Vorapaxar monotherapy for secondary stroke prevention: A call for randomized trial

Serebruany, Victor L.; Kim, Moo H; Hanley, Daniel F.

doi:10.1177/1747493016632253

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Similarly, dual antiplatelet therapy is effective just in the early phases of the ischaemic stroke (21-30 days) before becoming useless or detrimental. In the case of Vorapaxar, which is the only approved drug of a novel class antithrombotic agent acting on the protease-activated receptor-1 (PAR-1), trials directly assessing stroke management are lacking (3). PAR-1 is fundamental for pleiotropy of coagulation factors in the CNS (4).…”

Section: The Brain Coagulomementioning

confidence: 99%

“…In the case of vorapaxar, which is the only approved drug of a novel class antithrombotic agent acting on the protease-activated receptor-1 (PAR-1), trials directly assessing stroke management are lacking. 4 PAR-1 is fundamental for pleiotropy of coagulation factors in the central nervous system (CNS). 5 The main proteases that can activate PAR-1 are matrix metalloproteinase 9 (MMP-9) 5 and thrombin, whose activation state, concentration, and association with activated protein C (aPC) lead to differential pathway activation in physiology 6 as well as CNS pathologies.…”

Section: Theme 1: the “Coagulome” As A Critical Driver Of Cardiovascu...mentioning

confidence: 99%

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Blood Coagulation and Beyond: Position Paper from the Fourth Maastricht Consensus Conference on Thrombosis

et al. 2023

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The 4th Maastricht Consensus Conference on Thrombosis (MCCT), included the following themes: Theme 1: The “coagulome” as a critical driver of cardiovascular disease Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbiome status. Virus infections associated-coagulopathies perturb the hemostatic balance resulting in thrombosis and/or bleeding. Theme 3: How to limit bleeding risks: insights from translational studies This theme included state of the art methodology for exploring the contribution of genetic determinants of a bleeding diathesis; determination of polymorphisms in genes that control the rate of metabolism by the liver of P2Y12 inhibitors, to improve safety of antithrombotic therapy. Novel reversal agents for direct oral anticoagulants are discussed. Theme 4: Hemostasis in extracorporeal systems: how to utilize ex vivo models? Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularised organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation (ECMO) associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management Plenary presentations addressed controversial areas, ie thrombophilia testing, thrombosis risk assessment in hemophilia, novel antiplatelet strategies and clinically tested factor XI(a) inhibitors,both possibly with reduced bleeding risk. Finally, Covid-19 associated coagulopathy is revisited.

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Section: The Brain Coagulomementioning

confidence: 99%