| The thrombin hypothesis in ACS: a disappointing disconnect between bench data and bedside clinical trials. | |
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MedLine Citation:
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PMID: 20103015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Studies have demonstrated the efficacy and safety of unfractionated heparin and low-molecular-weight heparin in the management of patients with acute coronary syndrome. However, a common limitation of unfractionated heparin and low-molecular-weight heparin is that neither can neutralize clot-bound thrombin. To overcome this limitation of the broad heparin-based anticoagulants, novel anticoagulants targeted for both the free and clot-bound forms of thrombin (direct thrombin inhibitors), or other individual components of the coagulation cascade (eg, direct and indirect factor Xa inhibitors), were developed. These targeted anticoagulation agents showed promising results in preclinical testing and have been evaluated in large-scale clinical acute coronary syndrome trials. This review discusses the disconnect between the excellent preclinical findings obtained with these novel, targeted agents and the efficacy and safety data observed in patients with acute coronary syndrome, compared with the broader-range heparin-based anticoagulants. |
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Authors:
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Marc Cohen |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The American journal of medicine Volume: 123 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-27 Completed Date: 2010-02-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 103-10 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiology, Newark Beth Israel Medical Center, Newark, NJ; Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA. marcohen@sbhcs.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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drug therapy* Anticoagulants / therapeutic use* Factor Xa / antagonists & inhibitors Heparin / therapeutic use* Humans Platelet Aggregation Inhibitors / therapeutic use Protease Inhibitors / therapeutic use Thrombin / antagonists & inhibitors* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 0/Protease Inhibitors; 9005-49-6/Heparin; EC 3.4.21.5/Thrombin; EC 3.4.21.6/Factor Xa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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