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Fibrinolysis stroke

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https://www.readbyqxmd.com/read/29649768/the-level-of-circulating-fibroblast-activation-protein-correlates-with-incorporation-of-alpha-2-antiplasmin-into-the-fibrin-clot
#1
Shirley Uitte de Willige, Joyce J C M Malfliet, Shiraazkhan Abdul, Frank W G Leebeek, Dingeman C Rijken
INTRODUCTION: Circulating fibroblast activation protein (cFAP) cleaves alpha-2-antiplasmin (α2AP) N-terminally, converting native Met-α2AP into Asn-α2AP. Previous studies in purified model systems showed that Asn-α2AP is faster incorporated into a fibrin clot by activated factor XIII than Met-α2AP, making the fibrin clot more resistant to fibrinolysis. The objective was to investigate whether cFAP level in plasma associated with the amount of α2AP incorporation into fibrin in a new plasma-based clotting assay...
April 3, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29625717/prospective-observational-study-in-elderly-patients-with-non-valvular-atrial-fibrillation-rationale-and-design-of-the-all-nippon-af-in-the-elderly-anafie-registry
#2
Hiroshi Inoue, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Takanori Ikeda, Ken Okumura, Yukihiro Koretsune, Wataru Shimizu, Hiroyuki Tsutsui, Kazunori Toyoda, Atsushi Hirayama, Masahiro Yasaka, Takenori Yamaguchi, Masahiro Akishita, Naoyuki Hasebe, Kazuomi Kario, Yuji Mizokami, Ken Nagata, Masato Nakamura, Yasuo Terauchi, Takatsugu Yamamoto, Satoshi Teramukai, Tetsuya Kimura, Jumpei Kaburagi, Atsushi Takita
BACKGROUND: Although anticoagulation effectively prevents stroke in patients with atrial fibrillation (AF), it has been underused in elderly AF patients for many reasons, mainly because of knowledge gaps regarding cardiovascular treatment of these populations with multiple comorbidities and poor prognosis. The objectives of the All Nippon AF In the Elderly (ANAFIE) Registry are to collect real-world information about the clinical status of patients with non-valvular AF (NVAF) aged ≥75 years, current status of anticoagulant therapy, and prognosis with/without anticoagulation to establish a database for this specific patient population that is increasing remarkably worldwide...
April 3, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29604354/thrombin-like-enzymes-from-snake-venom-structural-characterization-and-mechanism-of-action
#3
REVIEW
Anwar Ullah, Rehana Masood, Ijaz Ali, Kifayat Ullah, Hamid Ali, Haji Akbar, Christian Betzel
Snake venom thrombin-like enzymes (SVTLEs) constitute the major portion (10-24%) of snake venom and these are the second most abundant enzymes present in the crude venom. During envenomation, these enzymes had shown prominently the various pathological effects, such as disturbance in hemostatic system, fibrinogenolysis, fibrinolysis, platelet aggregation, thrombosis, neurologic disorders, activation of coagulation factors, coagulant, procoagulant etc. These enzymes also been used as a therapeutic agent for the treatment of various diseases such as congestive heart failure, ischemic stroke, thrombotic disorders etc...
March 28, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29525822/ticagrelor-vs-clopidogrel-after-fibrinolytic-therapy-in-patients-with-st-elevation-myocardial-infarction-a-randomized-clinical-trial
#4
Otavio Berwanger, Jose C Nicolau, Antonio C Carvalho, Lixin Jiang, Shaun G Goodman, Stephen J Nicholls, Alexander Parkhomenko, Oleg Averkov, Carlos Tajer, Germán Malaga, Jose F K Saraiva, Francisco A Fonseca, Fábio A De Luca, Helio P Guimaraes, Pedro G M de Barros E Silva, Lucas P Damiani, Denise M Paisani, Camila M R Lasagno, Carolina T Candido, Nanci Valeis, Diogo D F Moia, Leopoldo S Piegas, Christopher B Granger, Harvey D White, Renato D Lopes
Importance: The bleeding safety of ticagrelor in patients with ST-elevation myocardial infarction treated with fibrinolytic therapy remains uncertain. Objective: To evaluate the short-term safety of ticagrelor when compared with clopidogrel in patients with ST-elevation myocardial infarction treated with fibrinolytic therapy. Design, Setting and Participants: We conducted a multicenter, randomized, open-label with blinded end point adjudication trial that enrolled 3799 patients (younger than 75 years) with ST-segment elevation myocardial infarction receiving fibrinolytic therapy in 152 sites from 10 countries from November 2015 through November 2017...
March 11, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29476447/release-of-il-6-after-stroke-contributes-to-impaired-cerebral-autoregulation-and-hippocampal-neuronal-necrosis-through-nmda-receptor-activation-and-upregulation-of-et-1-and-jnk
#5
William M Armstead, Hugh Hekierski, Philip Pastor, Serge Yarovoi, Abd Al-Roof Higazi, Douglas B Cines
The sole FDA-approved drug treatment for ischemic stroke is tissue-type plasminogen activator (tPA). However, upregulation of JNK mitogen-activated protein kinase (MAPK) and endothelin 1 (ET-1) by tPA after stroke contributes to impaired cerebrovascular autoregulation. Wild-type (wt) tPA can bind to the lipoprotein-related receptor (LRP), which mediates vasodilation, or NMDA receptors (NMDA-Rs), exacerbating vasoconstriction. Elevations in IL-6, a marker of inflammation that accompanies stroke, are reported to be an adverse prognostic factor...
February 23, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29378443/thrombolysis-in-pregnancy-a-literature-review
#6
Marina Sousa Gomes, Mariana Guimarães, Nuno Montenegro
BACKGROUND: Changes in the coagulation system during pregnancy and puerperium produce a physiological hypercoagulable state. These changes are thought to be the cause of the higher rates of deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, and mechanical prosthetic valve thrombosis (PVT) during pregnancy. Thrombolysis can be a treatment option in this case. However, there are no available data from randomized controlled trials in pregnant patients and information about the security of thrombolytics in pregnancy is missing...
February 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29378352/atherothrombosis-and-thromboembolism-position-paper-from-the-second-maastricht-consensus-conference-on-thrombosis
#7
H M H Spronk, T Padro, J E Siland, J H Prochaska, J Winters, A C van der Wal, J J Posthuma, G Lowe, E d'Alessandro, P Wenzel, D M Coenen, P H Reitsma, W Ruf, R H van Gorp, R R Koenen, T Vajen, N A Alshaikh, A S Wolberg, F L Macrae, N Asquith, J Heemskerk, A Heinzmann, M Moorlag, N Mackman, P van der Meijden, J C M Meijers, M Heestermans, T Renné, S Dólleman, W Chayouâ, R A S Ariëns, C C Baaten, M Nagy, A Kuliopulos, J J Posma, P Harrison, M J Vries, H J G M Crijns, E A M P Dudink, H R Buller, Y M C Henskens, A Själander, S Zwaveling, O Erküner, J W Eikelboom, A Gulpen, F E C M Peeters, J Douxfils, R H Olie, T Baglin, A Leader, U Schotten, B Scaf, H M M van Beusekom, L O Mosnier, L van der Vorm, P Declerck, M Visser, D W J Dippel, V J Strijbis, K Pertiwi, A J Ten Cate-Hoek, H Ten Cate
Atherothrombosis is a leading cause of cardiovascular mortality and long-term morbidity. Platelets and coagulation proteases, interacting with circulating cells and in different vascular beds, modify several complex pathologies including atherosclerosis. In the second Maastricht Consensus Conference on Thrombosis, this theme was addressed by diverse scientists from bench to bedside. All presentations were discussed with audience members and the results of these discussions were incorporated in the final document that presents a state-of-the-art reflection of expert opinions and consensus recommendations regarding the following five topics: 1...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29313576/pharmacological-reperfusion-therapy-with-tenecteplase-in-7-668-indian-patients-with-st-elevation-myocardial-infarction-a-real-world-indian-experience
#8
S S Iyengar, Tiny Nair, Jagdish Hiremath, Anjan Lal Dutta, Uday Jadhav, V K Katyal, Dayanand Kumbla, Immaneni Sathyamurthy, R K Jain, M Srinivasan, Prasant Kr Sahoo
Objective: This real-world, observational, prescription event monitoring study was conducted to evaluate safety and efficacy of indigenous tenecteplase (TNK-tPA) in Indian patients presenting with ST elevation myocardial infarction (STEMI). Methods: This is a multi-centric, observational, prescription event monitoring study. Data was collected for 7,668 patients from 1,307 investigator sites across India from January 2011 to February 2016. Results: Overall, 76...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29304524/amino-fucoidan-as-a-vector-for-rtpa-induced-fibrinolysis-in-experimental-thrombotic-events
#9
Radouane Ghebouli, Stephane Loyau, Murielle Maire, Pierre Saboural, Jean-Philippe Collet, Martine Jandrot-Perrus, Didier Letourneur, Frédéric Chaubet, Jean-Baptiste Michel
Acute ischaemic stroke, myocardial infarction and pulmonary embolism are the main causes of mortality and morbidity worldwide. Thrombolysis by intravenous injection of recombinant tissue plasminogen activator (rtPA) remains the most common non-interventional treatment to recanalize occluded vessels. However, this procedure is limited by significant drawbacks, including high doses and bleeding complications. Recent studies showed that fucoidan targets the intraluminal thrombus in vivo. We have developed a chimaera covalently linking fucoidan, able to target platelets within the thrombus, to dilysine, able to non-covalently bind rtPA...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29262432/spontaneous-intraventricular-hemorrhage-when-should-intraventricular-tpa-be-considered
#10
Peter A Abdelmalik, Wendy C Ziai
Spontaneous intracerebral hemorrhage (ICH) is the most common cause of intraventricular hemorrhage (IVH) in adults. Complicating approximately 40% of ICH cases, IVH adds to the morbidity and mortality of this often fatal form of stroke. It is also a severity factor that complicates subarachnoid hemorrhage and traumatic brain injury, along with other less common causes of intracranial bleeding. Medical and surgical interventions to date have focused on limiting ICH and IVH expansion, controlling intracranial pressure, and relieving obstructive hydrocephalus...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29259732/edaravone-a-synthetic-free-radical-scavenger-enhances-alteplase-mediated-thrombolysis
#11
Kiyoshi Kikuchi, Kentaro Setoyama, Ko-Ichi Kawahara, Tomoka Nagasato, Takuto Terashi, Koki Ueda, Kazuki Nakanishi, Shotaro Otsuka, Naoki Miura, Hisayo Sameshima, Kazuya Hosokawa, Yoichiro Harada, Binita Shrestha, Mika Yamamoto, Yoko Morimoto-Yamashita, Haruna Kikuchi, Ryoji Kiyama, Chinatsu Kamikokuryo, Salunya Tancharoen, Harutoshi Sakakima, Motohiro Morioka, Eiichiro Tanaka, Takashi Ito, Ikuro Maruyama
The combination of alteplase, a recombinant tissue plasminogen activator, and edaravone, an antioxidant, reportedly enhances recanalization after acute ischemic stroke. We examined the influence of edaravone on the thrombolytic efficacy of alteplase by measuring thrombolysis using a newly developed microchip-based flow-chamber assay. Rat models of embolic cerebral ischemia were treated with either alteplase or alteplase-edaravone combination therapy. The combination therapy significantly reduced the infarct volume and improved neurological deficits...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29251337/-analysis-of-the-direct-costs-associated-with-mechanical-thrombectomy-and-intravenous-fibrinolysis-in-the-hospital-universitario-central-de-asturias
#12
P Vega-Valdes, E Murias-Quintana, E Morales-Santos, H Cigarran-Sexto, D Larrosa-Campo, L Benavente-Fernandez, M Gonzalez-Delgado, S Calleja-Puerta, F Garcia-Arias
INTRODUCTION: The increase in the indications for mechanical thrombectomy and its implementation in Spanish hospitals makes it necessary to determine the costs related to this treatment so as to be able to streamline economic resources and allow them to be distributed in an appropriate manner. AIMS: To analyse the direct costs associated with patients with acute ischaemic stroke who are treated with intravenous fibrinolysis and with mechanical thrombectomy, and to assess the effectiveness and safety of both treatments during the first 90 days of progression in the Hospital Universitario Central de Asturias...
January 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29236169/current-treatment-of-central-retinal-artery-occlusion-a-national-survey
#13
Teddy S Youn, Patrick Lavin, Morgan Patrylo, Joseph Schindler, Howard Kirshner, David M Greer, Matthew Schrag
BACKGROUND: Central retinal artery occlusion (CRAO) is an ophthalmological emergency, the retinal analog of a stroke. To date there is no consensus or national guidelines on how this disorder should be managed. As academic neurologists and ophthalmologists treat CRAO frequently, we set out to understand how these clinicians approach patients with CRAO with a national survey. METHODS: We identified university-associated teaching hospitals offering vascular neurology, neuro-ophthalmology and/or retina fellowships in the US and asked the directors of the programs to respond to questions in an open response format to profile the acute management of CRAO at their institution...
February 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29216502/intraventricular-hemorrhage-related-to-avm-rupture-description-outcomes-and-impact-of-intraventricular-fibrinolysis
#14
Vianney Gilard, Thomas Metayer, Clement Gakuba, Olivier Langlois, François Proust, Evelyne Emery, Thomas Gaberel
OBJECTIVES: Arteriovenous malformation (AVM) rupture could lead to intraventricular hemorrhage (IVH), a particularly severe form of intracranial bleeding. The epidemiology, presentation, management and outcomes of IVH related to AVM rupture have not been clearly addressed yet. The aim of the present study was to investigate the characteristics of IVH related to AVM rupture, with particular attention paid to functional outcomes and to the impact of intraventricular fibrinolysis (IVF). PATIENTS AND METHODS: Between 2011 and 2015, all patients suffering from IVH admitted in two tertiary neurosurgical centers were included in a prospective register...
January 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29153848/-maternal-death-by-stroke-results-from-the-french-enquiry-into-maternal-deaths-2010-2012
#15
H Cohen, M Rossignol
Stroke is a rare event during pregnancy (10/100,000) and can be ischemic (24%), hemorrhagic (74%) or both (2%). Pregnancy probably increases the risk even if it is discussed for arteriovenous malformation (AVM), aneurismal subarachnoid hemorrhage (SAH) and cavernomas. Between 2010 and 2012, 31 maternal deaths were associated with stroke. In 22 cases, stroke was the direct cause of death giving a maternal mortality ratio of 0,9/100,000 witch is not different from the former report (2007-2009). There were 2 cerebral thrombophlebitis, 2 ischemic strokes and 18 hemorrhagic strokes (4 SAH, 2 AVM)...
December 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29138181/one-year-outcome-of-intensive-insulin-therapy-combined-to-glucose-insulin-potassium-in-acute-coronary-syndrome-a-randomized-controlled-study
#16
Wahid Bouida, Kaouthar Beltaief, Mohamed Amine Msolli, Nasri Bzeouich, Adel Sekma, Malek Echeikh, Malek Mzali, Hamdi Boubaker, Mohamed Habib Grissa, Riadh Boukef, Mohsen Hassine, Zohra Dridi, Asma Belguith, Fadhel Najjar, Ines Khochtali, Semir Nouira
BACKGROUND: A number of factors may offset the cardioprotective effects of glucose-insulin-potassium (GIK) on outcome of patients with acute coronary syndrome, such as hyperglycemia induced by this cocktail infusion. We performed a study to evaluate the effect of intensive insulin therapy in association with GIK on 1-year outcome in patients hospitalized for acute coronary syndrome. METHODS AND RESULTS: In a randomized prospective controlled trial we included 772 patients with non-ST-segment elevation acute coronary syndrome...
November 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29115440/aspirin-ameliorates-cerebral-infarction-through-regulation-of-tlr4-nf%C3%A2-%C3%AE%C2%BAb%C3%A2-mediated-endoplasmic-reticulum-stress-in-mouse-model
#17
Xin Wang, Bin Shen, Dezhou Sun, Xiangyu Cui
Cerebral infarction is a cerebrovascular disease caused by local brain ischemic necrosis or softening, which is associated with diabetes, obesity, hypertension and rheumatic heart arrhythmia. Previous studies have indicated that aspirin is a potential oral anticoagulant in the treatment of cerebral ischemic stroke. However, the potential mechanism mediated by aspirin in cerebral infarction therapy is not well understood. The present study analyzed the therapeutic effects of aspirin on cerebral infarction and investigated the underlying molecular mechanism of aspirin‑ameliorated benefits for thrombolysis...
January 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29039441/rivaroxaban-attenuates-thrombosis-by-targeting-the-nf-%C3%AE%C2%BAb-signaling-pathway-in-a-rat-model-of-deep-venous-thrombus
#18
Junhao Ma, Xinxi Li, Yang Wang, Zhenwei Yang, Jun Luo
Anticoagulant therapy is commonly used for the prevention and treatment of patients with deep venous thrombus. Evidence has shown that rivaroxaban is a potential oral anticoagulant drug for the acute treatment of venous thromboembolism. However, the rivaroxaban-mediated molecular mechanism involved in the progression of deep venous thrombosis has not been investigated. In the present study, we investigated the efficacy of rivaroxaban and the underlying signaling pathways in the prevention and treatment of rats with deep venous thrombosis...
September 29, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28973661/cerebral-ischemic-reperfusion-injury-following-recanalization-of-large-vessel-occlusions
#19
Fawaz Al-Mufti, Krishna Amuluru, William Roth, Rolla Nuoman, Mohammad El-Ghanem, Philip M Meyers
Although stroke has recently dropped to become the nation's fifth leading cause of mortality, it remains the top leading cause of morbidity and disability in the US. Recent advances in stroke treatment, including intravenous fibrinolysis and mechanical thromboembolectomy, allow treatment of a greater proportion of stroke patients than ever before. While intra-arterial fibrinolysis with recombinant tissue plasminogen is an effective for treatment of a broad range of acute ischemic strokes, endovascular mechanical thromboembolectomy procedures treat severe strokes due to large artery occlusions, often resistant to intravenous drug...
July 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28958393/reliability-of-point-of-care-coagulometer-measurements-in-patients-with-acute-ischaemic-stroke-receiving-intravenous-fibrinolysis
#20
D Guisado-Alonso, F Fayos-Vidal, J Martí-Fàbregas, L Prats-Sánchez, R Marín-Bueno, A Martínez-Domeño, R Delgado-Mederos, P Camps-Renom
BACKGROUND: Speed of administration conditions the effectiveness of intravenous fibrinolysis in treating acute ischaemic stroke. To reduce the risk of haemorrhagic complications, the intervention is contraindicated in certain cases, such as where the International Normalised Ratio (INR) is ≥ 1.7. This study aimed to determine the reliability of point-of-care INR readings (POC-INR) taken using the CoaguChek(®) XS portable coagulometer compared to laboratory results (L-INR). METHODS: We conducted a retrospective observational study of consecutive patients admitted to our centre with acute ischaemic stroke and who were treated with intravenous fibrinolysis, over a period of 4 years...
September 25, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
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