Abstract:
:Acute myocardial infarction is initiated by plaque disruption of a fatty plaque with a thin fibrous cap which has been infiltrated by macrophages. The macrophages are attracted and stimulated by oxidized lipids to secrete metalloproteinases which dissolve collagen and arterial wall matrix and to synthesize tissue factor which accumulates in the fatty gruel, and initiates the thrombotic process when exposed to flowing blood after plaque disruption. This initiates thrombin generation which is greatly amplified by the coagulation cascade.Minute amounts of thrombin initiate platelet aggregation, deposition and secretion with growth of platelet-rich thrombus and an accompanying network of fibrin which is at the base of platelet deposition, and increased over regions of deep injury where there appears to be enhanced thrombin generation. Thrombin is necessary for upregulation of platelet membrane receptors, growth of thrombus, maintenance of platelet cohesion, conversion of fibrinogen to fibrin, cross-linking of fibrin and, in part, for activation of the fibrinolytic system.Thrombosis is directly related to local rheology (shear force, turbulence), thrombogenicity of the exposed arterial wall substrates, and modified by systemic factors. Acute vasoconstriction is directly related to platelet deposition, enhanced by endothelial dysfunction or absence, and increased by hypercholesterolemia which induces production of the potent vasoconstrictor endothelin.Direct thrombin inhibition with a high affinity inhibitor, such as hirudin, totally blocks growth of thrombus, inhibits fibrin formation at lower doses and platelet deposition at somewhat higher doses, and enhances dissolution of residual thrombus. Dissolution of residual thrombus reduces luminal obstruction, and may reduce the need for revascularization procedures since plaque disruption most often occurs in arteries with minor obstruction (<50% stenosis).Current recommendations include intravenous heparin 5000 U bolus + 1,000 U/hr to maintain the aPTT at 60-85 sec, and aspirin (160-325 mg loading followed by 80 mg/day). Maximal inhibition of thrombus at the culprit lesion includes maintenance of heparin infusion plus daily aspirin and conversion of heparin to warfarin to maintain the INR at 2.0-3.0 for 3-6 months along with aspirin 80 mg/day as suggested by the ATACS trial. The value of fixed-dose warfarin plus low-dose aspirin in the acute and chronic phase after myocardial infarction is currently being evaluated in the Coumadin Aspirin Reinfarction Study.
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Chesebro JH,Badimon JJ,Hassinger NL,McBane RD,Fuster V Vdoi
10.1007/BF01060732subject
Has Abstractpub_date
1995-01-01 00:00:00pages
231-235issue
3eissn
0929-5305issn
1573-742Xjournal_volume
1pub_type
杂志文章abstract::Monocytes and monocyte-derived microparticles (MMPs) play a major role in acute coronary syndrome (ASC). Activated monocytes (ac-M) and MMPs support thrombin generation via tissue factor (TF). The aim of this study was to evaluate the inhibitory effect of fondaparinux, a selective Xa inhibitor, on thrombin generation ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-010-0490-4
更新日期:2010-11-01 00:00:00
abstract::The effect of taurine on the plasma levels of L-arginine, asymmetrical dimethylarginine (ADMA) and L-arginine/ADMA ratio and nitric oxide was investigated in experimental endotoxemia. L-arginine and ADMA levels were quantified by high performance liquid chromatography with fluorescence detector. Nitric oxide level was...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0011-2
更新日期:2007-08-01 00:00:00
abstract::Measurements of infarct size by use of tripenyltetrazoliumchloride (TTC) is a widely accepted method used to delineate the extent of myocardial necrosis following coronary occlusion and reperfusion in various animal experiments. There is controversy, however, regarding the optimal reperfusion time for estimating the m...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/a:1018770711705
更新日期:2000-10-01 00:00:00
abstract::The postthrombotic syndrome (PTS) is the most common complication of deep venous thrombosis (DVT) yet has received little attention from clinicians and researchers. Clinically, PTS is characterized by chronic pain, swelling, heaviness and other signs in the affected limb. In severe cases, venous ulcers may develop. PT...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-006-5574-9
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:We studied whether 2 MHz transcranial color-coded duplex ultrasound (TCCD), combined with a second generation ECA, accelerate IV rtPA-thrombolysis in the acute phase of MCA stroke more than TCCD monitoring alone. METHODS:Non-randomized acute MCA stroke patients undergoing IV rtPA-thrombolysis and 2 MHZ-TCCD...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-007-0044-6
更新日期:2008-04-01 00:00:00
abstract::Although clinical evidence supports a plausible association between thyroid disorders and venous thrombosis, reliable evidence is so far lacking on the potential biological mechanisms and neither temporary nor permanent thromboembolic risk factors were constantly identified. We performed a 2-years retrospective analys...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-008-0269-z
更新日期:2009-10-01 00:00:00
abstract::Specific therapy of acute spinal ischemia is not established. We report the first case of an MRI-verified cervical spinal ischemia treated by thrombolysis and review the literature. A 72-year old woman with right-sided motor hemiparesis and trunk ataxia was treated by intravenous thrombolysis with full recovery. Three...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-015-1332-1
更新日期:2016-07-01 00:00:00
abstract::Reticulated platelets (RP) are young, hyperactive platelets that are increased during situations of enhanced platelet turnover such as acute myocardial infarction (AMI). The dynamics of RP levels after AMI is not established. We aimed to characterize the levels of circulating RP over time in patients with AMI. Patient...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-014-1156-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Oxidative stress play an important role triggering platelet/endothelial activation. AGI-1067 is a novel, phenolic antioxidant, and vascular protectant which dose-dependently inhibits PEA biomarkers in vitro. Whether treatment with AGI-1067 alters platelets in vivo is not known. We serially assessed release o...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11239-008-0233-y
更新日期:2009-05-01 00:00:00
abstract::Thrombosis resolution is an important component of treatment for deep vein thrombosis (DVT) and multiple anticoagulants are now available. It is unknown whether rivaroxaban contributes to a higher degree of thrombus resolution compared to conventional anticoagulation with warfarin. Our objective was to compare thrombu...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01932-8
更新日期:2020-02-01 00:00:00
abstract::Venous thromboembolism (VTE) is an important cause of morbidity and mortality in Western countries. The incidence rate of VTE is estimated at 1-2 cases per 1000 annually. This study was a population-based cohort study of previously treatment naïve patients with a first occurrence of venous thromboembolism (VTE), using...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01966-y
更新日期:2019-11-01 00:00:00
abstract::Background: Renal vein thrombosis (RVT) complicating the nephrotic syndrome is associated with a poor prognosis. Methods/Results: RVT was diagnosed in 12 of 60 patients with a diagnosis of nephrotic syndrome suggested by computed tomography (CT) and subsequently confirmed by selective renal angiography. Fifty patients...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF00226414
更新日期:1996-01-01 00:00:00
abstract::Increased level of soluble cell adhesion molecules may be a marker for atherosclerosis and/or reflect complication of the atherosclerotic plaque. To test whether expression of cell adhesion molecules is more pronounced in unstable versus stable coronary plaques, we measured the serum level of soluble E-selectin (sE-se...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/a:1018656530541
更新日期:2000-01-01 00:00:00
abstract::Direct oral anticoagulant (DOAC) starter packs are designed for unique treatment dosing for acute venous thromboembolism (VTE). Inappropriate use of 30-day DOAC starter packs in patients with atrial fibrillation (AF) may increase the risk for bleeding events given higher dosing in the first 1-3 weeks of treatment. A r...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02358-3
更新日期:2021-01-03 00:00:00
abstract::Warfarin is the most widely prescribed oral anticoagulant, but large interindividual variations exist in the dose required to achieve comparable therapeutic effects. Several clinical and genetic variables have been identified that influence warfarin dosing. However, interactions between genotype and nutrition remain u...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-013-0978-9
更新日期:2014-07-01 00:00:00
abstract::Coronary artery fistulae (CAF) are rare congenital or acquired in which a connection forms between one of the coronary arteries and a heart chamber or with other vessels. This paper describes three cases of CAF along with their initial presentation, imaging findings and management. The first case is a rare form of CAF...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-019-01897-8
更新日期:2019-08-01 00:00:00
abstract::In experimentally induced myocardial ischemia, mild hypothermia (33-35 degrees C) has a robust cardioprotective effect. Tissue plasminogen activator (t-PA) is a profibrinolytic enzyme that is released from the vascular endothelial cells in response to ischemia and other injurious stimuli. t-PA has also been found to h...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0350-2
更新日期:2010-04-01 00:00:00
abstract::D-Dimer is a biomarker of fibrin formation and degradation. While a D-dimer within normal limits is used to rule out the diagnosis of deep venous thrombosis and pulmonary embolism among patients with a low clinical probability of venous thromboembolism (VTE), the prognostic association of an elevated D-dimer with adve...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-014-1101-6
更新日期:2015-01-01 00:00:00
abstract::On stimulation of platelets with agonists, for example, thrombin, a rapid rise in intracellular pH is observed. This alkalinization is mediated by an increase in transport activity of the Na(+)/H(+) exchanger isoform NHE1. In addition to this Na(+)/H(+) exchange mechanism, platelets express bicarbonate/chloride exchan...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1023/a:1008986329267
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:The missed diagnosis of acute myocardial infarction has been studied in the Emergency Department, but few studies have investigated how often coronary ischemia is correctly identified in the outpatient setting. METHODS:This was a single center retrospective observational study of patients with Health Allian...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0153-2
更新日期:2009-01-01 00:00:00
abstract::A significant proportion of the outcomes reported in trials assessing venous thromboembolism (VTE) prophylaxis in medical patients are related to asymptomatic events found on routine imaging studies. The implications of these events are controversial. Moreover, such trials did not always reflect the patient mix in tod...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-012-0730-x
更新日期:2012-07-01 00:00:00
abstract::Factor Xa (FXa) inhibitors are recommended for use in fixed doses without laboratory monitoring. However, prior studies reported the importance of establishing biomarkers representing anticoagulation intensity related to bleeding or thrombotic events. To test the hypothesis that prothrombin activation fragment 1 and 2...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02079-7
更新日期:2020-08-01 00:00:00
abstract::Heparin-induced thrombocytopenia (HIT) is a prothrombotic condition and it is associated with increased in vivo thrombin generation that needs to be treated with non-heparin anticoagulants such as direct thrombin inhibitors (DTIs). DTIs require parenteral administration and are associated with a non negligible risk of...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-015-1208-4
更新日期:2015-10-01 00:00:00
abstract::The US Surgical Care Improvement Project (SCIP) has approved two performance measures to improve venous thromboembolism (VTE) prevention. SCIP-VTE-2 measures the proportion of surgery patients who received appropriate VTE prophylaxis within 24 h prior to surgery to 24 h after surgery. This study assesses the current r...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0393-4
更新日期:2010-07-01 00:00:00
abstract::We describe a case of a 67-year-old woman with a history of cerebral infarction and pulmonary embolism that presented with chest pain. Subsequent evaluation resulted in a diagnosis of acute myocardial infarction and occult DVT, and imaging revealed a rare congenital absence of the infra-renal portion of the inferior v...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-005-1380-z
更新日期:2005-04-01 00:00:00
abstract::Whitmania pigra Whitman (W. pigra) has been widely employed in decoction for the treatment of blood stasis syndrome for many years in China. The aim of the present study was to explore the anti-venous thrombosis (VT) mechanism of the aqueous extract of W. pigra (AEW) in rats. Rats were orally administered with AEW. A ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02337-8
更新日期:2020-11-17 00:00:00
abstract::The objective was to compare the pharmacodynamic (PD) and pharmacokinetic (PK) effects of ticagrelor with clopidogrel among subjects of Hispanic ethnicity, as the PD and PK effects of antiplatelet agents among Hispanics are not specifically known. This was a randomised, open-label, crossover PD/PK study of 40 Hispanic...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11239-014-1135-9
更新日期:2015-01-01 00:00:00
abstract::Background: There is compelling evidence that coronary atherosclerosis represents a chronic active process characterized by inflammation, impaired fibrinolysis, intermittent plaque rupture, and luminal thrombosis. Identifying readily measurable plasma markers of procoagulant activity may have an important role in both...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF01062716
更新日期:1995-01-01 00:00:00
abstract:UNLABELLED:Platelet P-selectin and activated glycoprotein IIb-IIIa (GPIIb-IIIa) are markers of platelet activation and mediates platelet aggregation. Prasugrel (Pras) 5 mg may be used in very elderly (VE) acute coronary syndrome (ACS) patients undergoing PCI, but its effect on platelet P-selectin and activated GPIIb-II...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11239-016-1372-1
更新日期:2016-10-01 00:00:00
abstract::Since the reports by Weismann and Tobin in 1958 and Roberts et al. in 1964 called attention to paradoxical thrombosis in patients treated with heparin, the thrombotic aspect of the heparin-induced thrombocytopenia syndrome (HIT) has been emphasized. Yet to this day, the mechanism of thrombosis associated with HIT (HIT...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1023/a:1027372901367
更新日期:2000-11-01 00:00:00