Abstract：
:Clopidogrel is an oral tyenopiridin with a central role in the management of acute coronary syndromes and after stent implantation. Despite the use of this drug, many patients continue to experience thrombotic events which are usually referred as "therapy failure". Actually, to date, only stent thrombosis is considered therapy failure: mainly, it could be due to patient genetic predisposition or drug interaction, in particular with proton pump inhibitors. Genetic mutations in the CYP2C19 cytochrome (involved in the metabolism of clopidogrel and many other drugs) may lead to a lower concentration of active metabolites of the drug. In the same way, proton pump inhibitors interaction with the cytochrome may reduce clopidogrel activation. To overcome the problem some authors have suggested to increase the dosage of the drug, to use other drugs, to genotype patients, and not to use proton pomp inhibitors in patients on double antiplatelet therapy. Recent studies have shown that the interaction between clopidogrel and proton pump inhibitors is far to be clinically relevant and that the variability between the different assay to determine patients response to the drug does not allow, to date, to rely on their use. Moreover, double clopidogrel dose is as effective as low one in preventing major cardiovascular events, with a significant reduction in stent thrombosis in spite of a modest increase in major bleeding. Aim of this review article was to update current knowledge on clopidogrel, particularly focusing on the problem of "resistance" and PPI interaction. Moreover, we will discuss current strategies to overcome the resistance.
journal_name
Minerva Cardioangioljournal_title
Minerva cardioangiologicaauthors
Cialdella P,Gustapane M,Camaioni C,Biasucci LMsubject
Has Abstractpub_date
2013-12-01 00:00:00pages
683-9issue
6eissn
0026-4725issn
1827-1618pii
R05Y2013N06A0683journal_volume
61pub_type
杂志文章,评审abstract：:Calcium-antagonist and B-blockers are effective in improving exercise tolerance in patients with effort angina. We studied the short effects of oral administration of nifedipine (10 mg) and propranolol (80 mg) alone and in combination in 15 elderly patients with chronic exertional angina pectoris in a double-blind, ra...
journal_title：Minerva cardioangiologica
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1993-04-01 00:00:00
abstract：:The division of the venous circulation in to two sectors, one constituted by the superficial and deep venous trunks (macrocirculation) and the other by the capillaries and precapillary venules (microcirculation), is surely schematical but aids the comprehension of many hemodynamic effects connected to hampered venous ...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：1992-11-01 00:00:00
abstract：:An aneurysms of a renal vein is very uncommon an entity and even more so when a visceral vein is affected. The venous aneurysms are generally asymptomatic and are detected either at post-mortem examination or by Echography, CT scan or MR investigation. Occasionally they become symptomatic because of rupture, thrombosi...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：:Three hundred carotid plaques (stenosis 45 to 65%) in 300 asymptomatic patients were included into a follow-up study considering three ultrasound types of plaques: type 1, non echogenic; type 2 intermediate, partially echogenic and type 3 highly echogenic. Types 1 and 2 had regular contour/surface while type 3 was irr...
journal_title：Minerva cardioangiologica
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1992-07-01 00:00:00
abstract：:Endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAA) is the preferred first treatment option in case of patients with advanced age and/or fit anatomy owing to shorter length of in hospital staying, less complications or laparotomy-related re-interventions, and lower initial costs. Although it is a le...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2016-04-01 00:00:00
abstract：:Acute mesenteric ischemia is a severe complication after aortic reconstructive surgery for AAA repair. This ischemic event, due to a poor intestinal perfusion especially in ruptured AAA in consequence of the hypotension and the hypovolemic shock, shows different clinical manifestations such as delayed canalization, is...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1995-10-01 00:00:00
abstract：:Fragments of synthetic prostheses in knitted Dacron velour implanted years previously have been examined. Macrophages were found which fragment elements of the prostheses. It is concluded that synthetic knitted velour prostheses are biodegradable. ...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1990-06-01 00:00:00
abstract：:Renal denervation is a novel catheter based approach that has been shown to effectively lower blood pressure in patients with resistant hypertension. Small studies have shown additional benefits in patients being treated for hypertension, such as improvements in insulin sensitivity, sleep apnoea and arrhythmias. More ...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2013-06-01 00:00:00
abstract：:The role of routine intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) in the bare metal stent era remains controversial. The potential to reduce revascularization was reported without impacting non-fatal myocardial infarction and death. Drug-eluting stents (DES) have realized imp...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2008-02-01 00:00:00
abstract：BACKGROUND:Takotsubo Cardiomyopathy (TTC) is classified into 4 types dependent on anatomical area affected identified on gross visual assessment. We have sought to understand if it is feasible and advantageous to use left ventricular global longitudinal strain (LVGLS), LV segmental longitudinal strain and right ventric...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.20.05386-4
更新日期：2021-01-11 00:00:00
abstract：:Contrast enhanced computed tomography angiography (CTA) has seen rapid progress in its utility for the assessment of coronary artery disease (CAD) in the last few years. More and more technological enhancements have widened the horizons for the use of this non-invasive modality beyond its traditional role in assessmen...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2013-02-01 00:00:00
abstract：:Myocardial infarction in the under-40s is rare. A series of 19 patients, 3.07% of a two-year series of coronary cases, is presented with a view to evaluating the incidence of risk factors, with special attention to familial factors and dyslipoproteinaemia. Risk factors are discussed together with the statistical impor...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
abstract：:A case of pseudoaneurysm of the superficial femoral artery identified preoperatively by Magnetic Resonance is reported. The number of different parameters and planes covered by the technique permitted an accurate assessment of the site, extent, internal conformation and staging of the thrombotic deposits inside the ps...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：:A carotid stenosis is responsible for about 30% of strokes occurring. Carotid endarterectomy (CEA) is considered to be the gold standard treatment of a carotid stenosis. Carotid angioplasty and stenting (CAS) is emerging as a new alternative treatment for a carotid artery stenosis, but the risk of neurological complic...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2007-02-01 00:00:00
abstract：:In routine clinical practice, a sizeable proportion of patients with suspected coronary artery disease (CAD) undergo coronary angiography without prior non-invasive functional evaluation. In this situation, the decision wheter to perform revascularization is taken solely on the basis of angiographic parameters, which ...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2011-02-01 00:00:00
abstract：:The best timing of orotracheal intubation and invasive ventilation in COVID-19 patients with acute respiratory distress syndrome is unknown. The use of non-invasive ventilation, a life-saving technique in many medical conditions, is debated in patients with ARDS since prolonged NIV and delayed intubation may be harmfu...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.20.05356-6
更新日期：2020-10-15 00:00:00
abstract：:An epidemiological investigation of certain lipaemic parameters in some expressions of atherosclerotic disease with particular reference to HDL-cholesterol fractions is reported. The series consists of 94 normal weight subjects (45 m, 49 f, average age 61 +/- 5) subdivided as follows: 38 suffering from cerebral vascul...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1989-01-01 00:00:00
abstract：:Over the last years, endovascular intervention have become an important part of treatment in patients with congenital heart disease particularly for residual defects after surgery done in infancy. These transcatheter procedures can be described as dilatation of stenotic sites (angioplasty, endovascular stenting and va...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:Among the acute effects of cigarette smoking there are an increase in the arterial blood pressure and a decrease in skin temperature. The aim of this study is to evaluate whether these effects are more evident in hypertensive subjects (HTS) than in normotensive (NTS) ones. METHODS:A monitored Ambulatory Blo...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2003-08-01 00:00:00
abstract：:The aneurysm of the interatrial septum (ASA) is a rare congenital heart disease, easily recognizable by real time cross sectional two dimensional echocardiography. The ASA occurs as an isolated entity or may be associated with congenital heart disease. Usually ASA may cause serious complications such as embolic phenom...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:The Impella left ventricular support system consists of two main components: a family of different ventricular support catheters with a microaxial pump to be placed across the aortic valve and a single external controller which is connected to activate and control the pump function. Four Impella left ventricular suppo...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：10.23736/S0026-4725.18.04703-5
更新日期：2018-10-01 00:00:00
abstract：:Chronic vascular disorders of the upper limbs are not frequently encountered in women; in addition, advanced age of onset tends to suggest the presence of common diseases such as arteriosclerosis or microembolization. Nonetheless, diagnosis is not always straightforward and in some cases both-laboratory and instrument...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2000-11-01 00:00:00
abstract：:After recalling that cardiovascular complications represent the most frequent cause of mortality and morbidity in hypertensive patients, the author describes the main mechanism responsible for increased plasma level concentrations of Angiotensin in this syndrome. He subsequently illustrates the effects of ACE-inhibito...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2001-10-01 00:00:00
abstract：AIM:We aimed to investigate the effects of verapamil and adenosine in an adjunct to intravenous tirofiban on management and prognosis of no-reflow phenomenon during primary percutaneous coronary intervention (PPCI) and to compare their efficacies on reversing of no-reflow phenomenon and short and midterm survival. MET...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Adjuvant trastuzumab therapy increases survival rates in patients with early HER2-positive breast cancer, although it can be potentially cardiotoxic. The aim of this study was to evaluate the prevalence of left ventricular (LV) systolic dysfunction; and the relationship between the presence of cardiovascular...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.16.04278-X
更新日期：2017-06-01 00:00:00
abstract：:Use of definite molecular weight heparan sulphate in a protocol for the prevention of deep venous thrombosis in the total joint replacement surgery. The authors propose a working protocol for the prevention of deep venous thrombosis in prosthetic orthopaedic surgery. It requires that integration of pharmacological, an...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1996-09-01 00:00:00
abstract：:The clinical significance of coronary myocardial bridging has been debated and different interventional strategies proposed. We discuss the case of a patient who presented with the recent onset of symptoms of exertional chest pain, diaphoresis, and electrocardiographic signs of acute anterior myocardial wall ischemia....
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1998-04-01 00:00:00
abstract：BACKGROUND:Aim of this study is to estimate the effectiveness of epidural electric stimulation of spinal cord for the treatment of patients with severe peripheral chronic arteriopathy who can't be surgically treated or when surgical therapy failed. METHODS:A retrospective study was carried out on 18 patients with peri...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2002-12-01 00:00:00
abstract：:Percutaneous coronary interventions (PCI) have gained widespread acceptation among cardiologists and among the general population for a variety of clinical indications, comprising from stable angina to ST-elevation acute myocardial infarction, due to the undisputed clinical benefit they provide and to their large avai...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2013-10-01 00:00:00
abstract：:The incidence of district (cardiac, cerebral, renal) and systemic vascular complications was studied in a population of 3992 hypertensive in-patients during the period from 1984 to 1988. The total number of male hypertensive patients was always higher (2355) than that of female hypertensive patients (1637). From the a...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1990-11-01 00:00:00
