Abstract:
BACKGROUND:Factor Xa plays a central role in the generation of thrombin, making it a novel target for treatment of arterial thrombosis. Fondaparinux is a synthetic factor Xa inhibitor that has been shown to be superior to standard therapies for the prevention of venous thrombosis. We performed a randomized trial to determine the safety and feasibility of fondaparinux in the percutaneous coronary intervention (PCI) setting. METHODS AND RESULTS:A total of 350 patients undergoing elective or urgent PCI were randomized in a blinded manner to receive unfractionated heparin (UFH), 2.5 mg fondaparinux IV, or 5.0 mg fondaparinux IV. Randomization was stratified for planned or no planned use of glycoprotein (GP) IIb/IIIa antagonists. The primary safety outcome was total bleeding, which was a combination of major and minor bleeding events. The incidence of total bleeding was 7.7% in the UFH group and 6.4% in the combined fondaparinux groups (hazard ratio, 0.81; 95% confidence interval, 0.35 to 1.84; P=0.61). Bleeding was less common in the 2.5-mg fondaparinux group compared with the 5-mg fondaparinux group (3.4% versus 9.6%, P=0.06). The composite efficacy outcome of all-cause mortality, myocardial infarction, urgent revascularization, or need for a bailout GPIIb/IIIa antagonist was 6.0% in the UFH group and 6.0% in the fondaparinux group, with no significant difference in efficacy among the fondaparinux doses compared with UFH. Coagulation marker analysis at 6 and 12 hours after PCI demonstrated that fondaparinux was superior to UFH in inducing a sustained reduction in markers of thrombin generation, as measured by prothrombin fragment F1.2 (P=0.02). CONCLUSIONS:In this pilot study of patients undergoing contemporary PCI, factor Xa inhibition with the synthetic anticoagulant fondaparinux in doses of 2.5 and 5.0 mg was comparable to UFH for clinical safety and efficacy outcomes. These data form the basis for further evaluation of fondaparinux in arterial thrombosis.
journal_name
Circulationjournal_title
Circulationauthors
Mehta SR,Steg PG,Granger CB,Bassand JP,Faxon DP,Weitz JI,Afzal R,Rush B,Peters RJ,Natarajan MK,Velianou JL,Goodhart DM,Labinaz M,Tanguay JF,Fox KA,Yusuf S,ASPIRE Investigators.doi
10.1161/01.CIR.0000158485.70761.67subject
Has Abstractpub_date
2005-03-22 00:00:00pages
1390-7issue
11eissn
0009-7322issn
1524-4539pii
111/11/1390journal_volume
111pub_type
临床试验,杂志文章,多中心研究,随机对照试验相关文献
CIRCULATION文献大全abstract::Twenty-six major cardiovascular centers participated in a cooperative study of all cases of infective endocarditis occurring during a single calendar year to obtain an overview of infective endocarditis. The study was designed to learn which patients appear to be at highest risk to develop this infection after palliat...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.59.2.327
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Decreased renal function has been found to be an independent risk factor for cardiovascular outcomes in patients with chronic heart failure (CHF) with markedly reduced left ventricular ejection fraction (LVEF). The aim of this analysis was to evaluate the prognostic importance of renal function in a broader ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.580506
更新日期:2006-02-07 00:00:00
abstract:BACKGROUND:Receptors that couple via the stimulatory G protein, Gs, to adenylate cyclase and to a positive inotropic response have been extensively investigated in falling human heart. In contrast, much less is known about receptors, such as the A1-adenosine receptor, that couple to adenylate cyclase via the inhibitory...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.83.4.1343
更新日期:1991-04-01 00:00:00
abstract::The status of radioactive tracer studies in cardiovascular diagnosis is summarized. Planning guidelines are suggested for a hospital nuclear medical service including a central nuclear medical facility and satellite units, and resource criteria are given for professional personnel including training and duties, equipm...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1975-07-01 00:00:00
abstract::Transthyretin amyloid cardiomyopathy (ATTR-CM) results in a restrictive cardiomyopathy caused by extracellular deposition of transthyretin, normally involved in the transportation of the hormone thyroxine and retinol-binding protein, in the myocardium. Enthusiasm about ATTR-CM has grown as a result of 3 simultaneous a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIR.0000000000000792
更新日期:2020-07-07 00:00:00
abstract:BACKGROUND:Some large epidemiological studies have shown an increase in mortality at low levels of total and LDL cholesterol. It has been speculated that low cholesterol levels may play a causative role in this association. To investigate this question, we analyzed all deaths occurring among middle-aged men in the Müns...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/01.cir.96.7.2128
更新日期:1997-10-07 00:00:00
abstract:BACKGROUND:Because of the marked difference in the incidence and severity of cardiovascular diseases between men and premenopausal women, several groups have studied the effect of sex steroids, particularly estrogen, on vascular endothelial prostacyclin (PGI2) release. No previous studies have addressed the effect of e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.5.2519
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:Sirt7, 1 of the 7 members of the mammalian sirtuin family, promotes oncogenic transformation. Tumor growth and metastasis require fibrotic and angiogenic responses. Here, we investigated the role of Sirt7 in cardiovascular tissue repair process. METHODS AND RESULTS:In wild-type mice, Sirt7 expression increa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.014821
更新日期:2015-09-22 00:00:00
abstract:BACKGROUND:Anisotropic conduction properties may provide a substrate for reentrant arrhythmias. We investigated the age-dependent changes of structural and functional anisotropy in isolated right atria from infant (1 to 2 months), young (6 to 12 months), and old (6 to 10 years) dogs. METHODS AND RESULTS:The histology ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000015506.36371.0d
更新日期:2002-04-30 00:00:00
abstract:BACKGROUND:Numerous scales exist for the classification of major bleeding events. Limited data compare the most commonly used bleeding scales within a single at-risk cohort of patients with atrial fibrillation. Here, we analyze bleeding outcomes according to the ISTH (International Society on Thrombosis and Hemostasis)...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.119.041346
更新日期:2019-11-26 00:00:00
abstract:BACKGROUND:The substitution variants K35A,E38A,K74A, E75A,R77A (SakSTAR.M38) and K74A,E75A,R77A,E80A, D82A (SakSTAR.M89) of recombinant staphylokinase (SakSTAR) with reduced antibody reactivity were assayed for thrombolytic potency and antibody induction in animal models and in patients. METHODS AND RESULTS:In a 125I-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.2.207
更新日期:1996-07-15 00:00:00
abstract::A patient who had disabling supraventricular tachycardia showed electrophysiologic evidence of coexistent right and left Kent bundles. The supraventricular tachycardia was accelerated by sequential antegrade and retrograde conduction over the right and left Kent bundles, respectively. Spontaneous blocking of the condu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.62.3.657
更新日期:1980-09-01 00:00:00
abstract::Arterial oxygen transport (cardiac output x arterial oxygen content) may be decreased in heart failure. We studied the determinants of arterial oxygen transport in 15 patients with chronic, severe myocardial failure at rest and during cycle ergometry. During control therapy at rest, arterial oxygen tension was normal ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.1.143
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:A warm-water bath (WWB) or sauna bath (SB) has generally been considered inappropriate for patients with severe congestive heart failure (CHF). However, a comprehensive investigation of the hemodynamic effects of thermal vasodilation in CHF has not been previously undertaken. METHODS AND RESULTS:To investig...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.10.2582
更新日期:1995-05-15 00:00:00
abstract::Total body surface maps from 15 subjects with left bundle branch block and normal axis (LBBB-NA) and 10 subjects with left bundle branch block and left axis (LBBB-LA) were analyzed and compared with maps from normal subjects. In 19 of the 25 subjects with LBBB, the timing of early upper sternal positivity was similar ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.67.3.660
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:The aims of the present study were to define the prevalence of untreated atrial fibrillation (AF) in a systematic screening program using intermittent ECG recordings among 75- to 76-year-old individuals and to study the feasibility of initiating protective oral anticoagulant (OAC) treatment. METHODS AND RES...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.114.014343
更新日期:2015-06-23 00:00:00
abstract:BACKGROUND:Xenografts ultimately fail as a result of acute vascular rejection (AVR), a process characterized by intravascular thrombosis, fibrin deposition, and endothelial cell activation. METHODS AND RESULTS:We studied whether targeted deletion of Fgl-2, an inducible endothelial cell procoagulant, (Fgl-2-/-) in the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.534271
更新日期:2005-07-12 00:00:00
abstract:BACKGROUND:Endothelial dysfunction of coronary arteries with impaired vasodilation has been reported in patients with arterial hypertension. However, the effect of dynamic exercise on coronary vasomotion of a stenotic vessel segment before and after PTCA has not yet been evaluated in these patients. METHODS AND RESULT...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.12.1192
更新日期:1998-09-22 00:00:00
abstract:BACKGROUND:Among patients with documented stable coronary artery disease and in whom no revascularization was performed, we compared the respective values of angiographic diameter stenosis (DS) and fractional flow reserve (FFR) in predicting natural history. METHODS:The present analysis included the 607 patients from ...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/CIRCULATIONAHA.117.028782
更新日期:2018-04-03 00:00:00
abstract:BACKGROUND:Blood clotting activation is an important component of the inflammatory response; the outbursts of unstable angina are usually associated with increased thrombin formation and coronary mural thrombosis. METHODS AND RESULTS:To investigate 1) whether monocyte activation is responsible for the enhanced thrombi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.3.790
更新日期:1992-09-01 00:00:00
abstract::Premature opening of the pulmonary valve (opening independent of atrial or ventricular systole) was originally described in a case of sinus of Valsalva rupture into the right atrium. Since that time we have observed five additional cases in which the pulmonary valve opened prematurely. Entities encountered included: 1...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.55.1.128
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:ACE inhibitors exert both acute and chronic beneficial effects on cardiac function (eg, remodeling, diastolic dysfunction) in experimental studies and in patients. They inhibit the formation of angiotensin II as well as the degradation of endogenous bradykinin. We recently reported that bradykinin induces se...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.9.2660
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate dynamic changes in aortic regurgitant (AR) orifice area with the use of calibrated electromagnetic (EM) flowmeters and to validate a color Doppler flow convergence (FC) method for evaluating effective AR orifice area and regurgitant volume. METHODS AND RESULTS:In...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.93.3.594
更新日期:1996-02-01 00:00:00
abstract::One hundred eighty-eight patients with acute myocardial infarction were studied prospectively from August 1980 to September 1982. One hundred thirty-six of these patients were entered into a intracoronary streptokinase study after informed consent was obtained. The remaining 52 patients, who either met exclusion crite...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.68.1.131
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:Impaired endothelium-dependent, nitric oxide (NO)-mediated vasodilation may contribute to increased vasomotor tone in patients with heart failure. Whether decreased endothelium-dependent, NO-mediated vasodilation in patients with heart failure is due to decreased synthesis or increased degradation of NO is u...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.16.2113
更新日期:1999-04-27 00:00:00
abstract:BACKGROUND:Modeling of the time-[1-(11)C]acetate activity curve assumes a constant concentration of labeled tricarboxylic acid cycle intermediates and associated metabolites, such as glutamate and aspartate, which may, however, decrease in short-term hibernating myocardium. METHODS AND RESULTS:In 12 anesthetized pigs,...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.10.1009
更新日期:1998-03-17 00:00:00
abstract:BACKGROUND:Present therapies for acute coronary syndromes aim toward limiting platelet-platelet adhesion and aggregation processes. However, platelet-leukocyte interactions may contribute importantly to disease progression in the arterial wall. Recent studies suggest that prevention of platelet-leukocyte binding via P-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000015700.27754.6f
更新日期:2002-05-07 00:00:00
abstract:BACKGROUND:There is compelling experimental evidence that autologous skeletal muscle (SM) cell transplantation improves postinfarction cardiac function. This study assessed whether this benefit is still manifested in the clinically relevant setting of a treatment by ACE inhibitors. METHODS AND RESULTS:A myocardial inf...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc37t1.094593
更新日期:2001-09-18 00:00:00
abstract:BACKGROUND:Rosiglitazone improves glycemic control for patients with type 2 diabetes mellitus, but there remains controversy regarding an observed association with cardiovascular hazard. The cardiovascular effects of rosiglitazone for patients with coronary artery disease remain unknown. METHODS AND RESULTS:To examine...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.112.000678
更新日期:2013-08-20 00:00:00
abstract:BACKGROUND:Although echocardiography is commonly performed before coronary artery bypass surgery, there has yet to be a study examining the incremental prognostic value of a complete echocardiogram. METHODS AND RESULTS:Patients undergoing isolated coronary artery bypass surgery at 2 hospitals were divided into derivat...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.112.127639
更新日期:2013-01-22 00:00:00