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Fibrinolysis stroke

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https://www.readbyqxmd.com/read/28211169/a-first-in-human-study-of-ds-1040-an-inhibitor-of-the-activated-form-of-thrombin-activatable-fibrinolysis-inhibitor-in-healthy-subjects
#1
Jin Zhou, Jarema Kochan, Ophelia Yin, Vance Warren, Cynthia Zamora, George Atiee, Joseph Pav, Yasushi Orihashi, Vijay Vashi, Victor Dishy
BACKGROUND: Current treatments for acute ischemic stroke and venous thromboembolism, such as recombinant tissue plasminogen activator and thrombectomy, are limited by a narrow time window and the risk of bleeding. DS-1040 is a novel low-molecular weight compound inhibiting the activated form of thrombin-activatable fibrinolysis inhibitor (TAFIa), developed as a fibrinolysis enhancer for treatment of thromboembolic diseases. OBJECTIVES: This first-in-human, randomized, placebo-controlled, three-part, phase 1 study was conducted to evaluate the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of DS-1040 in healthy subjects...
February 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28188400/-juvenile-stroke-what-is-important
#2
M Fischer, B Eckert, J Röther
Stroke in young adults is a diagnostic and therapeutic challenge for all persons involved. Approximately 15% of ischemic strokes occur in young adults. Lack of awareness of the symptoms in emergency departments often results in delayed diagnosis and access to specific therapeutic options, such as revascularization. The causes are often heterogeneous and necessitate specific investigations. The etiology of juvenile stroke includes drug abuse, vasculitis and arteriopathies, such as reversible vasoconstriction syndrome and posterior reversible encephalopathy syndrome, although the prevalence of classical vascular risk factors is high...
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28169020/description-of-stroke-mimics-after-complete-neurovascular-assessment
#3
C Avellaneda-Gómez, A Rodríguez Campello, E Giralt Steinhauer, A Gómez González, M Serra Martínez, P de Ceballos Cerrajería, A Zabalza de Torres, E Cuadrado-Godia, A Ois Santiago, J Jiménez-Conde, J Roquer
INTRODUCTION: A considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with small samples. OBJECTIVE: The purpose of our study is to identify conditions that may present as SM, define their epidemiological and clinical characteristics, and determine the percentage of cases of SM treated with intravenous fibrinolysis...
February 4, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28116631/translational-initiatives-in-thrombolytic-therapy
#4
REVIEW
Melvin E Klegerman
Once thrombi have formed as part of the pathology defining myocardial infarction, ischemic stroke, peripheral arterial disease, deep venous thrombosis or other embolic disorders, the only clinically meaningful thrombolytic agents available for reversing the thrombogenic process are various plasminogen activators. These agents are enzymes that reverse fibrin polymerization underlying the coagulation process by converting endogenous plasminogen to plasmin, which cleaves the fibrin network to form increasingly smaller protein fragments, a process known as fibrinolysis...
January 23, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28089539/reperfusion-therapy-in-patients-with-acute-ischaemic-stroke-caused-by-cervical-artery-dissection
#5
L A Crespo Araico, R Vera Lechuga, A Cruz-Culebras, C Matute Lozano, A de Felipe Mimbrera, P Agüero Rabes, E Viedma Guiard, C Estévez Fraga, J Masjuan Vallejo
INTRODUCTION: Cervical artery dissection (CAD) is responsible for up to 20% of all ischaemic strokes in patients younger than 45. The benefits of acute-phase reperfusion therapy in these patients have yet to be confirmed. METHODS: We conducted a retrospective review of patients with CAD admitted to a comprehensive stroke centre between 2010 and 2015. We recorded baseline clinical characteristics, treatments, functional outcomes, and mortality. RESULTS: We identified 35 cases of CAD (23 carotid/12 vertebral); mean age was 43...
January 12, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/27846459/simplifying-electrocardiographic-assessment-in-stemi-reperfusion-management-pros-and-cons
#6
REVIEW
Cheuk-Kit Wong
Current guidelines on STEMI reperfusion management do not incorporate further electrocardiographic details over the presence of significant ST elevation. Fibrinolysis is considered an alternative therapy to primary PCI if there is a long PCI-related delay, but the 2 therapies should not be combined. Meanwhile, reperfusion for ischemic stroke has evolved on mechanistic understanding - reperfusion benefit being greatest in the patient with small "core" infarct and large ischemic "penumbra". Fibrinolysis is not regarded as an alternative to mechanical thrombectomy, and the 2 therapies can be combined...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27821064/the-prognostic-utility-of-grace-risk-score-in-predictive-cardiovascular-event-rate-in-stemi-patients-with-successful-fibrinolysis-and-delay-intervention-in-non-pci-capable-hospital-a-retrospective-cohort-study
#7
Yotsawee Chotechuang, Arintaya Phrommintikul, Roungtiva Muenpa, Jayanton Patumanond, Tuanchai Chaichuen, Srun Kuanprasert, Noparat Thanachikun, Thanawat Benjanuwatra, Apichard Sukonthasarn
BACKGROUND: Fibrinolytic therapy is the main reperfusion therapy for most STEMI patients in several countries. Current practice guidelines recommended routine early pharmacoinvasive (within 3-24 h after successful fibrinolysis, however it cannot be performed in timely fashion due to limitation of PCI-capable hospitals. This study aimed to evaluate the prognostic utility of the GRACE score in patients receiving delayed intervention after successful fibrinolysis in non PCI-capable hospital...
November 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27814743/prehospital-fibrinolysis-versus-primary-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Vincent Roule, Pierre Ardouin, Katrien Blanchart, Adrien Lemaitre, Julien Wain-Hobson, Damien Legallois, Joachim Alexandre, Rémi Sabatier, Paul Milliez, Farzin Beygui
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI), but its benefit over prehospital fibrinolysis (FL) is not clear. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials in which outcomes of patients with STEMI managed with FL early in the prehospital setting versus PPCI were compared. RESULTS: Compared with PPCI, FL was consistently associated with similar rates of short-term (30-90 days) death (relative risk [RR] 0...
November 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27812152/the-comparison-of-the-outcomes-between-primary-pci-fibrinolysis-and-no-reperfusion-in-patients-%C3%A2-75-years-old-with-st-segment-elevation-myocardial-infarction-results-from-the-chinese-acute-myocardial-infarction-cami-registry
#9
He Peiyuan, Yang Jingang, Xu Haiyan, Gao Xiaojin, Xian Ying, Wu Yuan, Li Wei, Wang Yang, Tang Xinran, Yan Ruohua, Jin Chen, Song Lei, Zhang Xuan, Fu Rui, Ye Yunqing, Dong Qiuting, Sun Hui, Yan Xinxin, Gao Runlin, Yang Yuejin
BACKGROUND: Only a few randomized trials have analyzed the clinical outcomes of elderly ST-segment elevation myocardial infarction (STEMI) patients (≥ 75 years old). Therefore, the best reperfusion strategy has not been well established. An observational study focused on clinical outcomes was performed in this population. METHODS: Based on the national registry on STEMI patients, the in-hospital outcomes of elderly patients with different reperfusion strategies were compared...
2016: PloS One
https://www.readbyqxmd.com/read/27669126/endothelial-cell-senescence-and-thrombosis-ageing-clots
#10
REVIEW
Magdalena L Bochenek, Eva Schütz, Katrin Schäfer
Age is an important cardiovascular risk factor. Among others, age is associated with an increased risk to develop thrombotic cardiovascular complications, both in the arterial (acute myocardial infarction, stroke) and the venous (deep vein thrombosis, pulmonary embolism) system, which cannot be explained by the age-associated increase in cardiovascular risk factors alone. A number of studies have demonstrated that the accumulation of senescent endothelial cells and specific phenotypic and functional alterations associated with endothelial cell senescence may play an important role during the development and progression of cardiovascular disease...
November 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27664152/endovascular-treatment-of-thrombosis-and-embolism
#11
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27582112/pharmacoinvasive-strategy-versus-primary-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction-a-propensity-score-matched-analysis
#12
Doo Sun Sim, Myung Ho Jeong, Youngkeun Ahn, Young Jo Kim, Shung Chull Chae, Taek Jong Hong, In Whan Seong, Jei Keon Chae, Chong Jin Kim, Myeong Chan Cho, Seung-Woon Rha, Jang Ho Bae, Ki Bae Seung, Seung Jung Park
BACKGROUND: The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute ST-elevation or Non-ST-elevation Myocardial Infarction 2015 suggested that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PPCI). We sought to assess the clinical impact of pharmacoinvasive strategy compared with PPCI in real-world patients with ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We used the Korea Acute Myocardial Infarction Registry to identify ST-segment-elevation myocardial infarction patients receiving either pharmacoinvasive strategy defined as fibrinolysis followed by percutaneous coronary intervention (rescue/urgent or routine elective; n=708) or PPCI (n=8878)...
September 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27514779/evaluation-of-hypercoagulability-state-in-perinatal-arterial-ischemic-stroke-with-rotation-thromboelastometry
#13
Ozan Kocak, Coskun Yarar, Ayşe Bozkurt Turhan, Olga Meltem Akay, Kursat Bora Carman, Ayten Yakut
BACKGROUND: Perinatal arterial ischemic stroke (PAIS) is an important cause of pediatric morbidity and mortality. The etiology of PAIS remains unknown. Several maternal-neonatal disorders, and especially prothrombotic risk factors, have been reported in infants with perinatal stroke (PS). Rotation thromboelastometry (ROTEM) can analyze the coagulation system, from the beginning of coagulation, through clot formation, and ending with fibrinolysis. The aim of this study was to evaluate the hypercoagulability state in PAIS patients using ROTEM...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27470988/inhibition-of-thrombin-activatable-fibrinolysis-inhibitor-and-plasminogen-activator-inhibitor-1-reduces-ischemic-brain-damage-in-mice
#14
Frederik Denorme, Tine Wyseure, Miet Peeters, Nele Vandeputte, Ann Gils, Hans Deckmyn, Karen Vanhoorelbeke, Paul J Declerck, Simon F De Meyer
BACKGROUND AND PURPOSE: Cerebral ischemia and reperfusion is associated with activation of the coagulation cascade and fibrin deposition in cerebral microvessels. Both thrombin-activatable fibrinolysis inhibitor (TAFI) and plasminogen activator inhibitor-1 (PAI-1) attenuate fibrinolysis and are therefore attractive targets for the treatment of ischemic stroke. METHODS: TAFI and PAI-1 were inhibited by monoclonal antibodies in a mouse model of transient middle cerebral artery occlusion...
September 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27469579/analysis-of-the-new-code-stroke-protocol-in-asturias-after-one-year-experience-at-one-hospital
#15
C García-Cabo, L Benavente, J Martínez-Ramos, Á Pérez-Álvarez, A Trigo, S Calleja
INTRODUCTION: Prehospital code stroke (CS) systems have been proved effective for improving access to specialised medical care in acute stroke cases. They also improve the prognosis of this disease, which is one of the leading causes of death and disability in our setting. The aim of this study is to analyse results one year after implementation of the new code stroke protocol at one hospital in Asturias. PATIENTS AND METHODS: We prospectively included patients who were admitted to our tertiary care centre as per the code stroke protocol for the period of one year...
July 25, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/27412192/a-multicenter-randomized-trial-on-neuroprotection-with-remote-ischemic-per-conditioning-during-acute-ischemic-stroke-the-remote-ischemic-conditioning-in-acute-brain-infarction-study-protocol
#16
Fernando Pico, Charlotte Rosso, Elena Meseguer, Marie-Laure Chadenat, Amina Cattenoy, Philippe Aegerter, Sandrine Deltour, Jennifer Yeung, Hassan Hosseini, Yves Lambert, Didier Smadja, Yves Samson, Pierre Amarenco
RATIONALE: Remote ischemic per-conditioning-causing transient limb ischemia to induce ischemic tolerance in other organs-reduces final infarct size in animal stroke models. AIM: To evaluate whether remote ischemic per-conditioning during acute ischemic stroke (<6 h) reduces brain infarct size at 24 h. METHODS AND DESIGN: This study is being performed in five French hospitals using a prospective randomized open blinded end-point design...
July 13, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27387478/changes-in-activated-thrombin-activatable-fibrinolysis-inhibitor-levels-following-thrombolytic-therapy-in-ischemic-stroke-patients-correlate-with-clinical-outcome
#17
Marie-Christine Alessi, Christophe Gaudin, Philippe Grosjean, Valérie Martin, Serge Timsit, Marie-Hélène Mahagne, Vincent Larrue, Igor Sibon, Mathieu Zuber, Raf Brouns, Joan Montaner, Mar Castellanos, Yves Donazzolo, Tae-Hee Cho, Laurent Suissa, Laura Mechtouff, Laurent Derex, Pierre Suchon, Anna Mezzapesa, Norbert Nighoghossian
BACKGROUND AND PURPOSE: Thrombin-activatable fibrinolysis inhibitor (TAFI) activation following thrombolysis may affect thrombolysis effectiveness in acute ischemic stroke (AIS). To support this hypothesis, we propose to study the relationship between TAFI consumption, activated/inactivated TAFI (TAFIa/ai) and stroke severity and outcome in 2 groups of AIS patients, one treated and one untreated with intravenous recombinant tissue type plasminogen activator (rt-PA). METHODS: In this prospective, longitudinal, multicenter, observational study, we aimed to study the association between TAFIa/ai and stroke outcome...
2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27362966/plasminogen-and-stroke-more-is-better
#18
R L Medcalf
No abstract text is available yet for this article.
September 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27357914/haemostatic-biomarkers-are-associated-with-long-term-recurrent-vascular-events-after-ischaemic-stroke
#19
Annie Pedersen, Petra Redfors, Linnea Lundberg, Ann Gils, Paul J Declerck, Staffan Nilsson, Katarina Jood, Christina Jern
Ischaemic stroke patients continue to be at risk for recurrent vascular events for many years. Predictors of long-term prognosis are needed. It was the objective of this study to investigate levels of four haemostatic proteins as long-term predictors of recurrent vascular events after ischaemic stroke. We prospectively followed 548 ischaemic stroke patients, 18-69 years, and registered recurrent vascular events. Plasma levels of tissue-type plasminogen activator (t-PA), von Willebrand factor (VWF), fibrinogen and thrombin activatable fibrinolysis inhibitor activation peptide (TAFI-AP) were measured three months after index stroke...
August 30, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27320247/the-correlation-of-d-dimer-levels-with-patient-outcomes-in-acute-ischemic-cerebrovascular-disease-complicating-coronary-heart-disease
#20
Yanling Wang, Adam Hafeez, Fanhua Meng, Ruihua Zhang, Xuemei Wang, Xiaomeng Chen, Qi Kong, Huishan Du, Xin Ma
OBJECTIVE: To investigate the correlation between nerve function defect, their degree of recovery, and D-dimer levels in patients with acute ischemic cerebrovascular disease (AICVD) complicating coronary heart disease (CHD) in winter. METHODS: From 1 October, 2014 to 31 December, 2014, we enrolled patients in a consecutive manner with AICVD who were hospitalized in the Department of Neurology, Beijing Luhe hospital, Capital Medical University. The patients were selected that had an occurrence of AICVD within the last 14 days...
June 2016: Neurological Research
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