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https://www.readbyqxmd.com/read/28549218/exosite-2-directed-ligands-attenuate-protein-c-activation-by-the-thrombin-thrombomodulin-complex
#1
Kai Chen, Alan R Stafford, Chengliang Wu, Calvin Yeh, Paul Y Kim, James C Fredenburgh, Jeffrey I Weitz
Thrombin activity, inhibition, and localization are regulated by two exosites that flank the active site. Substrates, cofactors and inhibitors bind to exosite 1 to promote active site access, whereas exosite 2 interactions retain thrombin on cells, platelets, and proteins. The exosites also serve allosteric roles, whereby ligand binding alters thrombin activity. Previously, we showed that ligands that bind exosite 2 attenuate the exosite 1-mediated interaction of thrombin with fibrin, demonstrating allosteric connection between the exosites...
May 26, 2017: Biochemistry
https://www.readbyqxmd.com/read/28548953/from-rapalogs-to-anti-aging-formula
#2
Mikhail V Blagosklonny
Inhibitors of mTOR, including clinically available rapalogs such as rapamycin (Sirolimus) and Everolimus, are gerosuppressants, which suppress cellular senescence. Rapamycin slows aging and extends life span in a variety of species from worm to mammals. Rapalogs can prevent age-related diseases, including cancer, atherosclerosis, obesity, neurodegeneration and retinopathy and potentially rejuvenate stem cells, immunity and metabolism. Here, I further suggest how rapamycin can be combined with metformin, inhibitors of angiotensin II signaling (Losartan, Lisinopril), statins (simvastatin, atorvastatin), propranolol, aspirin and a PDE5 inhibitor...
May 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#3
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develops atrial fibrillation after CTI ablation. No uniform recommendations are available to guide anticoagulation regimes or ECG monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: Ablation strategy, oral anticoagulation (OAC) management and ECG monitoring after successful cavotricuspid isthmus (CTI) ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28546529/the-safety-of-electrical-cardioversion-under-the-control-of-transesophageal-echocardiography-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#4
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AF) requires adequate oral anticoagulation (OAC) prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    Assessment of risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of DCC under transesophageal echocardiography control (TEE) in patients with inadequate anticoagulation. PATIENTS AND METHODS    From the cohort of 316 patients admitted for DCC, 139 (age 63...
May 25, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28546438/specific-antidotes-for-bleeding-associated-with-direct-oral-anticoagulants
#5
Allison Burnett, Deborah Siegal, Mark Crowther
No abstract text is available yet for this article.
May 25, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28546279/impact-of-residual-pulmonary-obstruction-on-the-long-term-outcome-of-patients-with-pulmonary-embolism
#6
Raffaele Pesavento, Lucia Filippi, Antonio Palla, Adriana Visonà, Carlo Bova, Marco Marzolo, Fernando Porro, Sabina Villalta, Maurizio Ciammaichella, Eugenio Bucherini, Giovanni Nante, Sandra Battistelli, Maria Lorenza Muiesan, Giampietro Beltramello, Domenico Prisco, Franco Casazza, Walter Ageno, Gualtiero Palareti, Roberto Quintavalla, Simonetta Monti, Nicola Mumoli, Nello Zanatta, Roberto Cappelli, Marco Cattaneo, Valentino Moretti, Francesco Corà, Mario Bazzan, Angelo Ghirarduzzi, Anna Chiara Frigo, Massimo Miniati, Paolo Prandoni
The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28546102/after-failure-with-acenocoumarol-rivaroxaban-in-antiphospholipid-syndrome-a-report-of-2-cases
#7
Javier José Mateos Rodríguez, David Bellido, David Castro, José Portillo Sánchez, Raúl Vanegas, Alicia Núñez García
Antiphospholipid syndrome is characterized by abortions or thrombotic phenomena associated with specific antibodies. Anticoagulant therapy is based on vitamin K antagonists. We present two cases in which the use of rivaroxaban achieved control of the disease after the failure of acenocoumarol.
May 22, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28545622/warfarin-and-the-risk-of-stroke-and-bleeding-in-patients-with-atrial-fibrillation-receiving-dialysis-a-systematic-review-and-meta-analysis
#8
REVIEW
Ziv Harel, Glenn M Chertow, Prakesh S Shah, Shai Harel, Paul Dorian, Andrew T Yan, Gustavo Saposnik, Manish M Sood, Amber O Molnar, Jeffrey Perl, Rachel M Wald, Sam Silver, Ron Wald
BACKGROUND: Patients with atrial fibrillation who receive dialysis are at a high risk of ischemic stroke. The role of warfarin in mitigating this risk in patients with atrial fibrillation who receive dialysis is uncertain. Our objective was to examine the safety and efficacy of warfarin in patients who have atrial fibrillation and receive dialysis. METHODS: We used MedLine, Embase, and the Cochrane Library to conduct a systematic review and meta-analysis of published and unpublished observational and interventional studies related to the use of warfarin in patients with atrial fibrillation who receive dialysis, and provided data on the risk of stroke and/or bleeding outcomes relative to placebo or no anticoagulation therapy...
June 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28544618/a-method-for-maintaining-vascular-access-when-impella-exchange-is-required
#9
B Scott Cook, Cleve Wilson, Brooke Kaiser, Raj Baljepally
A 45-year old male with no prior cardiac history, presented with cardiogenic shock in the setting of an anterolateral ST elevation myocardial infarction. We first placed a 2.5 Impella for hemodynamic support, and proceeded with emergent percutaneous coronary intervention to the proximal LAD. Several hours following percutaneous coronary intervention (PCI), the patient became acutely hypotensive and an echocardiogram revealed the Impella catheter was kinked within the left ventricle. The patient was taken back to the cath lab for Impella adjustment; however, damage to the distal catheter required the Impella be exchanged...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28544489/thromboembolic-and-bleeding-complications-during-oral-anticoagulation-therapy-in-cancer-patients-with-atrial-fibrillation-a-danish-nationwide-population-based-cohort-study
#10
Anne G Ording, Erzsébet Horváth-Puhó, Kasper Adelborg, Lars Pedersen, Paolo Prandoni, Henrik T Sørensen
Coexisting cancer in patients with atrial fibrillation (AF) has been associated with thromboembolism and bleeding. We used Danish population-based medical databases to conduct a population-based cohort study that included all AF patients who redeemed a prescription for vitamin K antagonists (VKA) or non-VKA oral anticoagulant (NOAC) between July 2004 and December 2013. We characterized these patients according to the presence (N = 11,855) or absence (N = 56,264) of a cancer diagnosis before redemption of their oral anticoagulant prescription, and then examined their 1-year risk of thromboembolic or bleeding complications or death...
May 19, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28544422/assessment-of-clinically-relevant-bleeding-as-a-surrogate-outcome-for-major-bleeding-validation-by-meta-analysis-of-randomized-controlled-trials
#11
S Laporte, C Chapelle, L Bertoletti, E Ollier, P Zufferey, J-C Lega, A Merah, H Décousus, S Schulman, G Meyer, M Cucherat, P Mismetti
BACKGROUND: Clinically relevant bleeding (CRB), comprising major bleeding and clinically relevant non-major bleeding, has been used as a surrogate for major bleeding in most anticoagulant trials, but its validity for estimating compromise between thrombotic and bleeding events has never been assessed. METHODS: We systematically reviewed randomized phase III trials comparing new anticoagulants with standard of care for venous thromboembolism prevention following major orthopedic surgery, venous thromboembolism (VTE) treatment, or stroke and systemic embolism prevention in atrial fibrillation (AF), and reporting both major bleeding and CRB rates...
May 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28544302/predictors-of-delay-to-cystoscopy-and-adequacy-of-investigations-in-patients-with-haematuria
#12
Brian Ngo, Nathan Papa, Marlon Perera, Damien Bolton, Shomik Sengupta
OBJECTIVE: To identify factors that impact on the timeliness and adequacy of haematuria evaluation. PATIENTS AND METHODS: We undertook a retrospective cohort study identifying patients who underwent cystoscopy for investigation of haematuria at our institution between 1 January 2015 and 31 December 2015. Data on patient demographics, smoking status, anticoagulation, type of haematuria and referring clinician were collected. Exclusion criteria included patient age <18 years, known history of bladder/urinary tract/renal cancer, cystoscopy for indications other than haematuria and unknown date of urology consultation...
May 2017: BJU International
https://www.readbyqxmd.com/read/28544292/perioperative-adverse-events-in-patients-on-continued-anticoagulation-undergoing-photoselective-vaporisation-of-the-prostate-with-the-180-w-greenlight-lithium-triborate-laser
#13
Georgia L Knapp, Venu Chalasani, Henry H Woo
OBJECTIVES: To compare perioperative factors and adverse events (AEs) in men undergoing photoselective vaporisation of the prostate (PVP) with or without continued anticoagulation therapy. PATIENTS AND METHODS: Retrospective review of a PVP database of men treated with the 180-W lithium triborate (LBO) laser from 2010 to 2016. Of 373 men, 59 underwent PVP with continued anticoagulant therapy, which was defined as treatment with heparin, warfarin, clopidogrel, dipyridamol or new oral anticoagulant drugs...
May 2017: BJU International
https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#14
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28544166/clinical-features-of-extremely-elderly-patients-with-heart-failure
#15
Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Takamasa Sato, Satoshi Suzuki, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
AIM: To investigate the clinical features of heart failure in extremely elderly patients. METHODS: We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years-of-age, n = 88) and a non-extremely elderly group (<85 years-of-age, n = 1075). RESULTS: The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β-blockers and anticoagulants compared with the non-extremely elderly group...
May 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28544091/a-new-predictive-model-for-acute-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-a-cohort-study
#16
Akira Shimomura, Naoyoshi Nagata, Takuro Shimbo, Toshiyuki Sakurai, Shiori Moriyasu, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Junichi Akiyama, Naomi Uemura
BACKGROUND: We developed a predictive model of long-term gastrointestinal (GI) bleeding risk in patients receiving oral anticoagulants and compared it with the HAS-BLED score. METHODS: We periodically followed a cohort of 508 patients taking oral anticoagulants (66 direct oral anticoagulants users and 442 warfarin users). Absence of GI bleeding at an initial examination, and any subsequent GI bleeding, were confirmed endoscopically. The bleeding model was developed by multivariate survival analysis and evaluated by Harrell's c-index...
May 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28543980/multicenter-analysis-of-the-use-of-transjugular-intrahepatic-portosystemic-shunt-tips-for-management-of-mpn-associated-portal-hypertension
#17
Christopher R Reilly, Daria V Babushok, Karlyn Martin, Jerry L Spivak, Michael Streiff, Ranjeeta Bahirwani, Jeffrey Mondschein, Brady Stein, Alison Moliterno, Elizabeth O Hexner
BCR-ABL1-negative myeloproliferative neoplasms (MPNs) are clonal stem cell disorders defined by proliferation of one or more myeloid lineages, and carry an increased risk of vascular events and progression to myelofibrosis and leukemia. Portal hypertension (pHTN) occurs in 7-18% of MPN patients via both thrombotic and nonthrombotic mechanisms and portends a poor prognosis. Transjugular intrahepatic portosystemic shunt (TIPS) has been used in the management of MPN-associated pHTN; however, data on long-term outcomes of TIPS in this setting is limited and the optimal management of medically refractory MPN-associated pHTN is not known...
May 24, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28543543/cardiac-implantable-electronic-device-haematomas-risk-factors-and-effect-of-prophylactic-pressure-bandaging
#18
Youlin Koh, Nicholas E Bingham, Natalie Law, Dustin Le, Justin A Mariani
BACKGROUND: Cardiac implantable electronic device (CIED) haematomas are associated with many adverse outcomes. We examined the incidence and risk factors associated with haematoma formation post CIED implantation, and explored the preventative effect of prophylactic pressure bandaging (PPB) in a large tertiary centre. METHODS: 1091 devices were implanted during October 2011 to December 2014. Clinically significant haematomas (CSH) were those that necessitated prolonged admission, including those due to reoperation, and clinically suspicious haematomas were swellings noted by medical/nursing staff...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543401/oral-anticoagulation-management-in-patients-with-atrial-fibrillation-undergoing-cardiac-implantable-electronic-device-implantation
#19
Eric Black-Maier, Sunghee Kim, Benjamin A Steinberg, Gregg C Fonarow, James V Freeman, Peter R Kowey, Jack Ansell, Bernard J Gersh, Kenneth W Mahaffey, Gerald Naccarelli, Elaine M Hylek, Alan S Go, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Oral anticoagulation (OAC) therapy is associated with increased periprocedural risks after cardiac implantable electronic device (CIED) implantation. Patterns of anticoagulation management involving non-vitamin K antagonist oral anticoagulants (NOACs) have not been characterized. HYPOTHESIS: Anticoagulation strategies and outcomes differ by anticoagulant type in patients undergoing CIED implantation. METHODS: Using the nationwide Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we assessed how atrial fibrillation (AF) patients undergoing CIED implantation were cared for and their subsequent outcomes...
May 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28542447/exploratory-plasma-proteomic-analysis-in-a-randomized-crossover-trial-of-aspirin-among-healthy-men-and-women
#20
Xiaoliang Wang, Ali Shojaie, Yuzheng Zhang, David Shelley, Paul D Lampe, Lisa Levy, Ulrike Peters, John D Potter, Emily White, Johanna W Lampe
Long-term use of aspirin is associated with lower risk of colorectal cancer and other cancers; however, the mechanism of chemopreventive effect of aspirin is not fully understood. Animal studies suggest that COX-2, NFκB signaling and Wnt/β-catenin pathways may play a role, but no clinical trials have systematically evaluated the biological response to aspirin in healthy humans. Using a high-density antibody array, we assessed the difference in plasma protein levels after 60 days of regular dose aspirin (325 mg/day) compared to placebo in a randomized double-blinded crossover trial of 44 healthy non-smoking men and women, aged 21-45 years...
2017: PloS One
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