Coronary artery disease
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Coronary artery disease · Sep 2012
ReviewAnticoagulants for the treatment of acute coronary syndrome in the era of new oral agents.
Acute coronary syndromes (ACS) cause cessation of myocardial blood flow leading to coronary ischemia. The standard medical treatment includes heparin or low molecular weight heparin in the hospital, antiplatelet agents in the hospital and long term, and occasionally warfarin long term. All of these therapies are associated with bleeding complications. ⋯ In this review, we discuss the new agents, rivaroxaban, apixaban, and dabigatran, for the potential treatment of ACS. We also review the relevant clinical trials evaluating their effects in ACS. These novel anticoagulants allow convenience of use with no requirement for laboratory monitoring and limited drug interactions, which may provide multifaceted treatment options for ACS and anticoagulation in the future.
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Coronary artery disease · Aug 2012
The relationship between red blood cell distribution width and the clinical outcomes in non-ST elevation myocardial infarction and unstable angina pectoris: a 3-year follow-up.
Red blood cell distribution width (RDW), a marker of variation in the size of the circulating red blood cells, was evaluated in patients with non-ST elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP). ⋯ RDW is a readily available clinical laboratory value associated with long-term cardiovascular mortality in NSTEMI and UAP.
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Coronary artery disease · Aug 2012
Impact of diabetes mellitus on patients with unprotected left main coronary artery lesion disease treated with either percutaneous coronary intervention or coronary-artery bypass grafting.
This study was conducted to evaluate the impact of diabetes on patients with unprotected left main coronary artery (LMCA) disease treated with either percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG). ⋯ There was a prognostic impact of diabetes mellitus on treatment effects in patients with unprotected LMCA lesions who underwent DES or CABG. For patients with unprotected LMCA lesions, PCI with DES was an acceptable alternative to CABG at risk for higher repeat revascularization in the nondiabetic cohort, whereas in the diabetic cohort PCI with DES was inferior to CABG in terms of both safety and efficacy.
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Coronary artery disease · Jun 2012
Ischemic postconditioning through percutaneous transluminal coronary angioplasty in pigs: roles of PI3K activation.
Ischemic postconditioning (IPOC) has been suggested to reduce ischemic reperfusion injury. It remains unclear whether the activation of phosphatidylinositol 3 kinase (PI3K)/Akt is a causal mechanism in the cardioprotection afforded by IPOC, which was examined in the model of percutaneous transluminal coronary angioplasty (PTCA) minipigs. ⋯ Our findings show that IPOC is capable of protecting the myocardium against IR injury in the PTCA minipig model. The PI3K/Akt-signaling pathway is involved in the cardioprotective effect of IPOC.
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Coronary artery disease · Jun 2012
Comparative StudyBrain natriuretic peptide in apical ballooning syndrome (Takotsubo/stress cardiomyopathy): comparison with acute myocardial infarction.
Apical ballooning syndrome (ABS) is a transient cause of ventricular dysfunction. The aim of this study was to determine the clinical and hemodynamic correlates of brain natriuretic peptide (BNP) levels in ABS and compare the biomarker profiles in ABS with acute myocardial infarction controls. ⋯ BNP elevation is almost universal in ABS. Cardiac hemodynamic indices do not correlate with BNP levels. The magnitude of BNP elevation is higher in ABS compared with STEMI and NSTEMI.