Search Results
Results 251 - 300 of 594
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Becker R C - - 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 materials (which stimulates localized thrombosis on foreign surfaces) are associated with platelet aggregation and thrombin-mediated bioamplification ...
Mahaffey K W - - 2001
Heparin-induced thrombocytopenia (HIT) is not uncommon in clinical practice, and may go unrecognized in a substantial number of patients. The pathophysiology of HIT has only recently been better understood. Patients with HIT may require anticoagulation for thrombotic complications that result in severe morbidity and mortality. These patients may also require ...
Chang H K - - 2001
We describe two cases with Behcet's disease (BD) developing osteonecrosis or bone infarction. One patient developed the extensive bone infarction of the left knee without the use of corticosteroids. The other patient had osteonecrosis at the right femoral head. He had had a past history of significant corticosteroid administration to ...
Bates E R - - 2001
This review focuses on the use of bivalirudin as a replacement anticoagulant for heparin in patients undergoing percutaneous coronary intervention, or who are being treated for unstable angina pectoris, ST-elevation, or non-ST-elevation myocardial infarction. Potential advantages of bivalirudin include a lack of dependence on antithrombin III for anticoagulant activity, the ...
Hallgren C G - - 2001
High intake of fish has been associated with reduced risk of CHD. The high content of n-3 polyunsaturated fatty acids (PUFA) in fish has been suggested to be a protective factor. In addition, fish is the entirely dominating source of methylmercury for the general population, and the concentration of Hg ...
Spandorfer J - - 2001
Patients maintained on warfarin for atrial fibrillation, mechanical heart valves, or deep venous thrombosis may occasionally need to stop their anticoagulation during invasive procedures. This article reviews the literature on bleeding risks of certain procedures, thrombosis risks of stopping anticoagulation, and heparin and warfarin pharmacokinetics. Recommendations regarding how to manage ...
Srinivasan S K - - 2001
Antiphospholipid antibody syndrome (APAS) commonly presents with cutaneous infarctions mimicking thromboembolic vaso-occlusive disease. Systemic anticoagulation is the standard of care for this disorder, but treatment failures can occur. The authors report the first successful treatment of cutaneous infarctions due to APAS with low-dose, intravenous tissue plasminogen activator (rTPA) in a ...
Chen J L - - 2001
Argatroban, a direct thrombin inhibitor derived from arginine, is an effective anticoagulant indicated for prophylaxis or treatment of thrombosis in patients with heparin-induced thrombocytopenia (HIT). Argatroban has been used as an alternative anticoagulant in patients with HIT in various clinical conditions including interventional cardiovascular procedures that require anticoagulation. Satisfactory clinical ...
ten Berg J M - - 2001
BACKGROUND: In the randomized Balloon Angioplasty and Anticoagulation Study (BAAS), the addition of oral anticoagulants to aspirin significantly reduced early and late events after coronary angioplasty. However, bleeding episodes were increased. The present report studied the intensity and the duration of anticoagulation as predictors of thrombotic and bleeding events. METHODS ...
Lanzarini L - - 2001
The echocardiographic characteristics and evolution of multiple pedunculated left atrial and left ventricular intracavitary thrombi in a patient with alcoholic cardiomyopathy are reported. The patient had a long history of left ventricular dysfunction and atrial fibrillation but the referring physician had not prescribed anticoagulant prophylaxis. Multiple, non-fatal, systemic embolizations occurred ...
Affleck D G - - 2001
Gene therapy is a potential new strategy for the treatment of cardiovascular disease. The most efficacious method of gene delivery remains a key hurdle to effective gene therapy. We present the application of a novel, nonviral gene delivery system (TerplexDNA) to augment myocardial transfection. The hearts of New Zealand white ...
Klein A L - - 2001
Electrical cardioversion of patients with atrial fibrillation (AF) is frequently performed to relieve symptoms and improve cardiac performance. Patients undergoing cardioversion are treated conventionally with therapeutic anticoagulation for three weeks before and four weeks after cardioversion to decrease the risk of thromboembolism. A transesophageal echocardiography (TEE)-guided strategy has been proposed ...
Nawarskas J J - - 2001
Bivalirudin is one of the first of a new class of anticoagulants known as direct thrombin inhibitors. These drugs are able to overcome many of the shortcomings of traditional heparin anticoagulation by virtue of this unique mechanism of action. Bivalirudin is a semisynthetic derivative of hirudin, a modified component of ...
Algra A - - 2001
This paper summarises the benefits and risks of anticoagulant treatment in patients who have had cerebral ischaemia. In patients with a cardiac source of embolism (in most studies atrial fibrillation), anticoagulation with a target intensity of an INR of 2.0--3.0 is the therapy of first choice. In the case of ...
ten Berg Jurriën M - - 2001
Thrombosis plays a major role in acute vessel closure both after coronary balloon angioplasty and after stenting. This review will address the role of antiplatelet and anticoagulant therapy in preventing early thrombotic complications after percutaneous coronary intervention. The focus will be on agents that are routinely available and commonly used.
Levine M N - - 2001
Bleeding is the major complication of anticoagulant therapy. The criteria for defining the severity of bleeding varied considerably between studies, accounting in part for the variation in the rates of bleeding reported. Since the last review, there have been several meta-analyses published on the rates of major bleeding in trials ...
Kelly J - - 2001
BACKGROUND: Treatment for venous thromboembolism (VTE) is highly effective in preventing morbidity and mortality, yet pulmonary embolism (PE) accounts for up to 25% of early deaths after stroke. This is because the current diagnostic paradigm is reactive rather than proactive: the clinician responds to VTE when it becomes symptomatic, in ...
Shively B K - - 2001
Therapy to prevent deep venous thrombosis (DVT) and pulmonary embolism remains essential for inpatients, despite short periods of bedrest and hospitalization. Although most available data pertain to surgical patients, subgroups of medical patients are at moderate, high, and very high risk for DVT. These include patients admitted to the medical ...
Lip G Y - - 2001
Patients with chronic heart failure (heart failure) are at risk of thromboembolic events, including stroke, pulmonary embolism and peripheral arterial embolism, whilst coronary ischaemic events also contribute to the progression of heart failure. Long-term oral anticoagulation is established in certain groups, including patients with heart failure and atrial fibrillation but ...
Diet F - - 2000
The risk of thromboembolic complications in patients with heart failure and/or chronic left-ventricular systolic dysfunction is increased. Nevertheless, anticoagulant therapy in these patients is still a subject of debate. Atrial fibrillation is the only prospectively evaluated, proven thromboembolic risk factor and patients with atrial fibrillation benefit from long term anticoagulant ...
O'Gara P J - - 2000
The use of heparin-bonded cardiopulmonary bypass circuits (HBCs) with reduced anticoagulation protocol during cardiac surgery attenuates some of the adverse pathophysiologic responses to cardiopulmonary bypass (CPB). The strategies of how to maximize improvements in clinical outcomes using this technique are still debated. This article describes in detail a comprehensive approach ...
Schütt M - - 2000
Increased thrombin generation associated with resistance to activated protein C makes the latter a likely candidate for an increased risk of acute coronary events. Activated protein C resistance (factor V Leiden) on its own, however, appears to have no significant effect in this regard. We describe a case of recurrent ...
Zakynthinos E G - - 2000
We describe a previously healthy 28-year-old woman who presented with the clinical picture of large vessel occlusions (stroke with left hemiparesis, myocardial infarction) and developed multi-organ failure (i.e. kidneys, heart, brain, liver, blood, skin) over a very short period of time. Peripheral blood smear was consistent with thrombotic thrombocytopenic purpura. ...
Berndt N - - 2000
All mechanical heart valves are thrombogenic, and are associated with thromboembolic complications becomes ineffective. when anticoagulation Controversy exists with regard to the appropriate and safe anticoagulation regimen of gravid women with mechanical heart valve prostheses. While oral anticoagulants such as warfarin may be associated with fetal complications, the role of ...
Becker R C - - 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 activation, coagulation cascade stimulation and vascular endothelial cell injury. Although heparin (or other sulfated mucopolysaccharide compound) cessation represents ...
Miller F H - - 2000
Invasive aspergillosis is a rare but important cause of morbidity and mortality in patients with AIDS. In the majority of patients, invasive aspergillosis involves the lungs. Extrapulmonary involvement with total splenic infarction has not been previously described. We illustrate a patient who developed total splenic infarction and septic emboli to ...
Hogan W J WJ Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, - - 2000
Hemostatic aspects of antiphospholipid syndrome (APS) present unique challenges to clinicians and laboratory personnel alike, particularly in the perioperative period. These challenges are especially evident in patients requiring cardiac valve replacement surgery. However, the literature outlining the optimal approach in such patients is limited. We present the case of a ...
Pullicino P P Department of Neurology, State University of New York at Buffalo 14203, USA. - - 2000
Infarcts of the rostral brainstem often cause vertical gaze palsies but may also produce inappropriate convergence that manifests as pseudoabducens palsy and convergence-retraction nystagmus (CRN). Although the substrate for vergence has been defined in the monkey as lying dorsal and lateral to the oculomotor nucleus, the human homologue is unknown. ...
Fulton D R - - 2000
Kawasaki disease is the leading cause of acquired heart disease in childhood. Despite treatment with intravenous gamma globulin, 2% to 4% of patients have coronary abnormalities. Those with giant aneurysms are at risk for stenosis and myocardial ischemia/infarction, and require aggressive anticoagulation with frequent follow-up, including stress testing and coronary ...
Jick S S - - 2000
STUDY OBJECTIVE: To obtain formally quantified data on the relation of meloxicam to newly diagnosed gastrointestinal problems, myocardial infarction, or treated hypertension. DESIGN: Nested case-control study. SETTING: United Kingdom-based General Practice Research Database. PATIENTS: Patients who received prescriptions for meloxicam, diclofenac, naproxen, or piroxicam formed the study population. Cases were ...
Sun S S - - 2000
111In-oxine-labelled platelet heart scintigraphy (In-plt) was used to evaluate the activity of left atrial thrombi detected by transoesophageal echocardiography (TEE) in 16 cases of rheumatic heart disease. The effect of anticoagulants on the therapeutic intervention of these patients was evaluated by In-plt and TEE. In-plt was performed in all patients ...
Moudgil S S - - 2000
Background and Purpose-The fornix connects various structures involved in memory. We report a patient with anterograde amnesia after an acute ischemic infarct in the anterior fornix. Case Description-A 71-year-old female with acute-onset amnesia had neuroimaging studies showing ischemic infarction of both columns and the body of the fornix and the ...
Scatena R - - 2000
Bivalirudin (Angiomax, The Medicines Company) is a synthetic 20 amino acid peptide rationally designed on the basis of structural studies of hirudin, a naturally occurring anticoagulant. Bivalirudin represents a new class of anticoagulant drugs that directly inhibits thrombin, a key component in blood clot formation and extension. With its high ...
Iga K - - 2000
The present study analyzed the clinical backgrounds of 9 patients with fresh left ventricular thrombus (LVT) detected by two-dimensional echocardiography during the past 5 years. Patients with acute myocardial infarction were excluded. Left ventricular systolic function was disturbed either diffusely or segmentally in all patients with a mean ejection fraction ...
Onder F - - 2000
BACKGROUND: Isolated down-gaze palsy is the least common pathology of vertical gaze. Patients with low-gaze palsy may consult an ophthalmologist with difficulty in reading and this may be the only ocular finding of a central nervous system lesion. METHODS: A 43-year-old man with isolated down-gaze palsy was examined. The medical ...
Galante A - - 2000
To test whether Helicobacter pylori may contribute to the inflammatory response following myocardial infarction, the levels of IgG antibodies to Helicobacter pylori and some parameters of leukocyte activity were measured in 63 patients and 61 comparable controls. Helicobacter pylori-positive patients showed a significantly higher expression of the adhesion molecule LFA-1 ...
Rho R - - 2000
Systemic embolic complications in patients with cardiomyopathy are associated with significant morbidity and mortality. Despite the lack of prospective, randomized control data, the literature supports the use of left ventricular ejection fraction as an important determinant of the need for systemic anticoagulation therapy in patients with systolic dysfunction. This review ...
Agraharkar M - - 2000
Henoch-Schönlein purpura (HSP) is usually a mild condition involving the skin, gut, joints, and kidneys and has a good prognosis. We present a 63-year-old Hispanic man who had an unusually severe form of HSP with a fatal outcome attributable to vasculitis causing myocardial necrosis. There is only one citation in ...
Goldhaber S Z - - 2000
Massive pulmonary embolism (PE) is surprisingly common and is not necessarily heralded by dramatic symptoms or signs. The death rate from PE remains high, and the most common cause of mortality is recurrent PE, not cancer. Prevention of recurrent embolism with intensive anticoagulation remains the foundation of therapy. The Food ...
Gordon M B - - 2000
A case of multiple thrombotic diatheses discovered in the setting of mesenteric venous infarction is discussed. The patient had deficiencies of protein C, protein S, antithrombin III; was heterozygous for factor V Leiden; and had polycythemia vera. Adequate anticoagulation could not be established with heparin administration and hirudin was used. ...
Johnston N - - 1999
The most common anticoagulant used for cardiopulmonary bypass is heparin. An alternate form of anticoagulant therapy is needed for patients who have immune-mediated heparin-associated thrombocytopenia (HIT). Thrombocytopenia causes bleeding and may lead to serious arterial and venous thrombosis. HIT or heparin-induced thrombocytopenia with thrombosis type II (HITT) are both described ...
Maharaj S - - 1999
BACKGROUND: Standard thromboprophylaxis of patients with mechanical heart valves is achieved using warfarin. In certain patients this may be very difficult; thus, alternative pharmacotherapy must be used. OBJECTIVE: To report a case of a patient who successfully used dalteparin, a low-molecular-weight heparin, for anticoagulation. CASE SUMMARY: A 58-year-old white woman ...
Tangelder M J - - 1999
We sought to determine the efficacy of antiplatelet therapy and oral anticoagulants in maintaining graft patency and preventing ischemic complications in patients after infrainguinal bypass surgery. We performed a meta-analysis of randomized controlled trials of aspirin with or without other antiplatelet therapy and oral anticoagulants after infrainguinal bypass surgery. Outcome ...
Despotis G J - - 1999
The literature does not consistently support the importance of anticoagulation monitoring techniques during CPB. This is best reflected by studies that have evaluated the impact of the ACT method on blood loss and transfusion outcomes. Inconsistent findings from studies that evaluated the impact of ACT monitoring may be related to ...
Verheugt F W - - 1999
Insertion of a mechanical artificial heart valve is an absolute indication for the use of lifelong oral anticoagulation, irrespective the presence or absence of atrial fibrillation. Depending on the type and position of the artificial valve the optimal International Normalized Ratio (INR) for these patients is between 2.5 and 4.5, ...
Spanier T B - - 1999
Cardiac transplantation was successfully performed in a patient with end-stage ischemic cardiomyopathy and hereditary protein S deficiency who had undergone two previous coronary artery bypass graft procedures. Routine intraoperative heparinization and reversal with protamine was undertaken, and the antifibrinolytic agent aprotinin was infused throughout the procedure without perioperative hemorrhage or ...
Sachdev G P - - 1999
The recommendations of the Fifth American College of Chest Physicians (ACCP) Consensus Conference on Antithrombotic Therapy are reviewed, with a focus on outpatient anticoagulation management in adults. Numerous therapeutic recommendations have changed since the Fourth ACCP Consensus Conference on Antithrombotic Therapy. The system of grading recommendations has been modified to ...
Espínola-Zavaleta N - - 1999
BACKGROUND: A third to half of the patients with primary antiphospholipid syndrome have valve disease. METHODS AND RESULTS: The echocardiographic characteristics of primary antiphospholipid syndrome were analyzed, and the utility of treatment with anticoagulants and/or antiplatelet agents (acetylsalicylic acid) is examined with the use of transesophageal echocardiography in the evaluation ...
Choy J B - - 1999
The goal of anticoagulant therapy in unstable angina is to prevent progression of a subocclusive coronary thrombus to complete occlusion of the coronary artery, thereby preventing myocardial infarction and death. Although these have been many advances in therapy with anticoagulants, considerable morbidity and mortality remains. Also, although combination therapy with ...
Smith P - - 1999
Three long-term studies on oral anticoagulation, the Sixty Plus trial, the WARIS study, and the ASPECT trial all meet the methodological requirements for modern stand alone clinical trials: large number of patients, double-blinded, placebo-controlled design, and intention to treat analysis. All demonstrate significant reduction in recurrent myocardial infarction, and all ...
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