Abstract:
BACKGROUND:The aim of this study was to compare rate of onset, magnitude, and consistency of platelet inhibition after administration of prasugrel or clopidogrel and to relate platelet inhibition to systemic exposure to each active metabolite. Thienopyridines are prodrugs, metabolized in vivo to active metabolites that inhibit the platelet P2Y12 adenosine diphosphate (ADP) receptor. METHODS:This was an open-label, 2-way, crossover study that randomized healthy subjects (n = 68) to an oral loading dose (LD) of prasugrel 60 mg or clopidogrel 300 mg. Platelet aggregation response to 5 and 20 micromol/L of ADP was measured by turbidometric aggregometry. Plasma concentrations of the active metabolites of prasugrel and clopidogrel were quantified by liquid chromatography with tandem mass spectrometry detection methods. RESULTS:Inhibition of platelet aggregation (IPA) after prasugrel was significantly higher (P < .01) than that after clopidogrel from 15 minutes through 24 hours (5 micromol/L ADP) and from 30 minutes through 24 hours (20 micromol/L ADP). For 20 micromol/L ADP, the median time to reach > or = 20% IPA was 30 minutes for prasugrel and 1.5 hours for clopidogrel (P < .001). The maximum IPA was 84.1% +/- 9.5% with prasugrel versus 48.9% +/- 27.0% with clopidogrel for 5 micromol/L ADP and 78.8% +/- 9.2% versus 35.0% +/- 24.5%, respectively, for 20 micromol/L ADP (P < .001). Response to prasugrel was more consistent compared to clopidogrel (P < .01). The lower IPA response to clopidogrel was associated with lower plasma concentrations of its active metabolite (P < .001). CONCLUSIONS:Prasugrel 60 mg LD results in more rapid, potent, and consistent inhibition of platelet function than clopidogrel 300 mg LD. Lower IPA responses to clopidogrel were associated with lower concentrations of its active metabolite.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Brandt JT,Payne CD,Wiviott SD,Weerakkody G,Farid NA,Small DS,Jakubowski JA,Naganuma H,Winters KJdoi
10.1016/j.ahj.2006.10.010subject
Has Abstractpub_date
2007-01-01 00:00:00pages
66.e9-16issue
1eissn
0002-8703issn
1097-6744pii
S0002-8703(06)00902-1journal_volume
153pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Cardiac magnetic resonance (cMR) perfusion imaging is a promising technique to assess coronary artery disease (CAD). Our objective was to evaluate accuracy of various cMR imaging parameters to detect significant CAD as compared with angiography or fractional flow reserve (FFR). METHODS:We prospectively enro...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.04.024
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:The contemporary magnitude and prognostic implications of complete heart block (CHB) in patients with acute myocardial infarction (AMI) are unknown. As part of a community-based study of patients hospitalized with AMI in the Worcester, MA, metropolitan area, changes over time in the incidence rates of CHB co...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.03.011
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Few data are available concerning the effects on clinical outcome and left ventricular function of abciximab administration in patients undergoing rescue percutaneous transluminal coronary angioplasty (PTCA) after failed thrombolysis for acute myocardial infarction. The aim of the study was to investigate su...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2002.119762
更新日期:2002-02-01 00:00:00
abstract::The records of 64 patients with progressive systemic sclerosis (PSS) were reviewed. More than 100 items from the patient's history, physical examination, and laboratory tests were encoded. A two-tailed Gehan's test was used to evaluate the effect of each variable on patient survival. Variables significant at the 0.05 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90525-3
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Previous studies reported an impairment of nervous autonomic activity in patients with Duchenne muscular dystrophy (DMD). However, the relationship of the autonomic dysfunction to the impairment of cardiac mechanical function and of respiratory failure is not completely understood. METHODS:We evaluated card...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.114804
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine if depression is associated with worse disease-specific functional status in patients with coronary artery disease. The study was designed as a cross-sectional survey and 3-month longitudinal cohort. METHODS AND RESULTS:The study took place in outpatient clinics ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.106600
更新日期:2000-07-01 00:00:00
abstract::Our experience with the use of five new antiarrhythmic drugs for treating life-threatening arrhythmias in children will be briefly reviewed. Prevention of recurrent episodes of atrial flutter with digoxin and local anesthetic antiarrhythmic drugs often is only moderately successful, benefiting 65% of patients. Amiodar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90027-5
更新日期:1987-01-01 00:00:00
abstract:CLINICAL SCENARIO:A 67-year-old man is referred to your cardiology clinic complaining of worsening angina and dyspnea on exertion. Physical examination reveals a harsh grade IV/VI late-peaking crescendo-decresendo systolic murmur, loudest at the upper sternal border. The aortic closure sound is diminished. Echocardiogr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.05.031
更新日期:2004-07-01 00:00:00
abstract::Three hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.5 years a...
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(87)90742-3
更新日期:1987-09-01 00:00:00
abstract::To examine the recovery time of left atrial mechanical function after electrical cardioversion of atrial fibrillation, we recorded transmitral flow, pulmonary venous flow velocities, and interatrial septal motion during atrial systole within 24 hours (16 +/- 5 hours) and 10 days after cardioversion in 25 patients with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90353-1
更新日期:1996-02-01 00:00:00
abstract::The hemodynamic hallmark of hypertension is increased systemic vascular resistance, although this variable is usually not determined in hypertensive patients because it has generally required invasive procedures to measure cardiac output. Reliable, totally noninvasive methods are now available that measure cardiac out...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(88)90565-0
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Platelets play an important role in the natural history of coronary artery disease. Enhanced platelet aggregation and receptor expression unquestionably occur after coronary stent implantation; however, the functional characteristics of platelets before stenting have not been fully elucidated. METHODS:Plate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.116478
更新日期:2001-10-01 00:00:00
abstract::To determine the clinical usefulness of echocardiography in patients with anteroseptal myocardial infarction, echocardiograms were performed within 24 hours of admission on 40 patients with acute transmural anteroseptal myocardial infarction. Twenty-one patients had normal septal motion and septal systolic thickening,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90007-3
更新日期:1979-06-01 00:00:00
abstract::Acute myocardial infarction (MI) patients remain at high risk for recurrent events. Cholesterol efflux, mediated by apolipoprotein A-I, removes excess cholesterol from atherosclerotic plaque and transports it to the liver for excretion. Impaired cholesterol efflux is associated with higher cardiovascular (CV) event ra...
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.2020.10.052
更新日期:2021-01-01 00:00:00
abstract::Myocardial ischemia, electrolyte changes, and fluctuations in autonomic tone may play an important role in the presentation of malignant ventricular arrhythmias. beta-Adrenoceptor blocking agents have been shown to decrease the incidence of ventricular fibrillation and sudden cardiac death in patients with coronary ar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90015-9
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Although outcomes data on transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (Mitraclip) are available via the Transcatheter Valve Therapy (TVT) registry, dissemination of TVT data is often delayed. The Food and Drug Administration's Manufacturer and User Facility Device Expe...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.10.013
更新日期:2018-04-01 00:00:00
abstract::Coronary arterial stenosis of varying severity and length were created in open-chest dogs. The reactive hyperemic responses (RHR) to 15 second occlusions were used to produce flow increases and judge the physiological significance of the narrowings. RHR are sensitive indices of functional impairment when resting flow ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80010-5
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is a major public health problem in the United States. We assess the prevalence of diabetes in Dallas County, quantify the association between diabetes and subclinical cardiovascular disease, and assess the use of evidence-based cardiovascular disease risk-modifying therapies. METHODS:This...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.10.016
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Patients with an implantable cardioverter defibrillator (ICD) are at increased risk of anxiety disorders. In turn, anxiety has been identified as a precipitant of ventricular arrhythmias. Anxiety may in part be attributed to concerns about the ICD firing, but the relationship between ICD concerns, psychologi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.06.031
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:The latest cholesterol guidelines have shifted focus from achieving low-density lipoprotein cholesterol (LDL-C) targets toward statin use and intensity guided by atherosclerotic cardiovascular disease (ASCVD) risk. METHODS:Statin use and intensity were evaluated in 5,905 statin-eligible primary or secondary...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2017.08.005
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Kidney failure causes anemia and is associated with a very high risk of coronary heart disease (CHD). Mildly to moderately decreased kidney function is far more common and also is associated with an elevated prevalence of anemia and CHD risk. Recent data suggest an even higher risk of CHD when both condition...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.055
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is histopathologically characterized by myocyte hypertrophy, disarray, interstitial fibrosis, and small intramural coronary arteriole dysplasia, which contribute to disease progression. Longitudinal systolic and early diastolic strain rate (SR) measurements by speckle tracki...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.06.011
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Type III hyperlipoproteinemia is characterized by the accumulation of chylomicron and very low density lipoprotein (VLDL) remnants. Individuals with this disorder have a high risk of premature atherosclerosis, and hypolipidemic drugs are useful in their management. METHODS:We compared, in a double-blind, pl...
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(99)70262-0
更新日期:1999-07-01 00:00:00
abstract::Externally recorded STI were compared with invasively determined EF in 10 normal subjects and 86 patients with various forms of chronic heart disease. From phono-, apex-, and electrocardiograms and carotid pulse tracings, recorded without rigidly controlled conditions (postabsorptive state, fixed time of day, exclusio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80246-9
更新日期:1977-03-01 00:00:00
abstract:BACKGROUND:The human KCNE1 protein forms the β-subunit of the IKs potassium channel and is important in the regulation of the atrial action potential duration. The purpose of this study was to investigate the association between the nonsynonymous 112G>A mutation of the KCNE1 gene and postcardiac surgery atrial fibrilla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.09.020
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Patients with recurrent forms of atrial fibrillation may receive dual-chamber pacemakers after atrioventricular junction ablation for refractory symptoms. These patients are at risk for chronic atrial fibrillation, which would negate the benefits of dual-chamber pacing. The purpose of this study was to exami...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-8703(99)70223-1
更新日期:1999-04-01 00:00:00
abstract::When AV conduction is normal, the absence of VA conduction is not abnormal. Analogous information about retrograde sinoatrial conduction is not available. Although the premature atrial stimulas (PAS) technique can demonstrate the presence of sinoatrial entrance block (SAEB), both its prevalence and its relationship to...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90484-1
更新日期:1981-12-01 00:00:00
abstract::Adenosine thallium stress testing has a demonstrated utility in the detection of coronary artery disease. The optimal dose for diagnostic efficacy with minimal side effects has not been critically evaluated. A randomized 3- and 6-minute infusion of adenosine (140 micrograms/kg/min) was performed in 11 subjects. Subjec...
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(07)80015-9
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:We evaluated ethnic differences in the 10-year risk of myocardial infarction or coronary death derived from Framingham risk equation and in a composite measure of emerging cardiovascular disease risk factors in women and whether statistical adjustments for educational attainment, geographic location, and lif...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.08.027
更新日期:2005-06-01 00:00:00
abstract::The effect of the reperfusion on myocardial infarction has been studied in the rat in order to assess the possible reversibility of myocardial damage. The present study deals with reperfusion of experimental myocardial infarction in the rat. Two groups of animals were compared: one was subjected to permanent ischemia ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80255-x
更新日期:1977-03-01 00:00:00