Scholars@Duke
Richard Clinton Becker

Richard Clinton Becker

Adjunct Professor in the Department of Medicine
Medicine, Cardiology
richard.becker@duke.edu
CVC 4th Floor Room 4936, Cincinnati, OH 45267
231 Albert Sabin Way, Cincinnati, OH 45267

Selected Publications

Reply.

Journal Article Hepatology · September 2016 Full text Link to item Cite

Foreword

Journal Article Law & Contemporary Problems · 2015 Open Access Link to item Cite

The effect of the REG2 Anticoagulation System on thrombin generation kinetics: a pharmacodynamic and pharmacokinetic first-in-human study.

Journal Article J Thromb Thrombolysis · October 2014 The REG2 Anticoagulation System consists of pegnivacogin, a subcutaneously administered aptamer factor IXa inhibitor, and its intravenous active control agent, anivamersen. Its effect on thrombin generation is unknown. A prospectively designed thrombin gen ... Full text Link to item Cite

ABO blood group influences transfusion and survival after cardiac surgery.

Journal Article J Thromb Thrombolysis · October 2014 ABO dependent variation in von Willebrand factor (vWf) and procoagulant factor VIII (FVIII) is a plausible mechanism for modulating perioperative hemostasis and bleeding. Group AB has the highest and group O the lowest vWf and FVIII levels. Therefore, we t ... Full text Link to item Cite

Management of major bleeding events in patients treated with rivaroxaban vs. warfarin: results from the ROCKET AF trial.

Journal Article Eur Heart J · July 21, 2014 AIMS: There are no data regarding management and outcomes of major bleeding events in patients treated with oral factor Xa inhibitors. METHODS AND RESULTS: Using data from ROCKET AF, we analysed the management and outcomes of major bleeding overall and acc ... Full text Link to item Cite

Efficacy and safety of rivaroxaban compared with warfarin among elderly patients with nonvalvular atrial fibrillation in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF).

Journal Article Circulation · July 8, 2014 BACKGROUND: Nonvalvular atrial fibrillation is common in elderly patients, who face an elevated risk of stroke but difficulty sustaining warfarin treatment. The oral factor Xa inhibitor rivaroxaban was noninferior to warfarin in the Rivaroxaban Once Daily, ... Full text Link to item Cite

Polymorphism of the cystatin C gene in patients with acute coronary syndromes: Results from the PLATelet inhibition and patient Outcomes study.

Journal Article Am Heart J · July 2014 PURPOSE: Elevated cystatin C concentration is an independent risk factor for cardiovascular (CV) events in patients with acute coronary syndromes. Genetic polymorphisms in CST3 influence cystatin C levels, but their relationship to outcomes is unclear. MET ... Full text Link to item Cite

The efficacy of ticagrelor is maintained in women with acute coronary syndromes participating in the prospective, randomized, PLATelet inhibition and patient Outcomes (PLATO) trial.

Journal Article Eur Heart J · June 14, 2014 AIMS: The aim of this study was to assess the relationship between sex and clinical outcomes and treatment-related complications in patients with ST-elevation or non-ST-elevation acute coronary syndromes (ACS) randomized to treatment with ticagrelor or clo ... Full text Link to item Cite

Rivaroxaban for stroke prevention in East Asian patients from the ROCKET AF trial.

Journal Article Stroke · June 2014 BACKGROUND AND PURPOSE: In Rivaroxaban Once Daily Oral Direct Factor Xa Inhibitor Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) trial, rivaroxaban was noninferior to dose-adjusted warfarin ... Full text Link to item Cite

Use and outcomes of antiarrhythmic therapy in patients with atrial fibrillation receiving oral anticoagulation: results from the ROCKET AF trial.

Journal Article Heart Rhythm · June 2014 BACKGROUND: Antiarrhythmic drugs (AADs) and anticoagulation are mainstays of atrial fibrillation (AF) treatment. OBJECTIVE: To study the use and outcomes of AAD therapy in anticoagulated patients with AF. METHODS: Patients in the Rivaroxaban Once Daily Ora ... Full text Link to item Cite

A freeze on tailored antiplatelet therapy?

Journal Article Circulation · May 27, 2014 Full text Link to item Cite

Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF).

Journal Article Circulation · May 6, 2014 BACKGROUND: During long-term anticoagulation in atrial fibrillation, temporary interruptions (TIs) of therapy are common, but the relationship between patient outcomes and TIs has not been well studied. We sought to determine reasons for TI, the characteri ... Full text Link to item Cite

Effects of vorapaxar on platelet reactivity and biomarker expression in non-ST-elevation acute coronary syndromes. The TRACER Pharmacodynamic Substudy.

Journal Article Thromb Haemost · May 5, 2014 Vorapaxar is an antagonist of the protease activated receptor-1 (PAR-1), the principal platelet thrombin receptor. The Thrombin Receptor Antagonist for Clinical Event Reduction (TRACER) trial evaluated vorapaxar compared to placebo in non-ST-elevation (NST ... Full text Link to item Cite

Intracranial hemorrhage among patients with atrial fibrillation anticoagulated with warfarin or rivaroxaban: the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation.

Journal Article Stroke · May 2014 BACKGROUND AND PURPOSE: Intracranial hemorrhage (ICH) is a life-threatening complication of anticoagulation. METHODS: We investigated the rate, outcomes, and predictors of ICH in 14 264 patients with atrial fibrillation from Rivaroxaban Once Daily, Oral, D ... Full text Link to item Cite

The unmet need for philanthropic funding of early career cardiovascular investigators.

Journal Article J Thromb Thrombolysis · May 2014 Philanthropic donations have funded scientific investigations of cardiovascular disease for much of human history, and the patrons who enabled them are indirectly responsible for major breakthroughs in the field. Today, however, the lion's share of funding ... Full text Link to item Cite

Ticagrelor effects on myocardial infarction and the impact of event adjudication in the PLATO (Platelet Inhibition and Patient Outcomes) trial.

Journal Article J Am Coll Cardiol · April 22, 2014 OBJECTIVES: This study sought to report the treatment effect of ticagrelor on myocardial infarction (MI) and the strategy for and impact of event adjudication in the PLATO (Platelet Inhibition and Patient Outcomes) trial. BACKGROUND: In PLATO, ticagrelor r ... Full text Link to item Cite

Novel oral anticoagulants: pharmacology, coagulation measures, and considerations for reversal.

Journal Article J Thromb Thrombolysis · April 2014 Novel oral anticoagulants (NOAC) provide an effective and, in some cases, superior alternative to traditional, oral vitamin K antagonists such as warfarin. These drugs differ in their pharmacokinetic and pharmacodynamics profiles, which is important for se ... Full text Link to item Cite

Factors associated with major bleeding events: insights from the ROCKET AF trial (rivaroxaban once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation).

Journal Article J Am Coll Cardiol · March 11, 2014 OBJECTIVES: This study sought to report additional safety results from the ROCKET AF (Rivaroxaban Once-daily oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation). BACKGROUND ... Full text Link to item Cite

Assessing exertional dyspnea in patients with idiopathic pulmonary fibrosis.

Journal Article Respir Med · January 2014 BACKGROUND: Dyspnea is a hallmark symptom of idiopathic pulmonary fibrosis (IPF), and dyspnea induced physical activity limitation is a prominent driver of quality of life impairment among IPF patients. METHODS: We examined response data for the 21 physica ... Full text Link to item Cite

Editor's page

Journal Article Journal of Thrombosis and Thrombolysis · 2014 Full text Cite

Transitioning to and from the novel oral anticoagulants: A management strategy for clinicians

Journal Article Journal of Thrombosis and Thrombolysis · 2014 Vitamin K antagonists have been the only available oral anticoagulant therapy for decades until the recent introduction of novel (new) oral anticoagulants. This breakthrough provides patients with alternative treatment choices that have predictable pharmac ... Full text Cite

Pharmacogenetics of antiplatelet therapy

Journal Article Current Atherosclerosis Reports · 2014 There has been substantial progress toward understanding and investigating the specific genetic factors that influence interindividual variations in platelet-directed therapy. There has also been substantial progress toward better understanding of the phar ... Full text Cite

Ischaemic cardiac outcomes in patients with atrial fibrillation treated with vitamin K antagonism or factor Xa inhibition: results from the ROCKET AF trial.

Journal Article Eur Heart J · January 2014 AIMS: We investigated the prevalence of prior myocardial infarction (MI) and incidence of ischaemic cardiovascular (CV) events among atrial fibrillation (AF) patients. METHODS AND RESULTS: In ROCKET AF, 14 264 patients with nonvalvular AF were randomized t ... Full text Link to item Cite

Relationship between time in therapeutic range and comparative treatment effect of rivaroxaban and warfarin: Results from the ROCKET AF trial

Conference Journal of the American Heart Association · January 1, 2014 Background: Time in therapeutic range (TTR) is a standard quality measure of the use of warfarin. We assessed the relative effects of rivaroxaban versus warfarin at the level of trial center TTR (cTTR) since such analysis preserves randomized comparisons. ... Full text Cite

The pharmacology of novel oral anticoagulants.

Journal Article J Thromb Thrombolysis · 2014 Anticoagulation for the prevention of stroke is an important aspect of the management of atrial fibrillation. Novel anticoagulants including oral factor Xa inhibitors rivaroxaban and apixaban and the direct thrombin inhibitor dabigatran have emerged as imp ... Full text Link to item Cite

Structure-function relationships of factor Xa inhibitors: implications for the practicing clinician.

Journal Article J Thromb Thrombolysis · 2014 The recent development and approval of novel oral anticoagulants represents a significant success in the intelligent design of target-specific therapeutics. However, while these agents obviate many of the shortcomings of their predecessor (warfarin), they ... Full text Link to item Cite

Emerging paradigms in arterial thrombosis.

Journal Article J Thromb Thrombolysis · January 2014 A traditional perspective of arterial thrombosis begins with vessel wall injury and exposure of subendothelial proteins, including collagen and tissue factor, to circulating cellular and non-cellular components. Adhesion and activation of platelets, mediat ... Full text Link to item Cite

Antithrombotic treatment in transcatheter aortic valve implantation: insights for cerebrovascular and bleeding events.

Journal Article J Am Coll Cardiol · December 24, 2013 Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic alternative for patients with symptomatic aortic stenosis at high or prohibitive surgical risk. However, patients undergoing TAVI are also at high risk for both bleeding and stroke ... 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

Anticoagulation and monitoring of a novel and reversible factor IXa inhibitor

Journal Article Drug Development Research · December 1, 2013 Clinical Development Phases I-III Regulatory, Quality, Manufacturing Thrombosis as a clinical phenotype is ubiquitous in human diseases and conditions, ranging from atherosclerosis and other vascular disorders to trauma, surgery, malignancy, infections, bl ... Full text Cite

Comparison of long-term outcomes between older Asian and white patients with non-ST-segment elevation myocardial infarction: findings from CRUSADE-CMS database.

Journal Article Am Heart J · December 2013 BACKGROUND: In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes. METHODS: We linked Centers for ... Full text Link to item Cite

Oral anticoagulants in older adults with atrial fibrillation.

Journal Article J Thromb Thrombolysis · November 2013 Atrial fibrillation (AF) is the most common arrhythmia in adults and contributes directly to adverse clinical events, ranging from ischemic stroke to heart failure and cardiovascular death. Because the incidence of AF and its attendant complications increa ... Full text Link to item Cite

Funding opportunities for clinical investigators in the early stages of career development in cardiovascular research.

Journal Article J Thromb Thrombolysis · November 2013 Contemporary cardiovascular research offers junior investigators the opportunity to explore the gamut of biomedical questions. Despite the recent reduction in the availability of funding mechanisms that have historically served as the primary pathways for ... Full text Link to item Cite

Safety of very early sheath removal in patients treated with REG1 for acute coronary syndromes: insights from the RADAR trial.

Journal Article J Invasive Cardiol · November 2013 BACKGROUND: RADAR compared REG1 (25%, 50%, 75%, 100% reversal) with unfractionated heparin (UFH) in 640 acute coronary syndrome (ACS) patients (479 REG1 patients, 161 UFH patients) undergoing an invasive management strategy. We sought to determine whether ... Link to item Cite

Aspirin exposure reveals novel genes associated with platelet function and cardiovascular events.

Journal Article J Am Coll Cardiol · October 1, 2013 OBJECTIVES: The aim of this study was to develop ribonucleic acid (RNA) profiles that could serve as novel biomarkers for the response to aspirin. BACKGROUND: Aspirin reduces death and myocardial infarction (MI), suggesting that aspirin interacts with biol ... Full text Link to item Cite

Cystatin C- and creatinine-based estimates of renal function and their value for risk prediction in patients with acute coronary syndrome: results from the PLATelet Inhibition and Patient Outcomes (PLATO) study.

Journal Article Clin Chem · September 2013 BACKGROUND: The estimated glomerular filtration rate (eGFR) independently predicts cardiovascular death or myocardial infarction (MI) and can be estimated by creatinine and cystatin C concentrations. We evaluated 2 different cystatin C assays, alone or com ... Full text Link to item Cite

Hemostasis and Thrombosis

Journal Article · August 29, 2013 Full text Cite

A Phase 2, randomized, partially blinded, active-controlled study assessing the efficacy and safety of variable anticoagulation reversal using the REG1 system in patients with acute coronary syndromes: results of the RADAR trial.

Journal Article Eur Heart J · August 2013 AIMS: We sought to determine the degree of anticoagulation reversal required to mitigate bleeding, and assess the feasibility of using pegnivacogin to prevent ischaemic events in acute coronary syndrome (ACS) patients managed with an early invasive approac ... Full text Link to item Cite

Clinical strategies for selecting oral anticoagulants in patients with atrial fibrillation.

Journal Article J Thromb Thrombolysis · August 2013 Atrial fibrillation is a common arrhythmia. One of the important aspects of the management of atrial fibrillation is stroke prevention. Warfarin has been the longstanding anticoagulant used for stroke prevention in patients with atrial fibrillation. There ... Full text Link to item Cite

Suspected acute exacerbation of idiopathic pulmonary fibrosis as an outcome measure in clinical trials.

Journal Article Respir Res · July 13, 2013 BACKGROUND: Acute exacerbation of idiopathic pulmonary fibrosis has become an important outcome measure in clinical trials. This study aimed to explore the concept of suspected acute exacerbation as an outcome measure. METHODS: Three investigators retrospe ... Full text Link to item Cite

Highlights from the fifth international symposium of thrombosis and anticoagulation (ISTA V), October 18-19, 2012, Belo Horizonte, Minas Gerais, Brazil.

Journal Article J Thromb Thrombolysis · July 2013 To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Fifth International Symposium of Thrombosis and Anticoagulation was held in Belo Horizonte, Minas Gerais, Brazil, on October 18-19, 2012. This scientific p ... Full text Link to item Cite

Efficacy and safety of rivaroxaban in patients with heart failure and nonvalvular atrial fibrillation: insights from ROCKET AF.

Journal Article Circ Heart Fail · July 2013 BACKGROUND: In Rivaroxaban Once daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF), rivaroxaban was noninferior to warfarin for the prevention of stroke ... Full text Link to item Cite

End of study transition from study drug to open-label vitamin K antagonist therapy: the ROCKET AF experience.

Journal Article Circ Cardiovasc Qual Outcomes · July 2013 BACKGROUND: To evaluate the previously reported excess of thromboembolic events during the 30 days after the end of study (EOS) visit when participants transitioned from blinded therapy to open-label vitamin K antagonist. METHODS AND RESULTS: At the EOS vi ... Full text Link to item Cite

Clinical outcomes with rivaroxaban in patients transitioned from vitamin K antagonist therapy: a subgroup analysis of a randomized trial.

Journal Article Ann Intern Med · June 18, 2013 BACKGROUND: In ROCKET AF (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation), a large randomized, clinical trial, rivaroxaban was noninferior to w ... Full text Link to item Cite

Effect of escitalopram on mental stress-induced myocardial ischemia: results of the REMIT trial.

Journal Article JAMA · May 22, 2013 IMPORTANCE: Mental stress can induce myocardial ischemia and also has been implicated in triggering cardiac events. However, pharmacological interventions aimed at reducing mental stress-induced myocardial ischemia (MSIMI) have not been well studied. OBJEC ... Full text Link to item Cite

Outcomes after cardioversion and atrial fibrillation ablation in patients treated with rivaroxaban and warfarin in the ROCKET AF trial.

Journal Article J Am Coll Cardiol · May 14, 2013 OBJECTIVES: This study sought to investigate the outcomes following cardioversion or catheter ablation in patients with atrial fibrillation (AF) treated with warfarin or rivaroxaban. BACKGROUND: There are limited data on outcomes following cardioversion or ... Full text Link to item Cite

Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart disease.

Journal Article J Am Coll Cardiol · February 19, 2013 OBJECTIVES: The goal of this study was to evaluate the prevalence and clinical characteristics of mental stress-induced myocardial ischemia. BACKGROUND: Mental stress-induced myocardial ischemia is prevalent and a risk factor for poor prognosis in patients ... Full text Link to item Cite

Impact of global geographic region on time in therapeutic range on warfarin anticoagulant therapy: data from the ROCKET AF clinical trial.

Journal Article J Am Heart Assoc · February 19, 2013 BACKGROUND: Vitamin K antagonist (VKA) therapy remains the most common method of stroke prevention in patients with atrial fibrillation. Time in therapeutic range (TTR) is a widely cited measure of the quality of VKA therapy. We sought to identify factors ... Full text Link to item Cite

Outcomes of discontinuing rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: analysis from the ROCKET AF trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation).

Journal Article J Am Coll Cardiol · February 12, 2013 OBJECTIVES: The purpose of this study was to understand the possible risk of discontinuation in the context of clinical care. BACKGROUND: Rivaroxaban is noninferior to warfarin for preventing stroke in atrial fibrillation patients. Concerns exist regarding ... Full text Link to item Cite

Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation) and ATRIA (AnTicoagulation and Risk factors In Atrial fibrillation) study cohorts.

Journal Article Circulation · January 15, 2013 BACKGROUND: We sought to define the factors associated with the occurrence of stroke and systemic embolism in a large, international atrial fibrillation (AF) trial. METHODS AND RESULTS: In ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibitio ... Full text Link to item Cite

A functional polymorphism in the 5HTR2C gene associated with stress responses also predicts incident cardiovascular events.

Journal Article PLoS One · 2013 Previously we have shown that a functional nonsynonymous single nucleotide polymorphism (rs6318) of the 5HTR2C gene located on the X-chromosome is associated with hypothalamic-pituitary-adrenal axis response to a stress recall task, and with endophenotypes ... Full text Open Access Link to item Cite

Biomarkers in relation to the effects of ticagrelor compared with clopidogrel in non-ST-elevation acute coronary syndrome patients managed with or without in-hospital revascularization: A substudy from the prospective randomized platelet inhibition and patient outcomes (PLATO) trial

Journal Article Circulation · 2013 BACKGROUND: Risk stratification and the use of specific biomarkers have been proposed for tailoring treatment in patients with NSTE-ACS. We investigated the prognostic importance of hs-TnT, NT-proBNP and GDF-15 in relation to randomized treatment (ticagrel ... Full text Cite

Antiplatelet therapy in prevention of cardio- and venous thromboembolic events

Journal Article Journal of Thrombosis and Thrombolysis · 2013 The contribution of platelets in the pathophysiology of low-shear thrombosis-specifically, in atrial fibrillation (AF) and venous thromboembolic events (VTE)-remains less clear than for arterial thrombosis. AF itself appears to lead to platelet activation, ... Full text Cite

The effect of surface contact activation and temperature on plasma coagulation with an RNA aptamer directed against factor IXa.

Journal Article J Thromb Thrombolysis · January 2013 The anticoagulant properties of a novel RNA aptamer that binds FIXa depend collectively on the intensity of surface contact activation of human blood plasma, aptamer concentration, and its binding affinity for FIXa. Accordingly, anticoagulation efficiency ... Full text Link to item Cite

Hyperreactive platelet phenotypes: relationship to altered serotonin transporter number, transport kinetics and intrinsic response to adrenergic co-stimulation.

Journal Article Thromb Haemost · January 2013 The mechanism underlying a hyperreactive platelet phenotype remains unknown. Since serotonin has been shown to influence platelet biology and atherothrombosis, we sought to investigate the association of platelet serotonin transporter number, binding affin ... Full text Link to item Cite

Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease.

Journal Article Psychosom Med · 2013 OBJECTIVES: The aim of this study was to examine the associations between depressive symptoms and mental stress-induced myocardial ischemia (MSIMI) in patients with coronary heart disease (CHD). METHODS: Adult patients with documented CHD were recruited fo ... Full text Link to item Cite

Plasma proteomics of patients with non-valvular atrial fibrillation on chronic anti-coagulation with warfarin or a direct factor Xa inhibitor.

Journal Article Thromb Haemost · December 2012 Plasma proteins mediate thrombogenesis, inflammation, endocardial injury and structural remodelling in atrial fibrillation (AF). We hypothesised that anti-coagulation with rivaroxaban, a direct factor Xa inhibitor, would differentially modulate biologicall ... Full text Link to item Cite

Antithrombotic therapy in heparin-induced thrombocytopenia: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · November 2012 Heparin-induced thrombocytopenia (HIT) is a clinicopathologic syndrome initiated by heparin exposure and characterized by thrombocytopenia and paradoxical thrombophilia. HIT is mediated by the formation of antibodies against the platelet factor 4/heparin c ... Full text Link to item Cite

Outcome and causes of renal deterioration evaluated by serial cystatin C measurements in acute coronary syndrome patients -- results from the PLATelet inhibition and patient Outcomes (PLATO) study.

Journal Article Am Heart J · November 2012 BACKGROUND: To investigate if ticagrelor treatment and other clinical characteristics were associated with increased cystatin C concentrations and if a deterioration in estimated renal function was associated with worse outcome in patients with acute coron ... Full text Link to item Cite

Electrophysiology in China: a special supplement. Introduction.

Journal Article J Cardiovasc Electrophysiol · November 2012 Full text Link to item Cite

Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery.

Journal Article J Am Coll Cardiol · October 23, 2012 OBJECTIVES: This study investigated the differences in specific causes of post-coronary artery bypass graft surgery (CABG) deaths in the PLATO (Platelet Inhibition and Patient Outcomes) trial. BACKGROUND: In the PLATO trial, patients assigned to ticagrelor ... Full text Link to item Cite

Ticagrelor versus clopidogrel in elderly patients with acute coronary syndromes: a substudy from the prospective randomized PLATelet inhibition and patient Outcomes (PLATO) trial.

Journal Article Circ Cardiovasc Qual Outcomes · September 1, 2012 BACKGROUND: Elderly patients with acute coronary syndrome are at high risk of recurrent ischemic events and death, and for both antithrombotic therapy and catheter-based complications. This prespecified analysis investigates the effect and treatment-relate ... Full text Link to item Cite

Prior smoking status, clinical outcomes, and the comparison of ticagrelor with clopidogrel in acute coronary syndromes-insights from the PLATelet inhibition and patient Outcomes (PLATO) trial.

Journal Article Am Heart J · September 2012 BACKGROUND: Habitual smoking has been associated with increased platelet reactivity, increased risk of thrombotic complications and greater efficacy of clopidogrel therapy over placebo. In the PLATO trial, ticagrelor compared to clopidogrel in patients wit ... Full text Link to item Cite

Antidote control of aptamer therapeutics: the road to a safer class of drug agents.

Journal Article Curr Pharm Biotechnol · August 2012 Aptamers, or nucleic acid ligands, have gained clinical interest over the past 20 years due to their unique characteristics, which are a combination of the best facets of small molecules and antibodies. The high binding affinity and specificity of aptamers ... Full text Link to item Cite

Highlights from the IV International Symposium of Thrombosis and Anticoagulation (ISTA), October 20-21, 2011, Salvador, Bahia, Brazil.

Journal Article J Thromb Thrombolysis · July 2012 To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Fourth International Symposium of Thrombosis and Anticoagulation was held in Salvador, Bahia, Brazil, from October 20-21, 2011. This scientific program was ... Full text Link to item Cite

A phase 1 ascending dose study of a subcutaneously administered factor IXa inhibitor and its active control agent.

Journal Article J Thromb Haemost · July 2012 BACKGROUND: The REG2 anticoagulation system consists of pegnivacogin, a subcutaneously administered aptamer factor IXa inhibitor, and its intravenous control agent, anivamersen. OBJECTIVES: To assess the safety, tolerability and pharmacokinetic and pharmac ... Full text Link to item Cite

Activated partial thromboplastin time measurement is not associated with clinical outcomes in patients with high-risk non-ST-segment elevation acute coronary syndromes treated with unfractionated heparin.

Journal Article J Thromb Thrombolysis · July 2012 Our objective was to determine the association of activated partial thromboplastin time (aPTT) with recurrent ischemic events and non-coronary artery bypass surgery-related thrombolysis in myocardial infarction major bleeding. We studied 4,985 patients wit ... Full text Link to item Cite

Pharmacodynamic effects of cangrelor and clopidogrel: the platelet function substudy from the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials.

Journal Article J Thromb Thrombolysis · July 2012 Cangrelor is an intravenous antagonist of the P2Y(12) receptor characterized by rapid, potent, predictable, and reversible platelet inhibition. However, cangrelor was not superior to clopidogrel in reducing the incidence of ischemic events in the cangrelor ... Full text Link to item Cite

Biomarker science: on a theme of personalized medicine.

Journal Article J Thromb Thrombolysis · July 2012 Full text Link to item Cite

Bleeding-associated outcomes with preoperative clopidogrel use in on- and off-pump coronary artery bypass.

Journal Article J Thromb Thrombolysis · July 2012 Clopidogrel use prior to coronary artery bypass graft surgery in patients presenting with acute coronary syndromes is associated with a greater incidence of procedural related morbidity. We studied the impact of clopidogrel pre-treatment in patients underg ... Full text Link to item Cite

To bridge or not to bridge: these are the questions.

Journal Article J Thromb Thrombolysis · July 2012 Full text Link to item Cite

Ticagrelor versus clopidogrel in patients with acute coronary syndromes and a history of stroke or transient ischemic attack.

Journal Article Circulation · June 12, 2012 BACKGROUND: Patients with acute coronary syndromes and history of stroke or transient ischemic attack (TIA) have an increased rate of recurrent cardiac events and intracranial hemorrhages. METHODS AND RESULTS: We evaluated treatment effects of ticagrelor v ... Full text Link to item Cite

A guidance pathway for the selection of novel anticoagulants in the treatment of atrial fibrillation.

Journal Article Crit Pathw Cardiol · June 2012 Oral anticoagulation with vitamin K antagonists has served as the primary treatment for the prevention of stroke and systemic embolization in patients with atrial fibrillation (AF) for decades. Over the past several years, multiple novel oral anticoagulant ... Full text Link to item Cite

CYP2C19 and PON1 polymorphisms regulating clopidogrel bioactivation in Chinese, Malay and Indian subjects.

Journal Article Pharmacogenomics · April 2012 UNLABELLED: AIM, MATERIALS & METHODS: We investigated the functional significance of CYP2C19*2, *3, *17 and PON1 Q192R SNPs in 89 consecutive Asian patients on clopidogrel treatment and the prevalence of functionally significant polymorphisms among 300 Chi ... Full text Link to item Cite

Rivaroxaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of ROCKET AF.

Journal Article Lancet Neurol · April 2012 BACKGROUND: In ROCKET AF, rivaroxaban was non-inferior to adjusted-dose warfarin in preventing stroke or systemic embolism among patients with atrial fibrillation (AF). We aimed to investigate whether the efficacy and safety of rivaroxaban compared with wa ... Full text Link to item Cite

Time-dependent changes in non-COX-1-dependent platelet function with daily aspirin therapy.

Journal Article J Thromb Thrombolysis · April 2012 To develop an integrated metric of non-COX-1-dependent platelet function (NCDPF) to measure the temporal response to aspirin in healthy volunteers and diabetics. NCDPF on aspirin demonstrates wide variability, despite suppression of COX-1. Although a varie ... Full text Link to item Cite

Evaluation of dose requirements for prolonged bivalirudin administration in patients with renal insufficiency and suspected heparin-induced thrombocytopenia.

Journal Article J Thromb Thrombolysis · April 2012 Bivalirudin, a direct thrombin inhibitor, is indicated for patients with suspected heparin-induced thrombocytopenia (HIT) with anticipated percutaneous coronary intervention (PCI). Data is limited on dose selection among patients with renal insufficiency, ... Full text Link to item Cite

Platelet biology and response to antiplatelet therapy in women: implications for the development and use of antiplatelet pharmacotherapies for cardiovascular disease.

Journal Article J Am Coll Cardiol · March 6, 2012 Women are underrepresented in cardiovascular studies, even as their preponderance in the aging population steadily increases. Although concerns have been raised about the differential benefit of antiplatelet medications for women, the propensity for increa ... Full text Link to item Cite

Oral factor Xa inhibitors for the long-term management of ACS.

Journal Article Nat Rev Cardiol · February 21, 2012 Despite considerable reductions in cardiovascular events in patients with an acute coronary syndrome (ACS) receiving dual antiplatelet therapy (DAPT), substantial residual risk persists. This unmet need has stimulated the development of anticoagulant drugs ... Full text Link to item Cite

Rapidly regulating platelet activity in vivo with an antidote controlled platelet inhibitor.

Journal Article Mol Ther · February 2012 Millions of individuals are prescribed platelet inhibitors, such as aspirin and clopidogrel, to reduce their risk of thrombosis-related clinical events. Unfortunately many platelet inhibitors are contraindicated in surgical settings because of their inhere ... Full text Link to item Cite

Elite reviewers 2011

Journal Article Journal of Thrombosis and Thrombolysis · February 1, 2012 Full text Cite

Responses of mental stress-induced myocardial ischemia to escitalopram treatment: background, design, and method for the Responses of Mental Stress Induced Myocardial Ischemia to Escitalopram Treatment trial.

Journal Article Am Heart J · January 2012 BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is common in patients with clinically stable coronary heart disease (CHD) and is associated with poor outcomes. Depression is a risk factor of MSIMI. The REMIT trial investigates whether selecti ... Full text Link to item Cite

PAR-1 inhibitors: a novel class of antiplatelet agents for the treatment of patients with atherothrombosis.

Journal Article Handb Exp Pharmacol · 2012 Stroke and myocardial infarction are leading causes of death and disability worldwide. Typically, these events are triggered by the rupture or erosion of "vulnerable" atherosclerotic plaque, a phenomenon termed atherothrombosis.Three platelet activation pa ... Full text Link to item Cite

Protease-activated receptor-1 inhibitors: a novel class of antiplatelet agents for the treatment of patients with acute coronary syndrome.

Journal Article Adv Cardiol · 2012 The unifying basis of acute coronary syndrome (ACS) is the complication of a vulnerable coronary plaque, an event primarily mediated by platelet activation. Three major pathways are predominantly involved in this process: thromboxane A(2) via the thromboxa ... Full text Link to item Cite

Cystatin C and estimated glomerular filtration rate as predictors for adverse outcome in patients with ST-elevation and non-ST-elevation acute coronary syndromes: results from the Platelet Inhibition and Patient Outcomes study.

Journal Article Clin Chem · January 2012 BACKGROUND: We evaluated the predictive ability of cystatin C and creatinine-based estimations of glomerular filtration rate (eGFR), including the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation, in acute coronary syndrome (ACS) patients with (STE-A ... Full text Link to item Cite

Platelet-mediated thrombosis and drug-eluting stents.

Journal Article Circ Cardiovasc Interv · December 1, 2011 Full text Link to item Cite

Stroke prevention in atrial fibrillation.

Journal Article Cardiovasc Drugs Ther · December 2011 Full text Link to item Cite

Bleeding complications with the P2Y12 receptor antagonists clopidogrel and ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial.

Journal Article Eur Heart J · December 2011 AIMS More intense platelet-directed therapy for acute coronary syndrome (ACS) may increase bleeding risk. The aim of the current analysis was to determine the rate, clinical impact, and predictors of major and fatal bleeding complications in the PLATO stud ... Full text Link to item Cite

Pulmonary function in patients with acute coronary syndrome treated with ticagrelor or clopidogrel (from the Platelet Inhibition and Patient Outcomes [PLATO] pulmonary function substudy).

Journal Article Am J Cardiol · December 1, 2011 The Platelet Inhibition and Patient Outcomes (PLATO) trial showed that ticagrelor reduced the risk for cardiovascular events in patients with acute coronary syndromes compared to clopidogrel but was associated with increased incidence of dyspnea. This subs ... Full text Link to item Cite

Characterization of dyspnoea in PLATO study patients treated with ticagrelor or clopidogrel and its association with clinical outcomes.

Journal Article Eur Heart J · December 2011 AIMS To describe the incidence of dyspnoea and its associations with demographic characteristics and clinical outcomes in patients with acute coronary syndromes (ACS) treated with ticagrelor or clopidogrel in the PLATelet inhibition and patient Outcomes (P ... Full text Link to item Cite

Mechanisms of bleeding and approach to patients with axial-flow left ventricular assist devices.

Journal Article Circ Heart Fail · November 2011 Axial-flow LVADs have become an integral tool in the management of end-stage heart failure. Consequently, nonsurgical bleeding has emerged as a major source of morbidity and mortality in this fragile population. The mechanisms responsible for these adverse ... Full text Link to item Cite

Consensus document: antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting. A North-American perspective.

Journal Article Thromb Haemost · October 2011 The optimal regimen of the anticoagulant and antiplatelet therapies in patients with atrial fibrillation who have had a coronary stent is unclear. It is well recognised that "triple therapy" with aspirin, clopidogrel, and warfarin is associated with an inc ... Full text Link to item Cite

Pegnivacogin results in near complete FIX inhibition in acute coronary syndrome patients: RADAR pharmacokinetic and pharmacodynamic substudy.

Journal Article Eur Heart J · October 2011 AIMS: Establishing factor IX inhibition in patients with acute coronary syndrome/non-ST-elevation myocardial infarction (ACS/NSTEMI), a setting characterized by increased factor IX activity, is critical to investigate the REG1 system in this target populat ... Full text Link to item Cite

Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American perspective: executive summary.

Journal Article Circ Cardiovasc Interv · October 1, 2011 The optimal regimen of the anticoagulant and antiplatelet therapies in patients with atrial fibrillation who have had a coronary stent is unclear. It is well recognized that "triple therapy" with aspirin, clopidogrel, and warfarin is associated with an inc ... Full text Link to item Cite

Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment.

Journal Article Eur Heart J · October 2011 AIMS: Patients with non-valvular atrial fibrillation (AF) and renal insufficiency are at increased risk for ischaemic stroke and bleeding during anticoagulation. Rivaroxaban, an oral, direct factor Xa inhibitor metabolized predominantly by the liver, prese ... Full text Link to item Cite

Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.

Journal Article N Engl J Med · September 8, 2011 BACKGROUND: The use of warfarin reduces the rate of ischemic stroke in patients with atrial fibrillation but requires frequent monitoring and dose adjustment. Rivaroxaban, an oral factor Xa inhibitor, may provide more consistent and predictable anticoagula ... Full text Link to item Cite

The pharmacogenetics of antiplatelet agents: towards personalized therapy?

Journal Article Nat Rev Cardiol · August 9, 2011 Considerable variability exists in how individual patients respond to oral antiplatelet therapy, specifically to aspirin and to P2Y(12)-receptor inhibitors such as clopidogrel. This variability translates to differences in clinical outcomes and might in pa ... Full text Link to item Cite

Ticagrelor compared with clopidogrel by geographic region in the Platelet Inhibition and Patient Outcomes (PLATO) trial.

Journal Article Circulation · August 2, 2011 BACKGROUND: In the Platelet Inhibition and Patient Outcomes (PLATO) trial, a prespecified subgroup analysis showed a significant interaction between treatment and region (P=0.045), with less effect of ticagrelor in North America than in the rest of the wor ... Full text Link to item Cite

Highlights from the III International Symposium of Thrombosis and Anticoagulation (ISTA), October 14-16, 2010, São Paulo, Brazil.

Journal Article J Thromb Thrombolysis · August 2011 To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in São Paulo, Brazil, from October 14-16, 2010. This scientific program was devel ... Full text Link to item Cite

Chromogenic laboratory assays to measure the factor Xa-inhibiting properties of apixaban--an oral, direct and selective factor Xa inhibitor.

Journal Article J Thromb Thrombolysis · August 2011 An ability to readily determine an anticoagulant effect with an emerging class of direct, active site, oral factor Xa inhibitors is viewed by the medical community as attractive and by some as an absolute requirement for their use in clinical practice. We ... Full text Link to item Cite

Factor IXa as a target for pharmacologic inhibition in acute coronary syndrome.

Journal Article Cardiovasc Ther · August 2011 Anticoagulant therapy, combined with platelet-directed inhibitors, represents a standard-of-care in the management of patients with acute coronary syndrome, particularly those who require percutaneous coronary interventions. While a vast clinical experienc ... Full text Link to item Cite

Introduction

Journal Article Progress in Biomedical Optics and Imaging Proceedings of SPIE · July 25, 2011 Cite

Dose selection for a direct and selective factor IXa inhibitor and its complementary reversal agent: translating pharmacokinetic and pharmacodynamic properties of the REG1 system to clinical trial design.

Journal Article J Thromb Thrombolysis · July 2011 We performed detailed pharmacokinetic and pharmacodynamic modeling of REG1, an anticoagulation system composed of the direct factor IXa (FIXa) inhibitor pegnivacogin (RB006) and its matched active control agent anivamersen (RB007), with a focus on level of ... Full text Link to item Cite

The many faces of the contact pathway and their role in thrombosis.

Journal Article J Thromb Thrombolysis · July 2011 Understanding inherent differences between thrombosis and hemostasis in the vascular system are critical to developing safe and effective anticoagulants. To this end, constituents of the contact activated and intrinsic pathway of coagulation appear to be i ... Full text Link to item Cite

[Hematologic diseases: from within the heart].

Journal Article Rev Esp Cardiol · July 2011 The fundamental relationship between blood disorders and the cardiovascular system originates within multiple points of interface, ranging from the heart and its structural constituents to include heart chambers, valves, coronary arteries, coronary veins, ... Full text Link to item Cite

Troponin measurements during drug development--considerations for monitoring and management of potential cardiotoxicity: an educational collaboration among the Cardiac Safety Research Consortium, the Duke Clinical Research Institute, and the US Food and Drug Administration.

Journal Article Am Heart J · July 2011 Drug-induced cardiac toxicity is a recognized challenge in development and implementation of pharmacotherapy. Appropriate biomarkers are needed to detect these abnormalities early in development and to manage the risk of potentially cardiotoxic drugs or bi ... Full text Link to item Cite

Beyond thrombosis: the versatile platelet in critical illness.

Journal Article Chest · March 2011 Sepsis, acute lung injury, and ARDS contribute substantially to the expanding burden of critical illness within our ICUs. Each of these processes is characterized by a myriad of injurious events, including apoptosis, microvascular dysfunction, abnormal coa ... Full text Link to item Cite

Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: results from the PLATO (Platelet Inhibition and Patient Outcomes) trial.

Journal Article J Am Coll Cardiol · February 8, 2011 OBJECTIVES: The purpose of this study is to evaluate the efficacy and safety of ticagrelor and clopidogrel in patients with acute coronary syndrome undergoing coronary artery bypass graft surgery (CABG), as a post-randomization strategy. BACKGROUND: Ticagr ... Full text Link to item Cite

A randomized, partially blinded, multicenter, active-controlled, dose-ranging study assessing the safety, efficacy, and pharmacodynamics of the REG1 anticoagulation system in patients with acute coronary syndromes: design and rationale of the RADAR Phase IIb trial.

Journal Article Am Heart J · February 2011 Anticoagulants are the cornerstone of current acute coronary syndrome (ACS) therapy; however, anticoagulation regimens that aggressively reduce ischemic events are almost uniformly associated with more bleeding. REG1, an anticoagulation system, consists of ... Full text Link to item Cite

Heparin-associated anti-Xa activity and platelet-derived prothrombotic and proinflammatory biomarkers in moderate to high-risk patients with acute coronary syndrome.

Journal Article J Thromb Thrombolysis · February 2011 Heparin compounds, to include fractionated and unfractionated preparations, exert both antithrombotic and antiinflammatory effects through combined inhibition of factor Xa and thrombin. The contribution of modulated platelet activity in vivo is less clearl ... Full text Link to item Cite

How Should Patients Requiring Dual Antiplatelet Therapy be Managed When Undergoing Elective Endoscopic Gastrointestinal Procedures?

Journal Article Curr Treat Options Cardiovasc Med · February 2011 The following are general guidelines for the management of patients on dual antiplatelet therapy as they undergo gastrointestinal procedures with potential for bleeding complications: Avoid cessation of all antiplatelet therapies after percutaneous coronar ... Full text Link to item Cite

Translating nucleic acid aptamers to antithrombotic drugs in cardiovascular medicine.

Journal Article J Cardiovasc Transl Res · December 2010 Nucleic acid aptamers offer several distinct advantages for the selective inhibition of protein targets within the coagulation cascade. A highly attractive feature of aptamers as antithrombotics is their ability to encode for complementary "controlling age ... Full text Link to item Cite

Genetic regulation of platelet receptor expression and function: application in clinical practice and drug development.

Journal Article Arterioscler Thromb Vasc Biol · December 2010 Understanding genetic contributions to platelet function could have profound clinical ramifications for personalizing platelet-directed pharmacotherapy, by providing insight into the risks and possible benefits associated with specific genotypes. This arti ... Full text Link to item Cite

Genetics and Genomics in the Management of Hemostasis and Thrombosis

Journal Article · December 1, 2010 Blood coagulation is a cell surface biochemical event designed to stem the loss of blood following vascular injury and provide the necessary molecular, cellular, and protein constituents for growth and repair. In addition, coagulation occurring within medi ... Full text Cite

Ticagrelor versus clopidogrel in patients with ST-elevation acute coronary syndromes intended for reperfusion with primary percutaneous coronary intervention: A Platelet Inhibition and Patient Outcomes (PLATO) trial subgroup analysis.

Journal Article Circulation · November 23, 2010 BACKGROUND: Aspirin and clopidogrel are recommended for patients with acute coronary syndromes (ACS) or undergoing coronary stenting. Ticagrelor, a reversible oral P2Y12-receptor antagonist, provides faster, greater, and more consistent platelet inhibition ... Full text Link to item Cite

Effect of apixaban, an oral and direct factor Xa inhibitor, on coagulation activity biomarkers following acute coronary syndrome.

Journal Article Thromb Haemost · November 2010 Apixaban is an oral, direct factor Xa inhibitor under development for secondary prevention in acute coronary syndrome (ACS). Apixaban's effect on D-dimer and prothrombin fragment 1.2 (F1.2) (coagulation activity biomarkers ) was determined in a randomised, ... Full text Link to item Cite

Inhibitory effects of ticagrelor compared with clopidogrel on platelet function in patients with acute coronary syndromes: the PLATO (PLATelet inhibition and patient Outcomes) PLATELET substudy.

Journal Article J Am Coll Cardiol · October 26, 2010 OBJECTIVES: The PLATO (PLATelet inhibition and patient Outcomes) PLATELET substudy aimed to compare the antiplatelet effects of clopidogrel and ticagrelor in patients with acute coronary syndromes. BACKGROUND: The PLATO study demonstrated superiority of ti ... Full text Link to item Cite

Effect of CYP2C19 and ABCB1 single nucleotide polymorphisms on outcomes of treatment with ticagrelor versus clopidogrel for acute coronary syndromes: a genetic substudy of the PLATO trial.

Journal Article Lancet · October 16, 2010 BACKGROUND: In the PLATO trial of ticagrelor versus clopidogrel for treatment of acute coronary syndromes, ticagrelor reduced the composite outcome of cardiovascular death, myocardial infarction, and stroke, but increased events of major bleeding related t ... Full text Link to item Cite

Antiplatelet therapy in acute coronary syndrome (ACS): applying new science to clinical decisions.

Journal Article Am J Cardiol · October 15, 2010 The platelet is central to the pathogenesis of acute coronary syndromes (ACS), and antiplatelet therapy has demonstrated a significant reduction in the risk for ischemic events in patients with ACS. For patients with unstable angina or non-ST elevation myo ... Full text Link to item Cite

A clinical cardiology perspective of thrombophilias.

Journal Article J Thromb Thrombolysis · October 2010 Thrombophilias, an inherited and/or acquired predisposition to vascular thrombosis beyond hemostatic needs are common in cardiovascular medicine and include systemic disorders such as coronary atherosclerosis, atrial fibrillation, exogenous obesity, metabo ... Full text Link to item Cite

Dronedarone and vitamin K antagonists: a review of drug-drug interactions.

Journal Article Am Heart J · October 2010 Adverse drug events affect millions of patients each year. An important drug-drug interaction between amiodarone and vitamin K antagonists is encountered frequently in daily clinical practice. Warfarin, a commonly used anticoagulant, is a mixture of 2 opti ... Full text Link to item Cite

Thrombin receptor antagonists for the treatment of atherothrombosis: therapeutic potential of vorapaxar and E-5555.

Journal Article Drugs · October 1, 2010 Platelet activation, achieved through a variety of surface receptors and biochemical mediators, represents a key event in the pathogenesis of atherothrombosis and its clinical manifestations. The major pathways involved in platelet activation are triggered ... Full text Link to item Cite

Relationship between renal function and outcomes in high-risk patients with non-ST-segment elevation acute coronary syndromes: results from SYNERGY.

Journal Article Int J Cardiol · September 24, 2010 BACKGROUND: Chronic kidney disease (CKD) is a risk factor for coronary heart disease and bleeding with antithrombotic therapy in patients with acute coronary syndromes (ACS). We evaluated the effect of renal function on efficacy and outcomes in high-risk p ... 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

The effect of aspirin on endothelial progenitor cell biology: preliminary investigation of novel properties.

Journal Article Thromb Res · September 2010 UNLABELLED: Atherosclerosis develops in an environment of endothelial injury and inflammation. Circulating endothelial progenitor cells (EPCs) are required for vascular repair and restoration of normal endothelial function. We tested the hypothesis that th ... Full text Link to item Cite

First clinical application of an actively reversible direct factor IXa inhibitor as an anticoagulation strategy in patients undergoing percutaneous coronary intervention.

Journal Article Circulation · August 10, 2010 BACKGROUND: The ideal anticoagulant should prevent ischemic complications without increasing the risk of bleeding. Controlled anticoagulation is possible with the REG1 system, an RNA aptamer pair comprising the direct factor IXa inhibitor RB006 and its act ... Full text Link to item Cite

Antithrombotic therapy in acute coronary syndrome: how far up the coagulation cascade will we go?

Journal Article Curr Cardiol Rep · July 2010 The contribution of thrombosis to the natural history and clinical expression of advanced atherosclerotic coronary artery disease is well established. Less well understood is the biochemical and pathobiological distinction between normal hemostasis and thr ... Full text Link to item Cite

Economic assessment of thrombocytopenia: CATCH Registry.

Journal Article J Med Syst · June 2010 Thrombocytopenia is associated with increased patient risk. However, the costs of this complication are not well defined. This study assessed the impact of thrombocytopenia on in-hospital costs using results from CATCH, an observational study that examined ... Full text Link to item Cite

Cardiology

Journal Article · May 5, 2010 This chapter summarizes the pathobiological mechanisms of coronary atherothrombosis, including, as a platform for understanding pharmacotherapies and evidence-based treatment strategies, its development, natural history and the clinical expression of disea ... Full text Cite

Associations of depressive symptoms, trait hostility, and gender with C-reactive protein and interleukin-6 response after emotion recall.

Journal Article Psychosom Med · May 2010 OBJECTIVE: To examine the effects of depressive symptoms and hostility on changes in C-reactive protein (CRP) and interleukin (IL)-6 in response to an acute laboratory stressor. Depressive symptoms moderate the effect of trait hostility on circulating leve ... Full text Link to item Cite

Evaluation of a new heparin agent in percutaneous coronary intervention: results of the phase 2 evaluation of M118 IN pErcutaNeous Coronary intErvention (EMINENCE) Trial.

Journal Article Circulation · April 20, 2010 BACKGROUND: Factor Xa and factor IIa (thrombin) play roles in thrombotic complications after percutaneous coronary intervention. M118 is a novel low-molecular-weight heparin that has been rationally designed to capture the desired attributes of unfractiona ... Full text Link to item Cite

Antithrombotic therapy for ischemic stroke: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · April 2010 Acute ischemic stroke is the result of abrupt interruption of focal cerebral blood flow. The majority of ischemic strokes are caused by embolic or thrombotic arterial occlusions. Acute stroke management is complex, in part because of the varying etiologies ... Full text Link to item Cite

Bridging the gap between clinical trials of antiplatelet therapies and applications among elderly patients.

Journal Article Am Heart J · April 2010 Although patients aged > or =75 years represent nearly 40% of all those hospitalized with acute coronary syndromes, their enrollment in trials of therapeutic interventions has been relatively modest. Thus, scarce information exists to guide clinicians in d ... Full text Link to item Cite

Obesity in patients with non-ST-segment elevation acute coronary syndromes: results from the SYNERGY trial.

Journal Article Int J Cardiol · March 4, 2010 BACKGROUND: Obese patients are at increased risk of acute coronary syndromes (ACS). We evaluated the prevalence of obesity in a large ACS population, as well as the relationship between body mass index (BMI) and the use of cardiac medications and procedure ... Full text Link to item Cite

Reperfusion strategy and mortality in ST-elevation myocardial infarction among patients with and without impaired renal function.

Journal Article Ann Acad Med Singap · March 2010 INTRODUCTION: Several randomised controlled trials have demonstrated better outcomes with primary percutaneous coronary intervention (PCI) over fibrinolytic therapy in the treatment of patients with ST-segment elevation myocardial infarction (STEMI) and no ... Link to item Cite

Nucleic acid aptamers as antithrombotic agents: Opportunities in extracellular therapeutics.

Journal Article Thromb Haemost · March 2010 Antithrombotic therapy for the acute management of thrombotic disorders has been stimulated and guided actively by our current understanding of platelet biology, coagulation proteases, and vascular science. A translatable platform for coagulation, based so ... Full text Link to item 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

DVT: a new era in anticoagulant therapy.

Journal Article Arterioscler Thromb Vasc Biol · March 2010 Full text Link to item Cite

Evolution of the coronary care unit: clinical characteristics and temporal trends in healthcare delivery and outcomes.

Journal Article Crit Care Med · February 2010 OBJECTIVE: To describe long-term temporal trends in patient characteristics, processes of care, and in-hospital outcomes among unselected admissions within the contemporary coronary care unit. DESIGN: Hospital administrative database that records both paym ... Full text Link to item Cite

Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study.

Journal Article Lancet · January 23, 2010 BACKGROUND: Variation in and irreversibility of platelet inhibition with clopidogrel has led to controversy about its optimum dose and timing of administration in patients with acute coronary syndromes. We compared ticagrelor, a more potent reversible P2Y1 ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · 2010 Full text Cite

Translating Nucleic Acid Aptamers to Antithrombotic Drugs in Cardiovascular Medicine

Journal Article Journal of Cardiovascular Translational Research · 2010 Cite

Apixaban: an emerging oral factor Xa inhibitor.

Journal Article J Thromb Thrombolysis · January 2010 Apixaban, an oral direct factor Xa inhibitor, is currently in late stage clinical development for the prevention and treatment of thromboembolic diseases. In comparison with current treatment standards for venous thromboembolism (VTE) prophylaxis, apixaban ... Full text Link to item Cite

Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis.

Journal Article J Thromb Haemost · January 2010 AIM: To determine whether an association exists between mean platelet volume (MPV) and acute myocardial infarction (AMI) and other cardiovascular events. Platelet activity is a major culprit in atherothrombotic events. MPV, which is widely available in cli ... Full text Link to item Cite

Inhibitors of platelet adhesion.

Journal Article Circulation · December 15, 2009 Full text Link to item Cite

Platelet inhibition with cangrelor in patients undergoing PCI.

Journal Article N Engl J Med · December 10, 2009 BACKGROUND: Cangrelor, a nonthienopyridine adenosine triphosphate analogue, is an intravenous blocker of the adenosine diphosphate receptor P2Y(12). This agent might have a role in the treatment of patients who require rapid, predictable, and profound but ... Full text Link to item Cite

Management of platelet-directed pharmacotherapy in patients with atherosclerotic coronary artery disease undergoing elective endoscopic gastrointestinal procedures.

Journal Article J Am Coll Cardiol · December 8, 2009 The periprocedural management of patients with atherosclerotic coronary heart disease, including those who have heart disease and those who are undergoing percutaneous coronary intervention and stent placement who might require temporary interruption of pl ... Full text Link to item Cite

Management of platelet-directed pharmacotherapy in patients with atherosclerotic coronary artery disease undergoing elective endoscopic gastrointestinal procedures.

Journal Article Am J Gastroenterol · December 2009 The periprocedural management of patients with atherosclerotic coronary heart disease, including those who have heart disease and those who are undergoing percutaneous coronary intervention and stent placement who might require temporary interruption of pl ... Full text Link to item Cite

REG-1, a regimen comprising RB-006, a Factor IXa antagonist, and its oligonucleotide active control agent RB-007 for the potential treatment of arterial thrombosis.

Journal Article Curr Opin Mol Ther · December 2009 REG-1, under development by Regado Biosciences Inc, is an intravenously administered anticoagulant system comprising the Factor IXa-inhibiting aptamer RB-006 and its complementary active control oligonucleotide, RB-007, for the potential treatment of arter ... Link to item Cite

Hemostasis and Thrombosis

Journal Article · December 1, 2009 Full text Cite

Design and rationale of the Evaluation of M118 IN pErcutaNeous Coronary intErvention (EMINENCE) trial.

Journal Article Am Heart J · November 2009 BACKGROUND: Currently recommended anticoagulant agents used in the setting of percutaneous coronary intervention (PCI) inhibit, with varying degrees of intensity, 2 critical targets (factor Xa and/or IIa) of the coagulation cascade, yet they carry signific ... Full text Link to item Cite

Six-month follow-up of patients with in-hospital thrombocytopenia during heparin-based anticoagulation (from the Complications After Thrombocytopenia Caused by Heparin [CATCH] registry).

Journal Article Am J Cardiol · November 1, 2009 Thrombocytopenia is a predictor of adverse outcomes in patients with acute coronary syndromes and in critically ill patients. The Complications After Thrombocytopenia Caused by Heparin (CATCH) registry was designed to explore the incidence, management, and ... Full text Link to item Cite

Platelet functions beyond hemostasis.

Journal Article J Thromb Haemost · November 2009 Although their central role is in the prevention of bleeding, platelets probably contribute to diverse processes that extend beyond hemostasis and thrombosis. For example, platelets can recruit leukocytes and progenitor cells to sites of vascular injury an ... Full text Link to item Cite

Catheter thrombosis and percutaneous coronary intervention: fundamental perspectives on blood, artificial surfaces and antithrombotic drugs.

Journal Article J Thromb Thrombolysis · October 2009 Recent reports of catheter thrombosis among patients undergoing percutaneous coronary intervention (PCI) have had a significant impact on the development of new antithrombotic therapies. The overall incidence of this complication is unknown, mainly because ... Full text Link to item Cite

Ticagrelor versus clopidogrel in patients with acute coronary syndromes.

Journal Article N Engl J Med · September 10, 2009 BACKGROUND: Ticagrelor is an oral, reversible, direct-acting inhibitor of the adenosine diphosphate receptor P2Y12 that has a more rapid onset and more pronounced platelet inhibition than clopidogrel. METHODS: In this multicenter, double-blind, randomized ... Full text Link to item Cite

Antidote-controlled antithrombotic therapy targeting factor IXa and von Willebrand factor.

Journal Article Ann N Y Acad Sci · September 2009 Thrombotic disorders and their common clinical phenotypes of acute myocardial infarction, ischemic stroke, and venous thromboembolism are the proximate cause of substantial morbidity, mortality, and health care expenditures worldwide. Accordingly, therapie ... Full text Link to item Cite

Sex differences in mortality following acute coronary syndromes.

Journal Article JAMA · August 26, 2009 CONTEXT: Conflicting information exists about whether sex differences modulate short-term mortality following acute coronary syndromes (ACS). OBJECTIVES: To investigate the relationship between sex and 30-day mortality in ACS, and to determine whether this ... Full text Link to item Cite

A rationally designed heparin, M118, has anticoagulant activity similar to unfractionated heparin and different from Lovenox in a cell-based model of thrombin generation.

Journal Article J Thromb Thrombolysis · August 2009 Unfractionated heparin (UFH) enhances antithrombin (AT) inhibition of thrombin (IIa) and factor Xa (FXa). Low molecular weight heparins (LMWH) primarily enhance AT inhibition of FXa. M118 is a LMWH produced from UFH and retains its ability to promote both ... Full text Link to item Cite

A clinician's perspective of emerging P2Y(12)-directed pharmacotherapies, ex vivo measurement tools, and clinical outcomes.

Journal Article Platelets · August 2009 Platelet-initiated acute thrombosis and coronary embolization are fundamental to the pathophysiology of acute coronary syndromes. Pharmacotherapies aimed at disrupting platelet function via the P2Y(12) receptor have been successful at reducing the incidenc ... Full text Link to item Cite

Contribution of bleeding and thromboembolic events to in-hospital mortality among patients with thrombocytopenia treated with heparin.

Journal Article Am J Cardiol · July 15, 2009 In a population of patients experiencing thrombocytopenia while treated with heparin, bleeding and thromboses are well-appreciated complications, but their relative contributions to mortality have been less well described. In this population, the aims of t ... Full text Link to item Cite

Highlights from the I international symposium of thrombosis and anticoagulation in internal medicine, October 23-25, 2008, Sao Paulo, Brazil.

Journal Article J Thromb Thrombolysis · July 2009 The importance of thrombosis and anticoagulation in clinical practice is rooted firmly in several fundamental constructs that can be applied both broadly and globally. Awareness and the appropriate use of anticoagulant therapy remain the keys to prevention ... Full text Link to item Cite

The evolution of platelet-directed pharmacotherapy.

Journal Article J Thromb Haemost · July 2009 The evolution of platelet directed pharmacotherapy in the prevention and treatment of patients with thrombotic disorders is based soundly on a rapidly expanding knowledge of platelet biology. Traditionally viewed, throughout most of its relatively brief hi ... Full text Link to item Cite

Coagulopathy and Stroke

Journal Article · April 8, 2009 Full text Cite

Evaluation and management of thrombocytopenia and suspected heparin-induced thrombocytopenia in hospitalized patients: The Complications After Thrombocytopenia Caused by Heparin (CATCH) registry.

Journal Article Am Heart J · April 2009 BACKGROUND: Thrombocytopenia and heparin-induced thrombocytopenia (HIT) are potentially devastating paradoxical side effects of heparin therapy. We explored the evaluation, management, and clinical consequences of thrombocytopenia occurring during heparin ... Full text Link to item Cite

G-protein-coupled receptors as signaling targets for antiplatelet therapy.

Journal Article Arterioscler Thromb Vasc Biol · April 2009 Platelet G protein-coupled receptors (GPCRs) initiate and reinforce platelet activation and thrombus formation. The clinical utility of antagonists of the P2Y(12) receptor for ADP suggests that other GPCRs and their intracellular signaling pathways may rep ... Full text Link to item Cite

Next-generation antithrombin therapies.

Journal Article The Journal of invasive cardiology · April 2009 Cite

Comparison of ticagrelor, the first reversible oral P2Y(12) receptor antagonist, with clopidogrel in patients with acute coronary syndromes: Rationale, design, and baseline characteristics of the PLATelet inhibition and patient Outcomes (PLATO) trial.

Journal Article Am Heart J · April 2009 BACKGROUND: Antiplatelet therapy is essential treatment for acute coronary syndromes (ACS). Current therapies, however, have important limitations affecting their clinical success. Ticagrelor, the first reversible oral P2Y(12) receptor antagonist, provides ... Full text Link to item Cite

Biomarker science: direction for the scientific community.

Journal Article J Thromb Thrombolysis · April 2009 Full text Link to item Cite

Safety and tolerability of SCH 530348 in patients undergoing non-urgent percutaneous coronary intervention: a randomised, double-blind, placebo-controlled phase II study.

Journal Article Lancet · March 14, 2009 BACKGROUND: An antithrombotic drug is needed that safely reduces cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). We therefore assessed the tolerability and safety of SCH 530348-an oral platelet protease-activated rece ... Full text Link to item Cite

Advancing biomarker science in the 21st century.

Journal Article Circ Cardiovasc Interv · February 2009 Full text Link to item Cite

Hemostasis and thrombosis in older adults.

Journal Article J Thromb Thrombolysis · February 2009 Full text Link to item Cite

Cardiac rupture after myocardial infarction: new insights from murine models.

Journal Article Cardiol Rev · 2009 Cardiac rupture after a myocardial infarction is an uncommon event with devastating consequences. Although the clinical features of rupture have been described, the genetic and molecular influences on this outcome in patients are less certain. In mice, at ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · 2009 Full text Cite

Coagulation and fibrinolytic protein kinetics in cardiopulmonary bypass.

Journal Article J Thromb Thrombolysis · January 2009 The development of Cardiopulmonary Bypass (CPB) catopulted the field of cardiothoracic surgery into a new dimension--one that changed the lives of individuals with congenital and acquired heart disease worldwide. Despite its contributions, CPB has clear li ... Full text Link to item Cite

Biological and pharmacological aspects of perioperative hemorrhagic complications associated with oral platelet-directed antithrombotic agents. Focus on isolated coronary artery bypass grafting and oral irreversible P2Y(12) receptor antagonists.

Journal Article Thromb Res · 2009 Coronary arterial bypass grafting (CABG)-the most common heart surgery performed worldwide-is an effective procedure for treating patients with advanced, obstructive atherothrombotic coronary artery disease, prolonging survival in selected high-risk patien ... Full text Link to item Cite

Anticoagulant therapy during cardiopulmonary bypass.

Journal Article J Thromb Thrombolysis · December 2008 The prothrombotic and hemostatic-altering environment that characterizes cardiac surgery in general and cardiopulmonary bypass (CPB) in particular is unparalleled in medicine, causing, in an alarming number of patients, both thrombotic and hemorrhagic even ... Full text Link to item Cite

Hypercoagulable states in cardiovascular disease.

Journal Article Circulation · November 25, 2008 Full text Link to item Cite

Impact of clopidogrel in patients with acute coronary syndromes requiring coronary artery bypass surgery: a multicenter analysis.

Journal Article J Am Coll Cardiol · November 18, 2008 OBJECTIVES: The purpose of our multicenter study was to examine the impact of pre-operative administration of clopidogrel on reoperation rates, incidence of life-threatening bleeding, inpatient length of stay, and other bleeding-related outcomes in acute c ... Full text Link to item Cite

The editorialists reply

Journal Article New England Journal of Medicine · November 13, 2008 Full text Cite

Clopidogrel use and bleeding after coronary artery bypass graft surgery.

Journal Article Am Heart J · November 2008 BACKGROUND: Short-term use of clopidogrel plus aspirin among patients with acute coronary syndrome reduces ischemic events, but concerns about coronary artery bypass graft (CABG) surgery-related bleeding limit its early use. METHODS: Using data from 4,794 ... Full text Link to item Cite

Risk factors for thrombocytopenia in patients treated with prolonged heparin therapy - Reply

Journal Article Archives of Internal Medicine · October 27, 2008 Cite

Determining the efficacy of antiplatelet therapies for the individual: lessons from clinical trials.

Journal Article J Thromb Thrombolysis · August 2008 This article focuses on lessons learned from clinical trials of antiplatelet therapies-in particular, that the degree of inhibition of ex vivo platelet aggregation does not necessarily directly translate into clinical efficacy. As an example, the case of t ... Full text Link to item Cite

Delivery of optimized anticoagulant therapy: consensus statement from the Anticoagulation Forum.

Journal Article Ann Pharmacother · July 2008 OBJECTIVE: To provide recommendations, policies, and procedures pertaining to the provision of optimized anticoagulation therapy designed to achieve desired clinical endpoints while minimizing the risk of anticoagulant-related adverse outcomes (principally ... Full text Link to item Cite

Phase 1b randomized study of antidote-controlled modulation of factor IXa activity in patients with stable coronary artery disease.

Journal Article Circulation · June 3, 2008 BACKGROUND: Whether selective factor IXa inhibition produces an appropriate anticoagulant effect when combined with platelet-directed therapy in patients with stable coronary artery disease is unknown. REG1 consists of RB006 (drug), an injectable RNA aptam ... Full text Link to item Cite

The primary and secondary prevention of coronary artery disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Journal Article Chest · June 2008 The following chapter devoted to antithrombotic therapy for chronic coronary artery disease (CAD) is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade ... Full text Link to item Cite

The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Journal Article Chest · June 2008 This article discusses the perioperative management of antithrombotic therapy and is part of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). The primary objectives of this article are the following: (1) t ... Full text Link to item Cite

Antithrombotic therapy for non-ST-segment elevation acute coronary syndromes: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Journal Article Chest · June 2008 This chapter about antithrombotic therapy for coronary artery disease is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicans Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 recommendations are strong ... Full text Link to item Cite

Platelets: developmental biology, physiology, and translatable platforms for preclinical investigation and drug development.

Journal Article Platelets · June 2008 This paper, developed from the proceedings of the 2007 Platelet Colloquium, considers emerging constructs in platelet biology, preclinical models of thrombosis, and their potential application to the development of platelet-directed pharmacotherapies. Disc ... Full text Link to item Cite

Impact of home warfarin use on treatment patterns and bleeding complications for patients with non-ST-segment elevation acute coronary syndromes: observations from the CRUSADE quality improvement initiative.

Journal Article Eur Heart J · May 2008 AIMS: To examine treatment patterns and outcomes of patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) receiving long-term warfarin anticoagulation. METHODS AND RESULTS: We examined acute medication and invasive cardiac procedure use ... Full text Link to item Cite

A randomized, repeat-dose, pharmacodynamic and safety study of an antidote-controlled factor IXa inhibitor.

Journal Article J Thromb Haemost · May 2008 BACKGROUND: Active and safe reversibility of anticoagulation is an unmet need in clinical care. Factor IXa, required for rapid thrombin generation on platelet surfaces, is a novel target for modulating coagulation. REG1 comprises RB006 (drug) and RB007 (an ... Full text Link to item Cite

Emerging constructs to maintain safety among patients with acute coronary syndromes requiring surgical coronary revascularization

Journal Article European Heart Journal Supplement · May 1, 2008 Pharmacotherapies directed towards well-defined biochemical processes underlying coronary atherothrombosis have favourably influenced the natural history of disease; however, coronary revascularization is still required in 0-15 percent of patients admitted ... Full text Cite

Noninvasive, medical management for non-ST-elevation acute coronary syndromes.

Journal Article Am Heart J · March 2008 Despite emphasis on the use of invasive management strategies for patients with non-ST-elevation acute coronary syndromes (NSTE ACS) in recent practice guidelines, 27% to 56% of NSTE ACS patients do not undergo diagnostic angiography, and a further 45% to ... Full text Link to item Cite

Clopidogrel-associated bleeding and related complications in patients undergoing coronary artery bypass grafting.

Journal Article Pharmacotherapy · March 2008 OBJECTIVE: To determine if clopidogrel use before coronary artery bypass grafting (CABG) is associated with an increase in major bleeding, hemorrhage-related complications, or transfusion requirements. METHODS: A structured literature search of English-lan ... Full text Link to item Cite

Discharge antithrombotic strategies among patients with acute coronary syndrome previously on warfarin anticoagulation: physician practice in the CRUSADE registry.

Journal Article Am Heart J · February 2008 BACKGROUND: Patients experiencing acute coronary syndromes (ACS) with high-risk features frequently undergo percutaneous coronary intervention (PCI) with stent placement, prompting the requisite administration of aspirin and clopidogrel. The current manage ... Full text Link to item Cite

Identification and treatment of arterial thrombophilia.

Journal Article Curr Treat Options Cardiovasc Med · February 2008 Once the diagnosis of a thrombophilic state has been established, management must include one or more strategies designed to attenuate thrombotic risk and the likelihood of clinical events. In the case of drug-induced arterial thrombosis provoked by oral c ... Full text Link to item Cite

Incidence and prognostic significance of thrombocytopenia in patients treated with prolonged heparin therapy.

Journal Article Arch Intern Med · January 14, 2008 BACKGROUND: Despite widespread heparin use in clinical practice, the associated development of thrombocytopenia is an underrecognized and undertreated complication. METHODS: We analyzed data from consecutive hospitalized patients treated with heparin (unfr ... Full text Link to item Cite

Platelet activation and its patient-specific consequences.

Journal Article Thromb Res · 2008 Individuals vary in their thrombotic response to vascular injury. The reasons for this are numerous, involving heterogeneity in multiple platelet responses. Platelet research has tended to focus on functioning at the molecular level, and many experiments r ... Full text Link to item Cite

Low-dose aspirin in patients with stable cardiovascular disease: a meta-analysis.

Journal Article Am J Med · January 2008 OBJECTIVE: Many recommendations for aspirin in stable cardiovascular disease are based on analyses of all antiplatelet therapies at all dosages and in both stable and unstable patients. Our objective was to evaluate the benefit and risk of low-dose aspirin ... Full text Link to item Cite

Atherothrombosis and coronary artery disease

Journal Article · December 1, 2007 Full text Cite

Nucleic acid aptamers and their complimentary antidotes. Entering an era of antithrombotic pharmacobiologic therapy.

Journal Article Hamostaseologie · December 2007 The translation of fundamental science-based constructs to the preemptive identification and optimal management of individuals with or those at risk for thrombotic disorders of the cardiovascular system has taken a step closer to being realized with the de ... 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

The safety of warfarin therapy in the nursing home setting.

Journal Article Am J Med · June 2007 PURPOSE: We examined the preventability of adverse warfarin-related events and potential adverse warfarin-related events ("near misses") in the nursing home setting. METHODS: We performed a cohort study of all long-term care residents of 25 nursing homes ( ... Full text Link to item Cite

Platelets from genome to proteome and beyond.

Journal Article J Thromb Thrombolysis · June 2007 Full text Link to item Cite

Factor IXa inhibitors as novel anticoagulants.

Journal Article Arterioscler Thromb Vasc Biol · April 2007 Currently available anticoagulants are limited by modest therapeutic benefits, narrow clinical applications, increased bleeding risk, and drug-induced thrombophilia. Because factor IX plays a pivotal role in tissue factor (TF)-mediated thrombin generation, ... Full text Link to item Cite

Cardiology and the critical care crisis: a perspective.

Journal Article J Am Coll Cardiol · March 27, 2007 With an aging U.S. population and a declining physician supply, the care of critically ill patients will soon be reaching a level of crisis. At the same time, the evidence continues to mount in support of intensivist staffing to improve both patient outcom ... Full text Link to item Cite

Effect of combined anticoagulation using heparin and bivalirudin on the hemostatic and inflammatory responses to cardiopulmonary bypass in the rat.

Journal Article Anesthesiology · February 2007 BACKGROUND: Despite high-dose heparin anticoagulation, cardiopulmonary bypass (CPB) is still associated with marked hemostatic activation. The purpose of this study was to determine whether a reduced dose of bivalirudin, added as an adjunct to heparin, wou ... Full text Link to item Cite

Warfarin-induced vasculopathy.

Journal Article J Thromb Thrombolysis · February 2007 Full text Link to item Cite

Antidote-controlled platelet inhibition targeting von Willebrand factor with aptamers.

Journal Article Oligonucleotides · 2007 Thrombus formation is initiated by platelets and leads to cardiovascular, cerebrovascular, and peripheral vascular disease, the leading causes of morbidity and mortality in the Western world. A number of antiplatelet drugs have improved clinical outcomes f ... Full text Link to item Cite

First-in-human experience of an antidote-controlled anticoagulant using RNA aptamer technology: a phase 1a pharmacodynamic evaluation of a drug-antidote pair for the controlled regulation of factor IXa activity.

Journal Article Circulation · December 5, 2006 BACKGROUND: Selectivity, titratability, rapidity of onset, and active reversibility are desirable pharmacological properties of anticoagulant therapy administered for acute indications and collectively represent an attractive platform to maximize patient s ... Full text Link to item Cite

Biosignatures in thrombotic disorders.

Journal Article J Thromb Thrombolysis · October 2006 Full text Link to item Cite

The Worcester Venous Thromboembolism study: a population-based study of the clinical epidemiology of venous thromboembolism.

Journal Article J Gen Intern Med · July 2006 BACKGROUND: While there have been marked advances in diagnostic and therapeutic strategies for venous thromboembolism, our understanding of its clinical epidemiology is based on studies conducted more than a decade ago. OBJECTIVE: The purpose of this obser ... Full text Link to item Cite

Proinflammatory, immunomodulating, and prothrombotic properties of anemia and red blood cell transfusions.

Journal Article J Thromb Thrombolysis · April 2006 For many years, the traditional treatment for hospitalized patients in the United States who have developed anemia, whether associated with medical illness, surgical procedures or trauma, has been red blood cell transfusion, despite the absence of supporti ... Full text Link to item Cite

[Recent advances in atherothrombotic diseases].

Journal Article Recenti progressi in medicina · April 2006 New concepts in the field of atherothrombosis include the human potential to repair and regenerate areas of vascular damage through endogenous growth factors, and the identification of uncommon arterial thrombophilias that promote atherothrombosis. The end ... Cite

Nucleic acid aptamers as adjuncts to vaccine development.

Journal Article Curr Opin Mol Ther · April 2006 Nucleic acid 'aptamers', a term derived from the Latin word aptus, 'to fit', are RNA or DNA oligonucleotides that conform to the three-dimensional structure of a selected protein, peptide or small molecules' functional moiety. The 'lock and key' relationsh ... Link to item Cite

Initial experience with an intravenous P2Y12 platelet receptor antagonist in patients undergoing percutaneous coronary intervention: results from a 2-part, phase II, multicenter, randomized, placebo- and active-controlled trial.

Journal Article Am Heart J · March 2006 BACKGROUND: Platelet-initiated acute thrombosis and coronary embolization are fundamental in the pathophysiology of complications during percutaneous coronary intervention (PCI). Cangrelor (formerly AR-C69931MX) is a novel, rapidly acting, intravenous, spe ... Full text Link to item Cite

Cardiac tamponade in the fibrinolytic era: analysis of >100,000 patients with ST-segment elevation myocardial infarction.

Journal Article Am Heart J · February 2006 BACKGROUND: Cardiac tamponade is a life-threatening complication of acute myocardial infarction (MI). Data on the incidence, risk factors, and outcome of tamponade in patients with acute MI in the fibrinolytic era are limited. METHODS: Data from a combined ... Full text Link to item Cite

Effect of the novel direct factor Xa inhibitor DX-9065a on thrombin generation and inhibition among patients with stable atherosclerotic coronary artery disease.

Journal Article Thromb Res · 2006 INTRODUCTION: Thrombin, a pluripotential effector enzyme with prothrombotic, proinflammatory, and mitogenic properties, plays a pivotal role in the pathobiology and clinical expression of atherothrombotic coronary artery disease. Existing anticoagulant dru ... Full text Link to item Cite

Platelets in atherothrombosis.

Journal Article Mayo Clin Proc · January 2006 Atherosclerosis is a diffuse, systemic disease that affects the coronary, cerebral, and peripheral arterial trees. Disruption of atherosclerotic plaques leads to thrombus formation and arterial occlusion. This unpredictable and potentially life-threatening ... Full text Link to item Cite

Radiation exposure and coronary atherothrombosis.

Journal Article J Thromb Thrombolysis · December 2005 Full text Link to item Cite

Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation.

Journal Article J Am Coll Cardiol · November 1, 2005 OBJECTIVES: The purpose of this study was to determine both treatment gaps and predictors of warfarin use in atrial fibrillation (AF) patients enrolled in a national multicenter study. BACKGROUND: The National Anticoagulation Benchmark Outcomes Report (NAB ... Full text Link to item Cite

VII. Anticoagulant treatment of coronary disease

Journal Article Journal Des Maladies Vasculaires · September 1, 2005 Cite

Cell-based models of coagulation: a paradigm in evolution.

Journal Article J Thromb Thrombolysis · August 2005 Full text Link to item Cite

Antithrombotic therapy practices in US hospitals in an era of practice guidelines.

Journal Article Arch Intern Med · July 11, 2005 BACKGROUND: Antithrombotic therapy is efficacious for the prevention of thromboembolic disease, but it necessitates careful risk-benefit assessment. METHODS: Antithrombotic therapy data were retrospectively collected from inpatient medical records at 38 US ... Full text Link to item Cite

Nucleic acid aptamers in therapeutic anticoagulation. Technology, development and clinical application.

Journal Article Thromb Haemost · June 2005 The evolution of anticoagulant therapy for the prevention and treatment of thrombotic disorders has progressed at a relatively modest pace considering the scope of the problem and our current understanding of platelet biology, coagulation proteases, and va ... Full text Link to item Cite

First experience with direct, selective factor Xa inhibition in patients with non-ST-elevation acute coronary syndromes: results of the XaNADU-ACS Trial.

Journal Article J Thromb Haemost · March 2005 BACKGROUND: Unfractionated heparin is widely used in patients with non-ST-elevation acute coronary syndromes but has important limitations. Anticoagulants with predictable kinetics and anticoagulant effects, better efficacy, and greater safety are needed. ... Full text Link to item Cite

Identification, diagnosis and treatment of heparin-induced thrombocytopenia and thrombosis: a registry of prolonged heparin use and thrombocytopenia among hospitalized patients with and without cardiovascular disease. The Complication After Thrombocytopenia Caused by Heparin (CATCH) Registry steering committee.

Journal Article J Thromb Thrombolysis · February 2005 BACKGROUND: Heparin-induced thrombocytopenia (HIT) is estimated to occur in 1-5% of all patients receiving heparin, and 25-50% of such cases develop heparin-induced thrombocytopenia with thrombosis (HITT) A conservative estimate based only on cardiovascula ... Full text Link to item Cite

Biomarkers in atrial fibrillation: investigating biologic plausibility, cause, and effect.

Journal Article J Thromb Thrombolysis · February 2005 Atrial fibrillation, an increasingly common arrhythmia whose prevalence will reach epidemic proportions over the next two decades, is characterized by atrial/atrial appendage inflammation, fibrosis, remodeling, and endocardial thrombosis. Biomarkers measur ... Full text Link to item Cite

COX-2 inhibitors.

Journal Article Tex Heart Inst J · 2005 The totality of data--the vascular biology and dinical trial data available to date--support the following conclusions: if COX-2 inhibitors are to be used, they should be considered as 2nd- or 3rd-line agents. They should be used for brief periods of time ... Link to item Cite

Keynote address: COX-2 inhibitors

Journal Article Texas Heart Institute Journal · January 1, 2005 The totality of data-the vascular biology and clinical trial data available to date-support the following conclusions: if COX-2 inhibitors are to be used, they should be considered as 2nd- or 3rd-line agents. They should be used for brief periods of time a ... Cite

Novel constructs for thrombin inhibition.

Journal Article Am Heart J · January 2005 Full text Link to item Cite

Vascular endothelial tissue factor pathway inhibitor kinetics in culture following exposure to DX-9065a--a selective and direct factor Xa inhibitor.

Journal Article J Thromb Thrombolysis · December 2004 BACKGROUND: Tissue factor (TF), a membrane-bound glycoprotein that initiates blood coagulation by allosteric activation of factor (f) VII, is regulated predominantly by tissue factor pathway inhibitor (TFPI). Because vascular endothelial cells synthesize a ... Full text Link to item Cite

Development of DX-9065a, a novel direct factor Xa antagonist, in cardiovascular disease.

Journal Article Thromb Haemost · December 2004 The development of anticoagulants for treating patients with atherothrombotic disorders of the arterial circulatory system has focused, either directly or indirectly, on thrombin - a pleuripotential effector enzyme with prothrombotic and proinflammatory pr ... Full text Link to item Cite

Early withdrawal of statin therapy in patients with non-ST-segment elevation myocardial infarction: national registry of myocardial infarction.

Journal Article Arch Intern Med · October 25, 2004 BACKGROUND: There is increasing interest in the non-lipid-lowering effects of statins and their effect on outcomes in patients with acute coronary syndrome. It has been suggested that withdrawal of statin therapy during an acute coronary syndrome may atten ... Full text Link to item Cite

Antithrombotic therapy for coronary artery disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.

Journal Article Chest · September 2004 This chapter about antithrombotic therapy for coronary artery disease (CAD) is part of the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence Based Guidelines. Grade 1 recommendations are strong and indicate that the benefits do, ... Full text Link to item Cite

Coordinated series of studies to evaluate characteristics and mechanisms of acute coronary syndromes in high-risk patients randomly assigned to enoxaparin or unfractionated heparin: design and rationale of the SYNERGY Library.

Journal Article Am Heart J · August 2004 Clinical trials and accompanying substudies in patients with acute coronary syndromes (ACS) have over the last several years yielded a wealth of knowledge about the pathophysiology and management of this high-risk condition. The Superior Yield of the New s ... Full text Link to item Cite

The effect of temperature variation in vitro on platelet-leukocyte interactions and individual prothrombotic potential.

Journal Article J Thromb Thrombolysis · August 2004 BACKGROUND: Temperature variation within human atheromatous plaques, a finding which supports inflammatory cell-mediated thermogenesis, predicts clinical events among patients with coronary artery disease. PURPOSE: Our study was designed to investigate the ... Full text Link to item Cite

Initial experience with factor-Xa inhibition in percutaneous coronary intervention: the XaNADU-PCI Pilot.

Journal Article J Thromb Haemost · February 2004 BACKGROUND: Direct factor (F)Xa inhibition is an attractive method to limit thrombotic complications during percutaneous coronary intervention (PCI). OBJECTIVES: To investigate drug levels achieved, effect on coagulation markers, and preliminary efficacy a ... Full text Link to item Cite

When guidelines collide

Journal Article American Heart Journal · 2004 Full text Cite

Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial.

Journal Article JAMA : the journal of the American Medical Association · 2004 CONTEXT: Enoxaparin has demonstrated advantages over unfractionated heparin in low- to moderate-risk patients with non-ST-segment elevation acute coronary syndromes (ACS) treated with a conservative strategy. OBJECTIVES: To compare the outcomes of patients ... Cite

Association between factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations and events of the arterial circulatory system: a meta-analysis of published studies.

Journal Article Am Heart J · December 2003 BACKGROUND: The association between the inherited gene mutations of factor V, prothrombin, and homocysteine metabolism and venous thromboembolic events is accepted widely; however, their influence on the arterial circulatory system remains controversial. M ... Full text Link to item Cite

The impact of heparin compounds on cellular inflammatory responses: a construct for future investigation and pharmaceutical development.

Journal Article J Thromb Thrombolysis · February 2003 Atherosclerotic disease is recognized as a chronic inflammatory disorder with intermittent and widely variable phases of cellular proliferation and heightened thrombotic activity. The multi-tiered links between inflammation, atherogenesis and thrombogenesi ... Full text Link to item Cite

Plasmin-mediated proteolysis of vascular endothelial cell heparin releasable tissue factor pathway inhibitor.

Journal Article J Thromb Thrombolysis · February 2003 BACKGROUND: Fibrinolytic therapy represents a widely available and effective treatment modality for ST segment elevation myocardial infarction (MI). Its overall benefit is attenuated by a high incidence of coronary arterial reocclusion. METHODS/RESULTS: Hu ... Full text Link to item Cite

Factor Xa-A pleuripotential protease.

Journal Article J Thromb Thrombolysis · February 2003 Full text Link to item Cite

Bivalirudin, thrombin and platelets: Clinical implications and future directions

Journal Article Journal of Invasive Cardiology · 2003 Our current understanding of hemostasis and the roles of coagulation and platelets has evolved in recent years from the old "coagulation cascade" and "platelet pathway" models to an inter-related, cell-based model that more accurately represents in-vivo pr ... Cite

Population pharmacokinetics and pharmacodynamics of enoxaparin in unstable angina and non-ST-segment elevation myocardial infarction

Journal Article British Journal of Clinical Pharmacology · 2003 Aims: A major concern with any antithrombotic therapy is an increase in the risk of haemorrhage. The aim of this study was to analyse population pharmacokinetics and pharmacokinetic/pharmacodynamic (PK/PD) relationships for enoxaparin in patients with unst ... Full text Cite

Circadian variations in acute myocardial infarction: Patients or health care delivery?

Journal Article Journal of the American College of Cardiology · 2003 Full text Cite

Complicated Myocardial Infarction

Journal Article Critical Pathways in Cardiology · 2003 Full text Cite

Potential thrombophilic mutations/polymorphisms in patients with no flow-limiting stenosis after myocardial infarction.

Journal Article Am Heart J · January 2003 BACKGROUND: Although inherited thrombophilias are more common in patients with venous thromboembolism, their influence on the development of myocardial infarction (MI) requires clarification. METHODS AND RESULTS: To determine whether there are increased fr ... Full text Link to item Cite

Bivalirudin, thrombin and platelets: clinical implications and future directions.

Journal Article The Journal of invasive cardiology · 2003 Our current understanding of hemostasis and the roles of coagulation and platelets has evolved in recent years from the old "coagulation cascade" and "platelet pathway" models to an inter-related, cell-based model that more accurately represents in-vivo pr ... Cite

First experience with direct factor Xa inhibition in patients with stable coronary disease: a pharmacokinetic and pharmacodynamic evaluation.

Journal Article Circulation · May 21, 2002 BACKGROUND: Thrombin generation is critical to the formation of an arterial thrombus after rupture of an atherosclerotic plaque. In patients with stable coronary disease receiving standard medical therapy, we evaluated the pharmacokinetics, pharmacodynamic ... Full text Link to item Cite

Comparative efficacy of fibrinogen and platelet supplementation on the in vitro reversibility of competitive glycoprotein IIb/IIIa receptor-directed platelet inhibition

Journal Article American Heart Journal · 2002 Background: Platelet surface glycoprotein IIb/IIIa (αIIb/β 3) receptor inhibition, with prevention of fibrinogen binding and platelet aggregation, concomitantly attenuates arterial thrombotic capacity and impairs protective hemostasis, 2 divergent platelet ... Full text Cite

Influence of patient characteristics and renal function on factor Xa inhibition pharmacokinetics and pharmacodynamics after enoxaparin administration in non-ST-segment elevation acute coronary syndromes

Journal Article American Heart Journal · 2002 Background: The current standard of care for patients with non-ST-segment elevation acute coronary syndromes (ACS) includes antithrombotic therapy with aspirin and heparin. Although emerging data suggest that low-molecular weight preparations offer distinc ... Full text Cite

Intramural hematoma of the thoracic aorta in a woman with neurofibromatosis

Journal Article Annals of Thoracic Surgery · 2002 The natural history and preferred approach to patients with intramural hematoma of the aorta remains controversial. We describe herein the management of the case of a 45-year-old woman with acute onset of chest pain, intramural hematoma of the arch and pro ... Full text Cite

Comparative effects of unfractionated heparin and low molecular weight heparin on vascular endothelial cell tissue factor pathway inhibitor release: A model for assessing intrinsic thromboresistance

Journal Article Journal of Thrombosis and Thrombolysis · 2002 Objectives: The purpose of our study was to characterize tissue factor pathway inhibitor (TFPI) release from human vascular endothelial cells following daily exposure to varying concentrations of unfractionated heparin (UFH) and low molecular weight hepari ... Full text Cite

Antithrombotic therapy after myocardial infarction

Journal Article New England Journal of Medicine · 2002 Full text Cite

Choice of agents to limit the coagulation cascade in acute coronary syndromes

Journal Article Current Cardiology Reports · 2002 Arterial thrombosis, the predominant event in acute coronary syndromes (ACS), is the end-result of endothelial cell dysfunction, impaired vascular thromboresistance, and sudden atheromatous plaque disruption, each occurring amid a backdrop of inflammation ... Full text Cite

Physician attitudes concerning anticoagulation services in the long-term care setting

Journal Article Journal of Thrombosis and Thrombolysis · 2002 Objectives: There is little experience in the use of specialized anticoagulation services in the long-term care setting. Even less is known about physician attitudes regarding these services. To examine this issue, we surveyed physicians caring for nursing ... Full text Cite

Prevalence and quality of warfarin use for patients with atrial fibrillation in the long-term care setting

Journal Article Archives of Internal Medicine · 2001 Background: Evidence-based clinical practice guidelines recommend the use of warfarin sodium for stroke prevention in most patients with atrial fibrillation (AF) who do not have risk factors for hemorrhagic complications, irrespective of age. Methods: The ... Cite

Age and the utilization of cardiac catheterization following uncomplicated first acute myocardial infarction treated with thrombolytic therapy (The Second National Registry of Myocardial Infarction [NRMI-2])

Journal Article American Journal of Cardiology · 2001 Considerable data indicates that patients <50 years of age have lower morbidity and mortality after acute myocardial infarction (AMI) than older patients. It has been demonstrated that use of routine cardiac catheterization and revascularization in youn ... Full text Cite

Early clinical outcomes and routine management of patients with non-ST-segment elevation myocardial infarction: A nationwide perspective

Journal Article Archives of Internal Medicine · 2001 Background: Myocardial infarction (MI) in the absence of electrocardiographic ST-segment elevation or new bundle branch block is the cause of hospitalization for a large and steadily increasing proportion of patients with acute ischemic chest pain. Despite ... Cite

Anticoagulation and the heart

Journal Article Journal of Thrombosis and Thrombolysis · 2001 Cardiovascular disease is associated with a heightened risk of thrombosis that can manifest as acute myocardial infarction, cardiac death, and stroke. Similarly, valvular heart disease (which alters blood-flow dynamics) and the insertion of prosthetic mate ... Full text Cite

Markers of platelet activation and thrombin generation.

Journal Article Cardiovascular toxicology · 2001 The laboratory assessment of platelet biology and coagulation has traditionally focused on abnormalities, congenital or acquired, that provide insights for understanding hemostatic defects, unexplained bleeding, and pharmacologic titration of compounds des ... Cite

Short-term comparative outcomes associated with the use of GP IIb/IIIa antagonists in patients undergoing coronary intervention

Journal Article Journal of Thrombosis and Thrombolysis · 2001 Background: Platelet glycoprotein (GP) IIb/IIIa antagonists reduce the occurrence of death, myocardial infarction (MI) and urgent revascularization among patients undergoing percutaneous coronary intervention (PCI). Despite a similar mechanism of platelet ... Full text Cite

Prothrombin measurement using a patient self-testing system

Journal Article American Journal of Clinical Pathology · 2001 We enrolled 82 patients receiving oral anticoagulation in a pilot trial of a point-of-care (POC) prothrombin time (PT) device in a patient self-testing (PST) application in 7 US and Canadian hospital-based anticoagulation centers. The properly selected and ... Cite

Point-of-care prothrombin time measurement for professional and patient self-testing use: A multicenter clinical experience

Journal Article American Journal of Clinical Pathology · 2001 We enrolled 386 subjects in a multicenter study of a point-of-care (POC) prothrombin time (PT) testing device. POC tests were performed by health care professionals using venous and finger-stick specimens and by patients using finger-stick specimens. Venou ... Full text Cite

A critical review of clinical trials for low-molecular-weight heparin therapy in unstable coronary artery disease

Journal Article Clinical Cardiology · 2001 Unstable angina and non-ST-segment elevation myocardial infarction (MI) are collectively referred to as unstable coronary artery disease (UCAD). They are conditions that share a common pathophysiology and represent frequently encountered, potentially life- ... Cite

Comparative efficacy of fibrinogen and platelet supplementation on the in vitro reversibility of competitive glycoprotein IIb/IIIa (αIIb/β3) receptor-directed platelet inhibition

Journal Article American Heart Journal · 2001 Background: Platelet surface glycoprotein (GP) IIb/IIIa (αIIb/β3) receptor inhibition, by preventing fibrinogen binding and platelet aggregation, concomitantly attenuates arterial thrombotic capacity and impairs protective hemostasis, 2 divergent platelet- ... Full text Cite

Novel inhibitors of factor X for use in cardiovascular diseases

Journal Article Current Cardiology Reports · 2000 The complementary roles of platelets and thrombin in the pathophysiology of acute coronary syndromes suggests that for treatment to be effective, both mediators must be targeted. Although great strides have been made in the development of antiplatelet ther ... Full text Cite

The scientific basis for combined platelet and thrombin-directed pharmacotherapy in Acute Coronary Syndromes

Journal Article Journal of Invasive Cardiology · 2000 There exists incontrovertible scientific evidence that vascular endothelial cell dysfunction and atheromatous plaque disruption are causative pathobiologic events governing the clinical expression of disease in humans with coronary arteriosclerosis. A comp ... Cite

Critical pathways: A review

Journal Article Circulation · 2000 Cite

Recent strides in antithrombotic therapy

Journal Article Patient Care · 2000 The mainstays of antithrombotic therapy - aspirin, heparin, and warfarin - remain in the picture alongside some promising new arrivals. The search continues for better and safer ways to prevent new blood clots from forming and existing ones from growing. ... Cite

Hirudin-based anticoagulant strategies for patients with suspected heparin-induced thrombocytopenia undergoing percutaneous coronary interventions and bypass grafting

Journal Article Journal of Thrombosis and Thrombolysis · 2000 Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction that is associated with thrombotic events of the venous and arterial circulatory systems stemming from an intense and well-characterized prothrombotic triad of platelet acti ... Cite

Heparin-induced thrombocytopenia: Supplement to the journal of thrombosis and thrombolysis

Journal Article Journal of Thrombosis and Thrombolysis · 2000 Cite

Enoxaparin, a low molecular weight heparin, inhibits platelet-dependent prothrombinase assembly and activity by factor-Xa neutralization

Journal Article Journal of Thrombosis and Thrombolysis · 2000 Background: The available evidence suggests strongly that intravascular thrombosis is mediated predominantly by tissue-factor and its activation of factor X, which in the presence of factor Va, calcium, and phospholipid (prothrombinase complex) effectively ... Cite

Early and pre-discharge aspirin administration among patients with acute myocardial infarction: Current clinical practice and trends in the United States

Journal Article Journal of Thrombosis and Thrombolysis · 2000 Objectives: The purpose of our study was to determine the frequency of aspirin administration among patients with acute myocardial infarction (MI) as dictated by physicians practicing in the United States. Background: Aspirin (ASA), a widely available, ine ... Cite

Key references: Cardiac rupture.

Journal Article Journal of thrombosis and thrombolysis · 2000 Cite

Inhibition of platelet-dependent prothrombinase activity and thrombin generation by glycoprotein IIb/IIIa receptor-directed antagonists: Potential contributing mechanism of benefit in acute coronary syndromes

Journal Article Journal of Thrombosis and Thrombolysis · 2000 The glycoprotein (GP) IIb/IIIa receptor antagonists used widely in the medical treatment of acute coronary syndromes and during percutaneous coronary interventions, prevent fibrinogen cross-linking and platelet aggregation, critical initiating steps in art ... Cite

Key references: anticoagulants and coagulation monitoring.

Journal Article Journal of thrombosis and thrombolysis · 2000 Cite

Low molecular weight heparin in acute coronary syndromes - The emergence of dalteparin

Journal Article Today's Therapeutic Trends · 2000 Low molecular weight heparin (LMWH) preparations are widely used in the management of patients with arterial thrombotic disorders. In addition to a full complement of anti-ischemic therapy and early revascularization in those patients most likely to benefi ... Cite

Thrombin generation after the abrupt cessation of intravenous unfractionated heparin among patients with acute coronary syndromes: Potential mechanisms for heightened prothrombotic potential

Journal Article Journal of the American College of Cardiology · 1999 OBJECTIVES: The purpose of this study was to determine the mechanistic basis for thrombin generation and increased prothrombotic potential after the abrupt cessation of intravenous (IV) unfractionated heparin among patients with acute coronary syndromes. B ... Full text Cite

Thrombosis and the role of the platelet

Journal Article American Journal of Cardiology · 1999 Cite

Fatal cardiac rupture among patients treated with thrombolytic agents and adjunctive thrombin antagonists observations from the thrombolysis and thrombin inhibition in myocardial infarction 9 study

Journal Article Journal of the American College of Cardiology · 1999 OBJECTIVES: The purpose of this study was to determine the incidence and demographic characteristics of patients experiencing cardiac rupture after thrombolytic and adjunctive anticoagulant therapy and to identify possible associations between the mechanis ... Full text Cite

A randomized, multicenter trial of weight-adjusted intravenous heparin dose titration and point-of-care coagulation monitoring in hospitalized patients with active thromboembolic disease

Journal Article American Heart Journal · 1999 Background: Therapy with intravenous unfractionated heparin improves clinical outcome in patients with active thromboembolic disease, but achieving and maintaining a therapeutic level of anticoagulation remains a major challenge for clinicians. Methods A t ... Full text Cite

Diagnosis and management of inherited and acquired thrombophilias

Journal Article Journal of Thrombosis and Thrombolysis · 1999 Full text Cite

Ischemic preconditioning may be transferable via whole blood transfusion: Preliminary evidence

Journal Article Journal of Thrombosis and Thrombolysis · 1999 This research was designed to test the hypothesis that ischemic preconditioning can be transferred between animals via whole blood transfusion. Preconditioning at a distance refers to the reduction in myocardial infarct size seen when coronary artery occlu ... Full text Cite

Combining thrombolysis with the platelet glycoprotein IIb/IIIa inhibitor lamifiban: results of the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) trial.

Journal Article J Am Coll Cardiol · December 1998 OBJECTIVES: The trial was designed to assess the safety, pharmacodynamics and effects on reperfusion of the platelet glycoprotein (GP) IIb/IIIa inhibitor lamifiban when given with thrombolysis to patients with ST segment elevation acute myocardial infarcti ... Full text Link to item Cite

Use of bedside activated partial thromboplastin time monitor to adjust heparin dosing after thrombolysis for acute myocardial infarction: results of GUSTO-I. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article Am Heart J · November 1998 BACKGROUND: The safety and efficacy of bedside monitors of activated partial thromboplastin time (aPTT) have not been examined in a large population receiving intravenous heparin after thrombolytic treatment for acute myocardial infarction. We compared out ... Full text Link to item Cite

Thrombin generation, inhibition and clinical outcomes in patients with acute myocardial infarction treated with thrombolytic therapy and heparin: results from the GUSTO-I Trial. GUSTO-I Hemostasis Substudy Group. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · March 1, 1998 OBJECTIVES: We sought to assess the effects of antithrombotic therapy after thrombolysis for acute myocardial infarction on markers of thrombin generation and activity and to determine the relation of these markers with clinical outcomes. BACKGROUND: Throm ... Full text Link to item Cite

The cleaved peptide of the thrombin receptor is a strong platelet agonist

Journal Article Proceedings of the National Academy of Sciences of the United States of America · 1998 Thrombin cleaves its G-protein-linked seven-transmembrane domain receptor, thereby releasing a 41-aa peptide and generating a new amino terminus that acts as a tethered ligand for the receptor. Peptides corresponding to the new amino terminal end of the pr ... Full text Cite

Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction

Journal Article Journal of the American College of Cardiology · 1998 Objectives. This observational study sought to determine whether cases of acute myocardial infarction (AMI) reported to the second National Registry of Myocardial Infarction (NRMI-2) varied by season. Background. The existence of circadian variation in the ... Full text Cite

A clinician's view of thrombotic disorders of the cardiovascular system.

Journal Article Archives of pathology & laboratory medicine · 1998 Cite

Effects of prior aspirin and anti-ischemic therapy on outcome of patients with unstable angina

Journal Article American Journal of Cardiology · 1998 Both aspirin and β-adrenergic blocking drugs have been shown to reduce the risk of death or acute myocardial infarction (AMI) in patients with unstable angina, but their effect during chronic use on the presentation of acute coronary syndromes is less well ... Full text Cite

Management strategies for a better outcome in unstable coronary artery disease

Journal Article Clinical Cardiology · 1998 Unstable coronary artery disease is a term encompassing both unstable angina and non-Q-wave(non-ST-segment elevation) myocardial infarction. Patients with these conditions are at risk of early progression to acute myocardial infarction and death. Thus, man ... Cite

Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery disease

Journal Article Journal of the American College of Cardiology · 1998 Objectives. We sought to examine whether patients with stable coronary artery disease (CAD) have increased platelet reactivity and an enhanced propensity to form monocyte-platelet aggregates. Background. Platelet- dependent thrombosis and leukocyte infiltr ... Full text Cite

Guidelines for the management of patients with acute myocardial infarction

Journal Article Journal of Thrombosis and Thrombolysis · 1998 Full text Cite

Thrombin: Structure, biochemistry, measurement, and status in clinical medicine

Journal Article Journal of Thrombosis and Thrombolysis · 1998 Thrombin remains a molecule of great interest to scientists and clinicians alike because of its important role in hemostasis, thrombosis, inflammation and vascular remodeling. Yet one of the great challenges has been the inhibition of thrombin generation t ... Full text Cite

Early assessment and in-hospital management of patients with acute myocardial infarction at increased risk for adverse outcomes: A nationwide perspective of current clinical practice

Journal Article American Heart Journal · 1998 Background: Therapeutic decision making in critically ill patients requires both prompt and comprehensive analysis of available information. Data derived from randomized clinical trials provide a powerful tool for risk assessment in the setting of acute my ... Full text Cite

Pathobiology of thrombin in acute coronary syndromes

Journal Article American Heart Journal · 1998 Full text Cite

The need for wider utilization of thrombolytic therapy.

Journal Article Clin Cardiol · November 1997 Antithrombotic and thrombolytic therapies confer clear net benefits in the treatment of acute myocardial infarction (AMI). Antithrombotic therapy with aspirin yields conclusive reductions in vascular mortality as well as reinfarction and stroke and should ... Full text Link to item Cite

Clinical outcomes according to time to treatment.

Journal Article Clin Cardiol · November 1997 Twenty years ago, pathophysiologic studies showed that myocardial salvage in acute myocardial infarction depends on early intervention. A meta-analysis of the largest thrombolytic trials showed 1.6 lives saved/1000 treated for each hour closer to symptom o ... Full text Link to item Cite

The prothrombinase complex: Assembly and function

Journal Article Journal of Thrombosis and Thrombolysis · September 12, 1997 The prothrombinase complex plays a pivotal role in the coagulation cascade. It is responsible for the proteolytic conversion of prothrombin to thrombin-which in turn is involved directly in the formation of fibrin, activation of platelets, and feedback act ... Full text Cite

Incidence of stroke may be on the rise.

Journal Article Stroke; a journal of cerebral circulation · 1997 Cite

Outcome and profile of women and men presenting with acute coronary syndromes: A report from TIMI IIIB

Journal Article Journal of the American College of Cardiology · 1997 Objectives. Women and men enrolled in the Thrombolysis in Myocardial Infarction (TIMI) IIIB trial of unstable angina and non-Q wave myocardial infarction (MI) were evaluated to determine gender differences in characteristic and outcome. Background. Coronar ... Full text Cite

Reducing door-to-needle time: Treatment delay versus presentation delay

Journal Article Clinical Cardiology · 1997 One of the primary goals of the current American College of Cardiology/American Heart Association guidelines for treating patients with AMI is reduction of treatment delay. Delays consist of three phases: time from onset of symptoms to call for help, preho ... Cite

The need for long-term anticoagulants in venous thromboembolism: How long?

Journal Article Clinical and Applied Thrombosis/Hemostasis · 1997 Patients with venous thromboembolism are routinely treated with anticoagulants to minimize the risk of recurrent events: owever, a consensus has not been reached concerning the optimal duration of therapy. The available evidence does suggest that patients ... Full text Cite

Prehospital strategies to expedite myocardial salvage

Journal Article Clinical Cardiology · 1997 Recent large-scale clinical investigations have shown the overwhelming importance of early intervention in acute myocardial infarction (AMI), thereby underlining the crucial role of emergency medical technician- paramedics (EMT-Ps) in helping to assess and ... Cite

Dynamics of coronary thrombolysis and reocclusion

Journal Article Clinical Cardiology · 1997 The dynamics of coronary thrombosis and reocclusion may seem straightforward, but in actuality they are complex and incompletely understood. The pathobiology of coronary, thrombosis begins with the development of the atherosclerotic plaque. The initial ste ... Cite

Thrombolysis, the risk of rupture and other risks [1]

Journal Article Journal of the American College of Cardiology · 1997 Cite

Current and practical management of acute myocardial infarction

Journal Article Journal of Thrombosis and Thrombolysis · 1997 Full text Cite

Thrombolytic therapy in acute myocardial infarction: Management algorithms

Journal Article Journal of Thrombosis and Thrombolysis · 1997 Full text Cite

Editorial

Journal Article Stroke · 1997 Cite

Editorial: Evolution of direct thrombin antagonists: Acknowledging potential limitations

Journal Article Journal of Thrombosis and Thrombolysis · 1996 Cite

Prognostic value of plasma fibrinogen concentration in patients with unstable angina and non-Q-wave myocardial infarction (TIMI IIIB trial)

Journal Article American Journal of Cardiology · 1996 Inflammation may play an important role in acute coronary syndromes. We studied the prognostic value of fibrinogen, an acute-phase protein directly involved in thrombotic processes, measured serially in 1,473 patients with unstable angina and non-Q-wave my ... Full text Cite

A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction

Journal Article Journal of the American College of Cardiology · 1996 Objectives. This study was done to determine the incidence, timing and prevalence as a cause of death from cardiac rupture in patients with acute myocardial infarction. Background. Several clinical trials and overview analyses have suggested that the survi ... Full text Cite

Massive overdose of Cardizem CD

Journal Article Journal of Intensive Care Medicine · 1996 Long-acting diltiazem preparations are currently frequently prescribed, and the potential for serious morbidity and morbidity with an overdose can be significant. We present a case of Cardizem CD overdose in which a 22-year- old patient ingested 18.0 g, in ... Cite

Usefulness of fibrinogenolytic and procoagulant markers during thrombolytic therapy in predicting clinical outcomes in acute myocardial infarction

Journal Article American Journal of Cardiology · 1996 Thrombin activity is increased in the setting of acute myocardial infarction (AMI) and has been shown to increase further after the administration of thrombolytic therapy for acute infarction. This increase in thrombin activity may play an important role i ... Cite

Early cardiac rupture - A possible complication of thrombolytic and antithrombotic therapy

Journal Article Cardiology Review · 1996 We investigated the survival benefit conferred by thrombolytic therapy versus any paradoxical increase in early deaths due to cardiac rupture. Of 350,755 acute myocardial infarction patients enrolled at 1,073 hospitals, 122,243 received thrombolytic therap ... Cite

Relation between systemic anticoagulation as determined by activated partial thromboplastin time and heparin measurements and in-hospital clinical events in unstable angina and non-Q wave myocardial infarction

Journal Article American Heart Journal · 1996 Although coronary thrombosis is thought to play a pivotal role in the pathogenesis of unstable angina and non-Q wave myocardial infarction and antithrombotic therapy is a mainstay in the early management of these patients, the relation between measures of ... Full text Cite

Calcium channel antagonists in the modern era of coronary thrombolysis: Benefit or detriment?

Journal Article Cardiovascular Drugs and Therapy · 1996 Calcium channel antagonists are among the world's most widely prescribed class of drugs and are used most often in patients with hypertension and coronary artery disease. However, in the recent past serious questions have been raised concerning their poten ... Full text Cite

Anticoagulation in congestive cardiomyopathy: Steps toward defining the great unknown

Journal Article Journal of Thrombosis and Thrombolysis · 1996 It is generally agreed that congestive cardiomyopathy predisposes to the formation of cardiac thrombus and in turn systemic thromboembolism. Several uncontrolled studies have confirmed this association and have prompted wide-scale recommendations for long- ... Cite

Future directions

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Full text Cite

Improving the efficacy and stability of coronary reperfusion following thrombolysis: Exploring the thrombin hypothesis

Journal Article Journal of Thrombosis and Thrombolysis · 1995 A major assumption in the treatment of patients with acute myocardial infarction (MI) implies that the speed of coronary arterial reperfusion correlates directly with the overall extent of myocardial salvage, and that the extent of myocardial salvage, in t ... Full text Cite

The heparin rebound phenomenon-Does it offer insights toward understanding the pathobiology of coronary thrombosis and its treatment?

Journal Article Journal of Thrombosis and Thrombolysis · 1995 The heparin rebound phenomenon is a poorly characterized event occurring in patients treated with heparin. The pathobiology appears to be thrombin related; however, a primary platelet abnormality or a combination of coagulation and platelet-mediated events ... Full text Cite

Cardiac rupture in the thrombolytic era: Is it time to revise the textbooks?

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Full text Cite

Clinical experience with routine activated coagulation time monitoring during elective PTCA

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Background: Intracoronary thrombosis is an im portant factor in the pathogenesis of acute complications during percutaneous coronary interventions. The activated coagulation time (ACT) is a simple, reproducible bedside test that has become standard as the ... Full text Cite

Clinical utility of electrocardiographic ST-segment area for predicting unsatisfactory outcomes following thrombolytic therapy

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Background: The bedside surface 12-lead electrocardiogram is a mainstay in the early diagnostic evaluation of patients with suspected acute myocardial infarction. The presence of ST-segment elevation exceeding 1.0 mm in two or more anatomically associated ... Full text Cite

Dynamic nature of thrombin generation, fibrin formation, and platelet activation in unstable angina and non-Q-wave myocardial infarction

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Background: Thrombin and platelets are directly involved in arterial thrombosis, typically occurring at sites of atherosclerotic plaque rupture among patients with acute coronary syndromes. Understanding the dynamic nature of pathologic thrombosis has impo ... Full text Cite

Exploring the medical need for alternate site testing: A clinician's perspective

Journal Article Archives of Pathology and Laboratory Medicine · 1995 The ability of the clinician to make rapid and precise decisions is the cornerstone of cost-effective patient care. Alternate site testing can provide rapid information to clinicians in emergency departments and critical care units. This can increase cost- ... Cite

Arterial thrombosis for the clinician: Pathobiology and emerging concepts

Journal Article Cardiology Clinics · 1995 The prevention and treatment of coronary, atherosclerosis and thrombosis are linked closely by common pathobiologic features. Patient care will undoubtedly benefit from an increased knowledge of disease mechanisms and clinical expression. ... Cite

Coronary thrombolysis in the treatment of women with acute myocardial infarction

Journal Article Cardiology · 1995 Coronary thrombolysis is a mainstay in the treatment of acute myocardial infarction occurring in men and women. Despite a higher in-hospital mortality that cannot be explained completely by age and comorbid illnesses, women clearly benefit. The relatively ... Cite

Education and clinical research issues in women's health

Journal Article Cardiology · 1995 The evolution of women's health both in the United States and abroad is a direct result of an intense committment to scientific investigation and education. Society serves to benefit greatly from this global effort. ... Cite

Primary prevention of coronary heart disease in women

Journal Article Cardiology · 1995 Despite the fact that coronary heart (CHD) disease is the leading cause of death among postmenopausal women, research on primary prevention of CHD in women has been relatively sparse. Prevalence of CHD risk factors such as cigarette smoking and hypertensio ... Cite

Intravenous vitamin K1 injections: Dangerous prophylaxis [1]

Journal Article Archives of Internal Medicine · 1995 Cite

Antithrombotic therapy: An abbreviated reference for clinicians

Journal Article Archives of Internal Medicine · 1995 Antithrombotic therapy is a mainstay in the treatment of patients with thromboembolic diseases of the arterial and venous circulatory systems. Continued work and investigation has provided much-needed information directly applicable to meeting high standar ... Cite

Cardiac rupture associated with thrombolytic therapy: Impact of time to treatment in the late assessment of thrombolytic efficacy (LATE) study

Journal Article Journal of the American College of Cardiology · 1995 Objectives. This prospective ancillary study was conducted to determine the association between the time from symptom onset to treatment and cardiac rupture in patients with acute myocardial infarction. Background. There is strong evidence that the time wi ... Full text Cite

1995 American College of Cardiology Scientific Session at a glance

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Full text Cite

Achieving optimal reperfusion without adjunctive antithrombotic therapy: Novel thrombolytic dosing strategies

Journal Article Journal of Thrombosis and Thrombolysis · 1995 There is firm evidence that reperfusion therapy, to be effective must establish and maintain coronary arterial blood flow at a level sufficient to allow myocardial perfusion. However, current thrombolytic regimens have clear limitations, including a relati ... Full text Cite

1994 American Heart Association Scientific Sessions at a Glance

Journal Article Journal of Thrombosis and Thrombolysis · 1995 Full text Cite

Association between serial measures of systemic blood pressure and early coronary arterial perfusion status following intravenous thrombolytic therapy

Journal Article Journal of Thrombosis and Thrombolysis · 1994 Background: Systemic hypotension, at times transient while in other instances more prolonged, is common among patients with myocardial infarction (MI). It also is a characteristic feature for patients experiencing either advanced congestive heart failure o ... Full text Cite

Comparison of clinical outcomes for women and men after acute myocardial infarction

Journal Article Annals of Internal Medicine · 1994 Objectives: To assess differences in morbidity and mortality between men and women with acute myocardial infarction treated with thrombolytic therapy and the relation of differences to baseline patient characteristics and clinical features. Design: Seconda ... Cite

Hirudin: Its biology and clinical use

Journal Article Journal of Thrombosis and Thrombolysis · 1994 Over a century has passed since the anticoagulant properties of hirudin were identified. Our understanding of this unique and promising 65 amino acid polypeptide has grown steadily, allowing clinical experience to be gained. In acute myocardial infarction, ... Full text Cite

The emergence of thrombocardiolgy

Journal Article Journal of Thrombosis and Thrombolysis · 1994 Full text Cite

Platelet activation determined by flow cytometry persists despite antithrombotic therapy in patients with unstable angina and non-Q-wave myocardial infarction

Journal Article Journal of Thrombosis and Thrombolysis · 1994 Background: Current strategies in the treatment of patients with acute coronary syndromes include antiplatelet agents and thrombin antagonists, most commonly aspirin and heparin, respectively. Cardiac events, however, occur despite what is considered to be ... Full text Cite

Surface 12-lead electrocardiographic findings and plasma markers of thrombin activity and generation in patients with myocardial ischemia at rest

Journal Article Journal of Thrombosis and Thrombolysis · 1994 Background: Myocardial ischemia at rest is typically associated with atherosclerotic coronary artery disease, atheromatous plaque rupture, and intracoronary thrombosis. In areas of advanced disease and vascular injury, the extent of thrombus is influenced ... Full text Cite

Sex-related outcome differences after acute myocardial infarction [1]

Journal Article Annals of Internal Medicine · 1994 Cite

The clinical use of flow cytometry for assessing platelet activation in acute coronary syndromes

Journal Article Coronary Artery Disease · 1994 Background: Unstable angina signals a sudden transition from stable to unstable atherosclerotic coronary artery disease. Although assessment of platelet activity has been shown to provide diagnostic and prognostic information, most available methods lack s ... Cite

A pilot trial of recombinant desulfatohirudin compared with heparin in conjunction with tissue-type plasminogen activator and aspirin for acute myocardial infarction: Results of the Thrombolysis in Myocardial Infarction (TIMI) 5 trial

Journal Article Journal of the American College of Cardiology · 1994 Objectives. The purpose of this study was to assess the value of recombinant desulfatohirudin (hirudin) as adjunctive therapy to thrombolysis in acute myocardial infarction. Background. Failure to achieve initial reperfusion and reocclusion of the infarct- ... Cite

Beta-adrenergic blockade following thrombolytic therapy: Is it helpful or harmful?

Journal Article Clinical Cardiology · 1994 Beta-adrenergic blockade has been a mainstay in the treatment of patients with acute myocardial infarction for nearly two decades. Clearly, it has withstood the test of time. The emergence of thrombolytic therapy, however, has shifted the medical community ... Cite

Cardiovascular effects of anabolic steroids

Journal Article Primary Cardiology · 1994 Illicit anabolic steroid use is a major national health problem that is increasing steadily, especially among adolescent males. Anabolic steroids have been linked to several serious and potentially life-threatening medical conditions, including malignancie ... Cite

Expanding the paradigm of the renin-angiotensin system and angiotensin-converting enzyme inhibitors

Journal Article American Heart Journal · 1994 The renin-angiotensin system acts systemically and locally to influence vascular tone, blood volume, myocardial contractility, thromboresistance, and tissue responses to injury. ACE inhibitors have assumed a vital role in the treatment of patients with ven ... Full text Cite

Thrombolytic retreatment with tissue plasminogen activator for threatened reinfarction and thrombotic coronary reocclusion

Journal Article Clinical Cardiology · 1994 Following successful coronary arterial thrombolysis, thrombogenic substrate persists, increasing the risk of recurrent thrombosis, reocclusion, and reinfarction. The preferred treatment in this setting has not been established. Although many patients recei ... Cite

Bedside coagulation monitoring in heparin-treated patients with active thromboembolic disease: A coronary care unit experience

Journal Article American Heart Journal · 1994 Patients with active venous and arterial thromboembolic disorders are known to benefit from systemic anticoagulation with heparin. Clinical studies have shown, however, that therapeutic anticoagulation is rarely achieved rapidly and often is not maintained ... Full text Cite

Toward achieving optimal reperfusion: Revisiting thrombolysis

Journal Article Coronary Artery Disease · 1994 Cite

The thrombin hypothesis: Challenge for the 1990s

Journal Article Choices in Cardiology · 1994 A current limitation of thrombolytic therapy includes the finding that no more than 30% of victims of myocardial infarction achieve 'optimal' reperfusion. One challenge is to prove or disprove the thrombin hypothesis. Several large clinical trials are curr ... Cite

Diagnosis, management, and complications of nonpenetrating cardiac trauma: A perspective for practicing clinicians

Journal Article Journal of Intensive Care Medicine · 1993 We provide a state-of-the-art review for practicing clinicians concerning diagnosis and treatment of patients with nonpenetrating cardiac trauma. Internists, cardiologists, and intensivists are becoming increasingly involved in the diagnosis and management ... Cite

The role of blood viscosity in the development and progression of coronary artery disease.

Journal Article Cleveland Clinic journal of medicine · 1993 BACKGROUND: Although a great deal of attention has been directed to the risk factors for atherosclerotic coronary artery disease, relatively little research has been focused on the role of the circulating blood itself. OBJECTIVES: To review the possible ro ... Cite

Thrombolytic agents and anticoagulants

Journal Article Cardiovascular Drugs and Therapy · 1993 The medical and scientific communities, appreciating the pivotal role of thrombosis in the evolution and expression of atherosclerotic coronary artery disease, have embarked upon intense efforts to develop safe, effective, and affordable thrombolytic agent ... Full text Cite

Thrombolytic therapy: An orchestra without a conductor

Journal Article Journal of Intensive Care Medicine · 1993 Cite

Hemodynamic, mechanical, and metabolic determinants of thrombolytic efficacy: A theoretic framework for assessing the limitations of thrombolysis in patients with cardiogenic shock

Journal Article American Heart Journal · 1993 Although thrombolytic therapy has been shown to limit infarct size, preserve left ventricular function, and improve survival in most subgroups of patients with acute MI, a benefit has not been demonstrated in patients with clinical left ventricular dysfunc ... Full text Cite

A 37-year-old woman with altered mental status, fever, and renal failure

Journal Article Journal of Intensive Care Medicine · 1993 Cite

Cardiogenic shock: Elements of etiology, diagnosis, and therapy

Journal Article Clinical Cardiology · 1993 Cardiogenic shock usually is the result of marked depression in myocardial function. Rapid recognition and stabilization are essential if the patient is to survive. A variety of cardiovascular conditions can lead to cardiogenic shock; the most common of th ... Cite

Late thrombolytic therapy: Mechanism of benefit and potential risk among patients treated beyond 6 hours

Journal Article Coronary Artery Disease · 1993 Background: Thrombolytic therapy is the treatment of choice for many patients with myocardial Infarction, particularly those presenting to the hospital within 6 hours from symptom onset. Although prompt treatment promises to provide the greatest overall be ... Cite

The challenge of maintaining coronary arterial patency with intravenous heparin following tissue plasminogen activator administration

Journal Article Cardiology · 1993 It is widely accepted that coronary arterial patency, achieved early after symptom onset and maintained over time, is an absolute prerequisite for patient benefit following thrombolytic therapy. Conjunctive pharmacological agents such as heparin appear to ... Cite

Antiplatelet therapy in coronary heart disease: Emerging strategies for the treatment and prevention of acute myocardial infarction

Journal Article Archives of Pathology and Laboratory Medicine · 1993 Platelets, long recognized for their role in physiological (protective) hemostasis, have been shown conclusively to play an intricate role in both coronary arterial atherogenesis and acute thrombosis. Accordingly, antiplatelet agents have emerged as a prom ... Cite

Hemorrhagic potential of combined diltiazem and recombinant tissue-type plasminogen activator administration

Journal Article American Heart Journal · 1993 In the Thrombolysis in Myocardial Infarction (TIMI) phase II study, use of calcium channel antagonists at study entry was associated with an increased risk of intracerebral hemorrhage. Whether the observed association was due solely to chance, underlying c ... Cite

A comparison of heparin strategies after thrombolytic therapy

Journal Article American Heart Journal · 1993 Full text Cite

Mechanisms and management of cardiogenic shock

Journal Article Critical Care Clinics · 1993 Cite

Reocclusion following successful thrombolysis. Emerging concepts

Journal Article Cardiology · 1993 Thrombolytic therapy, through the restoration of coronary arterial blood flow and myocardial perfusion significantly improves outcome among patients with acute myocardial infarction. Despite its widely appreciated benefits, however, thrombolysis removes on ... Cite

Monitoring thrombolytic therapy

Journal Article Progress in Cardiovascular Diseases · 1992 Full text Cite

Tools for noninvasive assessment of coronary arterial reperfusion.

Journal Article Cleveland Clinic journal of medicine · 1992 For patients with acute myocardial infarction, the presence of a patent infarct-related coronary artery may be the most sensitive single predictor of clinical outcome and patient survival. Coronary angiography is the most direct means of assessing reperfus ... Cite

Recurrent myocardial ischemia following thrombolytic therapy: guidelines for practicing clinicians

Journal Article American Heart Journal · 1992 The natural history of patients with acute myocardial infarction treated with thrombolytic therapy includes two distinct phases: the initial or acute phase is characterized pathologically by atheromatous plaque rupture and thrombotic coronary arterial occl ... Full text Cite

Repeat thrombolysis for early coronary arterial reocclusion

Journal Article Coronary Artery Disease · 1992 Background: After successful coronary artery thrombolysis, thrombogenic substrate persists, increasing the risk of both reocclusion and reinfarction. Although many patients experiencing threatened reinfarction undergo emergent coronary angiography and mech ... Cite

Summary

Journal Article American Journal of Cardiology · 1992 Cite

Relationship between serum total cholesterol, infarct size, and early clinical outcome following acute myocardial infarction

Journal Article Cardiology · 1992 Strategies designed to decrease coronary heart disease (CHD) associated morbidity and mortality have focused primarily on established risk factors, including hypercholesterolemia, systemic hypertension, and cigarette smoking. Indeed, primary and secondary ... Cite

Thrombin antagonists and antiplatelet agents

Journal Article The American Journal of Cardiology · 1992 The clinical benefits of thrombolytic therapy for the treatment of myocardial infarction are recognized widely. However, 2 major limiting factors have become evident: (1)20-25% of coronary arterial thrombi are resistant to lysis; and (2) coronary reocclusi ... Cite

Seminars in thrombosis, thrombolysis, and vascular biology: 6. Procoagulant states

Journal Article Cardiology · 1992 Under normal physiologic conditions, blood flows freely within the coronary arteries and peripheral vasculature, providing oxygen and essential nutriments to vital organs and metabolically active tissues. The natural thromboresistant properties of the vasc ... Cite

Effect of serum total cholesterol on hemorrhagic complications following thrombolytic therapy for acute myocardial infarction

Journal Article Cardiology · 1991 Despite the well-known and widely publicized adverse effects of hypercholesterolemia on the cardiovascular system, cholesterol is a vital component of cellular membranes, maintaining vascular integrity and normal platelet activatability. To test the hypoth ... Cite

Seminars in thrombosis, thrombolysis, and vascular biology. Part 5: Cellular rheology and plasma viscosity

Journal Article Cardiology · 1991 The fundamental determinants of coronary blood flow include the vessel radius, pressure gradient, and the physical characteristics of the cellular components and fluid medium. Specifically, cellular rheology and plasma viscosity determine, to a significant ... Cite

Recombinant tissue-type plasminogen activator: Current concepts and guidelines for clinical use in acute myocardial infarction. Part II

Journal Article American Heart Journal · 1991 The extraordinarily high prevalence of coronary heart disease, coupled with the alarming incidence of MI in Western society, has encouraged the investigation and development of pharmacologic agents that can be employed widely, quickly, effectively, and saf ... Full text Cite

Adjunctive use of beta-adrenergic blockers, calcium antagonists and other therapies in coronary thrombolysis

Journal Article The American Journal of Cardiology · 1991 The availability of thrombdytic agents for use in the treatment of acute myocardial infarction is an important step in the management of a common, often debilitating, and potentially lethal disorder. However, despite the proven benefits of coronary thrombo ... Cite

Cardiovascular therapies in the 1990s: An overview

Journal Article Drugs · 1991 Cardiovascular medicine has evolved steadily over the past two decades. Inspired by progressive declines in the overall incidence and mortality rates from cardiovascular diseases, emphasis has been placed on 3 specific areas: prevention, early diagnosis, a ... Cite

Seminars in thrombosis, thrombolysis and vascular biology. 1. The vascular endothelium

Journal Article Cardiology · 1991 The vascular endothelium, once believed to act solely as a mechanical barrier is, in fact, the body's most active paracrine organ serving a vital role in vasomotion and thromboresistance. Vasoactive compounds such as prostacyclin and endothelium-derived re ... Cite

Seminars in thrombosis, thrombolysis and vascular biology 4. Fibrinolysis

Journal Article Cardiology · 1991 In general terms, thrombotic disorders of the cardiovascular system are characterized by poorly regulated, nonphysiologic thrombus formation. Considered more specifically, however, pathologic thrombosis represents a critical imbalance, frequently at both t ... Cite

Mechanical failure of a St. Jude Medical prosthesis

Journal Article The American Journal of Cardiology · 1991 The St. Jude Medical (SJM) prosthetic cardiac valve is a low-profile, bileaflet mechanical valve with an excellent record of durability and a low overall complication rate.1-3 Mechanical failure is a rare occurrence with this valve.4 We report a case of me ... Full text Cite

Heparin pharmacokinetics and in vitro anticoagulant activity in patients receiving nonionic radiographic contrast media

Journal Article Cardiology · 1991 Nonionic radiographic contrast media are used frequently in diagnostic and interventional angiography. However, there is concern that they may possess thrombogenic properties, and some studies have suggested that patients receiving nonionic contrast media ... Cite

Seminars in thrombosis, thrombolysis, and vascular biology, Part 2: Coagulation and thrombosis

Journal Article Cardiology · 1991 The hemostatic mechanism is a critical component of a normally functioning circulatory system, preventing life-threatening hemorrhage and assisting in the maintenance of vascular integrity. For longer than half a century, however, nonphysiological intravas ... Cite

Seminars in thrombosis, thrombolysis and vascular biology. 3. Platelet activity in cardiovascular disease

Journal Article Cardiology · 1991 Platelets contribute to normal hemostasis by adhering to subendothelial tissues after vascular damage has taken place and then recruiting additional platelets through the process of aggregation. Activation of the coagulation cascade ultimately results in f ... Cite

Tissue plasminogen activator and intracranial hemorrhage

Journal Article Annals of Internal Medicine · 1990 Cite

Recombinant t-PA and platelet activity

Journal Article Cleveland Clinic Journal of Medicine · 1990 Cite

Coronary heart disease risk factors in women

Journal Article Cardiology · 1990 Although men and women share a number of coronary risk factors including age, hypertension, cigarette smoking, diabetes, obesity, plasma lipoprotein concentration, and family history, the overall impact of these factors on the incidence and clinical manife ... Cite

Surgical revascularization in women

Journal Article Cardiology · 1990 Surgical revascularization is an important therapeutic option for both men and women with symptomatic coronary heart disease (CHD). Although men have a higher incidence of CHD, a selection bias in currently utilized evaluation processes for persons with ch ... Cite

Noninvasive diagnosis of coronary heart disease in women

Journal Article Cardiology · 1990 Coronary heart disease (CHD) is the leading cause of death in the United States accounting for over 600,000 deaths and 1 million hospital admissions each year. Although the overall prevalence of disease is lower in women than in men, one quarter of all dea ... Cite

Intravenous nitroglycerin-induced heparin resistance: A qualitative antithrombin III abnormality

Journal Article American Heart Journal · 1990 An ability of intravenous nitroglycerin to interfere with the anticoagulant properties of intravenous heparin would have profound clinical implications. To investigate nitroglycerin-heparin interactions, the following pilot study was performed. Patients (N ... Cite

Cardiovascular disease in women: Scope of the problem

Journal Article Cardiology · 1990 Coronary heart disease (CHD) is a major health problem in both men and women. Each year over 250,000 women in the United States alone die as a result of CHD, many of them suddenly. Women sustaining an acute myocardial infarction have a poor in-hospital and ... Cite

Coronary thrombolysis in women

Journal Article Cardiology · 1990 Acute myocardial infarction (AMI) is a major cause of morbidity and mortality throughout the world. Although the incidence of AMI is higher in men than women, it is responsible for more than 250,000 annual deaths among women within the United States alone. ... Cite

Reperfusion of nonviable myocardium: Lessons from thrombolytic therapy

Journal Article Journal of Intensive Care Medicine · 1990 Cite

Impact of atrial fibrillation on the in-hospital and long-term survival of patients with acute myocardial infarction: A community-wide perspective

Journal Article American Heart Journal · 1990 As part of an ongoing community-wide study examining changes over time in the incidence and survival rates of 4108 patients hospitalized with validated acute myocardial infarction (MI) in 16 hospitals in the Worcester, Massachusetts, metropolitan area duri ... Full text Cite

Circadian variations in cardiovascular disease

Journal Article Cleveland Clinic Journal of Medicine · 1989 Cite

Current management of acute myocardial infarction

Journal Article Current Problems in Cardiology · 1989 Cite

Rapid resolution of acute cor pulmonale with recombinant tissue plasminogen activator

Journal Article Chest · 1989 A case of massive pulmonary embolism complicated by acute cor pulmonale and shock is presented. The IV administration of recombinant tissue-type plasminogen activator (rt-PA) was associated with prompt reversal of clinical, ECG, and nuclea radiographic fin ... Cite

Postinfarction unstable angina. Pathophysologic basis for current modalities

Journal Article Cardiology · 1989 Unstable angina is an acute coronary syndrome characterized by the rapid progression of clinical symptoms which may culminate in acute myocardial infarction, infarct extension or sudden death. The pathologic substrate involves atherosclerotic plaque ruptur ... Cite

Electrocardiographic ST segment depression in coronary heart disease

Journal Article American Heart Journal · 1988 Cite

Coronary artery bypass surgery in women

Journal Article Clinical Cardiology · 1988 Coronary bypass surgery is performed more frequently in men than in women. A selection bias in favor of men may exist in currently utilized evaluation processes for patients with both chest pain syndromes and documented coronary artery disease. Surgery sho ... Cite

Marine omega-3 fatty acids and atherosclerosis.

Journal Article Annals of Internal Medicine · 1988 Cite

Cardiovascular disease in patients with chronic renal failure

Journal Article Cleveland Clinic Journal of Medicine · 1988 Cite

Beyond coronary thrombolysis

Journal Article Archives of Internal Medicine · 1988 In summary, the availability of the thrombolytic agents recombinant tissue plasminogen activator and streptokinase for use in the early treatment of AMI is an important step in the management of a common, often debilitating, and potentially lethal disorder ... Cite

Management of post-infarction angina

Journal Article Cardiology Clinics · 1988 Cite

Circadian variation in thrombolytic response to recombinant tissue-type plasminogen activator in acute myocardial infarction

Journal Article Journal of Applied Cardiology · 1988 To investigate the existence of a circadian variation in thrombolytic response to either intravenous streptokinase or recombinant tissue-type plasminogen activator (rt-PA), time of symptom onset, time of treatment and angiographically documented coronary r ... Cite

Right-sided endocardial lesions and flow-directed pulmonary artery catheters.

Journal Article Cleveland Clinic journal of medicine · 1987 Cite

Acquired factor X deficiency in systemic amyloidosis.

Journal Article Cleveland Clinic journal of medicine · 1987 Cite

Nocturnal diaphoresis in Prinzmetal angina.

Journal Article Annals of Internal Medicine · 1987 Cite

Nocturnal diaphoresis and coronary artery spasm. Contribution of the parasympathetic nervous system

Journal Article Cleveland Clinic Journal of Medicine · 1987 Coronary artery spasm may be important in a number of cardiovascular disorders including exertional angina, Prinzmetal's angina, silent ischemia, myocardial infarction, and sudden cardiac death. Abnormalities of the autonomic nervous system may play an int ... Cite

Bacterial tissue tropism: An in vitro model for infective endocarditis

Journal Article Cardiovascular Research · 1987 Since infective endocarditis may affect individuals without pre-existing valvar heart disease, and Staphylococcus aureus is the organism most commonly involved, the binding characteristics of S aureus to several components of normal vascular endothelium an ... Cite

Massive hemolysis in clostridium perfringens infections

Journal Article Journal of Surgical Oncology · 1987 Over a 14-month period at the Cleveland Clinic Foundation, 424 strians of Clostridium were isolated; of these, 52 strains were Clostridium perfringens isolated from 41 patients. Eight strains of C. perfringens were isolated from the blood of six patients; ... Cite

Myocardial infarction in patients undergoing noncardiac surgery.

Journal Article Cleveland Clinic journal of medicine · 1987 Cite

Penicillamine-induced insulin antibodies

Journal Article Annals of Internal Medicine · 1986 Cite

Primary tumors of the heart: A review with emphasis on diagnosis and potential treatment modalities

Journal Article Seminars in Surgical Oncology · 1985 Primary cardiac tumors, while uncommon, are not rare neoplasms. They occur in individuals of all ages. A variety of benign and malignant tumors has been described. Presenting signs and symptoms mimic numerous systemic and cardiac disease states. Echocardio ... Cite

Thrombotic thrombocytopenic purpura in a patient with systemic lupus erythematosus

Journal Article Cleveland Clinic Quarterly · 1985 A case is presented of a 38-year-old woman who had been diagnosed ten years earlier as having systemic lupus erythematosus (SLE). She presented with classical signs and symptoms of thrombotic thrombocytopenic purpura (TTP). Plasmapheresis and prednisone tr ... Cite