American heart journal
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American heart journal · Oct 1999
Review Comparative StudyPharmacokinetics and pharmacodynamics of glycoprotein IIb-IIIa inhibitors.
Antagonists of the platelet receptor glycoprotein (GP) IIb-IIIa are a novel class of antithrombotic agents that provide more comprehensive platelet blockade than the combination of aspirin and heparin. Studies in patients scheduled for percutaneous coronary intervention and those with unstable angina or non-Q-wave myocardial infarction have shown that a combination of intravenous GP IIb-IIIa inhibitors with aspirin and heparin is associated with a reduction in death or myocardial infarction compared with therapy with aspirin and heparin alone. As with other antithrombotic agents, the principal safety issue with GP IIb-IIIa inhibitors is bleeding, because the potent antiplatelet effect of these drugs may adversely affect hemostasis. ⋯ Additionally, antagonists of GP IIb-IIIa may increase the risk of thrombocytopenia. The safety profiles of various GP IIb-IIIa inhibitors are largely a function of their pharmacokinetic and pharmacodynamic properties, most notably the reversibility of platelet inhibition and the rate of plasma clearance. Knowledge of the pharmacokinetic and pharmacodynamic properties of the GP IIb-IIIa inhibitors is critical for the appropriate utilization of this new class of drugs.
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American heart journal · Oct 1999
Correlation between clinical and Doppler echocardiographic findings in patients with moderate and large pericardial effusion: implications for the diagnosis of cardiac tamponade.
Clinical data are of unquestionable value for management purposes in cardiac tamponade, whereas the precise value of Doppler echocardiographic findings is not yet fully understood. We aimed to prospectively assess the correlation between clinical and Doppler echocardiographic signs in the diagnosis of cardiac tamponade in a large series of patients with pericardial effusion. ⋯ There is a good correlation between absence of collapse and absence of tamponade, but the correlation is poor between collapse and tamponade. Abnormal venous flow has a good correlation with clinical features of tamponade, with a higher sensitivity than right ventricular collapse and a much higher specificity than right atrial collapse.