Abstract:
BACKGROUND:Pharmacoinvasive therapy for the treatment of ST elevation myocardial infarction (STEMI) is a strategy that combines early restoration of coronary flow via pharmacologically induced thrombolysis with subsequent, prompt percutaneous coronary intervention (PCI). Prior studies suggesting a heightened bleeding risk of PCI performed early after fibrinolysis predated contemporary pharmacoinvasive practice including use of femoral closure devices (CD), fibrin specific thrombolytics, lower doses of heparin and stents. METHODS:Consecutive patients were included in this retrospective registry study if they underwent emergent PCI for ST elevation myocardial infarction (STEMI) followed by immediate use of a groin closure device. Between Oct 1, 2002 and Jan 1, 2003, 27 patients were treated with immediate use of CD after post-thrombolytic PCI, performed within 12 hours of thrombolysis (pharmacoinvasive group). 58 patients were treated with immediate use of CD after primary PCI for STEMI. The two groups were compared with respect to the incidence of successful groin closure, bleeding complications, and clinical outcomes. Bleeding events were categorized according to the TIMI criteria. All baseline clinical and treatment variables were compared between the two groups to determine and the association of these variables (including use of thromblytic therapy) with TIMI major and TIMI minor bleeding was determined. RESULTS:Pharmacoinvasive recanalization with PCI occurred 348 +/- 183 minutes after initiation of fibrinolytic therapy. Glycoprotein IIb/IIIa inhibitors were used less frequently in the patients treated with a thrombolytic agent (59% vs. 90%, p < 0.01). Successful immediate hemostasis was obtained with CD in greater than 85% of patients in both groups (89% for pharmacoinvasive group vs. 86% for primary PCI group, p = 0.89). No patient required vascular surgical intervention. TIMI major bleeding and transfusion requirements were less than 5% in both groups. Antecedent thrombolytic therapy was not a predictor of bleeding complications after PCI. CONCLUSIONS:Use of CD as part of a contemporary pharmacoinvasive strategy is associated with a low rate of major bleeding complications.
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Gutierrez MJ,Aggarwal A,Gilbert K,Sobel BE,Dauerman HLdoi
10.1007/s11239-005-0344-7subject
Has Abstractpub_date
2004-12-01 00:00:00pages
187-92issue
3eissn
0929-5305issn
1573-742Xjournal_volume
18pub_type
杂志文章abstract::Persisting heparin-induced thrombocytopenia (HIT) is characterized by ongoing thrombocytopenia more than 7 days after stopping heparin. It is part of cases referred to as autoimmune HIT (aHIT). In contrast to typical HIT cases, aHIT involves heparin-independent platelet activation mechanism highlighted by a strongly p...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
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更新日期:2020-10-01 00:00:00
abstract::The benefit of intravenous thrombolysis (IVT) has been questioned for patients with diabetes mellitus (DM) in cases of acute ischemic stroke (IS). Our objective was to analyze the differences in outcome according to prior diagnosis of DM and the use or not of IVT. Observational study with inclusion of consecutive IS p...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-014-1110-5
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/A:1008866025015
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abstract:BACKGROUND:The endothelial ADP receptor P2Y(1) is responsible for a large part of the reactive hyperemia following cardiac ischemia. Tissue plasminogen activator (t-PA) increases during reactive hyperemia. We postulated that the release of t-PA during reactive hyperemia could be mitigated through blocking the coronary ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0010-3
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abstract:BACKGROUND:Apoptosis causes myocardiocyte loss during and after myocardial infarction. Therapeutic approaches designed to arrest apoptosis would be a significant new development in the recovery of acute myocardial infarction (AMI). In order to examine apoptotic markers in the circulation, serum levels of p53 and cytoch...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0328-0
更新日期:2010-01-01 00:00:00
abstract:UNLABELLED:Coronary artery calcification may play a significant role in the pathophysiology of plaque progression and healing. We hypothesized that osteoprotegerin, an inhibitor of osteoclastogenesis, may participate in the calcification of coronary plaques or the response to injury after coronary stenting. A prospecti...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-006-9026-3
更新日期:2006-12-01 00:00:00
abstract::Cardiac disease following radiation therapy represents a major consideration in the treatment of a variety of malignancies. Damage to the heart can manifest in a variety of pathologies including ischemic cardiac disease, cardiomyopathy, valvular dysfunction, arrhythmias, and pericarditis. This damage has been shown to...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
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更新日期:2020-10-08 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
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更新日期:2009-10-01 00:00:00
abstract::Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic microangiopathy caused by severely reduced activity of the von-Willebrand factor-cleaving protease ADAMTS13, mainly caused by anti-ADAMTS-13 antibodies. Although several test systems for ADAMTS13 measurement exist, long turn-around times hamper...
journal_title:Journal of thrombosis and thrombolysis
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-015-1275-6
更新日期:2016-05-01 00:00:00
abstract::The Tissue Factor/Factor VIIa (TF/FVIIa) complex is an attractive target for pharmacological interruption of thrombin generation and hence blood coagulation, as this complex is the initiation point of the extrinsic pathway of coagulation. TF is a cell membrane-associated protein that interacts with soluble FVIIa to ac...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/a:1023228827733
更新日期:2002-10-01 00:00:00
abstract::A 64-year-old man first developed ligneous conjunctivitis at the age of 58 years after right pulmonary resection because of suspected cancer; otherwise, he had been healthy. Since then, he began to suffer from various forms of chronic pseudomembranous mucositis. Laboratory tests demonstrated that he had 7.8 % of plasm...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-016-1375-y
更新日期:2016-08-01 00:00:00
abstract::Thromboembolism afflicts millions of patients annually in the United States and is associated with a significant cost burden. Recent advances in oral anticoagulation have provided clinicians with more options for management of these diseases. Accordingly, regulatory, legislative, and policy-making organizations have i...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-015-1198-2
更新日期:2015-04-01 00:00:00
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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::Subtilisin QK, a new fibrinolytic enzyme, could cleave directly cross-linked fibrin in vitro. To verify the thrombolytic function of Subtilisin QK in vivo, the thrombolytic effect of purified Subtilisin QK on tail-thrombus of mouse was investigated. After injected with carrageenan, the tail-thrombus of Subtilisin QK t...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0333-3
更新日期:2009-11-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01929-3
更新日期:2020-01-01 00:00:00
abstract::Hospital acquired venous thromboembolism (VTE) is a major source of morbidity and mortality, yet proven prevention measures are often underutilized. The lack of a validated VTE risk assessment model, difficulty integrating VTE risk assessment and prevention protocols into the routine process of care, and the lack of s...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0405-4
更新日期:2010-02-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-010-0490-4
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pub_type: 杂志文章
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-012-0748-0
更新日期:2012-10-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/a:1013232803747
更新日期:1998-01-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11239-006-5733-z
更新日期:2006-04-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-016-1335-6
更新日期:2016-07-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1023/a:1022066305399
更新日期:2002-08-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-012-0775-x
更新日期:2013-02-01 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::A perceived increased risk of bleeding is one of the most frequent reasons for withholding anticoagulation for stroke prevention in atrial fibrillation (AF). We previously conducted a randomized controlled trial of alert-based computerized decision support to increase prescription of anticoagulation in hospitalized pa...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02296-0
更新日期:2020-09-30 00:00:00
abstract::The occurrence of an inhibitor against coagulation factor V (FV) is a rare but challenging condition, which may span from asymptomatic laboratory abnormalities to potentially life-threatening bleeding. The onset of FV inhibitors has been associated most frequently in the past with the patients' exposure to topical bov...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-010-0529-6
更新日期:2011-05-01 00:00:00