Search Results
Results 401 - 450 of 1389
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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 ...
Verheugt F W A - - 2005
Fibrinolysis is the reference treatment for most myocardial infarctions with ST-segment elevation; alternatives are angioplasty, with or without stent. The earlier fibrinolysis is performed (preferably before hospitalization), the more effective it is. It can be optimized by adjuvant antiplatelet therapy, such as aspirin, and probably by anticoagulant treatment as well. ...
Shanmugam Ganesh - - 2005
The final common pathway of platelet aggregation leading to coronary thrombosis involves cross-linking of platelet receptor glycoprotein IIb-IIIa by primarily fibrinogen. Glycoprotein IIb-IIIa antagonists are being increasingly used as adjunctive therapy during percutaneous coronary intevention, and have shown to reduce the risk of death and myocardial infarction. However, a proportion ...
Lim Michael J - - 2005
Few data exist on the use of aggressive combination therapy with thienopyridines and glycoprotein IIb/IIIa inhibitors in higher risk patients with an acute coronary syndrome (ACS). The aim of this study was to characterize the combined use of these agents and the associated hospital outcomes in patients with ACS enrolled ...
Arab Dinesh - - 2005
OBJECTIVE: To define the optimal antiplatelet regime in patients requiring long-term anticoagulation who undergo percutaneous coronary intervention. BACKGROUND: Antiplatelet therapy following coronary intervention consists of a regime of aspirin and clopidogrel for the prevention of subacute stent thrombosis. The optimal antiplatelet therapy post-coronary intervention in patients on ongoing anticoagulation therapy ...
Verma Vijay K - - 2005
PURPOSE: The goal of modern therapy of acute myocardial infarction is twofold: to achieve rapid reperfusion of ischemic myocardium and to decrease subsequent remodeling, which can have deleterious effects on ventricular function and prognosis. The current paradigm for treatment of most patients with acute coronary syndromes is the consideration of ...
Masoudi Frederick A - - 2005
OBJECTIVES: We sought to determine patterns of aspirin use and the relationship between aspirin prescription and outcomes in patients with coronary artery disease (CAD) and heart failure (HF). BACKGROUND: Because of the potential for exacerbating hypertension or renal insufficiency and possible interactions with angiotensin-converting enzyme (ACE) inhibitors, the use of ...
Massie Barry M - - 2005
There has been ongoing controversy as to whether aspirin should be used in patients with chronic heart failure (CHF). The argument for aspirin is that many patients have underlying coronary disease, and aspirin prevents reinfarction and other vascular events. Arguments against the routine use of aspirin are that many CHF ...
Portnay Edward L EL Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520, - - 2005
We sought to assess the association between prior aspirin use and mortality, all-cause readmission, and condition-specific readmission at one month and six months in a national sample of Medicare beneficiaries hospitalized with a confirmed myocardial infarction (MI). Prior aspirin use is considered a marker of higher risk in patients with ...
Andreotti Felicita - - 2006
AIMS: In patients recovering from acute coronary syndromes (ACS) the role of oral anticoagulation (and its intensity) in addition to aspirin remains controversial. We conducted a specific meta-analysis of randomized trials comparing aspirin plus warfarin (A+W) with aspirin alone in such patients. METHODS AND RESULTS: MEDLINE and Cochrane databases yielded ...
Hobikoglu Gultekin F - - 2005
Aspirin is widely used for secondary prevention of cardiovascular disease, but is not effective for all patients. This phenomenon is called as aspirin resistance. Although the prognosis is worse in patients who develop acute coronary syndrome (ACS) while using aspirin, the frequency of aspirin resistance in these patients has not ...
Ferguson James J - - 2005
Evaluation of: Sabatine MS, Cannon CP, Gibson CM et al.: CLARITY-TIMI 28 Investigators. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N. Engl. J. Med. 352, 1179-1789 (2005). The CLopiodogrel as Adjunctive ReperfusIon TherapY (CLARITY) - Thrombolysis In Myocardial Infarction (TIMI) 28 study was ...
Leong Jee-Yoong - - 2005
BACKGROUND: There is evidence that clopidogrel (with or without aspirin) confers superior outcomes in patients with coronary artery disease. The purpose of this study is to review the effect of preoperative clopidogrel administration on clinical outcome, bleeding complications and resource utilization after coronary artery bypass graft surgery. METHODS: Patient data ...
Jamieson Dara G - - 2005
Patients experiencing stroke or transient ischemic attack (TIA) are at high risk for recurrent (secondary) strokes, which comprise 29% of all strokes in the United States. Current recommendations for prevention of secondary stroke from the American College of Chest Physicians (ACCP) call for the broad use of platelet antiaggregation (antiplatelet) ...
Keating Friederike K - - 2005
OBJECTIVE: To characterize effects of bivalirudin compared with unfractionated heparin plus eptifibatide on inflammation, and thrombin generation and activity after percutaneous coronary intervention. METHODS: We measured the concentration in blood of fibrinopeptide A, prothrombin fragment 1+2, soluble CD40 ligand, interleukin 1 receptor antagonist, interleukin 6, and high sensitivity C-reactive protein ...
Bezerra Daniel C - - 2005
Clopidogrel (Plavix(R)) is a potent platelet inhibitor that has been demonstrated to be significantly more effective than aspirin for the prevention of atherothrombotic events in patients with established atherosclerotic disease in the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) study. Furthermore, the benefit of clopidogrel compared ...
Rothberg Michael B - - 2005
BACKGROUND: After the acute coronary syndrome, adding warfarin to standard aspirin therapy decreases myocardial infarction and stroke but increases major bleeding. PURPOSE: To quantify the risks and benefits of warfarin therapy after the acute coronary syndrome. DATA SOURCES: MEDLINE from 1990 to October 2004. Additional data were obtained from study ...
Bramkamp Matthias - - 2005
Acute coronary syndromes account worldwide for a significant burden of hospital- and societal costs. Pharmacotherapy of acute coronary syndromes consists of a combined antithrombotic therapy. Remarkable therapeutic advances have been made with the introduction of glycoprotein IIb/IIIa receptor inhibitors, low molecular weight heparins and thienopyridines, such as clopidogrel. Based on ...
Wallentin Lars - - 2005
Given the pivotal role of thrombin in the pathogenesis of acute coronary syndromes (ACS) and its persistent activation at the site of arterial lesions, antithrombin agents are essential for the prevention of coronary events. Antiplatelet agents are used routinely in the prevention of ACS, but their inability to prevent thrombin ...
Doggrell Sheila A - - 2005
Clopidogrel was shown to have added benefits to aspirin in patients with acute coronary syndromes without ST-segment elevation in the Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) trial. The cost in CURE was estimated to be US442 dollars greater in the clopidogrel group and the incremental cost-effectiveness ratio ...
Harrison Claire N CN Department of Haematology, University of Cambridge, and Addenbrooke's National Health Service Trust, Cambridge, United - - 2005
We conducted a randomized comparison of hydroxyurea with anagrelide in the treatment of essential thrombocythemia. A total of 809 patients with essential thrombocythemia who were at high risk for vascular events received low-dose aspirin plus either anagrelide or hydroxyurea. The composite primary end point was the actuarial risk of arterial ...
Spiess Bruce D - - 2005
Although heparin/protamine has been the standard anticoagulation regimen in cardiac surgery for decades, it induces negative reactions within the vasculature. Heparin-induced thrombocytopenia (HIT) is a highly prothrombotic immune reaction to heparin that may result in death, limb ischemia leading to amputation, graft occlusion, and other severe thrombotic events. Patients undergoing ...
Dunn Andrew S - - 2005
BACKGROUND: To better inform clinicians on the optimal management of patients on oral anticoagulation who need to undergo surgery or invasive procedures, the authors performed a decision analysis examining whether a perioperative aggressive or minimalist strategy results in greater quality-adjusted survival. METHODS: A decision analysis model was created comparing withholding ...
Rice Lawrence - - 2005
New treatment strategies based on the availability of alternative anticoagulants have improved outcomes for patients with heparin-induced thrombocytopenia (HIT). Patients with HIT are at an extreme risk of thrombosis even after the discontinuation of heparin. Maintaining a high degree of awareness and instituting alternative anticoagulation immediately on suspicion of HIT ...
Wiviott Stephen D - - 2005
BACKGROUND: Despite the current standard antiplatelet regimen of aspirin and clopidogrel (with or without glycoprotein IIb/IIIa inhibitors) in percutaneous coronary intervention patients, periprocedural and postprocedural ischemic events continue to occur. Prasugrel (CS-747, LY640315), a novel potent thienopyridine P2Y(12) receptor antagonist, has the potential to achieve higher levels of inhibition of ...
Sakuma Tadamichi - - 2005
OBJECTIVE: We tested the hypothesis that simultaneous inhibition of the endothelial integrin alpha(v)beta(3) and the platelet glycoprotein IIb/IIIa receptor will substantially reduce infarct size in a model of acute coronary thrombosis and primary angioplasty. METHODS: Dogs were subjected to thrombus formation in the left anterior descending coronary artery followed by ...
Dogan Abdullah - - 2005
BACKGROUND: Current reperfusion strategies may fail to achieve optimal tissue perfusion in ST-elevation myocardial infarction (STEMI). We investigated the effect of clopidogrel plus aspirin on tissue perfusion and coronary flow in infarct patients treated with fibrinolytic agents. METHODS: Consecutive 78 patients with STEMI were randomized to receive clopidogrel plus aspirin ...
Manikappa S - - 2005
We report the successful use of r-hirudin (lepirudin) for cardiopulmonary bypass in a 67-year-old man who developed heparin-induced thrombocytopenia type II during heparin treatment of an extensive deep venous thrombosis. Lepirudin was monitored by the modified ecarin clotting time in a "mobile laboratory" set up next to the cardiac theatre, ...
Galla John M - - 2005
Enoxaparin (Lovenox; Roule-Poulenc Rorer, Inc.), a low molecular weight heparin (LMWH), is commonly used in the management of non-ST-segment elevation acute coronary syndromes (NSTE ACS) based on clinical trial outcomes. It is one of a group of glycosaminoglycan compounds that accelerate the inactivation of factor Xa by inducing a conformational ...
Giugliano Robert P - - 2005
BACKGROUND: The recent North American and European practice guidelines in patients with non-ST-segment elevation acute coronary syndrome (nSTE ACS) recommend glycoprotein IIb/IIIa (GpIIb-IIIa) inhibition in patients undergoing an early invasive treatment strategy. However, the guidelines are not explicit regarding the timing of initiation of GpIIb-IIIa antagonists, and there is marked ...
Corman Shelby L - - 2005
OBJECTIVE: To examine the evidence of a pharmacodynamic interaction between aspirin and nonsteroidal antiinflammatory drugs (NSAIDs); specifically, to determine whether a deleterious relationship exists with respect to the cardioprotective effects of aspirin. DATA SOURCES: Primary articles were identified by a MEDLINE search (1966-May 2004). Search terms included aspirin, nonsteroidal antiinflammatory ...
Berger Peter B - - 2005
Renal function significantly impacts morbidity and mortality after a percutaneous coronary intervention. Platelet glycoprotein (GP) IIb/IIIa inhibitors reduce ischemic complications during percutaneous coronary intervention; little is known of whether their safety and efficacy are influenced by renal function. In particular, whether outcome differences exist between agents that are renally excreted ...
Schwartz Kenneth A - - 2005
The hypothesis that aspirin resistance is often due to noncompliance was investigated. One hundred ninety patients with a history of myocardial infarction were evaluated using arachidonic acid-stimulated light aggregometry at 3 different time points: while receiving their usual daily aspirin, after not receiving aspirin for 7 days, and 2 hours ...
Hankey Graeme J - - 2005
Antiplatelet therapy is effective for reducing the risk of recurrent stroke and other serious vascular events in patients with recent TIA and ischemic stroke. Effective antiplatelet agents include aspirin, ticlopidine, clopidogrel, dipyridamole, and the combination of aspirin and dipyridamole. The combination of aspirin and clopidogrel is more effective than aspirin ...
Ziakas Antonios - - 2005
A 76-year-old male was admitted with Braunwald IIIB unstable angina and treated with intravenous heparin. Coronary angiography 20 days later revealed a severe stenosis in the left circumflex artery. During coronary angioplasty thrombus developed in the circumflex artery, extended in the left main and lead to its occlusion. Normal left ...
Large G A - - 2005
This review focuses on the modern management of the non-ST elevation acute coronary syndromes (unstable angina and non-ST elevation myocardial infarction). Patients with these syndromes are at varying degrees of risk of (re)infarction and death. This risk can be reliably predicted by clinical, electrocardiographic, and biochemical markers. Aspirin, clopidogrel, heparin ...
Das Pranab - - 2005
Non-ST elevation Acute Coronary Syndrome (NSTE-ACS) is a myocardial ischemic disorder frequently caused by coronary artery plaque rupture and partial or transient vessel occlusion. Platelets and thrombin play pivotal roles in formation and propagation of thrombus at the site of plaque disruption and embolization into the vascular bed. With the ...
Mahaffey Kenneth W - - 2005
BACKGROUND: In patients with non-ST-elevation acute coronary syndromes (NSTE ACS), enoxaparin has been shown to be superior to unfractionated heparin (UFH) and is associated with a reduction in ischemic end points with nonsignificant increases in bleeding. However, the critical trials comparing enoxaparin with UFH were conducted before the widespread use ...
Chimowitz Marc I - - 2005
BACKGROUND: Atherosclerotic intracranial arterial stenosis is an important cause of stroke. Warfarin is commonly used in preference to aspirin for this disorder, but these therapies have not been compared in a randomized trial. METHODS: We randomly assigned patients with transient ischemic attack or stroke caused by angiographically verified 50 to ...
Patteril Mathew - - 2005
BACKGROUND: The activated clotting time (ACT) is a standard monitor for heparin anticoagulation during cardiopulmonary bypass (CPB). This study determines the effect of upgrading our ACT system on our clinical practice with regards to the conduct and safety of heparin anticoagulation during cardiopulmonary bypass. METHODS: We compared the intraoperative heparin ...
Gluckman Tyler J - - 2005
The incidence of antiplatelet factor-4/heparin antibody formation in patients who receive contemporary doses of unfractionated heparin in the setting of percutaneous coronary revascularization is unknown. Also unknown is the ability of these antibodies to activate platelets or adversely affect clinical outcome in the absence of clinically recognized heparin-induced thrombocytopenia. To ...
Weintraub William S - - 2005
OBJECTIVES: We sought to evaluate the long-term cost-effectiveness of clopidogrel for up to one year after an acute coronary syndrome (ACS) without ST-segment elevation. BACKGROUND: The efficacy of platelet inhibition with clopidogrel for up to one year after ACS was demonstrated in the Clopidogrel in Unstable angina to prevent Recurrent ...
Sabatine Marc S - - 2005
BACKGROUND: A substantial proportion of patients receiving fibrinolytic therapy for myocardial infarction with ST-segment elevation have inadequate reperfusion or reocclusion of the infarct-related artery, leading to an increased risk of complications and death. METHODS: We enrolled 3491 patients, 18 to 75 years of age, who presented within 12 hours after ...
Su Ho-Ming - - 2005
Heparin, a commonly used anticoagulant agent, is frequently used in patients undergoing hemodialysis. As with most medications, heparin has a significant side effect profile. Two of its most important side effects, major bleeding and hyperkalemia, may be devastating without immediate diagnosis and treatment. Major bleeding such as gastrointestinal, genitourinary or ...
Menozzi Alberto - - 2005
Acute coronary syndromes represent a major health problem in terms of incidence and mortality. Intracoronary platelet-rich thrombi may develop in response to plaque rupture, and are involved in the pathogenesis of all acute coronary syndromes. The glycoprotein IIb/IIIa receptor, a platelet surface integrin, plays a key role in platelet aggregation ...
Alexander J H - - 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. OBJECTIVE: To investigate the efficacy and safety of a direct, selective factor Xa inhibitor, DX-9065a (Daiichi Pharmaceuticals LTD, Inc.) ...
Cay Serkan - - 2005
Clopidogrel is an effective antiplatelet agent and is useful in the prevention of stroke, myocardial infarction, and related vascular death in patients with vascular disease. Intracranial hemorrhage related with using antithrombotic agents, including clopidogrel can occur. We report a case of a 68-year-old-man who developed intracranial bleeding following clopidogrel usage ...
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