high platelet reactivity in aspirin treated patients.

Journal Article Platelets · September 2007 Selected aspirin treated patients may exhibit high platelet reactivity to agonists other than arachidonic acid. This study aimed to determine whether the VerifyNow identifies generalized high platelet reactivity supported by correlations with other establi ... Full text Link to item Cite

Evaluation of dose-related effects of aspirin on platelet function: results from the Aspirin-Induced Platelet Effect (ASPECT) study.

Journal Article Circulation · June 26, 2007 BACKGROUND: The antiplatelet effect of aspirin is attributed to platelet cyclooxygenase-1 inhibition. Controversy exists on the prevalence of platelet resistance to aspirin in patients with coronary artery disease and effects of aspirin dose on inhibition. ... Full text Link to item Cite

Resistance to antiplatelet drugs

Chapter · June 1, 2007 Cite

Increased risk in patients with high platelet aggregation receiving chronic clopidogrel therapy undergoing percutaneous coronary intervention: is the current antiplatelet therapy adequate?

Journal Article J Am Coll Cardiol · February 13, 2007 OBJECTIVES: We sought to determine whether patients receiving chronic clopidogrel therapy undergoing nonemergent stenting who display high on-treatment preprocedural platelet aggregation measured by standard light transmittance aggregometry and thrombelast ... Full text Link to item Cite

AZD6140.

Journal Article Expert Opin Investig Drugs · February 2007 Oral antiplatelet therapy with P2Y(12) receptor blockers (especially clopidogrel) is the current choice of treatment during acute coronary syndromes and percutaneous interventions. To address the various limitations of thienopyridine therapy (including res ... Full text Link to item Cite

Stent thrombosis associated with first-generation drug-eluting stents: issues with antiplatelet therapy.

Journal Article Neth Heart J · 2007 Notice of the rare but catastrophic occurrence of stent thrombosis in association with deployment of drug-eluting stents has focused attention on the adequacy of the current dual antiplatelet regimen of aspirin and clopidogrel. Some patients will not respo ... Full text Link to item Cite

Stent thrombosis: role of compliance and nonresponsiveness to antiplatelet therapy.

Journal Article Rev Cardiovasc Med · 2007 Percutaneous coronary intervention with drug-eluting stents has revolutionized the management of patients with symptomatic coronary artery disease. Although this strategy significantly reduces the incidence of restenosis and repeat revascularization, conce ... Link to item Cite

Assessment of clopidogrel responsiveness: measurements of maximum platelet aggregation, final platelet aggregation and their correlation with vasodilator-stimulated phosphoprotein in resistant patients.

Journal Article Thromb Res · 2007 BACKGROUND: Controversy surrounds the optimal platelet aggregation measurement to assess clopidogrel non-responsiveness. The P2Y12 reactivity ratio (PRR) determined by vasodilator-stimulated phosphoprotein phosphorylation levels has been used to indicate t ... Full text Link to item Cite

Clopidogrel resistance?

Journal Article Thromb Res · 2007 Clopidogrel is an effective inhibitor of platelet activation and aggregation due to its selective and irreversible blockade of the P2Y(12) receptor. Combination antiplatelet therapy with clopidogrel and aspirin is an important strategy for patients with ac ... Full text Link to item Cite

Delayed thrombin-induced platelet-fibrin clot generation by clopidogrel: a new dose-related effect demonstrated by thrombelastography in patients undergoing coronary artery stenting.

Journal Article Thromb Res · 2007 BACKGROUND: We have previously demonstrated that clopidogrel reduces platelet activation and aggregation in patients undergoing stenting. However, the effect of the clopidogrel loading dose on the rate of thrombin-induced platelet-fibrin clot formation is ... Full text Link to item Cite

Comparison of zotarolimus-eluting and sirolimus-eluting stents in patients with native coronary artery disease: a randomized controlled trial.

Journal Article J Am Coll Cardiol · December 19, 2006 OBJECTIVES: This trial examined the relative clinical efficacy, angiographic outcomes, and safety of zotarolimus-eluting coronary stents (ZES) with a phosphorylcholine polymer versus sirolimus-eluting stents (SES). BACKGROUND: Whether a cobalt-based alloy ... Full text Link to item Cite

Effect of clopidogrel with and without eptifibatide on tumor necrosis factor-alpha and C-reactive protein release after elective stenting: results from the CLEAR PLATELETS 1b study.

Journal Article J Am Coll Cardiol · December 5, 2006 OBJECTIVES: This study was performed to compare the effects of antiplatelet regimens on early inflammation and cardiac marker release after elective stenting. BACKGROUND: Few data exist regarding the comparative effects of specific antiplatelet regimens on ... Full text Link to item Cite

Prasugrel.

Journal Article Expert Opin Investig Drugs · December 2006 Clinical trials have demonstrated the superior clinical efficacy of dual antiplatelet therapy with a thienopyridine (a P2Y(12) receptor blocker) and aspirin (COX-1 inhibitor) in patients undergoing stenting as well as patients with acute coronary syndromes ... Full text Link to item Cite

Antiplatelet drug resistance and drug-drug interactions: Role of cytochrome P450 3A4.

Journal Article Pharm Res · December 2006 Antiplatelet therapy provided pivotal advances in the treatment of cardiovascular disease. Aspirin and thienopyridine, clopidogrel, is currently the treatment of choice in acute coronary syndromes and the prevention of thrombosis after coronary stent impla ... Full text Link to item Cite

Aspirin and clopidogrel resistance: consideration and management.

Journal Article J Interv Cardiol · October 2006 The efficacy with aspirin and clopidogrel treatment has been demonstrated in various clinical trials. Laboratory evaluation of platelet response in recent studies revealed that a distinctive response variability and nonresponsiveness/resistance in selected ... Full text Link to item Cite

Drug insight: Clopidogrel nonresponsiveness.

Journal Article Nat Clin Pract Cardiovasc Med · July 2006 Platelet reactivity to agonists and subsequent activation are important factors that affect the development of atherothrombosis and resultant ischemic events. Pharmacologic intervention with clopidogrel and aspirin during acute coronary syndromes and percu ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · June 20, 2006 Full text Cite

Antiplatelet therapy: current strategies and future trends.

Journal Article Future Cardiol · May 2006 Pharmacological management of thrombotic complications is strongly influenced by antiplatelet treatment strategies. Recent clinical trials have clearly indicated that current antiplatelet strategies may not inhibit recurrent thrombotic events in selected p ... Full text Link to item Cite

Neutral effect on markers of heart failure, inflammation, endothelial activation and function, and vagal tone after high-dose HMG-CoA reductase inhibition in non-diabetic patients with non-ischemic cardiomyopathy and average low-density lipoprotein level.

Journal Article J Am Coll Cardiol · January 17, 2006 OBJECTIVES: This study sought to determine the effect of aggressive 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) therapy on surrogate markers in non-ischemic cardiomyopathy (NICM) patients and average low-density lipoprotein ... Full text Link to item Cite

The relationship of platelet reactivity to the occurrence of post-stenting ischemic events: emergence of a new cardiovascular risk factor.

Journal Article Rev Cardiovasc Med · 2006 The reactivity of platelets to agonists plays a central role in the genesis of thrombosis following percutaneous coronary intervention (PCI) and spontaneous plaque rupture. Antiplatelet therapy has reduced the occurrence of thrombotic events following PCI, ... Link to item Cite

Clinical applications of antiplatelet therapy.

Journal Article Rev Cardiovasc Med · 2006 Dual antiplatelet therapy with aspirin and a thienopyridine has become the standard of care for patients undergoing percutaneous intervention with stenting, regardless of indication. This article will examine the evidence for and against the use of aspirin ... Link to item Cite

Clopidogrel resistance: implications for coronary stenting.

Journal Article Curr Pharm Des · 2006 Clopidogrel, in combination wih aspirin, is currently the drug of choice to prevent thrombosis after coronary stent implantation. Currently, clopidogrel is administered to the vast majority of patients without any assessment of platelet inhibition. Respons ... Full text Link to item Cite

Clopidogrel effect on platelet reactivity in patients with stent thrombosis: results of the CREST Study.

Journal Article J Am Coll Cardiol · November 15, 2005 OBJECTIVES: We investigated whether patients who suffered subacute stent thrombosis (SAT) have higher post-treatment reactivity than those who do not encounter stent thrombosis. BACKGROUND: High post-treatment platelet reactivity has been reported after co ... Full text Link to item Cite

Platelet reactivity in patients and recurrent events post-stenting: results of the PREPARE POST-STENTING Study.

Journal Article J Am Coll Cardiol · November 15, 2005 OBJECTIVES: We investigated the relation of high ex vivo platelet reactivity, rapid fibrin generation, and high thrombin-induced clot strength to postdischarge ischemic events in patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Hig ... Full text Link to item Cite

Overestimation of platelet aspirin resistance detection by thrombelastograph platelet mapping and validation by conventional aggregometry using arachidonic acid stimulation.

Journal Article J Am Coll Cardiol · November 1, 2005 OBJECTIVES: This study sought to determine the prevalence of platelet aspirin resistance using methods that directly indicate the degree of platelet cyclooxygenase inhibition. BACKGROUND: Aspirin resistance in platelets may be overestimated by nonspecific ... Full text Link to item Cite

Resistance to antiplatelet drugs: current status and future research.

Journal Article Expert Opin Pharmacother · October 2005 Platelet reactivity and activation are important factors during the development of atherothrombotic processes and subsequent ischaemic complications. Pharmacological agents that suppress platelet function are proved to be the most efficient in the preventi ... Full text Link to item Cite

The relation of dosing to clopidogrel responsiveness and the incidence of high post-treatment platelet aggregation in patients undergoing coronary stenting.

Journal Article J Am Coll Cardiol · May 3, 2005 OBJECTIVES: We determined the effect of clopidogrel dosing on the incidence of nonresponsiveness (NR) and high post-treatment platelet aggregation (post-PA). BACKGROUND: We have reported NR after a 300-mg loading dose. Limited information is available on t ... Full text Link to item Cite

Outcomes with the polymer-based paclitaxel-eluting TAXUS stent in patients with diabetes mellitus: the TAXUS-IV trial.

Journal Article J Am Coll Cardiol · April 19, 2005 OBJECTIVES: We sought to determine the safety and efficacy of polymer-regulated site-specific delivery of paclitaxel in patients with diabetes mellitus undergoing stent implantation. BACKGROUND: Percutaneous coronary intervention in patients with diabetes ... Full text Link to item Cite

Clopidogrel loading with eptifibatide to arrest the reactivity of platelets: results of the Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets (CLEAR PLATELETS) study.

Journal Article Circulation · March 8, 2005 BACKGROUND: Pretreatment is not the most common strategy practiced for clopidogrel administration in elective coronary stenting. Moreover, limited information is available on the antiplatelet pharmacodynamics of a 300-mg versus a 600-mg clopidogrel loading ... Full text Link to item Cite

Subacute stent thrombosis in an elderly man with clopidogrel resistance

Journal Article Clinical Geriatrics · March 1, 2005 Cite

Hypercoagulability affecting early vein graft patency does not exist after off-pump coronary artery bypass.

Journal Article J Cardiothorac Vasc Anesth · February 2005 OBJECTIVE: Hypercoagulability may compromise the patency of bypass grafts. The authors hypothesized that perioperative in vitro platelet responses to varying agonists (eg, thrombin, platelet activating factor, collagen, adenosine diphosphate) correlate wit ... Full text Link to item Cite

The platelet-related effects of tenecteplase versus alteplase versus reteplase.

Journal Article Blood Coagul Fibrinolysis · January 2005 Clinical studies have investigated the combination of glycoprotein (GP) IIb/IIIa inhibitors and thrombolytic agents for acute myocardial infarction. However, thrombolytic agents alone may possess direct antiplatelet properties that could affect reperfusion ... Full text Link to item Cite

The difference between clopidogrel responsiveness and posttreatment platelet reactivity.

Journal Article Thromb Res · 2005 BACKGROUND: Aggregation is the most common measure of platelet reactivity. The relative inhibition of platelet aggregation between pretreatment and posttreatment is the most common estimate of clopidogrel responsiveness. However, patients responsive to clo ... Full text Link to item Cite

Diastolic heart failure in the older patient

Journal Article Clinical Geriatrics · January 1, 2005 Cite

Platelet activation in myocardial ischemic syndromes.

Journal Article Expert Rev Cardiovasc Ther · July 2004 Platelets play a central role in the pathogenesis of atherosclerosis and thrombosis. Platelet adhesion and aggregate formation are critical events that occur in unstable coronary syndromes. Platelet activation precedes the formation of homotypic and hetero ... Full text Link to item Cite

Effect of angiotensin-converting enzyme inhibitors, beta blockers, statins, and aspirin on C-reactive protein levels in outpatients with heart failure.

Journal Article Am J Cardiol · March 15, 2004 C-reactive protein (CRP) levels were measured in a cohort of 96 outpatients with heart failure. Baseline angiotensin-converting enzyme inhibitor plus beta-blocker use were associated with lower levels of CRP; no relation was found between CRP levels and as ... Full text Link to item Cite

Failure of clopidogrel to reduce platelet reactivity and activation following standard dosing in elective stenting: implications for thrombotic events and restenosis.

Journal Article Platelets · March 2004 There is no information on long-term platelet reactivity and activation following elective stenting in patients treated with clopidogrel and aspirin. We measured platelet reactivity and activation at baseline and at 2 h, 24 h, 5 days and 30 days following ... Full text Link to item Cite

Contribution of hepatic cytochrome P450 3A4 metabolic activity to the phenomenon of clopidogrel resistance.

Journal Article Circulation · January 20, 2004 BACKGROUND: Interindividual variability of platelet inhibition after aspirin or clopidogrel administration has been described. Additionally, aspirin resistance and clopidogrel resistance occur in some individuals. Because the prodrug clopidogrel is activat ... Full text Link to item Cite

Platelet activation after stenting with heparin-coated versus noncoated stents.

Journal Article Am Heart J · October 2003 BACKGROUND: In animal models, heparin coating reduces platelet accumulation induced by coronary stenting. However, reduced platelet activation has never been demonstrated in humans. The purpose of the current study was to investigate the effect of heparin ... Full text Link to item Cite

Effects of roxifiban on platelet aggregation and major receptor expression in patients with coronary artery disease for the Roxifiban Oral Compound Kinetics Evaluation Trial-I (ROCKET-I Platelet Substudy).

Journal Article Am Heart J · July 2003 BACKGROUND: It has been expected that therapy with oral glycoprotein (GP) IIb/IIIa blockers including roxifiban will reduce mortality and vascular complications in a long-term. However, platelet-related properties of roxifiban in the clinical setting are n ... Full text Link to item Cite

Clopidogrel for coronary stenting: response variability, drug resistance, and the effect of pretreatment platelet reactivity.

Journal Article Circulation · June 17, 2003 BACKGROUND: Clopidogrel is administered to prevent stent thrombosis; however, the uniformity of platelet inhibition after treatment and the influence of pretreatment reactivity on drug response have not been described. METHODS AND RESULTS: Platelet aggrega ... Full text Link to item Cite

Effect of tenecteplase versus alteplase on platelets during the first 3 hours of treatment for acute myocardial infarction: the Assessment of the Safety and Efficacy of a New Thrombolytic Agent (ASSENT-2) platelet substudy.

Journal Article Am Heart J · April 2003 BACKGROUND: Platelets play a pivotal role in the pathogenesis of acute myocardial infarction, as well as in the occurrence of coronary artery reocclusion and bleeding events. Therefore, the success of fibrinolytic therapy may be dependent on its direct eff ... Full text Link to item Cite

The role of platelet receptors and adhesion molecules in coronary artery disease.

Journal Article Coron Artery Dis · February 2003 Platelets play a significant role in coronary artery disease through interactions with each other and with other cell types. These interactions are mediated by certain receptors on the surface of platelets and other cells which can lead to intra-coronary t ... Full text Link to item Cite

Onset and extent of platelet inhibition by clopidogrel loading in patients undergoing elective coronary stenting: the Plavix Reduction Of New Thrombus Occurrence (PRONTO) trial.

Journal Article Am Heart J · February 2003 BACKGROUND: Despite the common practice of clopidogrel loading for coronary stenting, the time dependence and degree of platelet inhibition after this therapy are not well defined. We sought to establish an optimal clopidogrel dosing regimen for sustained ... Full text Link to item Cite

The stratification of platelet reactivity and activation in patients with stable coronary artery disease on aspirin therapy.

Journal Article Thromb Res · 2003 UNLABELLED: Heightened platelet reactivity may affect the occurrence of ischemic events in patients with coronary artery disease on aspirin therapy. However, a definition to stratify platelet reactivity in this group of patients has not been previously rep ... Full text Link to item Cite

Effect of eptifibatide for acute coronary syndromes: rapid versus late administration--therapeutic yield on platelets (The EARLY Platelet Substudy).

Journal Article J Thromb Thrombolysis · December 2002 BACKGROUND: Receptors other than GP IIb/IIIa may mediate leukocyte-platelet-endothelial interactions that obstruct the microvasculature in acute coronary syndromes (ACS) and cause microinfarcts. The effect of eptifibatide on these receptors was investigate ... Full text Link to item Cite

The effect of blockade of the CD11/CD18 integrin receptor on infarct size in patients with acute myocardial infarction treated with direct angioplasty: the results of the HALT-MI study.

Journal Article J Am Coll Cardiol · October 2, 2002 OBJECTIVE: The purpose of this study was to determine whether Hu23F2G (LeukoArrest), an antibody to the CD11/CD18 integrin receptors, would reduce infarct size in patients undergoing primary angioplasty for an acute myocardial infarction. BACKGROUND: Reper ... Full text Link to item Cite

Could stent design affect platelet activation? Results of the Platelet Activation in STenting (PAST) Study.

Journal Article J Invasive Cardiol · October 2002 Platelet activation induced by coronary artery stenting may be related to stent design. In a prospective, randomized pilot study of 54 elective patients, platelet activation was analyzed before and at 2 hours, 24 hours, 5 days and 30 days post-implantation ... Link to item Cite

Whole blood impedance aggregometry for the assessment of platelet function in patients with congestive heart failure (EPCOT Trial).

Journal Article Eur J Heart Fail · August 2002 OBJECTIVE: Data from small studies have shown the presence of platelet abnormalities in patients with congestive heart failure (CHF). We sought to characterize the diagnostic utility of the whole blood aggregometry (WBA) in a random outpatient CHF populati ... Full text Link to item Cite

Evaluation of platelets in heart failure: is platelet activity related to etiology, functional class, or clinical outcomes?

Journal Article Am Heart J · June 2002 OBJECTIVES: We sought to determine whether platelet activity in patients with heart failure is related to an ischemic versus nonischemic etiologic condition, clinical disease severity, or adverse clinical outcomes. BACKGROUND: Platelet activity may affect ... Full text Link to item Cite

Failure of platelet parameters and biomarkers to correlate platelet function to severity and etiology of heart failure in patients enrolled in the EPCOT trial. With special reference to the Hemodyne hemostatic analyzer. Whole Blood Impedance Aggregometry for the Assessment of Platelet Function in Patients with Congestive Heart Failure.

Journal Article Pathophysiol Haemost Thromb · 2002 Data from small studies have suggested the presence of platelet abnormalities in patients with congestive heart failure (CHF). We sought to characterize the diagnostic utility of different platelet parameters and platelet-endothelial biomarkers in a random ... Full text Link to item Cite

Platelets and thrombolysis: Cooperation or contrariety?

Journal Article HeartDrug · December 1, 2001 Fibrinolytic therapy is the established treatment for the management of patients with ST elevation acute myocardial infarction (AMI). Present thrombolytic regimens have a number of limitations, including the failure to produce early and sustained reperfusi ... Full text Cite

Uniform platelet activation exists before coronary stent implantation despite aspirin therapy.

Journal Article Am Heart J · October 2001 BACKGROUND: Platelets play an important role in the natural history of coronary artery disease. Enhanced platelet aggregation and receptor expression unquestionably occur after coronary stent implantation; however, the functional characteristics of platele ... Full text Link to item Cite

Platelet inhibition by sertraline and N-desmethylsertraline: a possible missing link between depression, coronary events, and mortality benefits of selective serotonin reuptake inhibitors.

Journal Article Pharmacol Res · May 2001 Recently, clinical depression has been identified as an independent risk factor for increased mortality in patients following acute coronary events. Although the underlying mechanisms of this link remain uncertain, increased platelet activity has been sugg ... Full text Link to item Cite

Usefulness of combining necrosis and platelet markers in triaging patients presenting with chest pain to the emergency department.

Journal Article J Thromb Thrombolysis · April 2001 BACKGROUND: Myocardial injury and platelet activation play important roles in the pathogenesis of unstable coronary syndromes. We sought to determine whether the combined measurement of platelet and necrosis markers would improve risk stratification, and y ... Full text Link to item Cite

Clinical utility of the platelet function analyzer (PFA-100) for the assessment of the platelet status in patients with congestive heart failure (EPCOT trial).

Journal Article Thromb Res · March 15, 2001 BACKGROUND: Data from small studies have shown the presence of platelet abnormalities in patients with congestive heart failure (CHF). We sought to characterize the diagnostic utility of platelet function analyzer (PFA-100) in the CHF population. METHODS: ... Full text Link to item Cite

Relation of soluble and platelet P-selectin to early outcome in patients with acute myocardial infarction after thrombolytic therapy.

Journal Article Am J Cardiol · March 15, 2001 Pre- and post-treatment platelet and soluble P-selectin were measured in a group of patients enrolled in the GUSTO-III study and were correlated with clinical outcomes. A peak in soluble P-selectin levels at 3 hours after thrombolytic therapy and lower bas ... Full text Link to item Cite

Micromere descendants at the blastula stage are involved in normal archenteron formation in sea urchin embryos.

Journal Article Dev Genes Evol · February 2001 Several lines of evidence suggest that micromere signaling plays a key role in endo-mesoderm differentiation along the animal-vegetal (A-V) axis in sea urchin embryos. A recent study has suggested that the activity of micromeres of inducing endoderm differ ... Full text Link to item Cite

Preface

Chapter · 2001 Cite

Platelet function and fibrinolytic agents: two sides of a coin?

Journal Article Cardiology · 2001 Fibrinolytic therapy is the established treatment for the management of patients with ST elevation acute myocardial infarction (AMI). Present fibrinolytic regimens have a number of shortcomings, including the failure to produce early and sustained reperfus ... Full text Link to item Cite

The potential of monoclonal antibodies to reduce reperfusion injury in myocardial infarction.

Journal Article BioDrugs · 2001 Reperfusion injury is mediated, in part, by the accumulation of platelets and leucocytes in the microvasculature after reflow. These components of the blood pool form aggregates that can obstruct flow in small vessels. In addition, mediators released from ... Full text Link to item Cite

Depression and ischemic heart disease.

Journal Article Am Heart J · October 2000 Major depression is a common comorbidity associated with ischemic heart disease (IHD). There is growing evidence that psychological stress in general and depression in particular predispose to cardiovascular disease. Persons who have mental stress during d ... Full text Link to item Cite

The effect of chronic azithromycin therapy on soluble endothelium-derived adhesion molecules in patients with coronary artery disease.

Journal Article J Cardiovasc Pharmacol · October 2000 In patients with coronary artery disease (CAD), azithromycin therapy is associated with decreased cytokine levels and overall reduction of inflammation. Chlamydia pneumoniae (C.Pn) is a common pathogen that may be an important factor in the development and ... Full text Link to item Cite

Effect of coronary thrombolysis on the plasma concentration of osteonectin (SPARC, BM40) in patients with acute myocardial infarction.

Journal Article J Thromb Thrombolysis · October 2000 Osteonectin is a phosphoglycoprotein exclusively located in bone and platelet alpha-granules. Human platelet-derived osteonectin is released into plasma after thrombin-induced activation. Recognizing the unique distribution of the osteonectin pool, we firs ... Full text Link to item Cite

Pathophysiology and therapeutic modification of thrombin generation in patients with coronary artery disease.

Journal Article Eur J Pharmacol · August 18, 2000 Thrombin plays a central role in thrombogenesis: it activates platelets, converts fibrinogen to fibrin, and activates factor XIII, which then crosslinks and stabilizes the fibrin clot. In addition, thrombin amplifies coagulation by activating factors VIII ... Full text Link to item Cite

Hemostatic abnormalities in patients with congestive heart failure: diagnostic significance and clinical challenge.

Journal Article Int J Cardiol · August 2000 Knowledge of the pathogenesis of congestive heart failure (CHF) has improved greatly in recent years. However, this disease continues to cause one of the highest morbidities and mortalities in the Western world. The pathophysiology of heart failure is comp ... Full text Link to item Cite

Soluble P-selectin is not a surrogate marker for platelet P-selectin: evidence from a multicenter chest pain study group.

Journal Article J Thromb Thrombolysis · August 2000 It has been reported that platelet expression and plasma levels of soluble P-selectin are increased in patients with unstable coronary artery syndromes. However, the origin of soluble P-selectin remains unknown. We sought to determine whether platelet expr ... Full text Link to item Cite

Moderate alcohol consumption is associated with decreased platelet activity in patients presenting with acute myocardial infarction.

Journal Article J Thromb Thrombolysis · April 2000 Moderate alcohol consumption (MAC) and platelet inhibition have been independently associated with a reduced risk for the development of acute myocardial infarction (AMI). The effects of MAC on the initial platelet status in patients presenting with AMI ar ... Full text Link to item Cite

Role of soluble and platelet-bound P-selectin in discriminating cardiac from noncardiac chest pain at presentation in the emergency department.

Journal Article Am Heart J · February 2000 BACKGROUND: It has been reported that selectins participate in the pathogenesis of acute coronary syndromes by modulating platelet-leukocyte-endothelium interactions. Elevated P-selectin level also has been observed in the clinical setting of myocardial is ... Full text Link to item Cite

Combining necrosis and platelet markers for perfecting myocardial infarction rule out: how close are we?

Journal Article Cardiology · 2000 Each year, at least 5 million patients in the United States present to hospital emergency departments with the complaint of chest pain, and more than 10% of them will be diagnosed with acute myocardial infarction. One of the foremost tasks of the emergency ... Full text Link to item Cite

Soluble VCAM-1 and E-selectin, but not ICAM-1 discriminate endothelial injury in patients with documented coronary artery disease.

Journal Article Cardiology · 2000 It has been shown that endothelial cell adhesion molecules play an important role in the development of coronary atherosclerosis and inflammatory disease. We sought to test whether soluble vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion ... Full text Link to item Cite

Baseline platelet aggregation and major receptor expression predict subsequent activity following thrombolysis for acute myocardial infarction.

Journal Article Scand Cardiovasc J · 2000 The early identification of patients with heightened platelet activity for aggressive antiplatelet regimens represents a critical clinical issue in acute myocardial infarction (AMI) therapy. We sought to determine whether the degree of pre-reperfusion plat ... Full text Link to item Cite

Mild myocardial stunning affects platelet aggregation and certain hemostatic factors in swine.

Journal Article Clin Appl Thromb Hemost · October 1999 Myocardial stunning is characterized by transient contractile dysfunction occurring subsequent to an episode of ischemia followed by reperfusion. Platelet activation and hemostatic abnormalities have been described in patients with unstable angina and acut ... Full text Link to item Cite

The flow cytometer model markedly affects measurement of ex vivo whole blood platelet-bound P-selectin expression in patients with chest pain: are we comparing apples with oranges.

Journal Article Thromb Res · October 1, 1999 Surface expression of P-selectin is known to be a marker of platelet activation in patients with acute coronary syndromes. However, direct comparisons of flow cytometer data may be obscured by differences in methodology, artifactual platelet activation dur ... Full text Link to item Cite

Increased soluble platelet/endothelial cellular adhesion molecule-1 and osteonectin levels in patients with severe congestive heart failure. Independence of disease etiology, and antecedent aspirin therapy.

Journal Article Eur J Heart Fail · August 1999 BACKGROUND: Platelet-endothelial interactions modulated by adhesion molecules, may play an important role in the pathogenesis of congestive heart failure (CHF). Soluble levels of these molecules and platelet-derived substances are reportedly elevated in pa ... Full text Link to item Cite

Depression, coronary events, platelet inhibition, and serotonin reuptake inhibitors.

Journal Article Am J Cardiol · August 1, 1999 There is substantial clinical evidence that the incidence of depression and mortality after acute coronary events are strongly related. As mediators of coronary thrombosis, platelets may represent a link between these events, and could be possibly targeted ... Full text Link to item Cite

Clopidogrel: the future choice for preventing platelet activation during coronary stenting?

Journal Article Pharmacol Res · August 1999 Ticlopidine has become an established therapy in patients with stroke, and during stenting in patients with coronary artery disease. Clopidogrel, another thienopyridine, is a safe and promising alternative, that irreversibly inhibits ADP-induced platelet a ... Full text Link to item Cite

Plasma thromboxane and prostacyclin are linear related and increased in patients presenting with acute myocardial infarction.

Journal Article Prostaglandins Leukot Essent Fatty Acids · July 1999 The role of prostanoids in patients with ischemic heart disease including acute myocardial infarction (AMI) has been recognized. However, there is very limited knowledge of the baseline TXB2 and 6-keto-PGF1a plasma levels in patients with AMI before therap ... Full text Link to item Cite

Usefulness of soluble and surface-bound P-selectin in detecting heightened platelet activity in patients with congestive heart failure.

Journal Article Am J Cardiol · May 1, 1999 P-selectin is an important marker of platelet activation and may be up-regulated in patients with congestive heart failure (CHF). We sought to prospectively compare simultaneously determined platelet and soluble P-selectin in patients with CHF and in healt ... Full text Link to item Cite

Failure of thrombin generation markers to triage patients presenting with chest pain.

Journal Article Cardiology · 1999 Thrombin generation (TG) is an important pathogenic factor in acute coronary syndromes including acute myocardial infarction (AMI). Since the diagnostic utility of TG remains uncertain we sought to determine whether markers of TG may triage patients presen ... Full text Link to item Cite

Clinical utility of available methods for determining platelet function.

Journal Article Cardiology · 1999 Determination of platelet function has become increasingly important as new antiplatelet drugs are being developed. Objective means to monitor the pharmacological effects of these agents, in order to maximize efficacy and minimize toxicity, is needed. The ... Full text Link to item Cite

Effects of a novel Mac-1 inhibitor, NPC 15669, on hemostatic parameters during preconditioned myocardial infarction.

Journal Article Life Sci · 1999 NPC 15669, a member of the leumedins family, inhibits leukocyte adhesion to the endothelium by blockage of upregulation of a member of beta2 integrin family Mac-1 (CD11b/CD18). Inhibition of neutrophil-endothelial interactions may alter the course of myoca ... Full text Link to item Cite

Soluble PECAM-1, but not P-selectin, nor osteonectin identify acute myocardial infarction in patients presenting with chest pain.

Journal Article Cardiology · 1999 We sought to determine plasma levels of platelet/endothelial cell adhesion molecule-1 (PECAM-1), P-selectin, and platelet-derived osteonectin, and prospectively compare these data with the discharge diagnosis in patients presenting with chest pain in a com ... Full text Link to item Cite

Effect of thrombolytic therapy on platelet expression and plasma concentration of PECAM-1 (CD31) in patients with acute myocardial infarction.

Journal Article Arterioscler Thromb Vasc Biol · January 1999 Animal studies have shown that the administration of antibodies against platelet/endothelial cell adhesion molecule-1 (PECAM-1) before reperfusion can reduce infarct size. The purpose of the present study was to define the effects of thrombolytic therapy i ... Full text Link to item Cite

Chapter 4 Myocardial cell injury during ischemia and reflow

Journal Article Principles of Medical Biology · December 1, 1998 The transition from reversible to irreversible injury in the ischemic heart and the possibility of recovery following reflow is influenced by the following external and internal factors (Piper, 1990):o(a)The conditions of the ischemic region define the rec ... Full text Cite

Depressed plasma platelet-activating factor acetylhydrolase in patients presenting with acute myocardial infarction.

Journal Article Cardiology · October 1998 Cell membrane phospholipids, including platelet-activating factor (PAF), participate in the pathogenesis of acute myocardial infarction (AMI). The plasma level of PAF acetylhydrolase (AH) was determined in 18 patients at presentation with AMI before thromb ... Full text Link to item Cite

Heterogeneity of platelet aggregation and major surface receptor expression in patients with acute myocardial infarction.

Journal Article Am Heart J · September 1998 BACKGROUND: Platelets play an important role in the natural history of acute myocardial infarction (AMI). METHODS AND RESULTS: Platelet aggregation and receptor expression were studied in 23 patients with AMI before reperfusion therapy and compared with 10 ... Full text Link to item Cite

Serial changes of soluble endothelin-1 levels during myocardial ischaemia-reperfusion. Effects of magnesium, diltiazem and a novel MAC-1 inhibitor.

Journal Article Pharmacol Res · September 1998 The key role of endothelin-1 (ET-1) has been recognised in patients with ischaemic heart disease. However, the serial changes of ET-1 during both brief and prolonged ischaemia-reperfusion are poorly known. Serial changes of plasma ET-1 were measured during ... Full text Link to item Cite

Antecedent aspirin therapy inhibits baseline platelet activity in patients presenting with acute myocardial infarction. The GUSTO-III Platelet Substudy.

Journal Article Cardiology · July 1998 Aspirin therapy and platelet inhibition reduce the risk for the development of acute myocardial infarction (AMI). However, the effects of aspirin on baseline platelet activity in patients presenting with AMI are not known. We determined the effect of long- ... Full text Link to item Cite

Effects of reteplase and alteplase on platelet aggregation and major receptor expression during the first 24 hours of acute myocardial infarction treatment. GUSTO-III Investigators. Global Use of Strategies to Open Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · June 1998 OBJECTIVES: We sought to compare platelet characteristics after reteplase and alteplase therapy in the setting of the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO)-III trial. BACKGROUND: Platelet function may be impaired during thromb ... Full text Link to item Cite

Changes in hemostasis after parenteral magnesium in myocardial ischemia-reperfusion: from animal studies to clinical trials.

Journal Article Magnes Res · June 1998 There has been some debate regarding the benefit of parenteral magnesium (Mg) in the treatment of acute myocardial infarction (AMI), due to conflicting results from animal studies and recent clinical trials. Several different hypotheses, proposing antiplat ... Link to item Cite

Plasma fibronectin during myocardial ischemia-reperfusion: effects of magnesium, diltiazem, and a novel Mac-1 inhibitor.

Journal Article Am J Hematol · April 1998 The important role of fibronectin (Fn) has been recognized in patients with ischemic heart disease. However, serial changes of Fn during both brief and prolonged ischemia-reperfusion are poorly known. Plasma Fn was measured during acute myocardial infarcti ... Full text Link to item Cite

Soluble vascular cell adhesion molecule-1 and E-selectin in patients with acute myocardial infarction treated with thrombolytic agents.

Journal Article Am J Cardiol · March 15, 1998 Twenty-three patients enrolled in th GUSTO-III study underwent serial measurements of soluble vascular cell adhesion molecule-1 (VCAM-1) and E-selectin by enzyme-linked immunosorbent assay at prespecified time intervals. Soluble VCAM-1, but not E-selectin ... Full text Link to item Cite

Increased baseline levels of platelet P-selectin, and platelet-endothelial cell adhesion molecule-1 in patients with acute myocardial infarction as predictors of unsuccessful thrombolysis.

Journal Article Coron Artery Dis · 1998 BACKGROUND: Platelets play a pivotal role in the pathogenesis of acute myocardial infarction and their activation can cause thrombolysis to fail. METHODS: Baseline aggregation of platelets and expression of major surface receptors measured by flow cytometr ... Full text Link to item Cite

Depressed platelet status in an elderly patient with hemorrhagic stroke after thrombolysis for acute myocardial infarction. GUSTO-III Investigators.

Journal Article Stroke · January 1998 BACKGROUND: Impaired platelet function has been reported in acute myocardial infarction (AMI) and stroke. However, prospective data on the changes of platelet status in patients before the occurrence of hemorrhagic stroke after thrombolytic therapy are una ... Full text Link to item Cite

Crossreactivity of Human versus Swine Platelet Surface Antigens Is Similar for Glycoproteins Ib and IIIa, but Not for the Glycoprotein IIb/IIIa Complex.

Journal Article J Thromb Thrombolysis · 1998 Swine platalets are very similar to those of humans and are therefore relevant to cardiovascular research. The swine coronary circulation mimics the human circulation and is large enough to obtain multiple blood samples in survival experiments. In swine re ... Full text Link to item Cite

Survival in Acute Myocardial Infarction Induced by Coronary Ligation: Prognostic Relevance of Certain Hemostatic Factors During the Occlusion Phase.

Journal Article J Thromb Thrombolysis · 1998 Alterations in various hemostatic factor have been identified as risk factors for survival after acute myocardial infarction (AMI). However, these clinical data are primarily limited to observations made during the postinfarct stage. We assessed the effect ... Full text Link to item Cite

Effects of intracoronary diltiazem on certain hemostatic parameters during acute myocardial infarction in swine.

Journal Article Int J Cardiol · August 29, 1997 Controversy currently exists regarding the use of diltiazem in the treatment of acute myocardial infarction (AMI). due to conflicting results from clinical trials and animal studies. The purpose of this project was to evaluate the changes in the hemostatic ... Full text Link to item Cite

Bolus magnesium infusion in humans is associated with predominantly unfavourable changes in platelet aggregation and certain haemostatic factors.

Journal Article Pharmacol Res · July 1997 UNLABELLED: The purpose of this study was an attempt to extrapolate favorable observations on the effects of magnesium on platelets and haemostasis from animal models to humans. Intravenous magnesium in the treatment of acute myocardial infarction has been ... Full text Link to item Cite

Coronary artery angioplasty with a helical autoperfusion balloon catheter.

Journal Article Cathet Cardiovasc Diagn · February 1997 The initial in-hospital and long-term clinical experience with a helical autoperfusion balloon catheter in the treatment of coronary artery disease is reported. This new catheter design allows blood to flow passively around the inflated balloon through a p ... Full text Link to item Cite

Serial changes of the plasma prostanoids during myocardial ischemia-reperfusion in swine. Effects of magnesium, diltiazem, and a novel Mac-1 inhibitor.

Journal Article Prostaglandins Leukot Essent Fatty Acids · February 1997 The key role of prostanoids has been recognized in patients with ischemic heart disease. However, serial changes of thromboxane and prostacyclin during both brief and prolonged ischemia-reperfusion are poorly known. These plasma prostanoids were measured d ... Full text Link to item Cite

New concept in coronary angioplasty: dilatation with a helical balloon that allows simultaneous autoperfusion.

Conference Cathet Cardiovasc Diagn · January 1997 These preclinical studies investigate a new concept in coronary angioplasty and balloon catheter technology (the P100 catheter). The study sought to evaluate the morphology of experimental coronary arterial plaques dilated with the P100 in comparison to st ... Full text Link to item Cite

Could coenzyme Q10 affect hemostasis by inhibiting platelet vitronectin (CD51/CD61) receptor?

Journal Article Mol Aspects Med · 1997 Improved cardiovascular morbidity and mortality have been observed in several clinical studies of dietary supplementation with coenzyme Q10 (CoQ10, ubiquinone). Several mechanisms have been proposed to explain the effects of CoQ10. One attractive theory li ... Full text Link to item Cite

Dietary coenzyme Q10 supplementation alters platelet size and inhibits human vitronectin (CD51/CD61) receptor expression.

Journal Article J Cardiovasc Pharmacol · January 1997 Improved cardiovascular morbidity and mortality have been observed in several clinical studies of dietary supplementation with coenzyme Q10 (CoQ10, ubiquinone). Several mechanisms have been proposed to explain the effects of CoQ10, but a comprehensive expl ... Full text Link to item Cite

Percutaneous revascularization of an extensively diseased saphenous vein bypass graft with a saphenous vein-covered Palmaz stent.

Journal Article Cathet Cardiovasc Diagn · January 1997 A 68-year-old man developed unstable angina 12 years following coronary artery bypass surgery. Angiography revealed an extensive area of severe stenosis and diminished distal flow in a right coronary artery vein bypass graft. Given the high distal embolism ... Full text Link to item Cite

Hemostatic changes after early versus late intracoronary magnesium during acute myocardial infarction in swine.

Journal Article J Cardiovasc Pharmacol · December 1996 There has been some debate regarding the benefit of magnesium (Mg) in the treatment of acute myocardial infarction (AMI) because of conflicting results from recent clinical trials. Several different hypotheses have been advanced to explain the cardioprotec ... Full text Link to item Cite

Mild myocardial stunning affects platelet aggregation and hemostasis in swine

Journal Article FASEB Journal · December 1, 1996 The key role of platelet activation and hemostatic disorders have been increasingly recognized in patients with unstable angina and acute myocardial infarction. However, the dynamics of the hemostatic profile during brief ischemia-reperfusion are poorly un ... Cite

Changes in the haemostatic profile during magnesium deficiency in swine.

Journal Article Magnes Res · October 1996 Epidemiological studies of populations living in areas of low magnesium (Mg) intake have consistently shown a higher cardiovascular morbidity. Several hypotheses have been advanced to explain the cardioprotective properties of magnesium. Few studies, howev ... Link to item Cite

Intracoronary magnesium and diltiazem affect to a similar extent certain hemostatic factors during acute myocardial infarction in swine.

Journal Article Pharmacology · October 1996 The use of calcium antagonists and magnesium (Mg) in the treatment of acute myocardial infarction is controversial. We compared changes in hemostasis during acute myocardial infarction after either low-dose intracoronary Mg or diltiazem infusion in 20 York ... Full text Link to item Cite

Serial changes of natural antithrombotics during myocardial ischemia-reperfusion in swine. Effects of magnesium, diltiazem, and a novel Mac-1 inhibitor.

Journal Article Blood Coagul Fibrinolysis · September 1996 Plasma antithrombin-III (AT-III), protein S, and protein C were measured during myocardial stunning (MS) and acute myocardial infarction (AMI). The effects of magnesium (Mg), diltiazem, and a Mac-1 inhibitor on their plasma levels were elucidated. Forty-ni ... Full text Link to item Cite

Mac-1 inhibitor affects certain hemostatic parameters during myocardial stunning in swine.

Journal Article Pharmacology · August 1996 Myocardial stunning (MS) is a transient contractile dysfunction occurring subsequent to an episode of ischemia followed by reperfusion. NPC 15669 is a leumedin, which inhibits leukocyte adhesion to the endothelium by blocking Mac-1 upregulation. The effect ... Full text Link to item Cite

Pretreatment with an inhibitor of mac-1 alters regional and systemic platelet function during ischemia-reperfusion in swine.

Journal Article Pharmacology · August 1996 Myocardial ischemia-reperfusion alters regional and systemic platelet function. The aim of our study was to elucidate the role of the Mac-1 receptor in changes of platelet function by using the leumedin, NPC-15669, an inhibitor of Mac-1 upregulation. In an ... Full text Link to item Cite

Hemostatic changes after dietary coenzyme Q10 supplementation in swine.

Journal Article J Cardiovasc Pharmacol · August 1996 Improved cardiovascular morbidity and mortality have been observed in several clinical studies of dietary supplementation with coenzyme Q10 (CoQ10). We elucidated the effect of CoQ10 on certain hemostatic parameters that may influence the progression of he ... Full text Link to item Cite

Lesion-directed administration of alteplase with intracoronary heparin in patients with unstable angina and coronary thrombus undergoing angioplasty.

Journal Article Cathet Cardiovasc Diagn · April 1996 Percutaneous coronary revascularization in patients with unstable angina and coronary thrombus carries a high complication rate. A new strategy to reduce thrombus burden before revascularization was tested in a multicenter prospective trial. Patients with ... Full text Link to item Cite

The effect of intra-aortic balloon counterpulsation on coronary blood flow velocity distal to coronary artery stenoses.

Journal Article Cardiology · 1996 Despite the accepted clinical benefit of intra-aortic balloon counterpulsation (IABC), the physiologic explanation for its benefit remains controversial. Indirect methods of measuring coronary blood flow during IABC in obstructive coronary disease have yie ... Full text Link to item Cite

Zofenopril after anterior myocardial infarction.

Journal Article N Engl J Med · June 22, 1995 Link to item Cite

The use of the Tracker catheter as a guidewire support device in angioplasty of angulated and tortuous circumflex coronary arteries.

Journal Article J Invasive Cardiol · April 1995 Marked angulation and tortuosity of the coronary arteries, particularly the circumflex, can limit coronary angioplasty. Despite the use of adequate guide catheter support and high performance guidewires, it is often difficult or even impossible to reach th ... Link to item Cite

Regional and Systemic Platelet Function Is Altered by Myocardial Ischemia-Reperfusion.

Journal Article J Thromb Thrombolysis · 1995 Background: Myocardial reperfusion after short durations of ischemia causes prolonged contractile dysfunction (myocardial stunning). Recently it has also been suggested that ischemia-reperfusion results in impaired coronary endothelial function. Since plat ... Full text Link to item Cite

NPC 15669, an Antiinflammatory Leucine Derivative, Reduces In Vitro Platelet Aggregability in Both Swine and Human Plasma.

Journal Article J Thromb Thrombolysis · 1995 Background: Leumedins inhibit cell adhesion to endothelium via blockage of integrin binding. We tested a hypothesis that the novel leucine derivate NPC 15669 will affect in vitro platelet aggregability (PA) in both human and swine plasma. Methods and Resul ... Full text Link to item Cite

Effects of a Novel Leumedin NPC 15669 on Myocardial Stunning and Preconditioned Infarction Size in Swine.

Journal Article J Thromb Thrombolysis · 1995 Background: NPC is a member of the leumedins and is an inhibitor of leukocyte adhesion to endothelium via blockage of integrin binding. NPC 15669 also may have antiplatelet effects. We tested the efficacy of the novel leukocyte recruitment inhibitor NPC 15 ... Full text Link to item Cite

Pharmacomechanical thrombolysis of experimental pulmonary emboli. Rapid low-dose intraembolic therapy.

Journal Article Chest · November 1994 We utilized low-dose intraembolic urokinase (UK) infusions in a canine model of experimental pulmonary embolism (PE) and compared the arteriographic extent of thrombolysis with three other treatment regimens. Group 1 animals (n = 16) received the intraembo ... Full text Link to item Cite

Accelerated intravenous dosing of recombinant tissue-type plasminogen activator causes rapid but unstable reperfusion in a canine model of acute myocardial infarction.

Journal Article Coron Artery Dis · November 1994 BACKGROUND: Accelerated intravenous dosing is currently the preferred regimen for administering recombinant tissue-type plasminogen activator (rt-PA) in acute myocardial infarction (AMI). This regimen is recommended on the basis of clinical angiographic st ... Link to item Cite

Use of aortic counterpulsation to improve sustained coronary artery patency during acute myocardial infarction. Results of a randomized trial. The Randomized IABP Study Group.

Journal Article Circulation · August 1994 BACKGROUND: Aortic counterpulsation has been observed to reduce the rate of reocclusion of the infarct-related artery after patency has been restored during acute myocardial infarction in observational studies. To evaluate the benefit-to-risk ratio of aort ... Full text Link to item Cite

A randomized comparison of the effects of gradual prolonged versus standard primary balloon inflation on early and late outcome. Results of a multicenter clinical trial. Perfusion Balloon Catheter Study Group.

Journal Article Circulation · March 1994 BACKGROUND: Observational studies have suggested that prolonged balloon inflation during coronary angioplasty is associated with a high clinical success rate. This randomized clinical trial sought to evaluate the impact of primary gradual and prolonged inf ... Full text Link to item Cite

Arterial diastolic pressure augmentation by intra-aortic balloon counterpulsation enhances the onset of coronary artery reperfusion by thrombolytic therapy.

Journal Article Circulation · January 1994 BACKGROUND: The early establishment of infarct artery reperfusion by intravenous thrombolytic therapy has improved survival after acute myocardial infarction. Investigations of reperfusion have focused on the effects of specific thrombolytic agents, antico ... Full text Link to item Cite

A canine model of acute coronary artery thrombosis for the evaluation of reperfusion strategies.

Journal Article Cardiology · 1994 A model of coronary artery thrombosis which: (1) provides a stable thrombus; (2) incorporates intimal injury; (3) has a low mortality rate; (4) responds predictably to thrombolytic therapy, and (5) is technically simple, was developed. Intimal injury was p ... Full text Link to item Cite

Effect of magnesium sulphate infusion on ex vivo platelet aggregation in swine.

Journal Article Magnes Res · December 1993 The effect of magnesium sulphate infusion on ex vivo platelet aggregation in 11 female Yorkshire swine was observed using platelet-rich plasma and different agonists (ADP 5 mM; ADP 10 mM and collagen 1 mg/ml). Infusion of 1 g MgSO4 over 1 h produced a sign ... Link to item Cite

Rapid and accurate diagnosis of pulmonary emboli in a canine model using intravascular ultrasound imaging.

Journal Article Chest · November 1991 We utilized intravascular ultrasound (IVUS) imaging in a canine pulmonary embolism model to visualize experimental emboli. The images obtained were compared with those obtained by single-plane pulmonary arteriography in each of six animals. The vessel lume ... Full text Link to item Cite