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https://www.readbyqxmd.com/read/28528236/-management-of-the-bleeding-risk-associated-with-antiplatelet-agents
#1
A-C Martin, S Houssany-Pissot, D Zlotnik, G Taylor, A Godier
Like all antithrombotic drugs, antiplatelet agents expose to a risk of bleeding complications. Clinical research has extensively focused on the efficacy of these drugs to reduce ischemic events. The bleeding risk associated with them was solely considered as an inevitable and acceptable complication. When two new potent P2Y12-receptor inhibitors, prasugrel and ticagrelor, were marketed, the risk of major bleeding increased. These new agents have modified the balance between the absolute risk reduction in ischemic events and the absolute risk increase in bleeding events...
May 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28527773/prevalence-management-and-long-term-6-year-outcomes-of-atrial%C3%A2-fibrillation-among-patients-receiving-drug-eluting-coronary-stents
#2
Hyo-In Choi, Jung-Min Ahn, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVES: This study sought to investigate the incidence, management, and clinical relevance of atrial fibrillation (AF) during and after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and evaluate outcomes of different antithrombotic strategies. BACKGROUND: Uncertainty exists regarding the optimal antithrombotic strategy in patients with AF who are undergoing PCI with DES. METHODS: Using a consecutive series of 10,027 patients who underwent DES implantation between 2003 and 2011, we evaluated the overall prevalence and clinical impact of AF...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28524005/rivaroxaban-metabolism-pharmacologic-properties-and-drug-interactions
#3
Tomas Kvasnicka, Ivana Malikova, Zuzana Zenahlikova, Karolína Kettnerova, Radka Brzezkova, Tomas Zima, Jan Ulrych, Jan Briza, Ivan Netuka, Jan Kvasnicka
BACKGROUND: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. OBJECTIVE: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). This review discusses the properties, drug interactions, pharmacokinetics and clinical indications of rivaroxaban...
May 18, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#4
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28516514/single-incision-totally-extraperitoneal-inguinal-hernia-repair-is-feasible-and-safe-in-patients-on-antithrombotic-therapy-a-single-center-experience-of-92-procedures
#5
Masaki Wakasugi, Mitsuyoshi Tei, Yozo Suzuki, Kenta Furukawa, Toru Masuzawa, Kentaro Kishi, Masahiro Tanemura, Hiroki Akamatsu
INTRODUCTION: The aim of this study was to evaluate the feasibility and safety of SILS for totally extraperitoneal inguinal hernia repair for patients on antithrombotic therapy. METHODS: A total of 365 patients who underwent SILS for totally extraperitoneal inguinal hernia repair between January 2011 and November 2015 were analyzed retrospectively. Antithrombotic drugs were stopped preoperatively, and bridging intravenous heparin therapy was given according to the operative risk of each patient...
May 17, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28516446/a-primary-human-lung-alveolus-on-a-chip-model-of-intravascular-thrombosis-for-assessment-of-therapeutics
#6
Abhishek Jain, Riccardo Barrile, Andries D van der Meer, Akiko Mammoto, Tadanori Mammoto, Karen De Ceunynck, Omozuanvbo Aisiku, Monicah A Otieno, Calvert S Louden, Geraldine A Hamilton, Robert Flaumenhaft, Donald E Ingber
Pulmonary thrombosis is a significant cause of patient mortality, however, there are no effective in vitro models of thrombi formation in human lung microvessels, that could also assess therapeutics and toxicology of antithrombotic drugs. Here we show that a microfluidic lung alveolus-on-a-chip lined by human primary alveolar epithelium interfaced with endothelium, and cultured under flowing whole blood can be used to perform quantitative analysis of organ-level contributions to inflammation-induced thrombosis...
May 17, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28506579/-initial-management-of-st-elevation-myocardial-infarction-in-2014-from-guidelines-to-practices-survey-of-176-french-interventional-cardiologists
#7
E Capilla, R Poyet, A-V Tortat, F-X Brocq, F Pons, S Kerebel, C Jego, G R Cellarier
BACKGROUND: Real life management of myocardial infarction has not recently been evaluated in France. AIMS: To describe ST-elevation myocardial infarction management in France in 2014 and to compare it with current guidelines. METHODS: A multicentre study was performed. An e-mail questionnaire was sent to French interventional cardiologists. Demographic data of interventional cardiologists, procedural aspects of percutaneous coronary intervention, antithrombotic treatments and patient rehabilitation have been investigated...
May 12, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#8
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28487393/potent-thrombolytic-effect-of-n-acetylcysteine-on-arterial-thrombi
#9
Sara Martinez de Lizarrondo, Clément Gakuba, Bradley A Herbig, Yohann Repessé, Carine Ali, Cécile V Denis, Peter Lenting, Emmanuel Touzé, Scott L Diamond, Denis Vivien, Maxime Gauberti
Background -Platelet crosslinking during arterial thrombosis involves von Willebrand Factor (VWF) multimers. Therefore, proteolysis of VWF appears promising to disaggregate platelet-rich thrombi and restore vessel patency in acute thrombotic disorders such as ischemic stroke, acute coronary syndrome or acute limb ischemia. N-Acetylcysteine (NAC, a clinically approved mucolytic drug) can reduce intrachain disulfide bonds in large polymeric proteins. In the present study, we postulated that NAC might cleave the VWF multimers inside occlusive thrombi, thereby leading to their dissolution and arterial recanalization...
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28486420/a-fluorescent-probe-for-glycosaminoglycans-applied-to-the-detection-of-dermatan-sulfate-by-a-mix-and-read-assay
#10
Melissa Rappold, Ulrich Warttinger, Roland Krämer
Glycosaminoglycans are complex biomolecules of great biological and medical importance. The quantification of glycosaminoglycans, in particular in complex matrices, is challenging due to their inherent structural heterogeneity. Heparin Red, a polycationic, fluorescent perylene diimide derivative, has recently emerged as a commercial probe for the convenient detection of heparins by a mix-and-read fluorescence assay. The probe also detects glycosaminoglycans with a lower negative charge density than heparin, although with lower sensitivity...
May 9, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28481519/fibrin-targeted-and-h2o2-responsive-nanoparticles-as-a-theranostics-for-thrombosed-vessels
#11
Changsun Kang, Sian Gwon, Chulgyu Song, Peter M Kang, Seong-Cheol Park, Jongho Jeon, Do Won Hwang, Dongwon Lee
Thrombus (blood clot) is formed in the injured vessels to maintain the integrity of vasculature. However, obstruction of blood vessels by thrombosis slows blood flow, leading to death of tissues fed by the artery and is the main culprit of various life-threatening cardiovascular diseases. Herein, we report novel nanomedicine which could specifically image obstructed vessels and inhibit thrombus formation. Based on the unique physicochemical and biological characteristics of thrombus such as the abundance of fibrin and the elevated level of hydrogen peroxide (H2O2), we developed fibrin-targeted imaging and antithrombotic nanomedicine, termed FTIAN as a theranostic system for obstructive thrombosis...
May 8, 2017: ACS Nano
https://www.readbyqxmd.com/read/28479519/polysaccharides-based-nanocomplexes-for-the-prolonged-delivery-of-enoxaparin-in-vitro-and-in-vivo-evaluation
#12
Shaimaa S Ibrahim, Rihab Osman, Gehanne A S Awad, Nahed D Mortada, Ahmed-Shawky Geneidi
Thromboprophylaxis and anticoagulant therapy face serious medical challenges in terms of how crucial it is to maintain therapeutic activity of the anticoagulant agent over the required period of time. Failure to do so will lead to an increased risk of clot propagation if a subtherapeutic drug level is reached. On the other hand, higher-than intended anticoagulation levels might lead to an enhanced risk of hemorrhagic complications. Nanocomplexes (NCs) for the controlled delivery of the antithrombotic Enoxaparin (Enox) with dextran sulfate (DS) and chitosan (CS) were formulated, in an attempt to circumvent therapeutic and compliance challenges associated with the prolonged administration of the current dosage form...
May 4, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28473266/persistence-with-statins-in-primary-prevention-of-cardiovascular-disease-findings-from-a-cohort-of-spanish-workers
#13
Sara Malo, Isabel Aguilar-Palacio, Cristina Feja, Enrica Menditto, María Jesús Lallana, Elena Andrade, José Antonio Casasnovas, María José Rabanaque
INTRODUCTION AND OBJECTIVES: The aim of this study was to assess patterns of treatment persistence in a cohort of male Spanish workers receiving statin therapy for primary prevention of cardiovascular disease. METHODS: This descriptive study was conducted within the framework of the prospective longitudinal Aragon Workers' Health Study (N = 5400). Incident male statin users were identified based on data collected from the regional government's medication consumption information system...
May 1, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28467373/the-impact-of-the-low-molecular-weight-heparin-tinzaparin-on-the-sensitization-of-cisplatin-resistant-ovarian-cancers-preclinical-in-vivo-evaluation-in-xenograft-tumor-models
#14
Thomas Mueller, Daniel Bastian Pfankuchen, Kathleen Wantoch von Rekowski, Martin Schlesinger, Franziska Reipsch, Gerd Bendas
Resistance formation of tumors against chemotherapeutics is the major obstacle in clinical cancer therapy. Although low molecular weight heparin (LMWH) is an important component in oncology referring to guideline-based antithrombotic prophylaxis of tumor patients, a potential interference of LMWH with chemoresistance is unknown. We have recently shown that LMWH reverses the cisplatin resistance of A2780cis human ovarian cancer cells in vitro. Here we address the question whether this LMWH effect is also valid under in vivo conditions...
May 3, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28448853/a-cluster-of-aspartic-residues-in-the-extracellular-loop-ii-of-par-4-is-important-for-thrombin-interaction-and-activation-of-platelets
#15
Daniel Sánchez Centellas, Sushanth Gudlur, Alejandro Vicente-Carrillo, Sofia Ramström, Tomas L Lindahl
Thrombin activates platelets via proteolytic cleavage of protease-activated receptors (PARs) 1 and 4. The two PARs have distinct but complementary roles. The mechanisms responsible for PAR1 activation by thrombin have been extensively studied. However, much less is known regarding thrombin activation of PAR4, especially the potential involvement of regions of PAR4 other than the N-terminal, which is bound to the catalytic site of thrombin. We have studied PAR4 in S. cerevisiae strain MMY12, an expression system in which the GPCR receptors are connected to a Lac Z reporter gene resulting in increased β-galactosidase activity...
April 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28448438/antiplatelet-activity-of-a-newly-synthesized-novel-ruthenium-ii-a-potential-role-for-akt-jnk-signaling
#16
Themmila Khamrang, Kuo-Chen Hung, Chih-Hsuan Hsia, Cheng-Ying Hsieh, Marappan Velusamy, Thanasekaran Jayakumar, Joen-Rong Sheu
In oncotherapy, ruthenium complexes are considered as potential alternatives for platinum compounds, and have been proved as promising anticancer drugs with high efficacy and lesser side effects. Platelet activation plays a major role in cancer metastasis and progression. Hence, this study explored the effect of a newly synthesized ruthenium complex, [Ru(η⁶-cymene)(L)Cl]BF₄(TQ5), where L = 4-phenyl-2-pyridin-2-yl-quinazoline), on human platelet activation. TQ5 (3-5 µM) inhibited concentration-dependent collagen-induced platelet aggregation in washed human platelets...
April 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28435447/a-unique-recombinant-fluoroprobe-targeting-activated-platelets-allows-in-vivo-detection-of-arterial-thrombosis-and-pulmonary-embolism-using-a-novel-three-dimensional-fluorescence-emission-computed-tomography-flect-technology
#17
Bock Lim, Yu Yao, Alex Lin-I Huang, May Lin Yap, Ulrike Flierl, Jathushan Palasubramaniam, Maria T K Zaldivia, Xiaowei Wang, Karlheinz Peter
Progress in pharmaceutical development is highly-dependent on preclinical in vivo animal studies. Small animal imaging is invaluable for the identification of new disease markers and the evaluation of drug efficacy. Here, we report for the first time the use of a three-dimensional fluorescence bioimager called FLuorescence Emission Computed Tomography (FLECT) for the detection of a novel recombinant fluoroprobe that is safe, easily prepared on a large scale and stably stored prior to scan. This novel fluoroprobe (Targ-Cy7) comprises a single-chain antibody-fragment (scFvTarg), which binds exclusively to activated-platelets, conjugated to a near-infrared (NIR) dye, Cy7, for detection...
2017: Theranostics
https://www.readbyqxmd.com/read/28435120/the-role-of-platelets-in-hemostasis-and-the-effects-of-snake-venom-toxins-on-platelet-function
#18
REVIEW
Mayara Ribeiro de Queiroz, Bruna Barbosa de Sousa, Déborah Fernanda da Cunha Pereira, Carla Cristine Neves Mamede, Mariana Santos Matias, Nadia Cristina Gomes de Morais, Júnia de Oliveira Costa, Fábio de Oliveira
The human body has a set of physiological processes, known as hemostasis, which keeps the blood fluid and free of clots in normal vessels; in the case of vascular injury, this process induces the local formation of a hemostatic plug, preventing hemorrhage. The hemostatic system in humans presents complex physiological interactions that involve platelets, plasma proteins, endothelial and subendothelial structures. Disequilibrium in the regulatory mechanisms that control the growth and the size of the thrombus is one of the factors that favors the development of diseases related to vascular disorders such as myocardial infarction and stroke, which are among the leading causes of death in the western world...
April 20, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28427968/the-global-burden-of-atrial-fibrillation-and-stroke-a-systematic-review-of-the-clinical-epidemiology-of-atrial-fibrillation-in-asia
#19
Ying Bai, Yan-Liang Wang, Alena Shantsila, Gregory Y H Lip
BACKGROUND: Our previous review showed great variability on the incidence and prevalence of atrial fibrillation (AF) in non-Western cohorts, especially from Asian countries; in recent years, epidemiology studies on AF have been increasingly reported. METHODS: We therefore conducted an updated systematic review, to present the current knowledge base of AF epidemiology in Asian countries since our prior review. We also explored AF incidence and the risk of stroke in AF using meta-analysis, with I(2) testing the heterogeneity...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28427779/fish-oil-lc-pufas-do-not-affect-blood-coagulation-parameters-and-bleeding-manifestations-analysis-of-8-clinical-studies-with-selected-patient-groups-on-omega-3-enriched-medical-nutrition
#20
Stephanie Jeansen, Renger F Witkamp, Jossie A Garthoff, Ardy van Helvoort, Philip C Calder
BACKGROUND & AIMS: The increased consumption of fish oil enriched-products exposes a wide diversity of people, including elderly and those with impaired health to relatively high amounts of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs). There is an ongoing debate around the possible adverse effects of n-3 LC-PUFAs on bleeding risk, particularly relevant in people with a medical history of cardiovascular events or using antithrombotic drugs. METHODS: This analysis of 8 clinical intervention studies conducted with enteral medical nutrition products containing fish oil as a source of n-3 LC-PUFAs addresses the occurrence of bleeding-related adverse events and effects on key coagulation parameters (Prothrombin Time [PT], (activated) and Partial Thromboplastin Time [(a)PTT])...
March 29, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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