Aspirin Reload Before Elective Percutaneous Coronary Intervention

Basili, Stefania; Tanzilli, Gaetano; Raparelli, Valeria; Calvieri, Camilla; Pignatelli, Pasquale; Carnevale, Roberto; Dominici, Marcello; Placanica, Attilio; Arrivi, Alessio; Farcomeni, Alessio; Barillà, Francesco; Madon, E; Violi, Francesco

doi:10.1161/circinterventions.113.001197

Cited by 19 publications

(10 citation statements)

References 39 publications

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“…Sample Size Calculation Preliminary data reported a higher rate of pathologic post-procedural MBG in women (50%) compared to men (30%) despite a TIMI flow grade 3 after PCI [80].…”

Section: Statistical Analysis Planmentioning

confidence: 99%

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Raparelli

Proietti

Lenzi

et al. 2018

J. of Cardiovasc. Trans. Res.

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Improvements in ischemic heart disease (IHD) management have been unbalanced between sexes, with coronary microvascular dysfunction considered the likely underlying reason. The Endocrine Vascular disease Approach (EVA) is an observational study (Clinicaltrial.gov NCT02737982) aiming to assess sex and gender interactions between coronary circulation, sexual hormones, and platelet function. Consecutive patients with IHD undergoing coronary angiography will be recruited: (1) to assess sex and gender differences in angiographic reperfusion indexes; (2) to evaluate the effects of estrogen/androgen on sex-related differences in myocardial ischemia; (3) to investigate the platelet biology differences between men and women with IHD; (4) to verify sexand gender-driven interplay between response to percutaneous coronary intervention, platelets, sex hormones, and myocardial damage at baseline and its impact on 12-month outcomes. The integration of sex and gender in this translational project on IHD will contribute to the identification of new targets for further innovative clinical interventions. Keywords Sex. Gender. Coronary microvascular dysfunction. Sex steroid hormones. Platelet function. Clinical outcomes. Myocardial blush grade Abbreviations 1VD One-vessel disease 2VD Two-vessel disease 3VD Three-vessel disease ACS Acute coronary syndrome AR Androgen receptors CAD Coronary artery disease CMD Coronary microvascular dysfunction CMR Cardiac magnetic resonance CVD Cardiovascular disease E2 Estradiol eCRFs Electronic case report forms ER Estrogen receptor GP Glycoprotein IHD Ischemic heart disease INOCA Ischemia and no obstructive CAD MACE Major adverse cardiovascular events MBG Myocardial blush grade MMAS-4 Morisky Medication Adherence Scale-4 Items NOS Nitric oxide synthase NOX2 NADPH oxidase 2 NSTEMI Non-ST elevation myocardial infarction PCI Percutaneous coronary intervention STEMI ST elevation myocardial infarction (c)TFC (corrected) TIMI frame count Associate Editor Enrique Lara-Pezzi oversaw the review of this article

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“…Sample Size Calculation Preliminary data reported a higher rate of pathologic post-procedural MBG in women (50%) compared to men (30%) despite a TIMI flow grade 3 after PCI [80].…”

Section: Statistical Analysis Planmentioning

confidence: 99%

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Raparelli

Proietti

Lenzi

et al. 2018

J. of Cardiovasc. Trans. Res.

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“…Many studies have shown that aspirin treatment caused a strong decrease in NF-κB activation, inhibitor of IκB-α phosphorylation together with translocation of NF-κB p65 to nucleus and IKK-β activation ( Shi et al, 2017 ). And many studies have shown that aspirin could improve I/R injury indexes as a positive and meaningful drug in the treatment of cardiovascular and cerebrovascular diseases ( Basili et al, 2014 ). So we chose aspirin as the positive control to compare with the effect of GC in order to elucidate the exact mechanism.…”

Section: Discussionmentioning

confidence: 99%

Ginkgolide C Alleviates Myocardial Ischemia/Reperfusion-Induced Inflammatory Injury via Inhibition of CD40-NF-κB Pathway

Zhang

Han

et al. 2018

Front. Pharmacol.

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Increasing evidence shows that inflammation plays a vital role in the occurrence and development of ischemia/reperfusion (I/R). Suppression of excessive inflammation can ameliorate impaired cardiac function, which shows therapeutic potential for clinical treatment of myocardial ischemia/reperfusion (MI/R) diseases. In this study, we investigated whether Ginkgolide C (GC), a potent anti-inflammatory flavone, extenuated MI/R injury through inhibition of inflammation. In vivo, rats with the occlusion of the left anterior descending (LAD) coronary artery were applied to mimic MI/R injury. In vitro, primary cultured neonatal ventricular myocytes exposed to hypoxia/reoxygenation (H/R) were applied to further discuss the anti-H/R injury property of GC. The results revealed that GC significantly improved the symptoms of MI/R injury, as evidenced by reducing infarct size, preventing myofibrillar degeneration and reversing the mitochondria dysfunction. Moreover, histological analysis and Myeloperoxidase (MPO) activity measurement showed that GC remarkably suppressed Polymorphonuclears (PMNs) infiltration and ameliorated the histopathological damage. Furthermore, GC pretreatment was shown to improve H/R-induced ventricular myocytes viability and enhance tolerance of inflammatory insult, as evidenced by suppressing expression of CD40, translocation of NF-κB p65 subunit, phosphorylation of IκB-α, as well as the activity of IKK-β. In addition, downstream inflammatory cytokines modulated by NF-κB signaling were effectively down-regulated both in vivo and in vitro, as determined by immunohistochemistry and ELISA. In conclusion, these results indicate that GC possesses a beneficial effect against MI/R injury via inflammation inhibition that may involve suppression of CD40-NF-κB signal pathway and downstream inflammatory cytokines expression, which may offer an alternative medication for MI/R diseases.

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“…12 Moreover, a 325-mg LD of aspirin in patients on chronic low dose of aspirin undergoing elective PCI, has been shown to improve the myocardial reperfusion and myocardial injury indexes. 13 Features of angiographic complexity and potential impact on outcome were not reported in these 2 studies. However, a pre-interventional LD of 150-300 mg aspirin orally-or 75-150 mg intravenously -is considered the standard of care as per guideline suggestions, regardless of PCI complexity.…”

Section: Preprocedural Treatmentmentioning

confidence: 98%

Periprocedural Antithrombotic Treatment in Complex Percutaneous Coronary Intervention

Vlachakis

Varlamos

Benetou

et al. 2022

Journal of Cardiovascular Pharmacology

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:In recent years, the management of complex lesions in patients undergoing percutaneous coronary intervention (PCI) constitutes a field of high interest and concern for the interventional cardiology. As more and more studies demonstrate the increased hazard of ischemic events in this group of patients, it is of paramount importance for the physicians to choose the optimal periprocedural (pre-PCI, during-PCI and post-PCI) antithrombotic treatment strategies wisely. Evidence regarding the safety and efficacy of current anticoagulation recommendation, the possible beneficial role of the pretreatment with a potent P2Y12 inhibitor in the subgroup of patients with non-ST segment elevation myocardial infarction with complex lesions, and the impact of a more potent P2Y12 inhibitor in individuals with stable coronary artery disease undergoing complex PCI are needed. This will provide and serve as a guide to clinicians to deploy the maximum efficacy of the current choices of antithrombotic therapy, which will lead to an optimal balance between safety and efficacy in this demanding clinical scenario.

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Aspirin Reload Before Elective Percutaneous Coronary Intervention

Cited by 19 publications

References 39 publications

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Ginkgolide C Alleviates Myocardial Ischemia/Reperfusion-Induced Inflammatory Injury via Inhibition of CD40-NF-κB Pathway

Periprocedural Antithrombotic Treatment in Complex Percutaneous Coronary Intervention

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