Vorapaxar: A Protease-Activated Receptor Antagonist for the Prevention of Thrombotic Events.

Abstract:

:Antiplatelet therapy reduces the risks for cardiovascular morbidity and mortality in patients with atherosclerotic disease, and it is also beneficial in managing peripheral arterial disease (PAD). These agents work through various therapeutic pathways to achieve antithrombotic effects. Although single- or two-drug regimens have been deployed to prevent vascular events, approximately 10% of the patients with acute coronary syndrome remain at risk for recurrent thrombotic events and may need a more aggressive preventative strategy. Vorapaxar offers a unique mechanism for platelet inhibition via the antagonism of protease-activated receptor-1. It is approved for the reduction of thrombotic cardiovascular events in patients with a history of myocardial infarction (MI) or PAD. This new drug approval was mainly based on the results from subgroup analyses from a large landmark trial (Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-Thrombolysis in Myocardial Infarction 50), which found that vorapaxar reduces the rate of the combined end point of cardiovascular death, MI, stroke, and urgent coronary revascularization when used in addition to aspirin and/or clopidogrel in patients without a history of stroke. In this study, vorapaxar was discontinued in patients with a history of stroke due to excessive risk for intracranial hemorrhage after 2 years of therapy. As an adjunctive therapy to standard regimens, vorapaxar provides a greater net clinical benefit in MI patients who are at a lower risk for bleeding. In patients with PAD, it reduces the rates of recurrent acute limb ischemia with rehospitalization or peripheral revascularization. The most concerning adverse effect is bleeding. Vorapaxar should not be used in patients with a history of stroke, transient ischemic attack, intracranial hemorrhage, or active pathological bleeding. The risks and benefits of adding vorapaxar to intensify antiplatelet regimens should be assessed in individual patients to aim for additional therapeutic outcomes with minimal bleeding risks.

journal_name

Cardiol Rev

journal_title

Cardiology in review

authors

Lam S,Tran T

doi

10.1097/CRD.0000000000000075

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

261-7

issue

5

eissn

1061-5377

issn

1538-4683

journal_volume

23

pub_type

杂志文章,评审
  • Care of the Post-CABG Patient.

    abstract::An estimated 400,000 coronary artery bypass graft operations are performed annually in the United States. Saphenous vein grafts are the most commonly used conduits; however, graft failure is common. In contrast, left internal mammary artery grafts have more favorable long-term patency rates. Guidelines recommend aggre...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0000000000000261

    authors: Collins D,Goldberg S

    更新日期:2020-01-01 00:00:00

  • Inappropriate sinus tachycardia: current therapeutic options.

    abstract::Inappropriate sinus tachycardia (IST) is an uncommon form of arrhythmia characterized by an increased heart rate that is out of proportion to a normal physiologic demand. The etiology of IST remains ill-defined and controversial. Clinical presentation of IST is highly variable, from isolated to sustained palpitations,...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e31822f0b3e

    authors: Femenía F,Baranchuk A,Morillo CA

    更新日期:2012-01-01 00:00:00

  • Perspectives on sudden death prevention in hypertrophic cardiomyopathy.

    abstract::Sudden death (SD) is the most dramatic event in hypertrophic cardiomyopathy (HCM), often representing the first clinical manifestation of the disease, and the first concern of the clinicians who take care of such patients. HCM is now recognized as the primary cause of SD in young persons (<35 years of age), including ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0000000000000017

    authors: Efthimiadis GK,Zegkos T,Meditskou S,Hadjimiltiades S

    更新日期:2014-09-01 00:00:00

  • Relaxin: a new approach for the treatment of acute congestive heart failure.

    abstract::Relaxin, a naturally-occurring hormone in the insulin family, was discovered to have a physiologic role in pregnancy. Named initially for its relaxing effect on the pubic ligament, relaxin receptors have since been found to be widely distributed in many organs in both males and females. Acting through multiple pathway...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e3181f493e3

    authors: Grossman J,Frishman WH

    更新日期:2010-11-01 00:00:00

  • Recent advances in echocardiographic evaluation of left ventricular anatomy, perfusion, and function.

    abstract::This article provides a brief overview of several recently developed, emerging technologies and discusses their potential uses on clinical grounds. These new technologies include three-dimensional imaging, objective automated evaluation of ventricular function with acoustic quantification, assessment of regional ventr...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/00045415-200105000-00008

    authors: Mor-Avi V,Lang RM

    更新日期:2001-05-01 00:00:00

  • Application of intravascular ultrasound imaging in understanding and guiding percutaneous therapy for atherosclerotic coronary disease.

    abstract::Intravascular ultrasound imaging is a relatively new imaging modality that uses miniaturized ultrasound transducers, which are mounted on catheter tips and introduced into the vessel lumen to provide cross-sectional images of the vascular structure in real time. It has gained popularity rapidly among interventional ca...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/00045415-199909000-00014

    authors: Ziada KM,Tuzcu EM,Nissen SE

    更新日期:1999-09-01 00:00:00

  • Third-Generation LVADs: Has Anything Changed?

    abstract::The field of durable left ventricular assist devices has advanced dramatically since its introduction into the clinical realm. From the first-generation pulsatile HeartMate XVE device to the second-generation continuous axial flow HeartMate-2 to the current third-generation centrifugal flow devices, the left ventricul...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0000000000000268

    authors: Levine A,Gass A

    更新日期:2019-11-01 00:00:00

  • Work-related psychosocial factors and the development of ischemic heart disease: a systematic review.

    abstract::The literature on the relationship between work-related psychosocial factors and the development of ischemic heart disease (IHD) was systematically reviewed: 33 articles presented 51 analyses of studies involving male participants, 18 analyses involving female participants, and 8 analyses with both genders. Twenty of ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e318198c8e9

    authors: Eller NH,Netterstrøm B,Gyntelberg F,Kristensen TS,Nielsen F,Steptoe A,Theorell T

    更新日期:2009-03-01 00:00:00

  • Saphenous vein graft disease: review of pathophysiology, prevention, and treatment.

    abstract::Saphenous vein graft (SVG) disease after coronary artery bypass grafting (CABG) occurs in three phases: thrombosis, intimal hyperplasia, and atherosclerosis. Within the first month, thrombosis plays a major role. From month 1 to month 12, intimal hyperplasia occurs. Beyond 12 months, atherosclerosis becomes the primar...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e3182736190

    authors: Kim FY,Marhefka G,Ruggiero NJ,Adams S,Whellan DJ

    更新日期:2013-03-01 00:00:00

  • Is Anacetrapib Better Than Its CETP Inhibitor Counterparts?

    abstract::Cholesterol metabolism and transport has been a major focus in cardiovascular disease risk modification over the past several decades. Hydroxymethylglutaryl-CoA reductase inhibitors (statins) have been the most commonly used agents, with the greatest benefit in reducing both the primary and secondary risks of cardiova...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0000000000000245

    authors: Grabie M,Tai CH,Frishman WH

    更新日期:2019-09-01 00:00:00

  • Mitral valve endocarditis resulting from coagulase-negative Staphylococcus after stent implantation in a saphenous vein graft.

    abstract::Valvular endocarditis after percutaneous coronary intervention is unusual. We report a new case of mitral valve endocarditis after stent implantation to a saphenous vein graft. ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/01.crd.0000128842.48947.21

    authors: Palmer ND,Ramsdale DR

    更新日期:2005-05-01 00:00:00

  • Antiretroviral and statin drug-drug interactions.

    abstract::Patients living with the human immunodeficiency virus (HIV) are at risk for dyslipidemia as a result of the disease itself and from certain classes of antiretroviral therapy. The protease inhibitors and non-nucleoside reverse transcription inhibitors have been associated with elevated triglycerides, total, and low-den...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e3181903b7f

    authors: Ray GM

    更新日期:2009-01-01 00:00:00

  • Radiation-induced heart disease.

    abstract::Radiation-induced heart disease (RIHD) is becoming an increasing concern for patients and clinicians alike as the use of radiation therapy for the treatment of certain malignancies increases, and patient mortality secondary to neoplasms of the thorax, in particular Hodgkin's lymphoma and breast cancer, decreases. The ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e3182431c23

    authors: Filopei J,Frishman W

    更新日期:2012-07-01 00:00:00

  • A novel approach to left atrial appendage exclusion: the WATCHMAN device.

    abstract::Atrial fibrillation (AF), a very common cardiac arrhythmia, is a well-recognized predisposing factor for embolic stroke. While warfarin remains the cornerstone of anticoagulant treatment in patients with AF, it is often underutilized because of increased bleeding complications and frequent monitoring requirements. It ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e3181e53abb

    authors: Gorodnitskiy A,Lucariello RJ,Aizer A,Coppola JT

    更新日期:2010-09-01 00:00:00

  • The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy: Current and Future Perspectives.

    abstract::Two-dimensional speckle tracking echocardiography represents a novel, simple, and reproducible technique for the estimation of left ventricular myocardial deformation (strain) and the evaluation of left ventricular twist mechanics. During the last few years, its clinical and prognostic implications in cardiomyopathies...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0000000000000172

    authors: Zegkos T,Parcharidou D,Ntelios D,Efthimiadis G,Karvounis H

    更新日期:2018-05-01 00:00:00

  • Valvular aortic stenosis in the elderly.

    abstract::Elderly patients with valvular aortic stenosis have an increased prevalence of coronary risk factors, of coronary artery disease, and evidence of other atherosclerotic vascular diseases. Statins may reduce the progression of aortic stenosis (AS). Angina pectoris, syncope or near syncope, and congestive heart failure a...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e31805f6796

    authors: Aronow WS

    更新日期:2007-09-01 00:00:00

  • Pulmonary arterial hypertension and women.

    abstract::Pulmonary arterial hypertension (PAH) is a progressive disorder with a poor prognosis. It is characterized by sustained elevation of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR). It is defined hemodynamically by a mean PAP over 25 mm Hg, a pulmonary arterial wedge pressure of 15 mm Hg or les...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/01.crd.0000240529.49704.2e

    authors: De Marco T

    更新日期:2006-11-01 00:00:00

  • Effect of an ongoing educational program on the use of antiplatelet drugs, beta-blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering drugs in patients with coronary artery disease seen in an academic cardiology clinic.

    abstract::The effect of an ongoing educational program on the use of cardiovascular drugs in patients with coronary artery disease without contraindications to these drugs seen in an academic cardiology clinic was assessed in 100 patients seen during the 6-month period prior to the educational program and in 200 patients seen 9...

    journal_title:Cardiology in review

    pub_type: 杂志文章

    doi:10.1097/01.crd.0000131191.57664.e7

    authors: Nayak D,Aronow WS

    更新日期:2005-03-01 00:00:00

  • Toll-like receptors: new therapeutic targets for the treatment of atherosclerosis, acute coronary syndromes, and myocardial failure.

    abstract::The toll-like receptors (TLRs) are a class of transmembrane molecules that have important functions in both innate and acquired immunity. As part of the body's normal immune defense against microbial pathogens, stimulation of these receptors will trigger the inflammatory response cascade and the release of cytokines. ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e3181709fd8

    authors: Erickson B,Sperber K,Frishman WH

    更新日期:2008-11-01 00:00:00

  • The Mediterranean Diet and Cardiovascular Disease: Gaps in the Evidence and Research Challenges.

    abstract::In this article, we critically evaluate the evidence relating to the effects of the Mediterranean diet (MD) on the risk of cardiovascular disease (CVD). Strong evidence indicating that the MD prevents CVD has come from prospective cohort studies. However, there is only weak supporting evidence from randomized controll...

    journal_title:Cardiology in review

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/CRD.0000000000000222

    authors: Temple NJ,Guercio V,Tavani A

    更新日期:2019-05-01 00:00:00

  • Reverse Remodeling in Systolic Heart Failure.

    abstract::Left ventricular (LV) remodeling is the most common term used to describe the functional, structural, myocellular, and interstitial changes that occur in response to myocardial injury and/or chronic changes in myocardial loading conditions. Progression of LV remodeling over time in response to neurohormonal activation...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0000000000000068

    authors: Saraon T,Katz SD

    更新日期:2015-07-01 00:00:00

  • The cost-effectiveness of argatroban treatment in heparin-induced thrombocytopenia: the effect of early versus delayed treatment.

    abstract::A decision-tree analysis was used to estimate the average cost per patient using the direct thrombin inhibitor argatroban for early treatment (<48 hours after thrombocytopenia onset) compared with delayed treatment (> or =48 hours after thrombocytopenia onset) of immune-mediated heparin-induced thrombocytopenia (HIT) ...

    journal_title:Cardiology in review

    pub_type: 杂志文章

    doi:10.1097/01.crd.0000164011.17381.6f

    authors: Arnold RJ,Kim R,Tang B

    更新日期:2006-01-01 00:00:00

  • Brown adipose tissue thermogenesis: β3-adrenoreceptors as a potential target for the treatment of obesity in humans.

    abstract::It has been shown in rodents and newborn babies that brown adipose tissue (BAT) plays an important role in the generation of heat for maintenance of core body temperature. BAT is responsible for the process of adaptive thermogenesis, which involves heat generation in response to a drop in the environment's temperature...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e31829cabff

    authors: Mund RA,Frishman WH

    更新日期:2013-11-01 00:00:00

  • Confusion in revascularization: are women different and why?

    abstract::Cardiovascular disease is the leading cause of death in women in most developed countries of the world. Even though cardiovascular deaths of men in the United States have been declining, until recently the number of cardiovascular deaths in US women was on the rise, with 1 in 3 women dying from heart disease. Over the...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/CRD.0b013e31815cb185

    authors: Dullum MK,Dullum MK

    更新日期:2008-01-01 00:00:00

  • Primary pulmonary hypertension and cor pulmonale.

    abstract::Primary pulmonary hypertension and cor pulmonale represent forms of precapillary pulmonary hypertension due to intrinsic lung disease. In the case of primary pulmonary hypertension, this is due to disease of the pulmonary vasculature while cor pulmonale is related to diseases of the pulmonary vasculature, airways, or ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/00045415-200209000-00003

    authors: Lehrman S,Romano P,Frishman W,Rashid A,Dobkin J,Reichel J

    更新日期:2002-09-01 00:00:00

  • Inflammatory Cardiomyopathy: Case-based Review on Clinical Presentation, Diagnosis, and Management.

    abstract::Inflammatory cardiomyopathy is a broad term encompassing any disease leading to myocardial inflammation with associated cardiac dysfunction. While endomyocardial biopsy remains the gold standard for diagnosis, non-invasive imaging techniques, such as cardiac magnetic resonance imaging and positron emission tomography,...

    journal_title:Cardiology in review

    pub_type: 杂志文章

    doi:10.1097/CRD.0000000000000369

    authors: Li B,Lento PA,Pan S

    更新日期:2020-11-02 00:00:00

  • Acute pericarditis: diagnostic cues and common electrocardiographic manifestations.

    abstract::Acute pericarditis (AP) is basically a clinical diagnosis. Although specific electrocardiographic (ECG) manifestations may indeed point to its diagnosis, sole reliance on such findings in isolation of the clinical setting, however, is often the common pitfall that could lead to a misguided diagnosis. We briefly review...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/01.crd.0000210645.89717.34

    authors: Ariyarajah V,Spodick DH

    更新日期:2007-01-01 00:00:00

  • Gender differences and the outcome of interventions for acute coronary syndromes.

    abstract::Differences in the overall mortality for acute infarction in women vs men have been appreciated for some time. Some of these differences are based on the age at the time of presentation of women compared with men. Excess mortality in women is most clear at the younger end of the age spectrum. More careful examination ...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/00045415-200008040-00009

    authors: Feldman T,Silver R

    更新日期:2000-07-01 00:00:00

  • Heat shock proteins in cardiovascular disease a new therapeutic target.

    abstract::Cells have the capability of defending themselves from various stressors by activating a genetic program with the production of substances known as heat shock proteins and their regulatory partners, the heat shock transcription factors. In this article, heat shock proteins are discussed, including their roles in patho...

    journal_title:Cardiology in review

    pub_type: 杂志文章,评审

    doi:10.1097/01.crd.0000090894.70619.fa

    authors: Gupta M,Vavasis C,Frishman WH

    更新日期:2004-01-01 00:00:00

  • Association between Arsenic Exposure and Cardiovascular Disease.

    abstract::Arsenic is a ubiquitously dispersed metalloid that has been implicated as the cause of various adverse health effects. Human exposure to arsenic primarily occurs through contaminated drinking water and dietary intake of rice and grains, posing a great public health risk to millions of people worldwide. High levels of ...

    journal_title:Cardiology in review

    pub_type: 杂志文章

    doi:10.1097/CRD.0000000000000357

    authors: Kononenko M,Frishman WH

    更新日期:2020-09-15 00:00:00