The Experts below are selected from a list of 1179 Experts worldwide ranked by ideXlab platform
Egbert De Jong - One of the best experts on this subject based on the ideXlab platform.
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randomized comparison of enoxaparin a low molecular weight heparin with unfractionated heparin adjunctive to recombinant tissue plasminogen activator thrombolysis and aspirin second trial of heparin and aspirin reperfusion therapy hart ii
Circulation, 2002Co-Authors: Allan M. Ross, Whitney Schwartz, Peter Molhoek, Conor F Lundergan, Merrill L Knudtson, Yasmine C Draoui, Lorna Regalado, Veronique Le Louer, Frederique Bigonzi, Egbert De JongAbstract:Background— Adjunctive unfractionated heparin (UFH) during thrombolytic therapy for acute myocardial infarction (AMI) promotes the speed and magnitude of Coronary Artery Recanalization and reduces reocclusion. Low-molecular-weight heparins offer practical and potential pharmacological advantages over UFH in multiple applications but have not been systematically studied as adjuncts to fibrinolysis in AMI. Methods and Results— Four hundred patients undergoing reperfusion therapy with an accelerated recombinant tissue plasminogen activator regimen and aspirin for AMI were randomly assigned to receive adjunctive therapy for at least 3 days with either enoxaparin or UFH. The study was designed to show noninferiority of enoxaparin versus UFH with regard to infarct-related Artery patency. Ninety minutes after starting therapy, patency rates (thrombolysis in myocardial infarction [TIMI] flow grade 2 or 3) were 80.1% and 75.1% in the enoxaparin and UFH groups, respectively. Reocclusion at 5 to 7 days from TIMI gra...
Allan M. Ross - One of the best experts on this subject based on the ideXlab platform.
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Randomized Comparison of Enoxaparin, a Low-Molecular-Weight Heparin, With Unfractionated Heparin Adjunctive to Recombinant Tissue Plasminogen Activator Thrombolysis and Aspirin Second Trial of Heparin and Aspirin Reperfusion Therapy (HART II)
2015Co-Authors: Allan M. Ross, Whitney Schwartz, Ba Egbert De Jong, Md Karin CoyneAbstract:Background—Adjunctive unfractionated heparin (UFH) during thrombolytic therapy for acute myocardial infarction (AMI) promotes the speed and magnitude of Coronary Artery Recanalization and reduces reocclusion. Low-molecular-weight heparins offer practical and potential pharmacological advantages over UFH in multiple applications but have not been systematically studied as adjuncts to fibrinolysis in AMI. Methods and Results—Four hundred patients undergoing reperfusion therapy with an accelerated recombinant tissue plasminogen activator regimen and aspirin for AMI were randomly assigned to receive adjunctive therapy for at least 3 days with either enoxaparin or UFH. The study was designed to show noninferiority of enoxaparin versus UFH with regard to infarct-related Artery patency. Ninety minutes after starting therapy, patency rates (thrombolysis in myocardial infarction [TIMI] flow grade 2 or 3) were 80.1 % and 75.1 % in the enoxaparin and UFH groups, respectively
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randomized comparison of enoxaparin a low molecular weight heparin with unfractionated heparin adjunctive to recombinant tissue plasminogen activator thrombolysis and aspirin second trial of heparin and aspirin reperfusion therapy hart ii
Circulation, 2002Co-Authors: Allan M. Ross, Whitney Schwartz, Peter Molhoek, Conor F Lundergan, Merrill L Knudtson, Yasmine C Draoui, Lorna Regalado, Veronique Le Louer, Frederique Bigonzi, Egbert De JongAbstract:Background— Adjunctive unfractionated heparin (UFH) during thrombolytic therapy for acute myocardial infarction (AMI) promotes the speed and magnitude of Coronary Artery Recanalization and reduces reocclusion. Low-molecular-weight heparins offer practical and potential pharmacological advantages over UFH in multiple applications but have not been systematically studied as adjuncts to fibrinolysis in AMI. Methods and Results— Four hundred patients undergoing reperfusion therapy with an accelerated recombinant tissue plasminogen activator regimen and aspirin for AMI were randomly assigned to receive adjunctive therapy for at least 3 days with either enoxaparin or UFH. The study was designed to show noninferiority of enoxaparin versus UFH with regard to infarct-related Artery patency. Ninety minutes after starting therapy, patency rates (thrombolysis in myocardial infarction [TIMI] flow grade 2 or 3) were 80.1% and 75.1% in the enoxaparin and UFH groups, respectively. Reocclusion at 5 to 7 days from TIMI gra...
Gert Richardt - One of the best experts on this subject based on the ideXlab platform.
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course and prognostic implications of qt interval and qt interval variability after primary Coronary angioplasty in acute myocardial infarction
Journal of the American College of Cardiology, 2001Co-Authors: Hendrik Bonnemeier, Uwe K H Wiegand, Franz Hartmann, Frank Bode, Hugo A Katus, Gert RichardtAbstract:Abstract OBJECTIVES The aim of this study was to determine the influence of early reperfusion on the course of QT interval and QT interval variability in patients undergoing primary percutaneous transluminal Coronary angioplasty (PTCA) in acute myocardial infarction (AMI) and its prognostic implications on major arrhythmic events during one-year follow-up. BACKGROUND Although early Coronary Artery Recanalization by primary angioplasty is an established therapy in AMI, a substantial number of patients is still threatened by malignant arrhythmias even after early successful reperfusion, which may be caused by an inhomogeneity of ventricular repolarization despite reperfusion. METHODS Temporal fluctuations of ventricular repolarization were studied prospectively in 97 consecutive patients with a first AMI by measurements of QT interval and QT interval variability during and after successful PTCA (Thrombolysis in Myocardial Infarction flow grades 2 and 3). Continuous beat-to-beat QT interval measurement was performed from 24-h Holter monitoring, which was initiated at admission before PTCA. RESULTS Reperfusion caused a significant continuous increase of mean RR interval (738 ± 98 to 808.5 ± 121 ms; p CONCLUSIONS Reduction of QT interval and QT interval variability after timely reperfusion of the infarct-related Artery may be a previously unreported beneficial mechanism of primary PTCA in AMI, indicating successful reperfusion.
Jonathan Turner - One of the best experts on this subject based on the ideXlab platform.
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blockade of the platelet p2y12 receptor by ar c69931mx sustains Coronary Artery Recanalization and improves the myocardial tissue perfusion in a canine thrombosis model
Arteriosclerosis Thrombosis and Vascular Biology, 2003Co-Authors: Kai Wang, Xiaorong Zhou, Marc S Penn, Zhongmin Zhou, Khaldoun G Tarakji, Marcelo Carneiro, Daniel Murray, Allan L Klein, Robert G Humphries, Jonathan TurnerAbstract:Objective— Reperfusion therapy for myocardial infarction is limited by a significant reocclusion rate and less optimal myocardial tissue perfusion due to excessive platelet accumulation and recruitment at the sites of vascular injury. We assessed the influence of a selective P2Y 12 -receptor antagonist (AR-C69931MX), in conjunction with thrombolytic therapy, on the prevention of platelet aggregation and thrombus formation. Methods and Results— A canine Coronary electrolytic injury thrombosis model was used. Tissue-type plasminogen activator (t-PA; 1 mg/kg in phase I, 0.5 mg/kg in phase II in the AR-C69931MX group, and 1 mg/kg in the placebo group in phase I and II) was administered 30 minutes after thrombus formation; either saline or AR-C69931MX (4 μg · kg −1 · min −1 ) was given to all animals intravenously 10 minutes before t-PA administration for a total of 2 hours. All animals received heparin (80 U/kg) as an intravenous bolus followed by a continuous infusion of 17 U · kg −1 · h −1 . Myocardial tissue perfusion was evaluated by use of the colored microsphere technique and real-time myocardial contrast echocardiography. The incidences of reocclusion and cyclic flow variation were significantly decreased in the AR-C69931MX group ( P P Conclusions— The adjunctive administration of AR-C69931MX blocked ADP-mediated platelet aggregation and recruitment and prevented platelet-mediated thrombosis, resulting in prolongation of reperfusion time and a decrease in reocclusion and cyclic flow variations. Importantly, myocardial tissue perfusion was significantly improved in the P2Y 12 antagonist group.
D Collen - One of the best experts on this subject based on the ideXlab platform.
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a pilot study on bolus administration of recombinant staphylokinase for Coronary Artery thrombolysis
Thrombosis and Haemostasis, 1996Co-Authors: Steven Vanderschueren, D Collen, F Van De WerfAbstract:: Recombinant staphylokinase (Sak) is a highly fibrin-specific thrombolytic agent but the optimal dose and mode of administration remain to be defined. Intravenous (i.v.) infusion over 5 min of 20 mg Sak in 12 patients with acute myocardial infarction induced complete Coronary patency (TIMI perfusion grade 3) in 7 patients (58%) within 60 min. In 3 of the 5 patients with no or suboptimal flow (TIMI grade 0, 1 or 2) at 60 min, an additional 10 mg i.v. bolus of Sak resulted in TIMI grade 3 flow at 90 min. No major treatment-related complication occurred. Residual fibrinogen and alpha 2-antiplasmin levels at 90 min were 110 +/- 6.0% and 98 +/- 4.1% (mean +/- SEM) of baseline, respectively. Median antibody-related Sak-neutralizing activity was low at baseline (0.0 microgram/ml) and after 1 week (0.5 microgram/ml) but increased from day 10 on (to 4.0 micrograms/ml). Thus, bolus thrombolysis with Sak may induce efficient Coronary Artery Recanalization while preserving circulating fibrinogen and alpha 2-antiplasmin. Comparative trials of Coronary thrombolysis with double-bolus Sak appear to be warranted.
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thrombolytic therapy of peripheral arterial occlusion with recombinant staphylokinase
Circulation, 1995Co-Authors: Steven Vanderschueren, L Stockx, Guy Wilms, Hendrik Lacroix, Raymond Verhaeghe, Jozef Vermylen, D CollenAbstract:Background Recombinant staphylokinase (STAR) induces fibrin-specific Coronary Artery Recanalization in patients with evolving myocardial infarction. The present pilot study evaluates its thrombolytic efficacy, safety, fibrin specificity, and immunogenicity in patients with peripheral arterial occlusive disease. Methods and Results Thirty patients (37 to 86 years of age) with angiographically documented thromboembolic peripheral arterial occlusion of recent origin (21±5.5 days, mean±SEM) were treated with heparin and intra-arterial STAR given as a 1-mg bolus followed by a 0.5-mg/h infusion in 20 patients or as a 2-mg bolus followed by a 1-mg/h infusion in 10 subsequent patients. With 7.0±0.7 mg STAR infused over 8.7±1.0 hours, Recanalization was complete in 25 patients, partial in 2, and absent in 3. Two major hemorrhagic complications occurred: one fatal hemorrhagic stroke and one hypovolemic shock caused by bleeding at the angiographic puncture site. Administration of STAR did not induce fibrinogen break...
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Coronary thrombolysis with recombinant staphylokinase in patients with evolving myocardial infarction
Circulation, 1993Co-Authors: D Collen, F Van De WerfAbstract:BACKGROUNDStaphylokinase (STA), a protein with known profibrinolytic properties, is produced by transduced Staphylococcus aureus strains. In experimental animal models, recombinant staphylokinase (STAR) is less immunogenic and more active toward platelet-rich arterial blood clots than streptokinase.METHODS AND RESULTSIn the present study, 10 mg STAR given intravenously over 30 minutes was found to induce angiographically documented Coronary Artery Recanalization within 40 minutes in four of five patients with acute myocardial infarction. Plasma fibrinogen and alpha 2-antiplasmin levels were unaffected, and allergic reactions were not observed. Postinfusion disappearance of STAR antigen followed a biphasic mode with a t1/2 alpha of 6.3 +/- 0.6 minutes (mean +/- SD) and a t1/2 beta of 37 +/- 15 minutes, corresponding to a plasma clearance of 270 +/- 100 mL/min. Neutralizing antibodies against STAR could not be demonstrated at baseline and up to 6 days after infusion, but STAR neutralizing activity, which di...