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Victor L Serebruany, Seth D Fortmann, Daniel F Hanley, Moo Hyun Kim
BACKGROUND: Vorapaxar, a novel antiplatelet thrombin PAR-1 inhibitor, is currently approved for post myocardial infarction and peripheral artery disease indications with concomitant use of clopidogrel and/or aspirin. The vorapaxar safety profile was acceptable. However, aside from heightened bleeding risks, excesses of solid cancers and diplopia, there were more amyotrophic lateral sclerosis (ALS) diagnoses after vorapaxar. STUDY QUESTION: To assess the Food and Drug Administration (FDA) reviews on the potential association of vorapaxar with ALS...
March 2017: American Journal of Therapeutics
Victor L Serebruany, Moo Hyun Kim, Hector A Cabrera-Fuentes, Kwangmin Lee, Young Rak Cho, Kyungil Park, Tae Ho Park, Young Dae Kim, Sung-Cheol Yoon
The optimal duration and cancer risks of antiplatelet therapy following percutaneous coronary intervention (PCI) are unclear. We compared cancer and all-cause mortality after dual antiplatelet therapy (DAPT) for the combination of clopidogrel and aspirin (ASA) versus ASA alone over 18 months follow-up in event-free patients at 12 months DAPT from the Health Insurance Review and Assessment (HIRA) dataset via the Korean Outcomes Registry Evaluating Antithrombotics (KOREA). We selected PCI patients who were event free for 12 months and maintained a consistent antiplatelet regimen for 18 more months...
March 2, 2017: Thrombosis and Haemostasis
Cai De Jin, Moo Hyun Kim, Soo Jin Kim, Kwang Min Lee, Tae Hyung Kim, Young-Rak Cho, Victor L Serebruany
BACKGROUND: The optimal strategy to manage chronic total occlusion (CTO) remains unclear. The Japanese CTO multicenter registry (J-CTO) score is an established tool for predicting successful recanalization. However, it does not take into account nonangiographic predictors for final technique success. In the present study, we designed and tested a scoring model called the Busan single-center CTO registry (B-CTO) score combining clinical and angiographic characteristics to predict successful CTO recanalization in Korean patients...
February 8, 2017: Cardiology
Victor L Serebruany, Seth D Fortmann, Vasily Cherepanov, Oleg Litvinov, Moo Hyun Kim, Thomas A Marciniak
No abstract text is available yet for this article.
February 1, 2017: American Journal of Medicine
Victor Serebruany, Naida Bulaeva, Elena Golukhova
No abstract text is available yet for this article.
November 2016: Journal of Thoracic Disease
Soo Jin Kim, Moo Hyun Kim, Kwang Min Lee, Tae Hyung Kim, Sun Yong Choi, Min Kook Son, Ji Woen Park, Victor L Serebruany
BACKGROUND: Acute pulmonary thromboembolism (APTE) is a life-threatening condition, often manifesting with chest pain, dyspnea, and increased cardiac biomarkers including cardiac troponin I (CTI) and D-dimer. Therefore, APTE is often misdiagnosed with classical non-ST elevation myocardial infarction (NSTEMI), resulting in unnecessary coronary interventions and a delay of therapy. OBJECTIVES: Our aim was to distinguish APTE from NSTEMI based on CTI and D-dimer levels...
2017: Cardiology
Victor L Serebruany
No abstract text is available yet for this article.
September 28, 2016: Polskie Archiwum Medycyny Wewnętrznej
Long Zhe Guo, Moo Hyun Kim, Chang Heon Shim, Sun Young Choi, Victor L Serebruany
AIMS: Clinical utilization of dual antiplatelet therapy (DAPT) in patients with renal impairment (RI) following percutaneous coronary interventions (PCI) represents an urgent, unmet need choosing optimal agents, duration of treatment, and potential dose/regimen adjustment. The lack of any large randomized trials specifically in RI patients, and the absence of the uniformed clinical data reporting policy, clouds the reality. Moreover, triaging RI patients is problematic due to ongoing kidney deterioration, and the fact that RI patients are prone to both vascular occlusions and bleeding...
July 2016: European Heart Journal. Cardiovascular Pharmacotherapy
Long Zhe Guo, Moo Hyun Kim, Eun Seok Shin, Soe Hee Ann, Cai De Jin, Young-Rak Cho, Jong Sung Park, Kyungil Park, Tae-Ho Park, Michael S Lee, Victor L Serebruany
OBJECTIVE: The impact of thienopyridine reloading on clinical outcomes, and residual high platelet reactivity (HPR) is unclear. We sought to compare the HRP-related effect of prasugrel and clopidogrel reloading in the already clopidogrel-loaded patients undergoing percutaneous coronary intervention (PCI). MATERIALS AND METHODS: In this prospective, two-center, randomized, open-label study, patients with HPR who had undergone PCI after a clopidogrel (300-600mg) loading dose (LD) were enrolled...
November 1, 2016: International Journal of Cardiology
Victor Serebruany
No abstract text is available yet for this article.
June 2016: EBioMedicine
Hong-Zhe Zhang, Moo Hyun Kim, Long-Zhe Guo, Victor Serebruany
Clopidogrel response variability (CRV) is well documented, and may affect clinical outcomes. Impact of genetic polymorphisms is important for assessing and predicting CRV. The extensive evidence indicates the importance of CYP2C19 variants in reducing efficacy of clopidogrel. This study defined the impact of numerous genetic polymorphisms on CRV before and after percutaneous coronary interventions (PCI) exclusively in a Korean cohort assuming less genetic variability noise. One hundred and thirty-six patients of Korean origin undergoing PCI were included...
January 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Moo Hyun Kim, Sun Young Choi, Soo Yeon An, Victor Serebruany
BACKGROUND: Although low platelet reactivity (LPR) is commonly detected during bleeding, a validated threshold for reliable DAPT bleeding risk stratification is lacking. We tested the diagnostic utility of 3 conventional platelet-activity assays to define the predictive value (if any) of LPR for bleeding. HYPOTHESIS: We hypothesized whether one of these tests be better than any others for predicting bleeding events. METHODS: Patients (n = 800) following drug-eluting stent implantation received DAPT...
July 2016: Clinical Cardiology
Elena Z Golukhova, Olga Gromova, Marina Grigoryan, Vadim Merzlyakov, Konstantin Shumkov, Leo Bockeria, Victor L Serebruany
BACKGROUND: Prediction and potential prevention of sudden cardiac death (SCD) due to malignant ventricular arrhythmia (MVA) represent an obvious unmet medical need. We estimated the prognostic relevance of numerous biomarkers associated with future MVA development in patients with coronary artery disease (CAD) over 2 years of follow-up. METHODS: Patients with stable documented CAD (n = 97) with a mean age of 61 ± 10 years were prospectively enrolled in a single-center observational cohort study...
2016: Cardiology
Gamze Babur Guler, Mehmet Mustafa Can, Ekrem Guler, Tugba Akinci, Ozlem Sogukpinar, Suzan Hatipoglu, Fethi Kilicaslan, Victor L Serebruany
BACKGROUND: Pulmonary embolism (PE) is a life-threatening event with a broad presentation spectrum ranging from asymptomatic cases to sudden cardiac arrest. It is unclear if right atrial emboli cause PE in patients with atrial fibrillation (AF) or if mild PE itself increases right cardiac pressure provoking AF. OBJECTIVE: To determine the incidence and predictors of asymptomatic PE in patients undergoing AF ablation. METHOD AND RESULTS: Patients (n = 93) were screened and those with previous or current symptomatic PE or venous thromboembolism, pulmonary hypertension, increased right heart pressures detected on echocardiography, a history of stroke, transient ischemic attack, coagulopathy or cancer and inappropriate contrast for the evaluation of pulmonary arterial tree were excluded...
2016: Cardiology
Victor L Serebruany, Ales Tomek, Yury Pya, Makhabbat Bekbossynova, Moo Hyun Kim
Long-awaiting PHILO trial, conducted in 2011-2012 has been submitted and published late in 2015. In contrast to overall PLATO results, but similar to PLATO-US cohort, PHILO revealed numerical inferiority of ticagrelor with regard to death, myocardial infarction, stroke, and bleeding over clopidogrel. Hence, we comprehend the PHILO results in light of the PLATO-US evidence. To assess the PHILO (n=801) outcomes, applied statistics, and trial conduct, matching them with the PLATO-US (n=1413) patients. The Asian, predominantly Japanese ticagrelor patients had worsened outcomes even when compared to the negative American cohort with regard to death (OR=1...
July 15, 2016: International Journal of Cardiology
Victor L Serebruany, Moo Hyun Kim, Elena Golukhova, Yury Pya, Makhabbat Bekbossynova, Marco Cattaneo, Thomas A Marciniak
Despite advanced techniques and improved clinical outcomes, the optimal antiplatelet strategy following coronary artery bypass grafting (CABG) is an unsolved mystery. Vorapaxar, a novel platelet thrombin receptor (PAR-1/4) blocker, is currently approved for post-myocardial infarction and peripheral artery disease indications on top of clopidogrel or/and aspirin. We here summarize the outcomes in patients after CABG for justification of a future vorapaxar trial. We comprehended the CABG outcomes after vorapaxar yielded from TRACER, TRA2P trials, and affiliated FDA reviews...
July 15, 2016: International Journal of Cardiology
Victor Serebruany, Ales Tomek
PEGASUS trial reported reduction of composite primary endpoint after conventional 180mg/daily ticagrelor (CT), and lower 120mg/daily dose ticagrelor (LT) at expense of extra bleeding. Following approval of CT and LT for long-term secondary prevention indication, recent FDA review verified some bleeding outcomes in PEGASUS. To compare the risks after CT and LT against placebo by seven TIMI scale variables, and 9 bleeding categories considered as serious adverse events (SAE) in light of PEGASUS drug discontinuation rates (DDR)...
July 15, 2016: International Journal of Cardiology
Moo Hyun Kim, Kazuaki Mitsudo, Cai De Jin, Tae Hyung Kim, Young-Rak Cho, Jong-Sung Park, Kyungil Park, Tae-Ho Park, Victor Serebruany
OBJECTIVE: To assess hard major adverse clinical events (HMACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO). BACKGROUND: There are limited data regarding long-term HMACE risks based on PCI-CTO success. METHODS: First-time PCI was performed in 438 consecutive patients with 473 target CTO lesions. Patients after procedural success (n=355; 378 CTO lesions) and failure (n=83; 95 CTO lesions) were followed for an average 40months (7-77months range)...
June 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Long Zhe Guo, Moo Hyun Kim, Tae Hyung Kim, Jong Seong Park, Enze Jin, Chang Heon Shim, Sun Young Choi, Victor L Serebruany
BACKGROUND: Clopidogrel and aspirin combination remains a cornerstone for modern dual antiplatelet therapy (DAPT) following coronary stenting. Although monitoring is not currently recommended, certain high-risk cohorts may benefit from tailoring antiplatelet options to reduce thrombotic or/and hemorrhagic risks. Patients with diminished estimated glomerular filtration rate (eGFR) are prone to both vascular occlusions and bleeding events in whom monitoring may be especially advantageous...
2016: Nephron
Victor L Serebruany, Seth D Fortmann, Sunil V Rao, Jean-Francois Tanguay, Marie Lordkipanidze, Daniel F Hanley, Mehmet Can, Moo Hyun Kim, Thomas A Marciniak
Vorapaxar, a novel antiplatelet thrombin PAR-1 inhibitor, has been evaluated in the successful TRA2P trial and the failed TRACER trial. The drug is currently approved for post myocardial infarction and peripheral artery disease indications with concomitant use of clopidogrel and/or aspirin. The FDA ruled that the vorapaxar safety profile is acceptable. However, both trials revealed excess diplopia (double vision) usually reversible after vorapaxar. The diplopia risk appears to be small (about 1 extra case per 1,000 treated subjects), but real...
May 2, 2016: Thrombosis and Haemostasis
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