Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleEur 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 ...
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Journal articleCirculation · 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, ...
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Journal articleAm 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 ...
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Journal articleEur 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 ...
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Journal articleStroke · 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 ...
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Journal articleHeart 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 ...
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Journal articleCirculation · 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 ...
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Journal articleThromb 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleRespir 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 ...
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Journal articleJournal 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 ...
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Journal articleCurrent 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 ...
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Journal articleEur 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleDrug 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleClin 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 ...
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Journal articleEur 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 ...
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Journal articleJ 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 ...
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Journal articleRespir 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 ...
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Journal articleJ 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 ...
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Journal articleCirc 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 ...
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Journal articleCirc 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 ...
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Journal articleAnn 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 ...
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Journal articleJAMA · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleCirculation · 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 ...
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Journal articlePLoS 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 ...
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Journal articleCirculation · 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 ...
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Journal articleJournal 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, ...
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Journal articleJ 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 ...
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Journal articleThromb 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 ...
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Journal articlePsychosom 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 ...
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Journal articleThromb 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleCirc 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 ...
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Journal articleAm 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 ...
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Journal articleCurr 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleCirculation · 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 ...
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Journal articleCrit 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 ...
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Journal articlePharmacogenomics · 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 ...
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Journal articleLancet 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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, ...
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Journal articleJ 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 ...
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Journal articleNat 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 ...
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Journal articleMol 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 ...
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Journal articleAm 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 ...
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Journal articleHandb 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 ...
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Journal articleAdv 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 ...
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Journal articleClin 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 ...
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Journal articleEur 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 ...
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Journal articleAm 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 ...
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Journal articleEur 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 ...
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Journal articleCirc 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 ...
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Journal articleThromb 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 ...
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Journal articleEur 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 ...
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Journal articleCirc 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 ...
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Journal articleEur 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 ...
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Journal articleN 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 ...
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Journal articleNat 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 ...
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Journal articleCirculation · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleCardiovasc 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleRev 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, ...
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Journal articleAm 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 ...
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Journal articleChest · 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleCurr 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 ...
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Journal articleJ 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 ...
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Journal articleArterioscler 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 ...
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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 ...
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Journal articleCirculation · 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 ...
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Journal articleThromb 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, ...
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Journal articleJ 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 ...
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Journal articleLancet · 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleDrugs · 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 ...
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Journal articleInt 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 ...
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Journal articleJ 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 ...
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Journal articleThromb 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 ...
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Journal articleCirculation · 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 ...
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Journal articleCurr 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 ...
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Journal articleJ 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 ...
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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 ...
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Journal articlePsychosom 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 ...
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Journal articleCirculation · 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleInt 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 ...
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Journal articleAnn 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 ...
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Journal articleThromb 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 ...
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Journal articleThromb 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 ...
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Journal articleCrit 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 ...
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Journal articleLancet · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleN 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleCurr 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 ...
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Journal articleAm 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleN 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 ...
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Journal articleAnn 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 ...
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Journal articleJAMA · 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 ...
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Journal articleJ 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 ...
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Journal articlePlatelets · 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleArterioscler 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 ...
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Journal articleAm 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 ...
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Journal articleLancet · 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 ...
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Journal articleCardiol 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 ...
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Journal articleJ 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 ...
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Journal articleThromb 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleAnn 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 ...
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Journal articleCirculation · 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 ...
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Journal articleChest · 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 ...
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Journal articleChest · 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 ...
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Journal articleChest · 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 ...
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Journal articlePlatelets · 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 ...
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Journal articleEur 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 ...
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Journal articleJ 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 ...
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Journal articleEuropean 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 ...
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Journal articleAm 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 ...
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Journal articlePharmacotherapy · 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 ...
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Journal articleAm 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 ...
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Journal articleCurr 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 ...
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Journal articleArch 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 ...
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Journal articleThromb 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 ...
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Journal articleAm 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 ...
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Journal articleHamostaseologie · 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ( ...
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Journal articleArterioscler 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, ...
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Journal articleJ 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 ...
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Journal articleAnesthesiology · 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 ...
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Journal articleOligonucleotides · 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 ...
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Journal articleCirculation · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleRecenti Prog Med · 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 ...
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Journal articleCurr 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 ...
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Journal articleAm 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 ...
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Journal articleAm 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 ...
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Journal articleThromb 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 ...
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Journal articleMayo 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 ...
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Journal articleJ 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 ...
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Journal articleArch 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 ...
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Journal articleThromb 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 ...
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Journal articleJ 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. ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleTex 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 ...
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Journal articleTexas 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 ...
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Journal articleJ 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 ...
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Journal articleThromb 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 ...
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Journal articleArch 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 ...
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Journal articleChest · 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, ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJAMA : 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJournal 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 ...
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Journal articleBritish 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 ...
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Journal articleAm 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 ...
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Journal articleThe 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 ...
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Journal articleCirculation · 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 ...
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Journal articleAmerican 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 ...
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Journal articleAnnals 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 ...
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Journal articleJournal 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 ...
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Journal articleCurrent 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 ...
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Journal articleJournal 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 ...
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Journal articleArchives 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 ...
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Journal articleAmerican 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 ...
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Journal articleArchives 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 ...
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Journal articleJournal 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 ...
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Journal articleCardiovascular 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 ...
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Journal articleJournal 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 ...
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Journal articleAmerican 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 ...
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Journal articleAmerican 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 ...
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Journal articleClinical 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- ...
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Journal articleCurrent 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 ...
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Journal articleJournal 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 ...
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Journal articlePatient 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. ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleToday'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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleAmerican 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 ...
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Journal articleJournal 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleProceedings 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 ...
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Journal articleJournal 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 ...
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Journal articleAmerican 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 ...
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Journal articleClinical 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleAmerican 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 ...
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Journal articleClin 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 ...
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Journal articleClin 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleClinical 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 ...
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Journal articleClinical 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 ...
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Journal articleClinical 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 ...
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Journal articleClinical 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 ...
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Journal articleAmerican 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleAmerican 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 ...
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Journal articleCardiology 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 ...
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Journal articleAmerican 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 ...
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Journal articleCardiovascular 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 ...
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Journal articleJournal 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- ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleArchives 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- ...
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Journal articleCardiology 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. ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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. ...
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Journal articleCardiology · 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 ...
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Journal articleArchives 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleAnnals 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 ...
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Journal articleJournal 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, ...
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Journal articleJournal 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 ...
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Journal articleJournal 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 ...
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Journal articleCoronary 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 ...
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Journal articleJournal 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- ...
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Journal articleClinical 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 ...
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Journal articlePrimary 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 ...
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Journal articleAmerican 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 ...
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Journal articleClinical 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 ...
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Journal articleAmerican 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 ...
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Journal articleChoices 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 ...
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Journal articleJournal 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 ...
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Journal articleCleveland 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 ...
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Journal articleCardiovascular 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 ...
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Journal articleAmerican 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 ...
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Journal articleClinical 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 ...
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Journal articleCoronary 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 ...
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Journal articleCardiology · 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 ...
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Journal articleArchives 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 ...
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Journal articleAmerican 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCleveland 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 ...
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Journal articleAmerican 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 ...
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Journal articleCoronary 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 ...
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Journal articleCardiology · 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 ...
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Journal articleThe 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleAmerican 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 ...
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Journal articleThe 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 ...
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Journal articleDrugs · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleThe 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleAmerican 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 ...
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Journal articleCardiology · 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 ...
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Journal articleCardiology · 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. ...
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Journal articleAmerican 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 ...
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Journal articleChest · 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 ...
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Journal articleCardiology · 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 ...
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Journal articleClinical 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 ...
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Journal articleArchives 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 ...
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Journal articleJournal 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 ...
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Journal articleCleveland 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 ...
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Journal articleCardiovascular 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 ...
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Journal articleJournal 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; ...
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Journal articleSeminars 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 ...
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Journal articleCleveland 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 ...
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