Advances in Cardiology最新文献

Conclusion. 结论。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000341140

Dan Atar, Victor L Serebruany

引用次数: 0

Protease-activated receptor-1 inhibitors: a novel class of antiplatelet agents for the treatment of patients with acute coronary syndrome. 蛋白酶活化受体-1抑制剂:治疗急性冠脉综合征患者的一类新型抗血小板药物

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338045

Sergio Leonardi, Pierluigi Tricoci, Richard C Becker

{"title":"Protease-activated receptor-1 inhibitors: a novel class of antiplatelet agents for the treatment of patients with acute coronary syndrome.","authors":"Sergio Leonardi, Pierluigi Tricoci, Richard C Becker","doi":"10.1159/000338045","DOIUrl":"https://doi.org/10.1159/000338045","url":null,"abstract":"The unifying basis of acute coronary syndrome (ACS) is the complication of a vulnerable coronary plaque, an event primarily mediated by platelet activation. Three major pathways are predominantly involved in this process: thromboxane A(2) via the thromboxane A(2) receptor, adenosine diphosphate via the P2Y(12) receptor, and thrombin via the protease-activated receptor (PAR)-1, with the latter being the most potent platelet activator. Despite the effective inhibition of the first two pathways with aspirin and an expanding family of P2Y(12) inhibitors, respectively, the recurrence of ischemic events in patients with ACS remains high. There is also a growing concern regarding the safety profile in terms of bleeding with more powerful antiplatelet agents, which has tempered expectations of newly developed compounds. PAR-1 inhibitors are a novel class of antiplatelet agents that inhibit thrombin-mediated platelet activation. Preliminary data indicate that these compounds have the potential to improve ischemic prognosis without increasing the bleeding risk. In this chapter we will discuss the rationale for developing this novel class of antiplatelet agents and specifically, the two compounds in most advanced clinical development, vorapaxar and atopaxar.","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":"47 ","pages":"87-99"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000338045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30846004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Clopidogrel in coronary artery disease: update 2012. 氯吡格雷治疗冠状动脉疾病:2012年更新。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338051

Kurt Huber

引用次数: 4

Genetic considerations. 遗传因素。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338043

Matthew J Price

{"title":"Genetic considerations.","authors":"Matthew J Price","doi":"10.1159/000338043","DOIUrl":"https://doi.org/10.1159/000338043","url":null,"abstract":"Dual antiplatelet therapy with aspirin and a P2Y(12) receptor antagonist improves outcomes in patients with acute coronary syndrome and in those treated with percutaneous coronary intervention (PCI) and a coronary stent. Candidate gene and genome-wide association studies have found that common genetic polymorphisms of the cytochrome P450 (CYP) 2C19 isoenzyme that result in a loss of functional activity are associated with less exposure of clopidogrel active metabolite and a diminished antiplatelet effect. Meta-analyses of registries and genetic substudies of randomized clinical trials demonstrate that carriers of these polymorphisms who are treated with clopidogrel are at an increased risk of cardiovascular events, particularly stent thrombosis, compared with noncarriers. This deleterious effect appears to be attenuated in patients not treated with PCI. The influence of polymorphisms of other genes, such as ABCB1, is inconsistent across clinical studies. The clinical efficacy of the newer P2Y(12) antagonists prasugrel and ticagrelor do not appear to be affected by the CYP2C19 genotype, but these agents increase major bleeding not related to coronary artery bypass surgery. Although data from randomized clinical trials are currently lacking, these observations suggest that a pharmacogenomic-guided approach to antiplatelet therapy in acute coronary syndrome could potentially maximize ischemic benefit while minimizing bleeding risk.","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":"47 ","pages":"100-13"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000338043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30846005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Challenges in atrial fibrillation. 心房颤动的挑战。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338058

Ron Pisters, Hugo Ten Cate, Harry J Crijns

引用次数: 0

Antiplatelet therapy in acute coronary syndrome and atrial fibrillation: aspirin. 急性冠状动脉综合征和心房颤动的抗血小板治疗:阿司匹林。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338056

Jean-François Tanguay

引用次数: 2

Dipyridamole in antithrombotic treatment. 双嘧达莫在抗血栓治疗中的应用。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338053

Wolfgang G Eisert

{"title":"Dipyridamole in antithrombotic treatment.","authors":"Wolfgang G Eisert","doi":"10.1159/000338053","DOIUrl":"https://doi.org/10.1159/000338053","url":null,"abstract":"The antithrombotic activity of dipyridamole was initially discovered in an in vivo experiment about half a century ago. At that time science had not appreciated the complexity of the regulation of local thrombus formation. Inhibition of platelets has been the main focus for the prevention of arterial thrombus formation. Unfortunately, established in vitro test systems have to take away several important components of the hemostatic system. Rather than directly inhibiting platelet aggregation, dipyridamole amplifies endogenous antithrombotic systems and modulates or downregulates prothrombotic processes. While for many years the main focus had been on preventing acute thrombus formation in the case of a rupture of an atherosclerotic plaque in large coronary arteries, it now has been appreciated that perfusion of tissue and patency of small vessels and capillaries is equally important for preventing further damage to the tissue. Here dipyridamole was experimentally shown to improve perfusion and function in chronic hypoperfused tissue unrelated to its vasodilatory properties. Recently, several clinical trials have shown the benefit of dipyridamole when given in a formulation that assures a sufficient plasma concentration. Its potential to scavenge particularly peroxy radicals, its direct reduction of innate inflammation, and a chronic elevation of interstitial adenosine seems to be of more importance for the prevention of vascular and tissue damage than its adenosine- and prostacyclin-mediated antithrombotic effect. In its extended-release preparation with the tartaric acid nucleus, not only does it not seem to add significantly to the risk of bleeding, but seems to hold potential for protecting tissue from oxidative and metabolic stress.","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":"47 ","pages":"78-86"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000338053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30846003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Prasugrel. 你这个混蛋。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338044

Antonio Tello-Montoliu, Salvatore D Tomasello, Dominick J Angiolillo

{"title":"Prasugrel.","authors":"Antonio Tello-Montoliu, Salvatore D Tomasello, Dominick J Angiolillo","doi":"10.1159/000338044","DOIUrl":"https://doi.org/10.1159/000338044","url":null,"abstract":"Prasugrel is a third-generation thienopyridine which selectively inhibits the platelet P2Y(12) receptor more rapidly, more potently, and with less interindividual response variability compared with the second-generation thienopyridine clopidogrel. Large-scale phase III clinical testing showed that in high-to moderate-risk acute coronary syndrome patients undergoing percutaneous coronary intervention, prasugrel translates into a greater reduction in ischemic events, including stent thrombosis, in the short and long term compared to clopidogrel. Prasugrel, however, is associated with an increased risk of major bleeding, which is more pronounced in certain patient subgroups. The ideal patient population for prasugrel use are those patients without prior transient ischemic attack/stroke, <75 years of age and >60 kg in whom the greatest ischemic benefit is achieved without a significant increase in major bleeding risk. Dose modifications in specific populations or at given time-points may represent an avenue to minimize bleeding risk and therefore maximize the clinical benefit of prasugrel. Ongoing clinical studies with prasugrel will better define the safety and efficacy profiles of this agent and potentially set the basis for new indications for use.","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":"47 ","pages":"39-63"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000338044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30846001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bleeding and the use of antiplatelet agents in the management of acute coronary syndromes and atrial fibrillation. 出血和使用抗血小板药物在急性冠状动脉综合征和心房颤动的管理。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338072

John P Vavalle, Sunil V Rao

引用次数: 0

Antiplatelet therapy in stroke prevention. 抗血小板治疗预防脑卒中。

Advances in Cardiology Pub Date : 2012-01-01 Epub Date: 2012-08-09 DOI: 10.1159/000338050

Stavros Apostolakis, Francisco Marín, Gregory Y H Lip

引用次数: 6