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Tomoyo Sugiyama, Lei Xing, Erika Yamamoto, Francesco Fracassi, Hang Lee, Bo Yu, Ik-Kyung Jang
OBJECTIVE: Recent studies suggest that conservative management with antithrombotic therapy without stenting may be an option in selected patients with acute coronary syndrome (ACS). We evaluated whether a glycoprotein IIb/IIIa inhibitor, tirofiban, would offer additional benefit in patients with plaque erosion presenting with ACS who were treated with antiplatelet therapy without stenting. PATIENTS AND METHODS: Forty-nine patients who completed 1-year follow-up optical coherence tomography imaging in the EROSION study were divided into two groups: tirofiban (n=32) versus no tirofiban (n=17)...
February 28, 2018: Coronary Artery Disease
Monica Verdoia, Patrizia Pergolini, Lucia Barbieri, Roberta Rolla, Matteo Nardin, Federica Negro, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Recent trials have failed to demonstrate any clinical benefit from pre-treatment with dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary interventions, (PCI), even in the setting of acute coronary syndrome. However, suboptimal platelet inhibition during (PCI) has been shown to enhance the risk of acute ischemic complications, such as stent thrombosis and periprocedural myocardial infarction (PMI), thus raising the attention on the potential advantages of adjunctive glycoprotein IIbIIIa inhibitors to obviate to the delayed onset of action of oral antiplatelet drugs...
February 15, 2018: Thrombosis Research
Maria V Polito, Stefania Asparago, Gennaro Galasso, Rosario Farina, Antonio Panza, Severino Iesu, Federico Piscione
BACKGROUND: Many ST-segment elevation myocardial infarction (STEMI) patients have a multivessel disease that initially require percutaneous coronary intervention (PCI) of the culprit vessel but subsequently may require coronary artery bypass graft (CABG) of nonculprit vessels. Evidence supports staged revascularization, but the identification of optimal strategies (percutaneous or surgical), the timing and the management of antiplatelet therapy after recent PCI with stenting are matters of great controversies...
March 2018: Journal of Cardiovascular Medicine
Lanping Ding, Zhichun Gu, Rong Wang, Yichen Li, Yun Fang
RATIONALE: Stent thrombosis (ST) remains a thorny issue in spite of dual antiplatelet treatment with aspirin plus clopidogrel after stent-assisted coiling (SAC). We report a first case of acute ST after SAC in an intracranial aneurysm (IA) patient who carries two reduced-function CYP2C19 alleles. PATIENT CONCERNS: A 43-year-old Chinese male carrying two reduced-function CYP2C19 alleles was treated with a loading dose of clopidogrel 300 mg and aspirin 300 mg before SAC...
November 2017: Medicine (Baltimore)
Zhouling Xie, Lulu Zhao, Xue Ding, Yi Kong, Zhiyu Li
AIM: To find novel platelet aggregation inhibitors, two new series of 1,4-benzodioxine derivatives were synthesized and screened for the ability to inhibit platelet aggregation. MATERIALS & METHODS: The synthesized compounds were evaluated for antiplatelet aggregation activity using human blood platelet and GPIIb/IIIa antagonistic activity. RESULTS: Compound 9-2p showed significant antiplatelet activity with the IC50 values of 41.7 and 22...
January 30, 2018: Future Medicinal Chemistry
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
Yuanling Wu, Wenxian Li, Xiaomei Xie, Zhen Jing, Weibiao Lu, Li'an Huang
CONTEXT: Cervical spinal cord infarction is a rare and severe complication of vertebral artery dissection (VAD). We report a case of VAD in an acute stage followed by cervical spinal cord infarction that was treated using direct endovascular tirofiban infusion via digital subtraction angiography (DSA) monitoring. FINDINGS: A 48-year-old man presented with vertigo, neck pain, numbness and weakness in four limbs with subsequent cardiac and respiratory arrest. Neurological examination revealed hypoesthesia below the neck with grade one myodynamia on the right side of the limbs and zero on the left side...
January 11, 2018: Journal of Spinal Cord Medicine
Helei Jia, Changqing Lu, Panli Sun
We assessed the efficacy and safety of tirofiban intracoronary versus intravenous administration during percutaneous coronary intervention for patients with acute coronary syndrome. The databases of PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang Database were retrieved. A total of 437 articles were found, according to inclusive and exclusive criteria, 13 of which were finally included. Compared with subjects with intravenous administration, those with intracoronary administration were more likely to reach thrombolysis in myocardial infarction trial grade 3 flow (relative risk = 1...
December 5, 2017: Oncotarget
John-Ih Lee, Michael Gliem, Gebke Gerdes, Bernd Turowski, Marius Kaschner, Bastian Kraus, Hans-Peter Hartung, Sebastian Jander
BACKGROUND: In a proportion of stroke patients with acute large vessel occlusion permanent stent implantation is mandatory to achieve successful recanalization. The optimum platelet inhibition strategy after such emergency stenting is unknown. We therefore analyzed the outcome of early glycoprotein (gp) IIb/IIIa inhibitor treatment after emergency stenting in acute stroke. METHODS: Sixty patients with emergency stenting were identified in our stroke unit registry from 12/2010-06/2014 and analyzed retrospectively...
2017: PloS One
Lu Lin, Wei Li, Cheng-Chun Liu, Ya Wu, Shu-Han Huang, Xiao-Shu Li, Chun-Rong Liang, Huan Wang, Li-Li Zhang, Zhi-Qiang Xu, Yan-Jiang Wang, Wuwei Feng, Meng Zhang
BACKGROUND: There has been no effective treatment for acute ischemic stroke (AIS) patients who presented to the Emergency Department >4.5h without a visible arterial occlusion on the neurovascular imaging studies. In this study, we aimed to investigate whether intravenous antiplatelet agent tirofiban was safe and potentially effective in AIS patients who had no visible arterial occlusion and was outside of treatment window for Alteplase. The goal of this study was to collect preliminary data to plan a future phase II study...
December 15, 2017: Journal of the Neurological Sciences
Lan Li, Zhenrong Ge, Dengke Zhang, Jun Kuang, Xiang Ma, Shubin Jiang
Background: Although it has been shown to be superior to simple antithrombotic drug therapy, most patients are unable to receive timely percutaneous coronary intervention (PCI) and are treated with conventional triple antithrombotic therapy (aspirin, clopidogrel, low-molecular-weight heparin). Here, we evaluate the efficacy and safety of adding low-dose tirofiban to this regimen. Methods: A total of 1,783 patient records (unable to receive PCI) indicating non-ST-segment elevation acute coronary syndrome (NSTE-ACS) were included...
2017: Drug Design, Development and Therapy
Chunyan Chen, Tingting Li, Yuchen Zhao, Yinfeng Qian, Xiaoyi Li, Xiangrong Dai, Dake Huang, Tianzhong Pan, Lanlan Zhou
Blood-brain barrier (BBB) disruption, thrombus formation and immune-mediated inflammation are important steps in the pathophysiology of cerebral ischemia-reperfusion injury but are still inaccessible to therapeutic interventions. Recent studies have provided increasing evidence that blocking of platelet glycoprotein (GP) receptor Ib might represent a novel target in treating acute ischemic stroke. This research was conducted to explore the therapeutic efficacy and potential mechanisms of GPIbα inhibitor (anfibatide) in a model of brain ischemia-reperfusion injury in mice...
November 28, 2017: Brain, Behavior, and Immunity
Jae-Min Ahn, Jae-Sang Oh, Seok-Mann Yoon, Jae-Hyun Shim, Hyuk-Jin Oh, Hack-Gun Bae
Objective: We evaluate the rates and outcomes of major procedure-related complications during coiling. Materials and Methods: Between 2007 and 2015, 436 intracranial saccular aneurysms were treated. Complications are categorized as three types: intraprocedural aneurysm rupture (IAR), thromboembolism (TE), and post-procedural early rebleeding (PER). And we evaluated the risk factors of procedure related complications by multivariate analysis. Results: Complications occurred in 61 aneurysms (14%)...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Wenbo Zhao, Ruiwen Che, Shuyi Shang, Chuanjie Wu, Chuanhui Li, Longfei Wu, Jian Chen, Jiangang Duan, Haiqing Song, Hongqi Zhang, Feng Ling, Yuping Wang, David Liebeskind, Wuwei Feng, Xunming Ji
BACKGROUND AND PURPOSE: Chinese patients largely experience acute ischemic stroke (AIS) because of large artery atherosclerosis rather than cardioembolism, and whether tirofiban is safe and effective in these patients treated with endovascular thrombectomy (ET) is unknown. This study evaluated the safety and efficacy of tirofiban in Chinese patients with AIS treated with ET. METHODS: This observational study is based on a single-center prospective registry study...
December 2017: Stroke; a Journal of Cerebral Circulation
Si-Wei Li, Xue Feng, Hao Xu, Ke-Ji Chen
OBJECTIVE: To detect the anticoagulation and antiplatelet effects of different concentrations of puerarin, heparin sodium and tirofiban hydrochloride on the blood samples of healthy volunteers by Sonoclot coagulation and platelet function analyzer. METHODS: Peripheral blood samples were extracted from 20 healthy volunteers, followed by adding different concentrations of puerarin, heparin sodium and tirofiban hydrochloride. Samples were detected for activated clotting time (ACT), clot rate (CR) and platelet function (PF) by Sonoclot coagulation and platelet function analyzer instrument...
October 25, 2017: Chinese Journal of Integrative Medicine
Liang Cheng, Tingxiang Chen, Hang Li, Zhenghua Feng, Zhijie Li, Dingsheng Lin
No abstract text is available yet for this article.
October 9, 2017: Journal of Reconstructive Microsurgery
Waldo R Guerrero, Santiago Ortega-Gutierrez, Minako Hayakawa, Colin P Derdeyn, James D Rossen, David Hasan, Edgar A Samaniego
OBJECTIVE: Treatment of ruptured posterior circulation dissecting aneurysms is technically challenging with potentially high morbidity and mortality. We sought to assess the safety and feasibility of using a flow diversion devices (FDD) and a specific acute antiplatelet aggregation protocol in the management of ruptured dissecting aneurysms. METHODS: Subjects with ruptured dissecting aneurysms treated during a three-year period were retrospectively identified from a prospective registry...
October 5, 2017: World Neurosurgery
Yongliang Wang, Dana N LeVine, Margaret Gannon, Yuanchang Zhao, Anwesha Sarkar, Bailey Hoch, Xuefeng Wang
Integrin-transmitted cellular forces are critical for platelet adhesion, activation, aggregation and contraction during hemostasis and thrombosis. Measuring and mapping single platelet forces are desired in both research and clinical applications. Conventional force-to-strain based cell traction force microscopies have low resolution which is not ideal for cellular force mapping in small platelets. To enable platelet force mapping with submicron resolution, we developed a force-activatable biosensor named integrative tension sensor (ITS) which directly converts molecular tensions to fluorescent signals, therefore enabling cellular force mapping directly by fluorescence imaging...
September 8, 2017: Biosensors & Bioelectronics
Hongchen Zhao, Jinhua Zhang, Danyan Gu, Zongjie Shi, Jie Pan, Yu Geng, Tianming Shi
The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Tirofiban was injected intra-arterially via a temporarily deployed Solitaire stent with continuous intravenous infusion for the subsequent 24 h; half of the conventionally recommended dose was employed...
October 2017: Experimental and Therapeutic Medicine
Sang Heum Kim, Tae Gon Kim, Min Ho Kong
OBJECTIVE: Thromboembolism is the one of the most serious complications that can occur during endovascular coil embolization of cerebral aneurysm. We report on the effectiveness and safety of intra-arterial/intravenous (IA/IV) glycoprotein IIb/IIIa inhibitor (tirofiban) infusion for treating thromboembolism during endovascular coil embolization of cerebral aneurysm. METHODS: We performed a retrospective analysis of 242 patients with ruptured or unruptured cerebral aneurysms (n=264) who underwent endovascular coil embolization from January 2011 to June 2014...
September 2017: Journal of Korean Neurosurgical Society
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