Search Results
Results 351 - 400 of 1385
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Yeh Robert W - - 2006
Unfractionated heparin has historically been used as the anticoagulant of choice in the management of a number of thrombotic diseases. Recognition of the limitations of heparin has led to the development of a newer class of anticoagulants, the direct thrombin inhibitors. Argatroban is a synthetic small molecule that selectively inhibits ...
Morrow David A - - 2006
BACKGROUND: Despite advances in antithrombotic therapies and invasive technology, the risk of recurrent ischemic complications in patients with non-ST-elevation acute coronary syndromes (NSTE-ACSs) remains substantial. Ranolazine is a novel agent that inhibits the late sodium current thereby reducing cellular sodium and calcium overload and has been shown to reduce ischemia ...
La Manna Alessio - - 2006
The optimal management of acute myocardial infarction in elderly people (>or= 75 years) is controversial because elderly patients have been excluded or are under-represented in most acute myocardial infarction trials. Randomized studies show that, also in the elderly, thrombolytic therapy is effective in reducing mortality after acute myocardial infarction but ...
Boshkov Lynn K - - 2006
Repeated exposure to unfractionated heparin is the rule in many congenital heart disease patients. Heparin-induced thrombocytopenia occurs in 1% to 3% of adult cardiac surgeries, and carries high thrombotic morbidity (38% to 81%) and mortality (approximately 28%). Although heparin-induced thrombocytopenia appears to be infrequent in pediatric patients, particularly neonates, our ...
Rivera Juanita M JM Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minn 55905, - - 2006
We describe a 61-year-old woman with "broken heart syndrome" (Takotsubo-like cardiomyopathy) after abrupt postsurgical withdrawal of OxyContin. Her medical history was remarkable for long-term opiold dependence associated with the treatment of multi-Joint degenerative osteoarthritis. The patient presented to the emergency department 1 day after discharge from the hospital following total ...
Armstrong Paul W - - 2006
BACKGROUND: The optimal antithrombotic therapy to accompany tenecteplase in cases of acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We undertook a prespecified pooled analysis of data from the ASSENT-3 and ASSENT-3 PLUS trials. METHODS: We created a combined database of the 2040 and 818 patients who received enoxaparin in ...
Rasoul Saman - - 2006
AIMS: To compare dual vs. triple antiplatelet pre-treatment in patients with non-ST-elevation acute coronary syndrome (NSTE ACS) who were planned for early catheterization. METHODS AND RESULTS: A total of 328 consecutive patients with NSTE ACS were included and were randomized to pre-treatment with dual (n = 166, aspirin, clopidogrel 600 ...
Chakraborty Rabin - - 2006
During the last decade there has been a revolutionary change in the management of acute coronary syndrome (ACS). Despite this, many patients die because of failure of reaching the hospital well in time and reluctance together with fear attached to commence aggressive pharmacological and catheter intervention on the part of ...
Zeymer Uwe - - 2006
In randomized clinical trials, low-molecular-weight heparin enoxaparin has been shown to decrease ischemic complications in patients with acute coronary syndromes (ACSs) without ST elevations who are treated conservatively. Enoxaparin has been shown to be equally effective as unfractionated heparin in high-risk patients with an early invasive approach. Little is known ...
Abdallah Mouhamad - - 2007
We analyze the patterns of utilization of glycoprotein (GP) IIb/IIIa inhibitors in patients with non-ST-elevation myocardial infarction (NSTEMI) in a tertiary medical center in a developing country and we compare it to data from the national registry of myocardial infarction 4 (NRMI 4) in the USA. GP IIb/IIIa inhibitors were ...
Khurram Zakaria - - 2006
Dual antiplatelet therapy of aspirin and a thienopyridine is the standard of care following coronary stenting. Patients who are on chronic warfarin therapy and receive a coronary stent need to be treated with the triple therapy of aspirin, clopidogrel and warfarin; however, the bleeding risk in these patients is unknown. ...
Schoenhoff F - - 2006
Glycoprotein-IIb/IIIa inhibitors are now frequently used in the cardiological treatment of high-risk coronary patients even if the patient is considered suitable for surgical intervention. However, there is no consensus whether GPIIb/IIIa inhibitors should be stopped before operation because of an increased risk of bleeding or if surgery should even be ...
Inoue Tadao - - 2006
The antiplatelet agent, cilostazol, is known to reduce the risk of subsequent cerebral infarction. However, the cost effectiveness of such treatment in comparison to aspirin has not been studied. A Markov model was developed to calculate the health outcomes and associated costs for 65-year-old patients with cerebral infarction who were ...
Antman Elliott M - - 2006
BACKGROUND: Unfractionated heparin is often used as adjunctive therapy with fibrinolysis in patients with ST-elevation myocardial infarction. We compared a low-molecular-weight heparin, enoxaparin, with unfractionated heparin for this purpose. METHODS: We randomly assigned 20,506 patients with ST-elevation myocardial infarction who were scheduled to undergo fibrinolysis to receive enoxaparin throughout the ...
Wong P - - 2006
To examine the 21 month clinical outcome and bleeding complications in hospital survivors with non-ST segment elevation acute coronary syndromes (NSTEACS) who were discharged with combined clopidogrel and aspirin anti-thrombotic therapy, and compare with those having ST segment elevation myocardial infarction (STEMI) who were discharged with aspirin alone. Observational study. ...
Matthai William H WH - - 2006
Heparin-induced thrombocytopenia (HIT) is an antibody-mediated syndrome associated with heparin exposure, a falling platelet count and a high risk of thrombosis. Cardiovascular patients are at increased risk of HIT due to wide use of heparin in this population. Should HIT be suspected, heparin must be avoided in most situations, and ...
O'Donoghue Michelle - - 2006
The combination of aspirin, heparin, and fibrinolytics was established in the late 1980s and early 1990s as the foundation for pharmacologic reperfusion therapy for ST-elevation myocardial infarction (STEMI). Since that time, many attempts have been made to improve on this regimen with limited success. In the late 1990s, primary percutaneous ...
Puma Joseph A - - 2006
OBJECTIVES: In order to determine a differential benefit from treatment, we compared the long-term outcome of high-risk versus low-risk patients and evaluated survival free from death or myocardial infarction at one year. BACKGROUND: Newer anticoagulant strategies during percutaneous coronary intervention have necessitated a reanalysis of the role of intravenous GP ...
Rao Sunil V - - 2006
OBJECTIVES: The goal of this study was to determine the association between Thrombolysis In Myocardial Infarction (TIMI) and Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) bleeding and clinical outcomes. BACKGROUND: There are limited data on the relative utility of either scale at predicting clinical outcomes in patients ...
Hatice Selcuk
Glycoprotein IIb/ IIIa inhibitors and thienopyridine improve clinical outcomes of patients undergoing primary percutaneus coronary intervention. We present a case of a 74-year-old woman with acute anterior myocardial infarction, treated with primary coronary intervention in whom spontanoeus lingual hematoma was observed after co-administration of tirofiban and clopidogrel. This case emphasizes ...
Silva Matthew A - - 2006
The role of glycoprotein (Gp) IIb/IIIa receptor antagonists remains controversial and these agents are infrequently utilized during non-ST-segment elevation acute coronary syndromes (NSTE-ACS) despite American Heart Association/American College of Cardiology guidelines. Despite recommendations, the NRMI-4 (National Registry of Myocardial Infarction 4) and CRUSADE (Can rapid risk stratification of unstable angina ...
Fisher Marc - - 2006
The secondary prevention of ischemic stroke is aided by the use of antiplatelet therapy, and the predominant current choices are aspirin, aspirin plus extended-release dipyridamole, and clopidogrel. The potential utility of combining platelet antiaggregants with different mechanisms of action proved successful with aspirin plus extended-release dipyridamole, and this approach has ...
Curran Monique P - - 2006
Eptifibatide (Integrilin) is a highly specific, reversible, intravenously administered glycoprotein IIb/IIIa receptor antagonist that acts at the final common step of the platelet aggregation pathway. Data from large clinical trials indicate that intravenous eptifibatide as adjunctive therapy to standard care is effective in patients with non-ST-segment elevation (NSTE) acute coronary ...
Murdoch David - - 2006
Triflusal (Aflen, Disgren, Tecnosal, Triflux) is a novel platelet antiaggregant with structural similarities to salicylates, but which is not derived from aspirin. It has similar efficacy to aspirin in patients with cerebral or myocardial infarction, but has a reduced risk of haemorrhagic complications. In addition, triflusal plus moderate-intensity anticoagulation has ...
Natarajan Madhu K - - 2006
BACKGROUND: Direct comparison of low-molecular-weight heparin, dalteparin, with unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) is limited. This study examined the relative effects of dalteparin and UFH on coagulation and angiographic and clinical indices during PCI. METHODS: This was a double-blind randomized study, stratified by planned glycoprotein IIb/IIIa inhibitor ...
Tran Huyen - - 2006
The pathogenesis of ST-elevation myocardial infarction (STEMI) involves plaque disruption, platelet aggregation and intracoronary artery thrombus formation. Aspirin is the cornerstone of antiplatelet therapy in patients with STEMI, reducing the risk of recurrent myocardial infarction or death during the acute phase and long term by about one-quarter. Recent large randomized ...
Mitrovska S - - 2006
OBJECTIVE: The primary objective of this study is to analyse relationship between activated partial thromboplastin time (aPTT) and clinical events in patients with unstable coronary artery disease. BACKGROUND: Unfractionated heparin (UFH) is considered as a standard therapy in the management of unstable coronary artery disease. His efficacy is concerned to ...
Wang Xu-Kai - - 2006
BACKGROUND: Acute myocardial infarction (AMI) is one of the most serious cardiovascular diseases, with acute ST-segment elevation myocardial infarction (STEMI) showing a higher mortality rate than non-ST-segment elevation myocardial infarction (NSTEMI). There is evidence that low-molecular-weight heparin (LMWH) shows greater efficacy than unfractionated heparin (UFH). This open-label, single-centre, randomised study ...
Serebruany Michael V - - 2006
Heparin remains the most commonly used anticoagulant in the treatment of patients with acute vascular syndromes, including myocardial infarction, unstable angina and ischaemic stroke. However, heparin therapy is not always associated with a significant improvement of clinical outcomes, is linked with enhanced bleeding risk and can occasionally provoke the development ...
Bukow Simone C - - 2006
Tirofiban is one of three glycoprotein IIb/IIIa receptor antagonists approved by the US FDA, beside abciximab and eptifibatide. The approval of tirofiban covers conservative treatment of myocardial infarction and unstable angina, as well as percutaneous coronary intervention, for which treatment with tirofiban is recommended in moderate-to-high-risk patients. The efficacy of ...
Kou Victoria - - 2006
Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) represent two common, closely related acute coronary syndromes with potentially high morbidity and mortality. Integration of information from the history, physical exam, electrocardiogram, and cardiac biomarkers is used to formulate both the diagnosis of UA/NSTEMI and the overall assessment of patient ...
Steinhubl Steven R - - 2006
Antiplatelet therapy is the cornerstone of treatment for patients with an acute coronary syndrome (ACS). However, patients presenting with possible ACS are a heterogeneous population, and there is a choice of many potential combination antiplatelet therapies, with aspirin, thienopyridines (eg, clopidogrel), and glycoprotein (GP) IIb/IIIa antagonists. The ISAR-REACT-2 trial investigated ...
Kandzari David E - - 2006
The recognition that thrombosis is fundamental to acute coronary syndromes (ACS) has inspired the development of novel therapies to inhibit platelet aggregation and thrombus formation. Several recent advances have been made in the management of patients undergoing percutaneous coronary revascularization and those with acute coronary syndromes to improve early and ...
Bakhai Ameet - - 2006
More than 1.2 million percutaneous coronary intervention (PCI) procedures are performed each year in the United States, with average hospital costs of more than $10,000 per procedure. Despite ongoing improvements in device technology and adjunct pharmacology, both ischemic complications (eg, periprocedural myocardial infarction) and bleeding complications remain relatively common and ...
Dickie Jennifer S - - 2006
Clopidogrel bisulfate (hereafter, clopidogrel), a selective inhibitor of ADP-induced platelet aggregation, is approved for the reduction of atherothrombotic events in patients with ST-segment elevation myocardial infarction (STEMI). In COMMIT/CCS-2, a well designed trial in 45,852 adult patients with STEMI, relative to aspirin alone, clopidogrel 75 mg/day plus aspirin treatment significantly ...
Lee Michael S - - 2006
The standard of care for patients with acute coronary syndrome is antithrombotic and antiplatelet therapies along with early percutaneous coronary intervention. Because of the limitations of heparin, there has been an interest in direct thrombin inhibitors, such as bivalirudin, which is now the anticoagulant of choice in percutaneous coronary intervention.
Turpie Alexander G G - - 2006
The death rate of patients with ST-segment elevation myocardial infarction (STEMI) remains substantial. Fondaparinux is a synthetic selective Factor Xa inhibitor with a high efficacy and good safety, in terms of bleeding risk, in the prevention and treatment of venous thromboembolism, and in the treatment of non-ST elevation acute coronary ...
Yang Y-J - - 2006
To compare the effects of an aspirin-clopidogrel combination with those of the specific glycoprotein IIb/IIIa inhibitor tirofiban on myocardial no-reflow, nitric oxide concentration and activity of nitric oxide synthase (NOS) isoforms in a mini-swine model of acute myocardial infarction and reperfusion. Area of no-reflow was determined by both myocardial contrast ...
Almsherqi Zakaria A - - 2007
Antiplatelet treatment for patients undergoing percutaneous coronary interventions is a rapidly changing area. Thienopyridines derivatives (ticlopidine and clopidogrel) have shown to decrease major cardiovascular events. Ticlopidine can cause rare but serious side effects, especially during the first 3 months of treatment. Clopidogrel appears to be a safer alternative to ticlopidine. ...
Lekakis John P - - 2006
BACKGROUND: The safe use of selective inhibitors of cyclooxygenase-2 in patients with cardiovascular disease has been questioned because of studies showing an increased risk of cardiac events. We examined the short-term effect of rofecoxib, a selective cyclooxygenase-2 inhibitor, on endothelial function, oxidative damage and inflammation in patients with acute coronary ...
Brieger David B - - 2005
Patients presenting with acute coronary syndromes without ST elevation on their electrocardiogram continue to contribute an important healthcare burden. Medical treatments to control symptoms include nitrates and beta-blockers. Morphine is a very effective analgesic although its use may be associated with adverse outcomes. Oral antiplatelet therapies including aspirin and clopidogrel ...
Ebrahimi Ramin - - 2005
OBJECTIVE: This study evaluates outcomes with bivalirudin vs heparin in various patient subgroups and the overall population during percutaneous coronary interventions (PCI). BACKGROUND: Recent data suggest that bivalirudin, a reversible direct thrombin inhibitor, provides ischemic protection superior to heparin and comparable to heparin plus glycoprotein (GP) IIb/IIIa inhibitors but with ...
Benke Stanley - - 2005
Up to 50% of patients undergoing coronary artery bypass surgery will develop antibodies against the heparin-platelet factor 4 complex, and a small percentage of those will go on to develop heparin-induced thrombocytopenia. Thrombotic thrombocytopenic purpura has also been reported post-coronary artery bypass surgery. In this case report, we describe a ...
De Lorenzo F - - 2005
Cardiovascular diseases are the major cause of morbidity and mortality in the Western countries and their prevalence is increasing in developing world. The final biological evolution of atherosclerotic process, supporting development and progression of cardiovascular diseases, is thrombosis. In the most recent years several clinical trails have established that low ...
- - 2005
BACKGROUND: Factor Xa plays a central role in the generation of thrombin, making it a novel target for treatment of arterial thrombosis. Fondaparinux, a synthetic pentasaccharide, is a factor Xa inhibitor, which has been shown to be superior to enoxaparin for the prevention of venous thrombosis. We designed a large, ...
Sabatine Marc S - - 2005
BACKGROUND: Low-molecular-weight heparin (LMWH) offers pharmacological and practical advantages over unfractionated heparin (UFH). Whether these advantages translate into greater infarct-related artery patency and fewer adverse clinical events in patients with ST-elevation myocardial infarction (STEMI) receiving fibrinolytic therapy remains under study. METHODS AND RESULTS: We compared angiographic and clinical outcomes in ...
Konstantino Yuval - - 2006
BACKGROUND: Although clopidogrel and aspirin (dual therapy, DT) are used for acute coronary syndrome (ACS), sometimes treatment with warfarin (triple therapy, TT) is required. AIM: To determine the incidence, complications, and outcomes of TT. METHODS: We analyzed Israeli surveys of ACS from 2000 to 2004. RESULTS: In these surveys, 5,706 ...
de Feyter Pj - - 2005
Complications during percutaneous coronary intervention remain of great concern and in particular, intracoronary thrombus formation is an unwanted complication associated with mortality and morbidity. This has been prevented with the use of intense anticoagulant treatment, but often at the price of minor and major bleeding complications. Traditionally, unfractionated heparin has ...
Mehta Sameer K - - 2005
PURPOSE OF REVIEW: This review focuses on recent developments in three controversial areas of management of acute coronary syndromes. RECENT FINDINGS: There are potential benefits of an early invasive treatment strategy (routine cardiac catheterization and revascularization when appropriate) in the elderly, who are at high risk for adverse outcomes and ...
Chisholm Robert J - - 2005
A 90-year-old male underwent coronary stenting following a bout of coronary insufficiency. Coronary stenting was performed 6 hr following the last dose of low-molecular-weight heparin but was complicated by extensive intrastent clot formation. Low-molecular-weight heparin in the absence of a glycoprotein IIb/IIIa receptor blocker may be insufficient during percutaneous coronary ...
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