Abstract:
BACKGROUND:Despite the common practice of clopidogrel loading for coronary stenting, the time dependence and degree of platelet inhibition after this therapy are not well defined. We sought to establish an optimal clopidogrel dosing regimen for sustained platelet inhibition in stented patients. METHODS AND RESULTS:Platelets were assessed by conventional aggregation with 5 micromol/L adenosine diphosphate (ADP), 1 microg/mL collagen (COLL), and 750 micromol/L arachidonic acid; whole blood aggregation by 1 microg/mL collagen (WBA); shear-induced closure time (CT); contractile force (CF); and expression of 9 surface receptors by flow cytometry in 100 patients undergoing elective stent placement without glycoprotein (GP) IIb/IIIa receptor antagonists. Blood was obtained at baseline and serially over 5 days poststenting after different clopidogrel loading regimens: 300 mg 24 hours before (Group A), 12 hours before (Group B), 3 to 6 hours before (Group C), and 75 mg at the time of intervention (Group D). Before stenting, ADP, COLL, CT, and WBA were reduced by clopidogrel loading (P <.05). CF was not affected by clopidogrel. Before stenting, GP IIb/IIIa expression increased in groups A through C (P <.05), whereas PECAM-1 and CD107a were reduced (P <.05). At 2 hours and 2 days poststenting, platelets, in general, exhibited an increase in activity that was most inhibited by clopidogrel loading. Clopidogrel inhibited GP Ib, platelet/endothelial cell adhesion molecule-1, CD 107a, CD 151, and GP IIb/IIIa expression at day 5 poststenting. CONCLUSION:A 300 mg clopidogrel load given 3 to 24 hours before stenting inhibits platelets at the time of the procedure and reduces poststent activity more than a 75 mg dose given at the time of the procedure. The inhibition of adhesive molecule expression may also contribute an antithrombotic effect. Poststent activation of platelets may warrant higher periprocedural dosing.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Gurbel PA,Cummings CC,Bell CR,Alford AB,Meister AF,Serebruany VL,Plavix Reduction Of New Thrombus Occurrence (PRONTO) trial.doi
10.1067/mhj.2003.109subject
Has Abstractpub_date
2003-02-01 00:00:00pages
239-47issue
2eissn
0002-8703issn
1097-6744pii
S0002870302948088journal_volume
145pub_type
杂志文章abstract::Thirty-four patients with acute myocardial infarction (mean age 55 years) who received intracoronary streptokinase for coronary thrombosis were followed for a mean of 9.4 months (longest 25 months) following the procedure of percutaneous transluminal coronary recanalization (PTCR). Twelve patients had undergone corona...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90265-4
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:ST-elevation myocardial infarctions (STEMI) caused by proximal left-anterior descending (LAD) lesions have more myocardium at risk and worse outcomes than those located in other segments. The aim is to compare outcomes of patients with STEMI and proximal-LAD lesions treated with bare-metal stents (BMS) versu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2013.04.012
更新日期:2013-07-01 00:00:00
abstract::A morphologic study of 466 cardiac mural thrombi, 66 examples of nonbacterial thrombotic endocarditis, 25 myxomas, and 12 papillary endocardial lesions was performed. It appeared that three different sequences of organization of endocardial thrombi are possible. (1) Ordinary mural thrombi are converted into a flat, fi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90003-4
更新日期:1975-01-01 00:00:00
abstract::Three illustrative cases of refractory hypoxemia in adults are presented. In two cases contrast echocardiography was invaluable in establishing the diagnosis of a true anatomic right to left shunt, as well as in localizing the shunt to an intracardiac or extracardiac site. In the third case true anatomic right to left...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90126-t
更新日期:1993-04-01 00:00:00
abstract::This study sought to determine whether early treatment with angiotensin-converting enzyme (ACE) inhibitors in patients with acute myocardial infarction (AMI) is useful for the improvement of fibrinolytic function, as well as left ventricular function. This study was designed to examine the levels of plasma plasminogen...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(97)80021-x
更新日期:1997-11-01 00:00:00
abstract::Plasma concentrations of immunoreactive alpha-human atrial natriuretic polypeptide (i alpha-hANP) and cyclic guanosine monophosphate (cGMP) were measured in 70 patients with heart disease. Plasma concentrations of i alpha-hANP were directly related to the severity of heart disease (F = 29.61, p less than 0.001). Plasm...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90663-6
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Experimental studies suggest that metabolic myocardial support by intravenous (IV) glucose, insulin, and potassium (GIK) reduces ischemia-induced arrhythmias, cardiac arrest, mortality, progression from unstable angina pectoris to acute myocardial infarction (AMI), and myocardial infarction size. However, tr...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.02.002
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Patients with atrial fibrillation (AF) are at increased risk for ischemic stroke. In patients who have suffered a stroke, screening for AF is routinely performed only for a short period after the stroke as part of the evaluation for possible causes. If AF is detected after an ischemic stroke, oral anticoagul...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2010.03.032
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Cardiac pacing can be challenging after a Fontan operation, and limited data exist regarding pacing in adult Fontan patients. The objectives of our study were to determine risk factors for pacing and occurrence of device-related complications (DRCs) and pacemaker reinterventions. METHODS:We performed a retr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.08.019
更新日期:2017-12-01 00:00:00
abstract::CHD remains the leading cause of death in most developed countries; therefore, elucidation of risk factors and associated mechanisms for atherosclerosis and development of CHD has been a high priority. Data from the Framingham Heart Study and other large-scale epidemiologic studies have identified major risk factors a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90096-4
更新日期:1996-06-01 00:00:00
abstract::Nearly 800,000 of the 1 million patients hospitalized with acute heart failure (AHF) every year are initially treated by emergency physicians. Signs and symptoms are typically most severe at initial presentation, but with timely diagnostic and therapeutic management, rapid improvement can be achieved. As a direct resu...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2013.03.009
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Aging represents the most powerful risk for the development of atherosclerosis and atherosclerotic thromboembolic complications. Yet, the mechanism by which aging affects the arterial wall and its deterioration has remained essentially uncharacterized. FINDINGS:Chronic injuries to the arterial wall contribu...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2003.09.002
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Stroke is a rare but serious event that complicates the course of patients with acute coronary syndromes (ACS). The type, outcome, and risk factors of stroke occurring in stabilized patients with ACS have not been previously reported. METHODS:We evaluated stroke incidence, subtypes, and outcomes, in additio...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2004.01.028
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Assessing risk and weighing the potential benefits from evidence-based therapies are essential in the clinical decision making process of optimizing care and outcomes for patients presenting with acute coronary syndromes (ACS). Such practices are advocated in international clinical guidelines of ACS care. Wh...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.07.032
更新日期:2015-11-01 00:00:00
abstract::In a study of GTN absorption during exercise and high ambient temperature, 12 healthy volunteers carried 10 mg glyceryl trinitrate (GTN, nitroglycerin) transdermal patches for 6 hours during each of 3 days. During a control day the mean plasma GTN concentration ranged from 1.0 nmol/L (SD +/- 0.8 nmol/L) to 1.5 nmol/L ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(86)90518-1
更新日期:1986-09-01 00:00:00
abstract::Blood platelets play essential roles in normal coagulation and in coronary atherosclerotic disease and its complications. Various antiplatelet therapies, including aspirin, ticlopidine, and dipyridamole, have been developed for use in patients with known coronary artery artery disease to prevent ischemic complications...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(95)90091-8
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:It is unclear whether fibrinogen predicts cardiovascular events independently of echocardiographic cardiovascular abnormalities and traditional risk factors. METHODS:We studied 2671 American Indians who participated in the second Strong Heart Study examination (1993-1995) and were observed for an average of...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.144
更新日期:2003-03-01 00:00:00
abstract::Fifteen patients who arrived between 6 and 24 hours after the onset of acute myocardial infarction and who were found to have totally occluded coronary arteries, received aspirin, heparin, and tissue plasminogen activator given over 3 hours. Eight patients were randomly assigned to receive intravenous prostaglandin E1...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(94)90539-8
更新日期:1994-04-01 00:00:00
abstract::Radiofrequency-powered, thermal balloon angioplasty is a new technique that enhances luminal dilatation with less dissection than conventional angioplasty. The purpose of this study was to assess the effect of radiofrequency heating of balloon fluid on the pressure-volume mechanics of in vitro balloon angioplasty and ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90005-1
更新日期:1994-07-01 00:00:00
abstract::Anesthetized dogs were cooled to a core body temperature of 26 degree C. or maintained at a body temperature of 37 degree C. during periods of 5 and 10 hours of LAD coronary artery occlusion. Subsequent macroscopic dehydrogenase enzyme mapping showed that ischemic injury was 25 per cent less after 5 hours of coronary ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90010-8
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is associated with an adverse prognosis in patients with coronary heart disease. Cardiac rehabilitation (CR) improves morbidity and mortality among patients with coronary heart disease, but its impact on patients with concomitant CKD has not been described. METHODS:We compared b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.048
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:All patients who present to an emergency department (ED) are triaged. The ED triage score may determine when patients are seen by a physician. Half of patients with acute myocardial infarction (AMI) were given a low priority score in Ontario in 2000/2001. We assessed the appropriateness of ED triage and its ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2011.05.015
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Racial differences in cardiovascular mortality among women remain largely unexplained. Preliminary data suggest that African American and Caucasian differences in endothelial function may parallel differential cardiovascular disease (CVD) risk in women. To further study differences in endothelial function bet...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.04.032
更新日期:2004-10-01 00:00:00
abstract::Adequate hydration is recommended for acute ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) to prevent contrast-induced nephropathy (CIN). However, the optimal hydration regimen has not been well established in these high-risk patients. The objective of t...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.10.007
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Although there is evidence linking smoking and heart failure (HF), the association between lifetime smoking exposure and HF in older adults and the strength of this association among current and past smokers is not well known. METHODS:We examined the association between smoking status, pack-years of exposur...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.05.013
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Some pharmacist-managed anticoagulation services (PMAS) provide initial follow-up to patients on oral anticoagulant, who are transferred to their physician once they are stabilized. This may be as effective as and less expensive than long-term PMAS follow-up. METHODS:Once PMAS patients were stabilized and r...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.02.009
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a recently recognized condition where biomarkers and prognosis are less well studied than in MI with obstructive coronary artery disease (MI-CAD). We therefore aimed to investigate the one-year prognostic value of high-sensitivity ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2018.03.005
更新日期:2018-06-01 00:00:00
abstract::To observe the stereoscopic structure and the motion of the prolapsing mitral valve and its regurgitant jet in comparison with the normal mitral valve, four-dimensional (or dynamic three-dimensional) echocardiography of mitral valve apparatus was obtained in 20 patients with mitral valve prolapse and 10 unaffected sub...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70257-6
更新日期:1997-01-01 00:00:00
abstract::To assess the effects of chronic left ventricular (LV) dysfunction on intravascular pulmonary blood volume (PBV) and extravascular lung water (EVLW) lung fluid volumes, 56 dogs were evaluated by means of double-indicator dilution techniques. PBV and EVLW were measured in seven control dogs, in eight dogs 4 hours after...
journal_title:American heart journal
pub_type: 杂志文章,收录出版
doi:10.1016/0002-8703(84)90421-6
更新日期:1984-09-01 00:00:00
abstract::Contrast bidimensional echocardiographic (2DE) studies were performed in eight patients with d-transposition of the great vessels in the postoperative period of the Senning technique. Contrast was injected into a peripheral vein of all patients, and into the arterial atrium in five in the postoperative period. The 2DE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90552-0
更新日期:1984-07-01 00:00:00