Abstract:
:The formation of an intravascular thrombus underlies the clinical symptoms associated with acute coronary syndromes (ACS). Plaque rupture signals the recruitment and activation of platelets, initiation of the coagulation cascade, and generation of thrombin, resulting in the formation of a platelet-rich thrombus. Use of antithrombotic therapy, including antiplatelet and anticoagulant agents, is a crucial element in reducing the overall morbidity and mortality in patients with ACS. Current antiplatelet and anticoagulant therapies act on distinct sites in platelet activation pathways and the coagulation cascade, but because these agents target pathways necessary for protective hemostasis, their use increases the risk for bleeding complications. Previously, bleeding was considered an unavoidable side effect of ACS management with few clinical implications; however, bleeding has since been shown to be an independent predictor of short- and long-term mortality in patients with ACS. Therefore, the prevention of bleeding has become equally as important as the prevention of further ischemic events. Strategies to limit bleeding include bleeding risk stratification, appropriate dosing of antithrombotic drugs, use of the lowest dose of aspirin with proven efficacy, avoidance of combinations of antithrombotic agents unless for a proven indication, use of drugs proven to reduce the risk of bleeding, and choice of radial access over femoral access in case of invasive strategy. In this context, several novel therapeutic approaches are currently under clinical evaluation, including new antiplatelet agents, such as protease-activated receptor 1 antagonists, and new anticoagulants, such as direct-acting antagonists of factor Xa and factor IIa (thrombin). This review discusses antiplatelet and anticoagulant treatment strategies for the management of ACS, with a particular focus on their associated bleeding risks.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Bassand JPdoi
10.1016/j.ijcard.2011.10.104subject
Has Abstractpub_date
2013-02-10 00:00:00pages
5-18issue
1eissn
0167-5273issn
1874-1754pii
S0167-5273(11)01978-4journal_volume
163pub_type
杂志文章,评审abstract:BACKGROUND:Oral anticoagulant therapy is central to the prevention thromboembolic events in atrial fibrillation (AF) patients. The SAMe-TT2R2 score is a simple clinical-derived score designed to aid decision-making on whether or not a patient is likely to achieve good anticoagulation control on vitamin K Antagonists (V...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.04.131
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:Lipid lowering therapy constitutes the basis of cardiovascular disease therapy. The purpose of this study was to investigate effects of ezetimibe, a selective inhibitor of intestinal cholesterol absorption, on platelets and endothelial cells in an in vitro endothelial cell model. METHODS:After a 24h incubation...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.09.122
更新日期:2017-01-15 00:00:00
abstract:OBJECTIVES:To develop a quantitative event-free prediction model of late atrial arrhythmia after atrial septal defect (ASD) repair. BACKGROUND:The clinical management of ASD is driven by risk factors that determine the occurrence of late atrial arrhythmia. METHODS:Data from ASD type secundum patients, included in the...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2011.07.010
更新日期:2013-04-15 00:00:00
abstract::To evaluate the effect of ST-segment measurement point on diagnostic performance of the ST-segment/heart rate (ST/HR) hysteresis, the ST/HR index, and the end-exercise ST-segment depression in the detection of coronary artery disease, we analysed the exercise electrocardiograms of 347 patients using ST-segment depress...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(97)00157-5
更新日期:1997-10-10 00:00:00
abstract:BACKGROUND:Cardiac hypertrophy has been demonstrated to decreases the ATP-sensitive potassium channels (K(ATP)), the major protective mechanism following the energy depletion, a common condition seen during the reperfusion after open heart surgery. In this study we have demonstrated the role of ischemic preconditioning...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2003.06.010
更新日期:2004-07-01 00:00:00
abstract::Plasma levels of human thioredoxin are indicative of the responses against oxidative stress. We measured the plasma thioredoxin levels in patients with unstable angina in order to examine the relationships between subsequent clinical course and plasma thioredoxin levels before and after treatment for unstable angina. ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.01.010
更新日期:2005-03-18 00:00:00
abstract:AIM:To evaluate the predictive role of hs-CRP and fibrinogen for cardio- and cerebrovascular events in a population of patients with type 2 diabetes. METHODS:We studied 156 patients with type 2 diabetes, mean age 66+10 years, and 156 sex and age matched control subjects. Patients underwent physical examination, EKG, m...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.12.051
更新日期:2006-01-04 00:00:00
abstract:OBJECTIVE:Transcatheter aortic valve implantation (TAVI) has been designed to treat elderly patients with severe aortic stenosis at high risk for surgery. These patients are also often affected by severe iliac-femoral arteriopathy, rendering the trans-femoral approach unusable. We report our experience with the direct-...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.11.108
更新日期:2015-02-15 00:00:00
abstract:BACKGROUND:Cardiovascular safety concerns about inhaled ipratropium bromide have recently been raised. Nonetheless, the specific stroke risk associated with ipratropium use has not been evaluated thoroughly. METHODS:This was a population-based nested case-control study analyzing data from the National Health Insurance...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2012.02.012
更新日期:2012-07-12 00:00:00
abstract:BACKGROUND:Unwitnessed OHCA patients with non-shockable initial rhythms account for nearly half of all OHCA patients, and their prognosis is extremely poor. To date, no studies have focused on these patients. This study aimed to investigating the predictors of favorable and poor prognosis in these patients. METHODS:We...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.08.057
更新日期:2014-10-20 00:00:00
abstract::In heart failure, in addition to the renin-angiotensin-aldosterone system and sympathetic nervous system, the natriuretic peptide (NP) system plays a fundamental role among compensating mechanisms. The NPs undergo rapid enzymatic degradation that limits their vasorelaxant, natriuretic, and diuretic actions. Degradatio...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2016.04.180
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Defining an adequate endpoint for renal denervation trials represents a major challenge. A high inter-individual and intra-individual variability of blood pressure levels as well as a partial or total non-adherence on antihypertensive drugs hamper treatment evaluations after renal denervation. Blood pressure...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.06.110
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Low radiation doses from diagnostic and therapeutic procedures may increase cancer incidence after decades in cardiac patients. The aim of the study was to evaluate the long-term outcome and the prognostic effect of radiological exposure. METHODS:A retrospective cohort study examined 16,311 Italian cardiac ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2015.05.080
更新日期:2015-09-15 00:00:00
abstract:BACKGROUND:To consider hemodynamic assessment of myocardial bridging (MB) adequate, it is believed that inotropic stimulation with dobutamine should be estimated because its dynamic nature depends on the degree of extravascular coronary compression. This study evaluated comparative assessment of hemodynamic relevance o...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.09.101
更新日期:2016-12-15 00:00:00
abstract::Isolated noncompaction of the ventricular myocardium (INVM) is an unclassified cardiomyopathy and is thought to be due to arrest of myocardial morphogenesis. Left ventricular failure and ventricular arrhythmias may occur in approximately half of the patients and account for half of the death in this disorder. In this ...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2008.05.022
更新日期:2009-08-21 00:00:00
abstract:BACKGROUND:The activation of NOD-like receptor (NLR) family, pyrin-domain containing 3 (NLRP3) inflammasome has now been proven to have a close connection with myocardial ischemia (MI) during acute phase, but the mechanisms are not completely clear. This study investigated the role of NLRP3 inflammasome in pathogenesis...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2015.05.152
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Little is known about global patterns of critical care unit (CCU) care and the relationship with outcomes in patients with acute decompensated heart failure (ADHF). Whether a ward or a CCU admission is associated with better outcomes is unclear. METHODS:Patients in the Acute Study of Clinical Effectiveness ...
journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ijcard.2014.11.007
更新日期:2014-12-20 00:00:00
abstract:OBJECTIVE:Increased levels of neuro-hormonal biomarkers predict poor prognosis in patients with acute myocardial infarction (AMI) complicated by left ventricular systolic dysfunction (LVSD). The predictive value of repeated (one-month interval) brain natriuretic peptides (BNP) and big-endothelin 1 (BigET-1) measurement...
journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijcard.2017.02.018
更新日期:2017-08-15 00:00:00
abstract:BACKGROUND:Temporal dynamics of electrical wave propagation during AF is unknown. There are reports of transient linking of atrial activation. We aim to characterize temporal dynamics of wave propagation patterns during AF in an established chronically remodeled substrate. METHODS:Bi-atrial epicardial mapping of AF (m...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2015.07.057
更新日期:2015-11-15 00:00:00
abstract::In order to assess the long term effects of antihypertensive treatment on left ventricular diastolic function, 26 hypertensive patients were followed up for a mean of 4.25 years with two-dimensional and Doppler echocardiography. A significant reduction in left ventricular mass index was first apparent after 9 months o...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(95)02367-6
更新日期:1995-06-30 00:00:00
abstract:BACKGROUND:Previous studies have shown that air pollution particulate matter (PM) is associated with an increased risk for myocardial infarction. The effects of air pollution on the risk of ST-elevation myocardial infarction (STEMI), in particular the role of gaseous air pollutants such as NO2 and O3 and the susceptibi...
journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijcard.2016.07.191
更新日期:2016-11-15 00:00:00
abstract::A 72-year-old man with a large mass in the right atrium and the pulmonary embolism by chest computed tomography was diagnosed as the primary cardiac B-cell lymphoma (PCL) with pulmonary tumor embolism and pericardial effusion. Upon completion of initial chemotherapy, the mass was markedly reduced, and the pulmonary em...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2005.06.054
更新日期:2006-07-28 00:00:00
abstract:BACKGROUND:Endothelial dysfunction and abnormal vascular structure may be involved in the pathogenesis of chronic heart failure (HF). The purpose of this study was to evaluate simultaneously vascular function and vascular structure in patients with heart failure with preserved ejection fraction (HFpEF). METHODS:We mea...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.01.024
更新日期:2017-03-15 00:00:00
abstract:BACKGROUND:After aortic valve replacement (AVR), bicuspid aortic valve (BAV) patients continue to be at risk of aortic complications. Therefore, knowledge of native valve anatomy is important for follow-up. We aimed to determine the extent of which the presence of BAV disease is known in a regional post-AVR population....
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.09.084
更新日期:2016-12-15 00:00:00
abstract::A case of congenitally divided left atrium detected on cross-sectional echocardiography is described. Simultaneous Doppler examination helped to diagnose the obstructive nature of the partition within the left atrium by locating a turbulent high velocity (2.2 meters/second) diastolic signal. The diagnosis was confirme...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(88)90221-5
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) patients present with a variety of symptoms at different stages of the disease, but the underlying pathophysiology still is unclear. Left atrial (LA) function might be tightly related to changes in patients' symptoms, more than morphological and anatomic heart features, measurable by ultra...
journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijcard.2019.03.063
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:Study of outcomes of pregnancy in women with congenital heart disease. MATERIAL AND METHODS:The cardiac state during and after pregnancy was analysed in 173 women (mean age 28 years, range 21-41) referred for fetal echocardiography and evaluation of maternal heart during 201 pregnancies. Acyanotic lesions w...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2007.10.030
更新日期:2009-01-09 00:00:00
abstract::Low energy level irradiation (LLLI) has been found to modulate biological processes. The effect of LLLI on the development of acute myocardial infarction (MI) was investigated following chronic ligation of the left anterior descending (LAD) coronary artery in laboratory rats. The hearts of 22 rats were laser irradiate...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(01)00503-4
更新日期:2001-09-01 00:00:00
abstract::A review was undertaken of late post-infarct ventricular tachycardia in a district hospital cardiac care unit in order to study the clinical course of a total population of such patients from initial presentation to ultimate outcome. Thirty-six patients with this diagnosis were identified over a 3 1/2-yr period. Twelv...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(92)90235-u
更新日期:1992-06-01 00:00:00
abstract::It has been questioned for over 15 years why only less than 20% of TCFAs trigger ACS. We illustrate TCFA rupture into adjacent longitudinal necrotic shafts of massive amounts of thrombogenic material into the blood, leading to catastrophic clot formation. This is the potential mechanism for TCFAs triggering ACS. One c...
journal_title:International journal of cardiology
pub_type: 社论
doi:10.1016/j.ijcard.2014.09.144
更新日期:2014-12-20 00:00:00