Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes Undergoing PCI: A Long Way to Select Optimal Agent and Route

Puddu, Paolo Emilio; Schiariti, Michele; Bugiardini, Raffaele

doi:10.5402/2011/141430

Cited by 4 publications

(9 citation statements)

References 39 publications

(67 reference statements)

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“…Aspirin kullanımı trombin oluşumunu tam olarak etkilememektedir. Aspirin kullanan bazı bireylerde doku faktörle uyarıya bağlı olarak yüksek oranda trombin oluşumu görülmüştür [21,22]. eptifibatide ve abciximab trombin oluşumunu engellemiştir [22,23].…”

Section: Trombin Ve Trombosit Miktarının Etkisiunclassified

“…Aspirin kullanan bazı bireylerde doku faktörle uyarıya bağlı olarak yüksek oranda trombin oluşumu görülmüştür [21,22]. eptifibatide ve abciximab trombin oluşumunu engellemiştir [22,23]. Ancak yüksek konsantrasyonlarda, reaksiyon sisteminin kinetiği engel olduğundan bu etki ölçülememiştir.…”

Section: Trombin Ve Trombosit Miktarının Etkisiunclassified

“…Ancak yüksek konsantrasyonlarda, reaksiyon sisteminin kinetiği engel olduğundan bu etki ölçülememiştir. Benzer bulgular prostaglandin E1 kullanılan sistemlerde de ileri sürülmüştür [22,24]. Bu nedenle ilaç-etkili antitrombotik aktiviteyi ölçecek sistemin gücü, in vitro modellerde büyük ölçüde kullanılan uyaranın (agonistin) etkisine bağlıdır.…”

Section: Trombin Ve Trombosit Miktarının Etkisiunclassified

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The factors effecting thrombocyte function tests

Tetik¹

2012

CMJ

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Fizyolojik koşullarda sirkülasyondaki trombositlerin görevi bir damar hasarı oluştuğunda kan kaybını engellemektir. Subendotele trombosit-trombosit adezyonunu sağlayan ve hasara uğramış damar duvarında geçici olarak "trombosit tıkacı" oluşturan bu sistem ateroskleroz veya arterial tromboz gibi patolojik şartlarda ise lokal iskemiye veya aterosklerotik lezyona sebep olmaktadır. Klinik çalışmalarda temel alınan trombosit fonksiyon testleri trombositlerin agonistlere olan duyarlığı ve oluşan trombosit cevabındaki spesifiklik açısından öneme sahiptir. Bu çalışmada trombosit fonksiyon testlerini etkileyen parametreler, yapılmış çalışmalarla karşılaştırmalı olarak incelenmiştir.

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Section: Trombin Ve Trombosit Miktarının Etkisiunclassified

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The factors effecting thrombocyte function tests

Tetik¹

2012

CMJ

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“…Men may experience a greater benefit than women from angiotensin-converting enzyme inhibitors whereas β-blockers substantially improve survival in women, with possibly a greater benefit than in men. Clopidogrel appears to be equally effective in reducing cardiovascular events in both men and women [ 26 ], as were glycoprotein IIb/IIIa antagonists in randomized trials [ 10 , 37 ].…”

Section: Gender Bias For Treatment In Obstructive and Non-obstructivementioning

confidence: 99%

Age- and Gender-Normalized Coronary Incidence and Mortality Risks in Primary and Secondary Prevention

2012

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Epidemiologic differences in ischemic heart disease incidence between women and men remain largely unexplained. The reasons of women’s “protection” against coronary artery disease (CAD) are not still clear. However, there are subsets more likely to die of a first myocardial infarction. The purpose of this review is to underline different treatment strategies between genders and describe the role of classical and novel factors defined to evaluate CAD risk and mortality, aimed at assessing applicability and relevance for primary and secondary prevention. Women and men present different age-related risk patterns: it should be important to understand whether standard factors may index CAD risk, including mortality, in different ways and/or whether specific factors might be targeted gender-wise. Take home messages include: HDL-cholesterol levels, higher in pre-menopausal women than in men, are more strictly related to CAD. The same is true for high triglycerides and Lp(a). HDL-cholesterol levels are inversely related to incidence and mortality. In primary prevention the role of statins is not completely ascertained in women although in secondary prevention these agents are equally effective in both genders. Weight and glycemic control are effective to reduce cardiovascular disease (CVD) mortality in women from middle to older age. Blood pressure is strongly and directly related to CVD mortality, from middle to older age, particularly in diabetic and over weighted women. Kidney dysfunction, defined using UAE and eGFR predicts primary CVD incidence and risk in both genders. In secondary prediction, kidney dysfunction predicts sudden death in women in conjunction with left ventricular ejection fraction evaluation. Serum uric acid does not differentiate gender-related CVD incidences, although it increases with age. Age-related differences between genders have been related to loss of ovarian function traditionally and to lower iron stores more recently. QT interval, physiologically longer in women than men, may be an index of arrhythmic risk in patients with mitral valve prolapse and increased circulating levels of catecholamines. However, there are no large population-based studies to assess this. In conjunction with novel parameters, such as inflammatory markers and reproductive hormones, classical risk score in women may be implemented in the future.

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“…Long-term antiplatelet agents are key components of secondary prevention after acute coronary syndromes (ACS), including STEMI. However, there might be a critical balance to monitor: any effective antiplatelet regimen may be closely related to increased risk for bleeding, often necessitating discontinuation of treatment and directly impinging on a potentially worse long-term outcome [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Is There Still a Role for Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes?

et al. 2013

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The role played by glycoprotein (GP) IIb/IIIa inhibitors has continuously evolved from the initial introduction in mid 90 s until the most recent guidelines for treating acute coronary syndromes, and competed with a wider use of ADP inhibitors and novel anticoagulant drugs, to the extent that they stepped down from class I to class II recommendation in the routine setting of acute coronary syndromes. As a consequence, GP IIb/IIIa use was greatly narrowed. The purpose of this review is to define the roles that GP IIb/IIIa inhibitors may still have in acute ischemic settings by explaining why in high risk patients they might be preferable and/or whether they might be added to ADP inhibitors also emphasizing the underlying mechanistic actions. It is concluded that there might be a more extensive use of GP IIb/IIIa inhibitors in patients presenting with acute coronary syndromes, strictly based on the definition for a high risk procedure: complexity, angiographic characteristics and patient’s risk profile, regardless whether STEMI or NSTEMI. The positive elements one should appreciate in GP IIb/IIIa inhibitors are: efficacy, rapid onset and reversibility of action, absence of pharmacogenomic variability, pharmacoeconomic considerations and the possibility of intracoronary administration.

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Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes Undergoing PCI: A Long Way to Select Optimal Agent and Route

Cited by 4 publications

References 39 publications

The factors effecting thrombocyte function tests

The factors effecting thrombocyte function tests

Age- and Gender-Normalized Coronary Incidence and Mortality Risks in Primary and Secondary Prevention

Is There Still a Role for Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes?

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