Comparison of Shear Stress–Induced Thrombotic and Thrombolytic Effects Among 3 Different Antithrombotic Regimens in Patients With Acute Coronary Syndrome

Kim, Minsuk; Kang, Sang‐Won; Kim, Jeong-Ran; Park, Jin Joo; Cho, Young-seok; Youn, Tae‐Jin; Chae, In‐Ho; Suh, Jung–Won

doi:10.1177/1076029620912814

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…A recent study comparing similar thrombotic and thrombolytic activity in patients with AMI reported LT values of 1,664 AE 756 seconds. 32 Using the independent t-test and assuming a one-sided alpha of 0.05, 5% MACE, and 10% attrition rate, we calculated that 493 patients would be required to achieve a power 1-β >0.80, to determine a 12% difference in LT for an enrolment ratio of 1:1 between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2024

Thromb Haemost

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Background East Asians (EAs), compared to white Caucasians (W), have a lower risk of ischemic heart disease and a higher risk of bleeding with antithrombotic medications. The underlying mechanisms are incompletely understood. Objectives We sought to compare thrombotic profiles of EA and W patients with myocardial infarction (MI) and relate these to cardiovascular outcomes. Methods In a prospective study in the United Kingdom and Korea, blood samples from patients (n ¼ 515) with ST-or non-ST-elevation MI (STEMI and NSTEMI) were assessed using the Global Thrombosis Test, measuring thrombotic occlusion (OT) and endogenous fibrinolysis (lysis time [LT]). Patients were followed for 1 year for major adverse cardiovascular events (MACE) and bleeding. Results EA patients showed reduced OT (longer OT) compared to W (646 seconds vs. 436 seconds [320-580], p < 0.001), with similar LT. In STEMI, OT (588 seconds vs. 361 seconds [274-462], p < 0.001) and LT (1,854 seconds [1,389-2,729] vs. 1,338 seconds [1,104-1,788], p < 0.001) were longer in EA than W. In NSTEMI, OT was longer (OT: 734 seconds [541-866] vs. 580 seconds , p < 0.001) and LT shorter (1519 seconds [1,058-2,508] vs. 1,898 seconds [1,614-2,806], p ¼ 0.004) in EA than W patients. MACE was more frequent in W than EA (6.3 vs. 1.9%, p ¼ 0.014) and bleeding infrequent. While OT was unrelated, LT was a strong independent predictor of MACE event after adjustment for risk factors (hazard ratio: 3.70, 95% confidence interval: 1.43-9.57, p ¼ 0.007), predominantly in W patients, and more so in STEMI than NSTEMI patients. Conclusion EA patients exhibit different global thrombotic profiles to W, associated with a lower rate of cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Untitled

2024

Thromb Haemost

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“…A recent study comparing similar thrombotic and thrombolytic activity in patients with AMI reported LT values of 1,664 ± 756 seconds. 32 Using the independent t -test and assuming a one-sided alpha of 0.05, 5% MACE, and 10% attrition rate, we calculated that 493 patients would be required to achieve a power 1-β >0.80, to determine a 12% difference in LT for an enrolment ratio of 1:1 between the two groups.…”

Section: Methodsmentioning

confidence: 99%

Ethnic Differences in Thrombotic Profiles of Acute Coronary Syndrome Patients and Relationship to Cardiovascular Outcomes: A Comparison of East Asian and White subjects

Suh,

Memtsas,

Gue

et al. 2023

Thromb Haemost

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Background East Asians (EAs), compared to white Caucasians (W), have a lower risk of ischemic heart disease and a higher risk of bleeding with antithrombotic medications. The underlying mechanisms are incompletely understood. Objectives We sought to compare thrombotic profiles of EA and W patients with myocardial infarction (MI) and relate these to cardiovascular outcomes. Methods In a prospective study in the United Kingdom and Korea, blood samples from patients (n = 515) with ST- or non-ST-elevation MI (STEMI and NSTEMI) were assessed using the Global Thrombosis Test, measuring thrombotic occlusion (OT) and endogenous fibrinolysis (lysis time [LT]). Patients were followed for 1 year for major adverse cardiovascular events (MACE) and bleeding. Results EA patients showed reduced OT (longer OT) compared to W (646 seconds [470–818] vs. 436 seconds [320–580], p < 0.001), with similar LT. In STEMI, OT (588 seconds [440–759] vs. 361 seconds [274–462], p < 0.001) and LT (1,854 seconds [1,389–2,729] vs. 1,338 seconds [1,104–1,788], p < 0.001) were longer in EA than W. In NSTEMI, OT was longer (OT: 734 seconds [541–866] vs. 580 seconds [474–712], p < 0.001) and LT shorter (1519 seconds [1,058–2,508] vs. 1,898 seconds [1,614–2,806], p = 0.004) in EA than W patients. MACE was more frequent in W than EA (6.3 vs. 1.9%, p = 0.014) and bleeding infrequent. While OT was unrelated, LT was a strong independent predictor of MACE event after adjustment for risk factors (hazard ratio: 3.70, 95% confidence interval: 1.43–9.57, p = 0.007), predominantly in W patients, and more so in STEMI than NSTEMI patients. Conclusion EA patients exhibit different global thrombotic profiles to W, associated with a lower rate of cardiovascular events.

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“…Shear stress can cause a variety of clinical conditions. Platelet activation induced by shear stress is thought to be an important mechanism in acute coronary syndromes [ 148 ]. Shear stress is also associated with higher white matter lesion volume in migraine patients, which increases with lower endothelial shear stress [ 149 ].…”

Section: Clinical Applications Of the Mechanical Environment Of Stem ...mentioning

confidence: 99%

How the mechanical microenvironment of stem cell growth affects their differentiation: a review

Zhang

Wang

2022

Stem Cell Res Ther

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Stem cell differentiation is of great interest in medical research; however, specifically and effectively regulating stem cell differentiation is still a challenge. In addition to chemical factors, physical signals are an important component of the stem cell ecotone. The mechanical microenvironment of stem cells has a huge role in stem cell differentiation. Herein, we describe the knowledge accumulated to date on the mechanical environment in which stem cells exist, which consists of various factors, including the extracellular matrix and topology, substrate stiffness, shear stress, hydrostatic pressure, tension, and microgravity. We then detail the currently known signalling pathways that stem cells use to perceive the mechanical environment, including those involving nuclear factor-kB, the nicotinic acetylcholine receptor, the piezoelectric mechanosensitive ion channel, and hypoxia-inducible factor 1α. Using this information in clinical settings to treat diseases is the goal of this research, and we describe the progress that has been made. In this review, we examined the effects of mechanical factors in the stem cell growth microenvironment on stem cell differentiation, how mechanical signals are transmitted to and function within the cell, and the influence of mechanical factors on the use of stem cells in clinical applications.

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Comparison of Shear Stress–Induced Thrombotic and Thrombolytic Effects Among 3 Different Antithrombotic Regimens in Patients With Acute Coronary Syndrome

Cited by 5 publications

References 34 publications

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Untitled

Ethnic Differences in Thrombotic Profiles of Acute Coronary Syndrome Patients and Relationship to Cardiovascular Outcomes: A Comparison of East Asian and White subjects

How the mechanical microenvironment of stem cell growth affects their differentiation: a review

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