G Montalescot

..We sought to compare the antiplatelet effects of three clopidogrel loading doses (LDs)...

..The aim of this study was to describe the management and outcomes using 'real-world' data taking the new definition of acute myocardial infarction into account...

..To determine the relationship between anticoagulation levels during percutaneous coronary intervention, and ischaemic events and bleeding...

..Our purpose was to evaluate long-term mortality and identify factors associated with 1-year mortality in patients who underwent elective percutaneous coronary intervention (PCI)...

..This study aimed to identify predictors of adverse clinical or angiographic complications following PCI in patients from many different countries...

..We report here the first large and comparative series of consecutive patients anticoagulated with low molecular weight heparin (LMWH) after mechanical heart valve replacement...

..Combined antithrombotic therapy also increases the benefit of early invasive strategies including coronary angiogram with stent-based percutaneous coronary angioplasty...

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..To this aim, a task force for primary PCI in AMI was formed to develop a set of recommendations to complement and assist clinical judgment. This paper represents the product of their recommendations...

..No systematic reviews have comprehensively examined the effects of early vs delayed administration of these agents...

..This study investigated the effects of irbesartan vs. enalapril, with early vs. late treatment, on markers of inflammation and ischaemic heart disease in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS)...

..4% among patients who received neither GP IIb/IIIa inhibitors nor a stent, compared to patients who received both GP IIb/IIIa inhibitors and a stent (7.3%), GP IIb/IIIa inhibitors alone (12.8%), or a stent alone (6.7%)...

..Future trials should report the rates of periprocedural complications when assessing the safety of novel anticoagulation therapies in PCI...

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..vWF and its receptor glycoprotein Ib/IX play a key role in acute coronary syndromes. vWF is linked to inflammation and, like glycoprotein Ib/IX, is affected more favorably by the LWMHs than by UFH...

..We tested the hypothesis that different anticoagulant treatments may produce different platelet effects and von Willebrand factor (vWf) release in unstable angina...

..Although patients with a recent interruption of OAA resemble those chronically treated by OAA, they display worse clinical outcomes...

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..Hypofibrinolysis promotes atherosclerosis progression and recurrent ischemic events in premature coronary artery disease. We investigated the role of fibrin physical properties in this particular setting...

..These findings provide new mechanistic information on reperfusion therapy...

..3%). CONCLUSIONS: PCI within 8 hours of the last enoxaparin subcutaneous injection seems to be safe and effective. The safety of subcutaneous LMW heparin in combination with platelet glycoprotein IIb/IIIa blockade awaits further study...

..CONCLUSIONS: The acute release of vWF and PAI-1 over the first 24 hours of STEMI is associated with death and heart failure. The acute rise of PAI-1 is also a strong independent predictor of death at 30 days...

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..Conflicting data exist on the risk of stent thrombosis with drug-eluting stents (DES) versus bare-metal stents (BMS). Little is known about the potential different characteristics and outcomes of DES versus BMS thrombosis...

..Based on these results, the current therapeutic guidelines for clinical practice issued by the American and European cardiology societies are given in the conclusion, with their level of evidence...

..Furthermore, these results provide a clear explanation for the hypofibrinolysis related to a defective fibrin architecture as described in venous thromboembolism and in premature coronary artery disease...

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..These modifications could participate in the better coronary artery patency observed with abciximab...

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..A careful identification of all potential relevant causes is the key point of the management strategy. Post-PCI rethrombosis is the third situation and probably the less frequent. However, it is the most difficult to deal with...

..The spontaneous changes in rest-redistribution thallium defect size were prospectively studied over six months in 52 patients with chronic Q wave myocardial infarction...

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..In these patients, enoxaparin with dose adjustment to creatinine clearance provides adequate anti-Xa levels and no excess of bleeding...

..Fluindione is a vitamin K antagonist with a long half-life. This study was designed to investigate the pharmacokinetics and pharmacodynamics of multiple doses of fluindione in patients...

..Ultrasonic energy could provide an alternative treatment for thrombotic vascular occlusion provided that more flexible guide wires could be designed...

..The FACT registry is currently the French registry including the greatest number of patients with acute coronary syndromes...

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..In conclusion, high hospital levels of CITP, a marker of collagen degradation and ventricular remodeling, are associated with late mortality and other serious clinical events after AMI...

..We compared traditional heparin treatment with intravenous enoxaparin in primary PCI...

..The diagnosis of a non-Q wave infarct was confirmed by myocardial scintigraphy using antimyosin monoclonal antibodies labelled with Indium 111. The site and size of the necrosis were also determined by this non-invasive investigation...

..The treatment of hyperhomocysteinaemia by folic acid supplements is effective in correcting plasma levels, without side effects and at a relatively low cost...

..Utilization of abciximab would be supported by the Cost saving approach of the EPIC trial 3-years follow-up which showed presentation of the initial benefits...

..In low-risk populations, a strategy using these biomarkers might help in identifying patients at greater risk of additional events...

..Organization of ambulance systems, prehospital management, and adequate PCI capacity appear now to be the key issues in providing reperfusion therapy for AMI...

..Adequate revascularisation of necrosed territories depends on a deeper understanding and more precise prospective assessment of postinfarction hibernating myocardium...

..Development of a biological assay for monitoring either LMWH or GP IIb/IIIa receptor antagonists is another important issue in the setting of antithrombotic combinations which are now commonplace...

..Finally, the potential benefit in terms of therapeutic intervention of such screening needs to be evaluated. These important issues warrant further clinical studies with appropriate design...

..The nature of the embolism was confirmed by anatomopathological examination after popliteal embolectomy. This complication would appear to be extremely rare but represents an additional risk in patients with calcific mitral stenosis...

..Global evaluation of the clinical benefits should be advocated with a register of ischaemic and serious haemorrhagic events amongst the criteria of evaluation of the trials...

..Late discontinuation of clopidogrel after an acute coronary syndrome or stent placement may be associated with a clinical rebound effect...

..Combination therapy with LMWH and GP IIb/IIIa inhibitors appears to be better tolerated than with UFH and GP IIb/IIIa inhibitors...

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..The P2 and P-selectin findings suggest the possibility of a partial agonist and/or pro-inflammatory effect...

..It is the main cause of death in Western populations, a major public health concern and its prevalence will further increase in the future...

..The manoeuverability of the guide wire and the relatively small size of the round distal tip explain why not all the thrombi could be treated.(ABSTRACT TRUNCATED AT 250 WORDS)..

..4% of the stenosis studied, there measuring 44 to 64%. The judgement of the cathetiser of these intermediary stenoses was essentially influenced by the recurrence of angina during follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)..

..Thus, with this little obstructive prosthesis the postoperative improvement obtained persisted for five years in most cases of aortic valve stenosis or regurgitation...

..Providing adequate answers to these relevant clinical issues should improve the clinical benefit of clopidogrel. All these important points are discussed in the following manuscript...

..This combined antithrombotic also allowed to increase the benefit of an early invasive strategy including coronary angiogram with stent percutaneous coronary intervention...

..Future rational use of these agents will require attention to disease and patient features to strike the optimal balance of benefit to risk...

..8 +/- 42.3 pg/ml if W/M was decreased versus 82.7 +/- 15.4 pg/ml when W/M was normal): this could be related to the degree of left ventricular hypertrophy...

..Several small studies have suggested that intravenous enoxaparin may be a safe and effective alternative. Our primary aim was to assess the safety of enoxaparin as compared with that of unfractionated heparin in elective PCI...

..Prasugrel, a potent and rapid-acting thienopyridine, is a potential alternative to clopidogrel. We aimed to assess prasugrel versus clopidogrel in patients undergoing percutaneous coronary intervention (PCI) for STEMI...

..A Bayesian method for individualization of dosage regimen was developed, based on a risk function for INR at steady state. Prescription rules for fluindione were derived using this method retrospectively on the 73 patients in this study...

..Despite its invasive caracteristic, coronarory angiography remains the gold-standard for the diagnosis of coronary artery disease. However, cardiac multi-slices CT-scan appears a promising technique for asymptomatic patients...

..Synthetic factor Xa inhibitors are at an early stage of development. Of the direct thrombin antagonists, bivalirudine provides an improved benefit/risk ratio and is a new option in the catheter laboratory...

..CONCLUSIONS: Fibrinolysis resistance that arises from the presence of gammaA/gamma' fibrinogen in the clot is related primarily to an increase of fibrin cross-linking with only slight modifications of the clot architecture...

..These improvements may explain the observed reduction in acute coronary syndrome following the implementation of the smoke-free legislation...

..We sought to compare coronary risk factors, angiographic features, acute results of percutaneous coronary intervention, in-hospital outcomes, and pre-specified 1 year prognosis of HIV-infected and HIV-uninfected patients with ACS...

..Conclusions: In this study, coronary angioplasty with an active stent in patients with chronic renal failure was associated with a lower mortality rate compared with inactive stents, with no increase in the risk of acute thrombosis...

..This study evaluated the ability of the bedside test Hemochron Jr. Hemonox (International Technidyne Corporation, Edison, New Jersey) to identify patients with insufficient anti-Xa activity level in the catheterization laboratory...

..This review examines all these important issues...

..This review provides a consensus opinion on the definition of high on-treatment platelet reactivity to ADP based on various methods reported in the literature and proposes how this measurement may be used in the future care of patients...

..The nationwide REGINA survey was designed to evaluate how the interruption of dual APT is managed in the 'real world'...

..However, little dosing information is available regarding the use of enoxaparin in patients with renal impairment...

..We investigated the association between plasma fetuin-A and clinical outcome after ST-elevation acute myocardial infarction (STEMI)...

..It is necessary therefore to weigh the indications for bronchoscopy and the subsequent benefits against the risks, not only of haemorrhage, but of thrombosis if the APAs are withdrawn...

..It is also demonstrated that its clinical efficacy depends on the time delay between symptom onset and initiation of the therapy. However, the clinical benefit of prehospital administration remains to be established...

..Finally, intravenous insulin therapy is promising in the initial phase of treatment of acute coronary syndromes with better defined blood glucose objectives...

..These findings provide new insights on the synergistic potential of GP IIb/IIIa inhibitors and fibrinolytic agents...

..We assessed whether the CYP2C19*2 polymorphism affected long-term prognosis of patients who were chronically treated with clopidogrel...

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..International guidelines recommend an early invasive strategy for patients with high-risk acute coronary syndromes without ST-segment elevation, but the optimal timing of intervention is uncertain...

..Limited data is available on the long-term outcome after sirolimus-eluting stent (SES) implantation for in-stent restenosis...

..The purpose of this study was to determine the prognostic value of circulating secretory phospholipase A2 (sPLA2) activity in patients with acute coronary syndromes (ACS)...

..However, the impact of this approach on postoperative outcome remains controversial...

..Since direct PCI is often a slow process, better use of existing and future therapies, as well as advances in patient transport, are expected to improve patient outcomes...

..Several important issues have to be faced including the identification of non responders, dose adjustment and the management of temporary interruption of antiplatelet agents in stable coronary artery disease patients...

..This combined antithrombotic also allowed to increase the benefit of an early invasive strategy including coronary angiogram with stent percutaneous coronary angioplasty...

..This study aimed to assess the clinical outcome and to analyse predictive factors of cardiac events in patients with in-stent restenosis treated with Sirolimus-eluting stent (SES)...

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..An additional second bolus could be proposed in patients with delayed or prolonged procedures...

..In conclusion, these studies provide the first definitive evidence that the alphaC domains play an important role in determining the structure and biophysical properties of clots and their susceptibility to fibrinolysis...

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