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Comparison of protein acetyltransferase action of CRTAase with the prototypes of HAT. ScientificWorldJournal 2014; 2014:578956. [PMID: 24688408 PMCID: PMC3932232 DOI: 10.1155/2014/578956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 12/04/2013] [Indexed: 12/21/2022] Open
Abstract
Our laboratory is credited for the discovery of enzymatic acetylation of protein, a phenomenon unknown till we identified an enzyme termed acetoxy drug: protein transacetylase (TAase), catalyzing the transfer of acetyl group from polyphenolic acetates to receptor proteins (RP). Later, TAase was identified as calreticulin (CR), an endoplasmic reticulum luminal protein. CR was termed calreticulin transacetylase (CRTAase). Our persistent study revealed that CR like other families of histone acetyltransferases (HATs) such as p300, Rtt109, PCAF, and ESA1, undergoes autoacetylation. The autoacetylated CR was characterized as a stable intermediate in CRTAase catalyzed protein acetylation, and similar was the case with ESA1. The autoacetylation of CR like that of HATs was found to enhance protein-protein interaction. CR like HAT-1, CBP, and p300 mediated the acylation of RP utilizing acetyl CoA and propionyl CoA as the substrates. The similarities between CRTAase and HATs in mediating protein acylation are highlighted in this review.
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Lipoprotein (a), LPA Ile4399Met, and fibrin clot properties. Thromb Res 2014; 133:863-7. [PMID: 24502962 DOI: 10.1016/j.thromres.2014.01.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 01/06/2014] [Accepted: 01/20/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Elevated lipoprotein(a) (Lp(a)) levels were reported to be associated with dense fibrin clots. The apo(a) component of Lp(a) is encoded by LPA, and the Met allele of the LPA Ile4399Met polymorphism is associated with elevated Lp(a) levels and cardiovascular disease risk. We investigated whether Ile4399Met was associated with fibrin clot properties. MATERIALS AND METHODS We determined plasma Lp(a) levels, fibrin clot permeability and lysis time for 64 LPA 4399Met carriers and 128 noncarriers matched for age, sex, ethnicity, and enrollment site. RESULTS Elevated Lp(a) levels were associated with reduced clot permeability and prolonged lysis time (P<0.0001). Carriers of 4399Met had higher Lp(a) levels compared with noncarriers (P=0.0003). However, this association differed by ethnicity (P=0.003 for interaction between genotype and ethnicity): compared with noncarriers, 4399Met carriers had 2.89 fold higher Lp(a) levels among Caucasians while no difference was observed among non-Caucasians (primarily East Asians and Hispanics). Among all subjects, no association was observed between Ile4399Met and clot properties, but this relationship also differed by ethnicity: among non-Caucasians, 4399Met carriers had increased clot permeability and shorter lysis time; whereas among Caucasians, the trend was for decreased permeability and longer lysis time (P<0.01 for interactions between genotype and ethnicity). CONCLUSIONS We confirmed that elevated Lp(a) levels are associated with dense fibrin clots, and found that the association of LPA 4399Met carriers and clot permeability as well as lysis time differ by ethnicity.
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104
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Jeong JC, Kim JE, Ryu JW, Joo KW, Kim HK. Plasma haemostatic potential of haemodialysis patients assessed by thrombin generation assay: hypercoagulability in patients with vascular access thrombosis. Thromb Res 2013; 132:604-9. [PMID: 24060191 DOI: 10.1016/j.thromres.2013.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 08/13/2013] [Accepted: 09/02/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Patients with end-stage renal disease (ESRD) on maintenance haemodialysis are predisposed to bleeding and thrombotic events. Recently thrombin generation assay (TGA) has been introduced as a laboratory assessment of global haemostatic potential. We investigated the global haemostatic potential assessed by TGA in ESRD patients on haemodialysis and patients who developed vascular access thrombosis. MATERIALS AND METHODS A total of 69 ESRD patients who underwent haemodialysis (58 stable patients and 11 vascular access thrombosis patients) were included and 33 healthy controls were included. TGA was performed on the calibrated automated thrombogram using tissue factor with/without addition of thrombomodulin or activated protein C, producing three parameters including lag time, endogenous thrombin potential (ETP) and peak thrombin. RESULTS Haemodialysis patients showed low ETP values measured by thrombin generation assay compared with the healthy controls. Interestingly, patients with vascular access thrombosis exhibited short PT and aPTT and increased resistance of coagulation inhibition to APC anticoagulant protein, reflecting hyper-coagulability. Haemodialysis patients who are taking anti-platelet agents showed decreased thrombin inhibition rate, representing antithrombotic effect of anti-platelet agents. CONCLUSION Whereas the haemodialysis patients showed hypo-coagulability, the patients with vascular access thrombosis exhibited hyper-coagulability. Further study is required to investigate how this haemostatic potential may be utilized to guide the physician to more effective management of haemostatic complication.
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Affiliation(s)
- Jong Cheol Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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106
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Gaunt TR, Zabaneh D, Shah S, Guyatt A, Ladroue C, Kumari M, Drenos F, Shah T, Talmud PJ, Casas JP, Lowe G, Rumley A, Lawlor DA, Kivimaki M, Whittaker J, Hingorani AD, Humphries SE, Day IN. Gene-centric association signals for haemostasis and thrombosis traits identified with the HumanCVD BeadChip. Thromb Haemost 2013; 110:995-1003. [PMID: 24178511 DOI: 10.1160/th13-02-0087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/05/2013] [Indexed: 01/08/2023]
Abstract
Coagulation phenotypes show strong intercorrelations, affect cardiovascular disease risk and are influenced by genetic variants. The objective of this study was to search for novel genetic variants influencing the following coagulation phenotypes: factor VII levels, fibrinogen levels, plasma viscosity and platelet count. We genotyped the British Women's Heart and Health Study (n=3,445) and the Whitehall II study (n=5,059) using the Illumina HumanCVD BeadArray to investigate genetic associations and pleiotropy. In addition to previously reported associations (SH2B3, F7/F10, PROCR, GCKR, FGA/FGB/FGG, IL5), we identified novel associations at GRK5 (rs10128498, p=1.30x10(-6)), GCKR (rs1260326, p=1.63x10(-6)), ZNF259-APOA5 (rs651821, p=7.17x10(-6)) with plasma viscosity; and at CSF1 (rs333948, p=8.88x10(-6)) with platelet count. A pleiotropic effect was identified in GCKR which associated with factor VII (p=2.16x10(-7)) and plasma viscosity (p=1.63x10(-6)), and, to a lesser extent, ZNF259-APOA5 which also associated with factor VII and fibrinogen (p<1.00x10-²) and plasma viscosity (p<1.00x10(-5)). Triglyceride associated variants were overrepresented in factor VII and plasma viscosity associations. Adjusting for triglyceride levels resulted in attenuation of associations at the GCKR and ZNF259-APOA5 loci. In addition to confirming previously reported associations, we identified four single nucleotide polymorphisms (SNPs) associated with plasma viscosity and platelet count and found evidence of pleiotropic effects with SNPs in GCKR and ZNF259-APOA5. These triglyceride-associated, pleiotropic SNPs suggest a possible causal role for triglycerides in coagulation.
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Affiliation(s)
- Tom R Gaunt
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Delilah Zabaneh
- University College London Genetics Institute, Department of Genetics, Environment and Evolution, Gower St, London WC1E 6BT, UK
| | - Sonia Shah
- University College London Genetics Institute, Department of Genetics, Environment and Evolution, Gower St, London WC1E 6BT, UK
| | - Anna Guyatt
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Christophe Ladroue
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Meena Kumari
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - Fotios Drenos
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, 5 University St, London WC1E 6JF, UK
| | - Tina Shah
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - Philippa J Talmud
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, 5 University St, London WC1E 6JF, UK
| | - Juan Pablo Casas
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Gordon Lowe
- Institute of Cardiovascular & Medical Sciences, Room 335, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Ann Rumley
- Institute of Cardiovascular & Medical Sciences, Room 335, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Debbie A Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Mika Kivimaki
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - John Whittaker
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.,Quantitative Sciences, GlaxoSmithKline, Stevenage, UK
| | - Aroon D Hingorani
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Street, London WC1E 6BT, UK
| | - Steve E Humphries
- University College London Genetics Institute, Department of Genetics, Environment and Evolution, Gower St, London WC1E 6BT, UK.,Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, 5 University St, London WC1E 6JF, UK
| | - Ian N Day
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
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107
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Xu X, Geng J, Liu G, Chen Z. Evaluation of optical coherence tomography for the measurement of the effects of activators and anticoagulants on the blood coagulation in vitro. IEEE Trans Biomed Eng 2013; 60:2100-6. [PMID: 23392340 PMCID: PMC3888882 DOI: 10.1109/tbme.2013.2245329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Optical properties of human blood during coagulation were studied using optical coherence tomography (OCT) and the parameter of clotting time derived from the 1/e light penetration depth (d(1/e)) versus time was developed in our previous work. In this study, in order to know if a new OCT test can characterize the blood-coagulation process under different treatments in vitro, the effects of two different activators (calcium ions and thrombin) and anticoagulants, i.e., acetylsalicylic acid (ASA, a well-known drug aspirin) and melagatran (a direct thrombin inhibitor), at various concentrations are evaluated. A swept-source OCT system with a 1300 nm center wavelength is used for detecting the blood-coagulation process in vitro under a static condition. A dynamic study of d1/e reveals a typical behavior due to coagulation induced by both calcium ions and thrombin, and the clotting time is concentration-dependent. Dose-dependent ASA and melagatran prolong the clotting times. ASA and melagatran have different effects on blood coagulation. As expected, melagatran is much more effective than ASA in anticoagulation by the OCT measurements. The OCT assay appears to be a simple method for the measurement of blood coagulation to assess the effects of activators and anticoagulants, which can be used for activator and anticoagulant screening.
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Affiliation(s)
- Xiangqun Xu
- Department of Chemistry, Zhejiang Sci-Tech University, Hangzhou 310018, China ()
| | - Jinhai Geng
- Department of Chemistry, Zhejiang Sci-Tech University, Hangzhou 310018, China ()
| | - Gangjun Liu
- Beckman Laser Institute, Department of Biomedical Engineering, University of California, Irvine, CA 92617 USA ()
| | - Zhongping Chen
- Beckman Laser Institute, Department of Biomedical Engineering, University of California, Irvine, CA 92617 USA ()
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108
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Horstman LL, Jy W, Bidot CJ, Nordberg ML, Minagar A, Alexander JS, Kelley RE, Ahn YS. Potential roles of cell-derived microparticles in ischemic brain disease. Neurol Res 2013; 31:799-806. [DOI: 10.1179/016164109x12445505689526] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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109
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Abstract
Pediatric patients with a variety of congenital and acquired cardiac conditions receive antithrombotic therapy. Many of the indications are empirical, and have either not been proven in controlled studies or are extrapolated from adult studies. This article reviews the current available literature regarding the use of anti-platelet drugs in the pediatric cardiac population.
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Affiliation(s)
- Sweta Mohanty
- Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
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110
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Gorog DA, Fuster V. Platelet function tests in clinical cardiology: unfulfilled expectations. J Am Coll Cardiol 2013; 61:2115-29. [PMID: 23541972 DOI: 10.1016/j.jacc.2012.11.080] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 11/20/2012] [Accepted: 11/26/2012] [Indexed: 01/04/2023]
Abstract
This review is a critical evaluation of publications in the past decade on the usefulness of platelet function tests (PFTs) in clinical cardiology, in aiding diagnosis, predicting risk, and monitoring therapy. The ideal PFT should: 1) detect baseline platelet hyperreactivity; 2) allow individualization of antiplatelet medication; 3) predict thrombotic risk; and 4) predict bleeding risk. The practicalities of clinical cardiology demand rapid, accurate, and reliable tests that are simple to operate at the bedside and available 24 h a day, 7 days a week. Point-of-care PFTs most widely evaluated clinically include PFA-100 and VerifyNow. None of these tests can reliably detect platelet hyperreactivity and thus identify a prothrombotic state. Identification of antiplatelet nonresponsiveness or hyporesponsiveness is highly test specific, and does not allow individualization of therapy. The power of PFTs in predicting thrombotic events for a given individual is variable and often modest, and alteration of antithrombotic treatment on the basis of the results of PFTs has not been shown to alter clinical outcome. PFTs in current mainstream use cannot reliably assess bleeding risk. These tests have been in use for over a decade, but the hopes raised by PFTs in clinical practice remain unfulfilled. Although physiologically relevant measurement of platelet function now is more important than ever, a critical reappraisal of available techniques in light of clinical requirements is needed. The use of native blood, global stimulus instead of individual agonists, contribution of thrombin generation by activated platelets to the test results, and establishment of a PFT therapeutic range for each antiplatelet drug should be considered and is discussed.
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Affiliation(s)
- Diana A Gorog
- National Heart & Lung Institute, Imperial College, London, United Kingdom.
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111
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Abstract
Aspirin is an irreversible inhibitor of platelet prostaglandin synthase activity, and is the most widely prescribed drug for the secondary prevention of cardiovascular disease. In recent years, clinical and laboratory evidence has shown significant individual variability in the response to aspirin and its link to clinical outcome. The term 'aspirin resistance' has been introduced to describe situations when clinical or ex-vivo effects of aspirin are less than expected. The accumulating evidence of increased risk of major adverse clinical events (MACE) associated with 'aspirin resistance' in the settings of acute coronary syndrome (ACS), stroke, and peripheral arterial disease has stimulated the search for ways of overcoming aspirin resistance. Existence of the link between high on-treatment platelet reactivity and atherothrombotic events suggests the common mechanisms for atherosclerosis progression and thrombotic complications with the platelets, being a key cellular interface between coagulation and inflammation. This review article provides a contemporary view on 'aspirin resistance' and discusses its definition, clinical importance, and possible mechanisms in light of recent data on the role of platelets in atherothrombosis.
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Affiliation(s)
- Nadzeya Kuzniatsova
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, England, United Kingdom
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112
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Schnell O, Erbach M, Hummel M. Primary and secondary prevention of cardiovascular disease in diabetes with aspirin. Diab Vasc Dis Res 2012; 9:245-55. [PMID: 22508698 DOI: 10.1177/1479164112441486] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Diabetes is associated with an increased cardiovascular risk. The role for aspirin in diabetes is of high clinical interest. Guidelines recommend that primary prevention of cardiovascular disease (CVD) in diabetes with aspirin should be based on the individual risk for CVD. New mechanistic studies suggest that enhanced platelet turnover may partly contribute to the fact the primary prevention studies found unequivocal results in diabetes. There is initial evidence that a potential future modification of dosages in diabetes may counteract the enhancement in platelet turnover in diabetes. The use of aspirin in diabetic patients for secondary prevention of CVD is supported by key evidence. The aim of the review is to present recent studies on aspirin for prevention of CVD in diabetes and to highlight its role also in view of new mechanistic and clinical studies with aspirin. Novel aspects of aspirin, e.g. its potential role for the prevention of cancer, are also presented.
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Affiliation(s)
- Oliver Schnell
- Diabetes Research Group, Helmholtz Centre Munich, Neuherberg, Germany.
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113
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Bratseth V, Pettersen AÅ, Opstad TB, Arnesen H, Seljeflot I. Markers of hypercoagulability in CAD patients. Effects of single aspirin and clopidogrel treatment. Thromb J 2012; 10:12. [PMID: 22883224 PMCID: PMC3552672 DOI: 10.1186/1477-9560-10-12] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 08/08/2012] [Indexed: 12/12/2022] Open
Abstract
UNLABELLED BACKGROUND Cardiovascular disease with disturbances in the haemostatic system, might lead to thrombotic complications with clinical manifestations like acute myocardial infarction (AMI) and stroke. Activation of the coagulation cascade with subsequent increased thrombin generation, characterizes a prothrombotic phenotype. In the present study we investigated whether prothrombotic markers were associated with risk factors and clinical subgroups in a cohort of patients with angiographically verified coronary artery disease (CAD). The patients were randomized to long-term treatment with the antiplatelet drugs aspirin or clopidogrel, and we further investigated the effect on hypercoagulability of such treatment for 1 year, of which limited data exists. METHODS Venous blood samples were collected in fasting condition between 08:00 and 10:30 am, at baseline when all patients were on aspirin therapy (n = 1001) and in 276 patients after 1 year follow-up on aspirin or clopidogrel. In vivo thrombin generation was assessed by prothrombin fragment 1 + 2 (F1+2) and D-dimer, and the endogenous thrombin potentiale (ETP) in the calibrated automated thrombogram (CAT) assay, representing ex vivo thrombin generation. In addition soluble tissue factor (sTF) and free- and total tissue factor pathway inhibitor (TFPI) were measured. RESULTS We found age to be significantly associated with F1+2 and D-dimer (β = 0.229 and β =0.417 respectively, p <0.001, both). Otherwise, only weak associations were found. F1+2 and D-dimer were higher in women compared to men (p <0.001 and p = 0.033, respectively). Smokers had elevated levels of ETP compared to non-smokers (p = 0.014). Additionally, patients on renin-angiotensin system (RAS) inhibition showed significantly higher levels of F1+2, compared to non-users (p = 0.013). Both aspirin and clopidogrel reduced levels of ETP after 12 months intervention (p = 0.003 and p <0.001, respectively) and the levels of F1+2 were significantly more reduced on aspirin compared to clopidogrel (p = 0.023). CONCLUSIONS In the present population of stable CAD, we could demonstrate a more hypercoagulable profile among women, smokers and patients on RAS medication, assessed by the prothrombotic markers F1+2, D-dimer and ETP. Long-term antiplatelet treatment with aspirin alone seems to attenuate thrombin generation to a greater extent than with clopidogrel alone. The study is registered at http://www.clinicaltrials.gov: NCT00222261.
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Affiliation(s)
- Vibeke Bratseth
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Pb 4956 Nydalen, Oslo, N-0424, Norway
| | - Alf-Åge Pettersen
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Pb 4956 Nydalen, Oslo, N-0424, Norway
- Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
| | - Trine B Opstad
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Pb 4956 Nydalen, Oslo, N-0424, Norway
- Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
| | - Harald Arnesen
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Pb 4956 Nydalen, Oslo, N-0424, Norway
- Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingebjørg Seljeflot
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Pb 4956 Nydalen, Oslo, N-0424, Norway
- Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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114
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Svensson J, Bergman AC, Adamson U, Blombäck M, Wallén H, Jörneskog G. Acetylation and glycation of fibrinogen in vitro occur at specific lysine residues in a concentration dependent manner: a mass spectrometric and isotope labeling study. Biochem Biophys Res Commun 2012; 421:335-42. [PMID: 22507986 DOI: 10.1016/j.bbrc.2012.03.154] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 03/31/2012] [Indexed: 10/28/2022]
Abstract
Aspirin may exert part of its antithrombotic effects through platelet-independent mechanisms. Diabetes is a condition in which the beneficial effects of aspirin are less prominent or absent - a phenomenon called "aspirin resistance". We investigated whether acetylation and glycation occur at specific sites in fibrinogen and if competition between glucose and aspirin in binding to fibrinogen occurs. Our hypothesis was that such competition might be one explanation to "aspirin resistance" in diabetes. After incubation of fibrinogen in vitro with aspirin (0.8 mM, 24 h) or glucose (100 mM, 5-10 days), we found 12 modified sites with mass spectrometric techniques. Acetylations in the α-chain: αK191, αK208, αK224, αK429, αK457, αK539, αK562, in the β-chain: βK233, and in the γ-chain: γK170 and γK273. Glycations were found at βK133 and γK75, alternatively γK85. Notably, the lysine 539 is a site involved in FXIII-mediated cross-linking of fibrin. With isotope labeling in vitro, using [(14)C-acetyl]salicylic acid and [(14)C]glucose, a labeling of 0.013-0.084 and 0.12-0.5 mol of acetylated and glycated adduct/mol fibrinogen, respectively, was found for clinically (12.9-100 μM aspirin) and physiologically (2-8 mM glucose) relevant plasma concentrations. No competition between acetylation and glycation could be demonstrated. Thus, fibrinogen is acetylated at several lysine residues, some of which are involved in the cross-linking of fibrinogen. This may mechanistically explain why aspirin facilitates fibrin degradation. We find no support for the idea that glycation of fibrin(ogen) interferes with acetylation of fibrinogen.
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Affiliation(s)
- Jan Svensson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital (Solna), SE-171 76 Stockholm, Sweden.
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115
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Xu ZH, Jiao JR, Yang R, Luo BY, Wang XF, Wu F. Aspirin Resistance: Clinical Significance and Genetic Polymorphism. J Int Med Res 2012; 40:282-92. [PMID: 22429367 DOI: 10.1177/147323001204000128] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE: To determine the prevalence, clinical implications and underlying mechanism of aspirin resistance in Chinese patients. METHODS: Platelet aggregation was determined by light transmission aggregometry (LTA) using four different inducers. Patients were divided into aspirin-resistant (AR), aspirin semi responder (ASR) and aspirin-sensitive (AS) groups, according to their LTA results. Aspirin resistance was assessed by thromboelastography (TEG, with arachidonic acid [AA] or adenosine diphosphate as inducers), serum/urinary 11-dehydrothromboxane B2 (11-DH-TXB2) assay, platelet function analyser-100 assay and P-selectin assay. Polymorphisms in the prostaglandin endoperoxide synthase 1 ( PTGS1) gene (A842G, C50T, C22T, G128A, C644A and C714A), the PTGS2 gene (G765C) and the integrin β3 ( ITGB3) gene (C196T) were examined. RESULTS: The study included 360 aspirin-treated patients and 314 healthy controls. AS patients had significantly lower levels of 11-DH-TXB2 than AR and ASR patients, and significantly lower levels of P-selectin than AR patients. TEG-AA was more sensitive, specific and consistent than P-selectin in detecting aspirin resistance. The frequency of the PTGS2 G765C mutation was significantly higher in the AR/ASR groups versus the AS group. CONCLUSIONS: TEG-AA was more sensitive, specific and consistent than the P-selectin assay for detecting aspirin resistance, and the PTGS2 G765C mutation may be related to aspirin resistance.
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Affiliation(s)
- Z-H Xu
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - J-R Jiao
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - R Yang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - B-Y Luo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - X-F Wang
- Department of Blood Transfusion, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - F Wu
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
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116
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Tehrani S, Antovic A, Mobarrez F, Mageed K, Lins PE, Adamson U, Wallén HN, Jörneskog G. High-dose aspirin is required to influence plasma fibrin network structure in patients with type 1 diabetes. Diabetes Care 2012; 35:404-8. [PMID: 22148098 PMCID: PMC3263903 DOI: 10.2337/dc11-1302] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Patients with type 1 diabetes form a less permeable fibrin network, which could contribute to their increased risk of cardiovascular disease (CVD). Low-dose aspirin treatment is the standard in the management of CVD; however, the effect seems reduced in patients with diabetes. We investigated the effects of low- and high-dose aspirin treatment on fibrin network formation in patients with type 1 diabetes (primary aim) and the possible interaction between the treatment effects of aspirin on fibrin network permeability and glycemic control in these patients (secondary aim). RESEARCH DESIGN AND METHODS Forty-eight patients (24 subjects with good [HbA(1c) <7.4%] and 24 subjects with poor [HbA(1c) >8.4%] glycemic control) were randomly assigned to treatment with 75 or 320 mg/day aspirin during 4 weeks in a crossover fashion. A 4-week washout period separated the treatment periods. The plasma fibrin network was assessed by determination of the permeability coefficient (K(s)). RESULTS Treatment with 75 mg aspirin did not influence fibrin network permeability (K(s)). However, K(s) increased significantly during treatment with 320 mg aspirin (P = 0.004), and a significant treatment effect was seen compared with treatment with 75 mg aspirin (P = 0.009). The increase in K(s) during high-dose aspirin treatment was significant in patients with poor glycemic control (P = 0.02), whereas K(s) only tended to increase in patients with good glycemic control (P = 0.06). CONCLUSIONS A high dose of aspirin is required to influence fibrin network permeability in patients with type 1 diabetes. The observed lack of effect with low-dose aspirin may contribute to aspirin treatment failure in diabetes.
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Affiliation(s)
- Sara Tehrani
- Division of Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
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117
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Is fibrin formation and thrombin generation increased during and after an acute coronary syndrome? Thromb Res 2011; 128:483-9. [DOI: 10.1016/j.thromres.2011.03.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 03/11/2011] [Accepted: 03/17/2011] [Indexed: 11/21/2022]
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118
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Affiliation(s)
- Kenneth G Mann
- Department of Biochemistry, Colchester Research Facility Room 235, University of Vermont, Colchester, VT 05446, USA.
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119
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Berent R, Auer J, Franklin B, Schmid P, von Duvillard SP. Platelet response to aspirin 50 and 100 mg in patients with coronary heart disease over a five-year period. Am J Cardiol 2011; 108:644-50. [PMID: 21684508 DOI: 10.1016/j.amjcard.2011.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 04/24/2011] [Accepted: 04/24/2011] [Indexed: 10/18/2022]
Abstract
Aspirin has been shown to decrease cardiovascular (CV) events by ∼25%. Despite aspirin therapy 10% to 20% of patients with arterial vascular disease develop atherothrombotic events. A meta-analysis of antiplatelet therapy showed a progressive decrease in clinical efficacy of aspirin after 2 years. Whether this is due to a decreased sensitivity to aspirin during long-term therapy remains unclear. A prospective randomized clinical trial with serial monitoring over 5 years was conducted in 100 patients with documented coronary heart disease. We investigated whether long-term treatment with aspirin 50 and 100 mg affects platelet response similarly. Occurrence of CV events was documented. Platelet sensitivity to aspirin, prostacyclin, and adenosine diphosphate-, collagen-, and epinephrine-induced platelet aggregation were evaluated over time. In addition, β-thromboglobulin and inflammatory markers were measured. Four patients were lost to follow-up and 10 patients died. Eleven patients developed nonfatal CV events. In the 2 groups platelet response to aspirin and the referenced variables remained unchanged over 5 years. In patients who developed CV events, the last monitoring interval revealed no difference in platelet response to aspirin. However, patients with nonfatal and fatal CV events showed increased inflammatory markers versus patients without CV events independent of aspirin 50 or 100 mg intake. In conclusion, our study revealed no difference in antiplatelet response to aspirin 50 versus 100 mg or CV events over 5 years in patients with coronary heart disease.
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120
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Undas A, Ariëns RAS. Fibrin clot structure and function: a role in the pathophysiology of arterial and venous thromboembolic diseases. Arterioscler Thromb Vasc Biol 2011; 31:e88-99. [PMID: 21836064 DOI: 10.1161/atvbaha.111.230631] [Citation(s) in RCA: 368] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The formation of fibrin clots that are relatively resistant to lysis represents the final step in blood coagulation. We discuss the genetic and environmental regulators of fibrin structure in relation to thrombotic disease. In addition, we discuss the implications of fibrin structure for treatment of thrombosis. Fibrin clots composed of compact, highly branched networks with thin fibers are resistant to lysis. Altered fibrin structure has consistently been reported in patients with several diseases complicated by thromboembolic events, including patients with acute or prior myocardial infarction, ischemic stroke, and venous thromboembolism. Relatives of patients with myocardial infarction or venous thromboembolism display similar fibrin abnormalities. Low-dose aspirin, statins, lowering of homocysteine, better diabetes control, smoking cessation, and suppression of inflammatory response increase clot permeability and susceptibility to lysis. Growing evidence indicates that abnormal fibrin properties represent a novel risk factor for arterial and venous thrombotic events, particularly of unknown etiology in young and middle-aged patients.
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Affiliation(s)
- Anetta Undas
- Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland
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121
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FitzGerald R, Pirmohamed M. Aspirin resistance: Effect of clinical, biochemical and genetic factors. Pharmacol Ther 2011; 130:213-25. [DOI: 10.1016/j.pharmthera.2011.01.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 01/18/2011] [Indexed: 01/08/2023]
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122
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Hess K, Grant PJ. Inflammation and thrombosis in diabetes. Thromb Haemost 2011; 105 Suppl 1:S43-54. [PMID: 21479339 DOI: 10.1160/ths10-11-0739] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 02/14/2011] [Indexed: 02/06/2023]
Abstract
Patients with diabetes mellitus are at increased risk of cardiovascular morbidity and mortality. Atherothrombosis, defined as atherosclerotic lesion disruption with superimposed thrombus formation, is the most common cause of death among these patients. Following plaque rupture, adherence of platelets is followed by local activation of coagulation, the formation of a cross-linked fibrin clot and the development of an occlusive platelet rich fibrin mesh. Patients with diabetes exhibit a thrombotic risk clustering which is composed of hyper-reactive platelets, up regulation of pro-thrombotic markers and suppression of fibrinolysis. These changes are mainly mediated by the presence of insulin resistance and dysglycaemia and an increased inflammatory state which directly affects platelet function, coagulation factors and clot structure. This prothrombotic state is related to increased cardiovascular risk and may account for the reduced response to antithrombotic therapeutic approaches, underpinning the need for adequate antithrombotic therapy in patients with diabetes to reduce their cardiovascular mortality.
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Affiliation(s)
- Katharina Hess
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, UK
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123
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Abstract
Cardiovascular disease (CVD) remains the main cause of mortality and morbidity in patients with diabetes. Prevention of CVD in diabetes involves a multifactorial approach that aims to treat the cluster of risk factors including hyperglycemia, dyslipidemia, obesity, hypertension, and hypercoagulation associated with this condition. Antiplatelets reduce the prothrombotic environment in diabetes, but complications of this therapeutic approach include a general risk of bleeding, specifically intracranial hemorrhage, the risk of which increases in the presence of hypertension. Current guidelines recommend the use of antiplatelet agents after tight control of blood pressure, which, in clinical practice, is not always possible. In this review, the evidence for antiplatelet use in diabetes with particular emphasis on patients with associated hypertension is examined. Safe levels of blood pressure with antiplatelet therapy, various studies, and general recommendations for diabetes patients, in light of current evidence, are explored.
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Affiliation(s)
- R. A. Ajjan
- From the Division of Cardiovascular and Diabetes Research, Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, United Kingdom
| | - Peter J. Grant
- From the Division of Cardiovascular and Diabetes Research, Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, United Kingdom
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124
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Schrör K, Huber K, Hohlfeld T. Functional testing methods for the antiplatelet effects of aspirin. Biomark Med 2011; 5:31-42. [DOI: 10.2217/bmm.10.122] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
At antiplatelet doses of 75–325 mg/day, aspirin irreversibly inhibits the platelet cyclooxygenase (COX)-1-dependent thromboxane A2 (TXA2) formation. This is the pharmacological mode of action of aspirin, and it can be predicted that if aspirin does not inhibit COX-1 sufficiently, patients will not benefit from its antiplatelet effects. A pharmacodynamic failure of aspirin occurs in 1–2% of patients. The vast majority of atherothrombotic events in patients treated with aspirin result from mechanisms that are dependent on residual (non-COX-1-dependent) platelet reactivity. Global tests of platelet activation in vitro may identify patients with high residual platelet reactivity but are not sufficiently specific to test the pharmacological effect of aspirin. A further problem is the absence of standardized normal ranges for many assays and the fact that different equipment measures different signals, which are also influenced by the agonist and the anticoagulant used. Similar considerations apply for the determination of platelet-derived biomarkers such as circulating P-selectin, soluble CD40 ligand and others. The direct measurement of inhibition of thromboxane-forming capacity is the most specific pharmacological assay for aspirin. However, there is no linear correlation between inhibition of TXA2 formation and inhibition of platelet function. Measurement of urinary levels of the TXB2 metabolite, 11-dehydro-thromboxane B2, represents an index of TXA2 biosynthesis in vivo, but is also sensitive to other cellular sources of TXA2. One general problem of all assays is the relationship with clinical outcome, which is still unclear. Monitoring aspirin treatment by testing platelet function or measuring biomarkers in clinical practice should not be recommended until a clear relationship for the predictive value of these assays for clinical outcome has been established.
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Affiliation(s)
| | - Kurt Huber
- 3. Medizinische Abteilung (Kardiologie), Wilhelminenspital, Montleartstrasse 37, 1160 Wien, Austria
| | - Thomas Hohlfeld
- Institut für Pharmakologie und Klinische Pharmakologie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum, Moorenstraße 5, 40225 Düsseldorf, Germany
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125
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Cilia La Corte AL, Philippou H, Ariëns RAS. Role of fibrin structure in thrombosis and vascular disease. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2011; 83:75-127. [PMID: 21570666 DOI: 10.1016/b978-0-12-381262-9.00003-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Fibrin clot formation is a key event in the development of thrombotic disease and is the final step in a multifactor coagulation cascade. Fibrinogen is a large glycoprotein that forms the basis of a fibrin clot. Each fibrinogen molecule is comprised of two sets of Aα, Bβ, and γ polypeptide chains that form a protein containing two distal D regions connected to a central E region by a coiled-coil segment. Fibrin is produced upon cleavage of the fibrinopeptides by thrombin, which can then form double-stranded half staggered oligomers that lengthen into protofibrils. The protofibrils then aggregate and branch, yielding a three-dimensional clot network. Factor XIII, a transglutaminase, cross-links the fibrin stabilizing the clot protecting it from mechanical stress and proteolytic attack. The mechanical properties of the fibrin clot are essential for its function as it must prevent bleeding but still allow the penetration of cells. This viscoelastic property is generated at the level of each individual fiber up to the complete clot. Fibrinolysis is the mechanism of clot removal, and involves a cascade of interacting zymogens and enzymes that act in concert with clot formation to maintain blood flow. Clots vary significantly in structure between individuals due to both genetic and environmental factors and this has an effect on clot stability and susceptibility to lysis. There is increasing evidence that clot structure is a determinant for the development of disease and this review will discuss the determinants for clot structure and the association with thrombosis and vascular disease.
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Affiliation(s)
- Amy L Cilia La Corte
- Division of Cardiovascular and Diabetes Research, Section on Mechanisms of Thrombosis, Leeds Institute for Genetics Health and Therapeutics, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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126
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He L, Chen X, Zhou M, Zhang D, Yang J, Yang M, Zhou D. Radix/rhizoma notoginseng extract (sanchitongtshu) for ischemic stroke: a randomized controlled study. PHYTOMEDICINE 2010; 18:437-42. [PMID: 21094030 DOI: 10.1016/j.phymed.2010.10.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 08/11/2010] [Accepted: 10/06/2010] [Indexed: 02/05/2023]
Abstract
Agents of sanchi have been widely used as a complementary medicine for stroke in China. Sanchitongshu is a new Chinese patent medicine extracted from sanchi which has stronger anti-platelet activity than other agents of sanchi. Our aim was to investigate the synergistic action of low dose of aspirin combined with sanchitongshu capsule in the treatment of patients with light and moderate ischemic stroke in acute and subacute stages. This was a multi-center, double-blinded, randomized controlled clinical trial conducted in four hospitals in China from July 2004 to 2006. 140 patients of ischemic stroke in anterior cerebral circulation within 30 days of onset were enrolled. Participants were assigned either to receive aspirin (50mg per day) and sanchitongshu capsule (200mg three times a day) or aspirin (50mg per day) and placebo capsule. Low dose of aspirin combined with sanchitongshu capsule significantly ameliorated neurological deficit (increased score of ESS: t=-5.02, p<0.0001) and activities of daily living (increased score of BI: t=-2.4, p=0.0178) after treatment compared with aspirin alone. Adverse reaction which occurred equally in both arms, was light to moderate and disappeared without special treatment. Sanchitongshu capsule, as a complementary medicine to aspirin, was effective in improving outcomes after ischemic stroke. It was a safe drug in our trial.
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Affiliation(s)
- Li He
- Department of Neurology, West China Hospital of Sichuan University, PR China
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127
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Undas A, Siudak Z, Topór-Mądry R, Leśniak M, Tracz W. Simvastatin administration reduces thromboxane production in subjects taking aspirin: links between aspirin resistance and thrombin generation. Int J Cardiol 2010; 154:59-64. [PMID: 21035882 DOI: 10.1016/j.ijcard.2010.09.093] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 07/20/2010] [Accepted: 09/05/2010] [Indexed: 12/01/2022]
Abstract
BACKGROUND Growing evidence indicates that statins may reduce thromboxane A(2) synthesis and thrombin generation. We investigated the relationships between thromboxane production, thrombin generation, and oxidative stress in patients receiving aspirin before and after statin administration. METHODS An open-label study was conducted in 112 men, aged 54.4 ± 7.3 years, at an increased cardiovascular risk receiving aspirin (75 mg/d). Prior to and following a 3-month simvastatin treatment (40 mg/d), we evaluated circulating thromboxane B(2) (TXB(2)), inflammatory markers, 8-isoprostane, and prothrombin fragment 1.2 (F1.2), a marker of thrombin generation, which was also measured in blood collected every 60s at the site of standardized skin incisions. RESULTS Subjects (n=28) with pretreatment TXB(2) concentrations in the highest quartile ("aspirin-resistant patients") were more frequently current smokers and had elevated C-reactive protein (CRP), interleukin-6, 8-isoprostane, shorter bleeding time, and increased F1.2 production in a model of microvascular injury, when compared with the 3 remaining quartiles (all, p<0.001). Simvastatin decreased serum TXB(2) in the whole group (by 20%, p=0.0008). Patients in the highest quartile of the baseline TXB(2) had still higher posttreatment TXB(2), CRP, interleukin-6, and F1.2 formation following injury (all, p<0.001). Simvastatin-induced change in TXB(2) correlated with the magnitude of changes in maximum levels and the velocity of F1.2 formation (all p<0.001) but not with changes in inflammatory markers or lipid profile. CONCLUSIONS The study shows that statins significantly reduce platelet TXA(2) formation in patients taking low-dose aspirin and this effect is associated with attenuated thrombin formation in response to vascular injury.
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Affiliation(s)
- Anetta Undas
- The Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland.
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128
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Kumar B, Ghosh KK, Dafonte PR. Comparative study of the cationic surfactants and their influence on the alkaline hydrolysis of acetylsalicylic acid. INT J CHEM KINET 2010. [DOI: 10.1002/kin.20515] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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129
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Peace A, McCall M, Tedesco T, Kenny D, Conroy RM, Foley D, Cox D. The role of weight and enteric coating on aspirin response in cardiovascular patients. J Thromb Haemost 2010; 8:2323-5. [PMID: 20653839 DOI: 10.1111/j.1538-7836.2010.03997.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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130
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Aspirin resistance following pediatric cardiac surgery. Thromb Res 2010; 126:200-6. [PMID: 20550971 DOI: 10.1016/j.thromres.2010.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 04/28/2010] [Accepted: 05/03/2010] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Aspirin is often used to prevent thrombosis in pediatric cardiac surgery. The primary study aim was to assess aspirin resistance in this context. Secondary aims were to evaluate (1) the relationship between elevated inflammatory markers and thrombosis and (2) aspirin's effect on these levels. MATERIALS AND METHODS This was a prospective observational study of children undergoing cardiac surgery managed with and without aspirin. Aspirin response was assessed using the VerifyNow system and urinary 11-dehydrothromboxane B2 (uTxB2) measurements. Laboratory studies of inflammation were also obtained. RESULTS 101 subjects were studied; 50 received aspirin. Six subjects (5.9%), 5 aspirin-treated, experienced symptomatic thrombosis. When measured by VerifyNow resistance was 43% after aspirin suppositories and 14% after additional days of oral aspirin. There was no correlation with thrombosis. Upper quartile post-operative day (POD) #5 uTxB2 was correlated with thrombosis in aspirin treated subjects (p<0.01). High risk aspirin-treated subjects who experienced thrombosis had higher POD#5 uTxB2. This finding did not reach statistical significance (p=0.07). Elevated pre-operative C-reactive protein (CRP) was independently associated with thrombosis (p<0.02) in all subjects and in high risk subjects (p=0.01). Inflammatory markers were not affected by aspirin. CONCLUSIONS Aspirin inhibited ex-vivo platelet function with a low incidence of resistance. Elevated POD#5 uTxB2 and pre-operative CRP were correlated with thrombosis in aspirin treated subjects. Further studies are needed to determine whether children with high levels of uTxB2 despite aspirin therapy and/or those with elevated preoperative CRP are at increased risk for thrombosis.
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131
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Saraf S, Christopoulos C, Salha IB, Stott DJ, Gorog DA. Impaired Endogenous Thrombolysis in Acute Coronary Syndrome Patients Predicts Cardiovascular Death and Nonfatal Myocardial Infarction. J Am Coll Cardiol 2010; 55:2107-15. [DOI: 10.1016/j.jacc.2010.01.033] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 12/23/2009] [Accepted: 01/06/2010] [Indexed: 10/19/2022]
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132
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Undas A, Zalewski J, Krochin M, Siudak Z, Sadowski M, Pregowski J, Dudek D, Janion M, Witkowski A, Zmudka K. Altered Plasma Fibrin Clot Properties Are Associated With In-Stent Thrombosis. Arterioscler Thromb Vasc Biol 2010; 30:276-82. [DOI: 10.1161/atvbaha.109.194936] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anetta Undas
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Jaroslaw Zalewski
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Marek Krochin
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Zbigniew Siudak
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Marcin Sadowski
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Jerzy Pregowski
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Dariusz Dudek
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Marianna Janion
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Adam Witkowski
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
| | - Krzysztof Zmudka
- From the Institute of Cardiology (A.U., Z.S., D.D., K.Z.), Jagiellonian University School of Medicine, Cracow, Poland; John Paul II Hospital (J.Z., M.K.), Cracow, Poland; Swietokrzyskie Cardiology Centre (M.S., M.J.), Kielce, Poland; and Department of Hemodynamics (J.P., A.W.), Institute of Cardiology, Warsaw, Poland
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Okano K, Naitou A, Yamamoto M, Araki M, Mimura Y, Ichihara K, Yamada O. Development of an improved assay system for activated platelet counts and evaluation by aspirin monitoring. Transl Res 2010; 155:89-96. [PMID: 20129489 DOI: 10.1016/j.trsl.2009.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 07/14/2009] [Accepted: 07/15/2009] [Indexed: 10/20/2022]
Abstract
Platelets represent a linkage among inflammation, thrombosis, and atherogenesis, and enhanced platelet activation is regarded as a risk for thrombotic disorders. The level of P-selectin expressed (CD62P) on the platelet surface is a useful marker of activated platelets (aPLT). Although CD62P has been measured briefly by flow cytometry using an anti-CD62P antibody, the assay remains imprecise and we tried to establish stable conditions for its measurement. The levels of aPLT are increased significantly by many factors, such as meals, sampling and keeping conditions, centrifugation, and the timing of fixation. For optimal results, sampling should be performed quickly in a K(2)-ethylenediaminetetraacetic acid (EDTA) containing a sample tube, and whole blood should be fixed with 666 mmol/L formaldehyde plus 167 mmol/L glyoxal for 5 min. After washing with phosphate buffered saline (PBS), the fixed platelets were reacted with anti-CD62P antibody for 20 min and measured by flow-cytometric detection for aPLT. The coefficient of variation of our aPLT assay was 10.4%. We also examined basic experiments to test the clinical application of our aPLT assay by monitoring aspirin therapy. The levels of aPLT after the administration of aspirin for 3 days were significantly lower than those in the group that did not receive aspirin. These results suggest that the aPLT assay is an effective analytical procedure for measuring platelet reactivity.
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Affiliation(s)
- Kozue Okano
- Faculty of Health Sciences, Yamaguchi University School of Medicine, Ube, Japan.
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134
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Antiaggregant Effect of Taurine Chloramines in the Presence of Serum Albumin. Bull Exp Biol Med 2009; 147:704-7. [DOI: 10.1007/s10517-009-0601-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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135
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Gardner M, Palmer J, Manrique C, Lastra G, Gardner DW, Sowers JR. Utility of aspirin therapy in patients with the cardiometabolic syndrome and diabetes. ACTA ACUST UNITED AC 2009; 4:96-101. [PMID: 19614796 DOI: 10.1111/j.1559-4572.2008.00037.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Paralleling the rise in obesity, the cardiometabolic syndrome is a rapidly growing health problem in the United States. There is a 3-fold increase in the prevalence of coronary heart disease, myocardial infarction, and stroke due to the coagulation, hemodynamic, and metabolic abnormalities seen in these individuals. The use of aspirin for secondary prevention and, to a lesser degree, primary prevention of cardiovascular events is a well-established standard of care. However, in patients with diabetes or the cardiometabolic syndrome, the role of aspirin in prevention of cardiovascular events remains controversial. In this review, the authors examine the clinical trial data on the use of aspirin in diabetes and the cardiometabolic syndrome for cardiovascular protection. They also explore, in addition to aspirin's effects on platelet aggregation, some of the mechanisms by which aspirin may favorably alter the course of atherosclerosis, effects on endothelial function, and glycemia.
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Affiliation(s)
- Michael Gardner
- Diabetes and Cardiovascular Center, University of Missouri School of Medicine and Truman VA Hospital, Columbia, MO 65212, USA.
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136
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Affiliation(s)
- Udaya S Tantry
- Sinai Center for Thrombosis Research, Baltimore, MD, USA
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137
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Dimitrow PP, Hlawaty M, Undas A, Śnieżek-Maciejewska M, Sobień B, Stępień E, Tracz W. Effect of aortic valve stenosis on haemostasis is independent from vascular atherosclerotic burden. Atherosclerosis 2009; 204:e103-8. [DOI: 10.1016/j.atherosclerosis.2008.12.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 12/21/2008] [Accepted: 12/21/2008] [Indexed: 10/21/2022]
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138
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Ajjan R, Standeven K, Khanbhai M, Phoenix F, Gersh K, Weisel J, Kearney M, Ariëns R, Grant P. Effects of Aspirin on Clot Structure and Fibrinolysis Using a Novel In Vitro Cellular System. Arterioscler Thromb Vasc Biol 2009; 29:712-7. [DOI: 10.1161/atvbaha.109.183707] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives—
The purpose of this study was to investigate the direct effects of aspirin on fibrin structure/function.
Methods and Results—
Chinese Hamster Ovary cell lines stably transfected with fibrinogen were grown in the absence (0) and presence of increasing concentrations of aspirin. Fibrinogen was purified from the media using affinity chromatography, and clots were made from recombinant protein. Mean final turbidity [OD(±SEM)] was 0.083(±0.03), 0.093(±0.002), 0.101(±0.005), and 0.125(±0.003) in clots made from 0, 1, 10, and 100 mg/L aspirin-treated fibrinogen, respectively (
P
<0.05). Permeability coefficient (Ks cm
2
×10
−8
) was 1.68(±0.29) and 4.13(±0.33) comparing fibrinogen produced from cells grown with 0 mg/L and 100 mg/L aspirin respectively (
P
<0.05). Scanning electron microscopy confirmed a looser clot structure and increased fiber thickness of clots made from aspirin-treated fibrinogen, whereas rheometer studies showed a significant 30% reduction in clot rigidity. Fibrinolysis was quicker in clots made from aspirin-treated fibrinogen. Ex vivo studies in 3 normal volunteers given 150 mg aspirin daily for 1 week demonstrated similar changes in clot structure/function.
Conclusion—
Aspirin directly altered clot structure resulting in the formation of clots with thicker fibers and bigger pores, which are easier to lyse. This study clearly demonstrates an alternative mode of action for aspirin, which should be considered in studies evaluating the biochemical efficacy of this agent.
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Affiliation(s)
- R.A. Ajjan
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - K.F. Standeven
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - M. Khanbhai
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - F. Phoenix
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - K.C. Gersh
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - J.W. Weisel
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - M.T. Kearney
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - R.A.S. Ariëns
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
| | - P.J. Grant
- From the Division of Cardiovascular and Diabetes Research (R.A.A., K.F.S., M.K., F.P., M.T.K., R.A.S.A., P.J.G.), Leeds Institute for Genetics, Health, and Therapeutics (LIGHT), University of Leeds, UK; and the Department of Cell and Developmental Biology (K.C.G., J.W.W.), University of Pennsylvania School of Medicine, Philadelphia
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139
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Gorog DA, Sweeny JM, Fuster V. Antiplatelet drug 'resistance'. Part 2: laboratory resistance to antiplatelet drugs—fact or artifact? Nat Rev Cardiol 2009; 6:365-73. [DOI: 10.1038/nrcardio.2009.13] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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140
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Endogenous thrombin potential (ETP) in plasma from patients with AMI during antithrombotic treatment. Thromb Res 2009; 123:573-9. [DOI: 10.1016/j.thromres.2008.03.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 02/24/2008] [Accepted: 03/16/2008] [Indexed: 11/20/2022]
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141
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Becker RC. Biological and pharmacological aspects of perioperative hemorrhagic complications associated with oral platelet-directed antithrombotic agents. Focus on isolated coronary artery bypass grafting and oral irreversible P2Y(12) receptor antagonists. Thromb Res 2008; 123:419-28. [PMID: 18937965 DOI: 10.1016/j.thromres.2008.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 05/09/2008] [Accepted: 05/13/2008] [Indexed: 10/21/2022]
Abstract
Coronary arterial bypass grafting (CABG)-the most common heart surgery performed worldwide-is an effective procedure for treating patients with advanced, obstructive atherothrombotic coronary artery disease, prolonging survival in selected high-risk patients. However, CABG is also associated with hemorrhagic complications, which can impact outcome measures such as perioperative morbidity, mortality, length of hospital stay, and health care expenditures. Recent observations have expanded our understanding of the complex process of hemostasis, fostering a more informed view of CABG-associated bleeding complications. Additional research is warranted to determine whether new antithrombotic drug treatment options, such as reversible P2Y12 receptor antagonists among patients with acute coronary syndromes, will favorably impact these clinically relevant complications.
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Affiliation(s)
- Richard C Becker
- Duke University School of Medicine, Durham, North Carolina, USA.
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142
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Abstract
We evaluated systemic alterations to the blood coagulation system that occur during a coronary thrombotic event. Peripheral blood coagulation in patients with acute coronary thrombosis was compared with that in people with stable coronary artery disease (CAD). Blood coagulation and platelet activation at the microvascular injury site were assessed using immunochemistry in 28 non-anticoagulated patients with acute myocardial infarction (AMI) versus 28 stable CAD patients matched for age, sex, risk factors, and medications. AMI was associated with increased maximum rates of thrombin-antithrombin complex generation (by 93.8%; P< .001), thrombin B-chain formation (by 57.1%; P< .001), prothrombin consumption (by 27.9%; P= .012), fibrinogen consumption (by 27.0%; P= .02), factor (f) Va light chain generation (by 44.2%; P= .003), and accelerated fVa inactivation (by 76.1%; P< .001), and with enhanced release of platelet-derived soluble CD40 ligand (by 44.4%; P< .001). FVa heavy chain availability was similar in both groups because of enhanced formation and activated protein C (APC)-mediated destruction. The velocity of coagulant reactions in AMI patients showed positive correlations with interleukin-6. Heparin treatment led to dampening of coagulant reactions with profiles similar to those for stable CAD. AMI-induced systemic activation of blood coagulation markedly modifies the pattern of coagulant reactions at the site of injury in peripheral vessels compared with that in stable CAD patients.
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143
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Eikelboom JW, Hankey GJ, Thom J, Bhatt DL, Steg PG, Montalescot G, Johnston SC, Steinhubl SR, Mak KH, Easton JD, Hamm C, Hu T, Fox KAA, Topol EJ. Incomplete inhibition of thromboxane biosynthesis by acetylsalicylic acid: determinants and effect on cardiovascular risk. Circulation 2008; 118:1705-12. [PMID: 18838564 DOI: 10.1161/circulationaha.108.768283] [Citation(s) in RCA: 168] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incomplete inhibition of platelet thromboxane generation, as measured by elevated urinary 11-dehydro thromboxane B(2) concentrations, has been associated with an increased risk of cardiovascular events. We aimed to determine the external validity of this association in aspirin-treated patients enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial and to determine whether there are any modifiable factors or interventions that lower urinary 11-dehydro thromboxane B(2) concentrations that could thereby reduce cardiovascular risk. METHODS AND RESULTS Urinary 11-dehydro thromboxane B(2) concentrations were measured in 3261 aspirin-treated patients at least 1 month after they had been randomly assigned to placebo or clopidogrel. Baseline urinary 11-dehydro thromboxane B(2) concentrations in the highest quartile were associated with an increased risk of stroke, myocardial infarction, or cardiovascular death compared with the lowest quartile (adjusted hazard ratio 1.66, 95% CI 1.06 to 2.61, P=0.03). Increasing age, female sex, history of peripheral artery disease, current smoking, and oral hypoglycemic or angiotensin-converting enzyme inhibitor therapy were independently associated with higher urinary concentrations of 11-dehydro thromboxane B(2), whereas aspirin dose > or =150 mg/d, history of treatment with nonsteroidal antiinflammatory drugs, history of hypercholesterolemia, and statin treatment were associated with lower concentrations. Randomization to clopidogrel (versus placebo) did not reduce the hazard of cardiovascular events in patients in the highest quartile of urinary 11-dehydro thromboxane B(2) levels. CONCLUSIONS In aspirin-treated patients, urinary concentrations of 11-dehydro thromboxane B(2) are an externally valid and potentially modifiable determinant of stroke, myocardial infarction, or cardiovascular death in patients at risk for atherothrombotic events.
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145
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Abstract
Clinically, aspirin resistance is defined as the failure of aspirin therapy to prevent an acute vascular thrombotic event despite regular intake of appropriate doses. In the laboratory, aspirin resistance encompasses the drug's failure to attain a particular level of platelet inhibition. From a clinical standpoint, the inability of aspirin to prevent a thrombotic event, despite appropriate cyclooxygenase-1 inhibition, implies the involvement of other factors. Evidence is emerging that aspirin resistance, as defined by residual platelet activity, merely reflects an individual's enhanced basal platelet function and suggests a hereditary component. Due to the multifactorial nature of cardiovascular disease, it is likely that a single therapy like aspirin cannot fully treat and prevent all thrombotic complications in the setting of atherosclerosis.
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Affiliation(s)
- Price Blair
- Boston University School of Medicine, 700 Albany Street, W507, Boston, MA 02118, USA
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146
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Navarro-Núñez L, Lozano ML, Palomo M, Martínez C, Vicente V, Castillo J, Benavente-García O, Diaz-Ricart M, Escolar G, Rivera J. Apigenin inhibits platelet adhesion and thrombus formation and synergizes with aspirin in the suppression of the arachidonic acid pathway. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2008; 56:2970-2976. [PMID: 18410117 DOI: 10.1021/jf0723209] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Previous studies using washed platelets demonstrated that certain flavonoids inhibit platelet function through several mechanisms including blockade of TxA(2) receptors (TPs). We aimed to analyze the binding capacity of flavonoids to TPs in platelet rich plasma (PRP), investigated their effect in flowing blood, and evaluated the ability of apigenin to improve the efficacy of aspirin in the inhibition of platelet aggregation. The binding of flavonoids to TPs in PRP was explored using binding assays and the TP antagonist [ (3)H]SQ29548. Effects of flavonoids on platelet adhesion were assessed using arterial subendothelium with annular plate perfusion chambers, and global evaluation of apigenin on high-shear-dependent platelet function was determined by the PFA-100. To evaluate the ability of apigenin to potentiate the effect of aspirin, arachidonic acid-induced platelet aggregation was measured prior to and after consumption of subaggregatory doses of aspirin in the presence or absence of apigenin. Binding assays revealed that apigenin was an efficient competitor of [ (3)H]SQ29548 binding to PRP ( K i = 155.3 +/- 65.4 microM), and perfusion studies showed that apigenin, genistein, and catechin significantly diminished thrombus formation when compared to control (26.2 +/- 3.8, 33.1 +/- 5.2, and 26.2 +/- 5.2 vs 76.6 +/- 2.6%, respectively; p < 0.05). Apigenin, similarly to the TP antagonist SQ29548, significantly prolonged collagen epinephrine-induced PFA-100 closure time in comparison to the control and, when added to platelets that had been exposed in vivo to aspirin, potentiated its inhibitory effect on platelet aggregation. The inhibitory effect of some flavonoids in the presence of plasma, particularly apigenin, might in part rely on TxA(2) receptor antagonism. There is a clear increase in the ex vivo antiplatelet effect of aspirin in the presence of apigenin, which encourages the idea of the combined use of aspirin and certain flavonoids in patients in which aspirin fails to properly suppress the TxA(2) pathway.
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Affiliation(s)
- L Navarro-Núñez
- Unit of Hematology and Clinical Oncology, Centro Regional de Hemodonación, University of Murcia, Murcia, Spain
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147
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Amlie-Lefond C, Sébire G, Fullerton HJ. Recent developments in childhood arterial ischaemic stroke. Lancet Neurol 2008; 7:425-35. [DOI: 10.1016/s1474-4422(08)70086-3] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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148
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Riondino S, Trifirò E, Principessa L, Mascioletti S, Di Renzo L, Gaudio C, Biasucci LM, Crea F, Pulcinelli FM. Lack of biological relevance of platelet cyclooxygenase-2 dependent thromboxane A2 production. Thromb Res 2008; 122:359-65. [DOI: 10.1016/j.thromres.2007.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 12/05/2007] [Accepted: 12/18/2007] [Indexed: 11/29/2022]
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149
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Abstract
The research aims of our laboratory are to provide a realistic description of biologic processes involved in protection from hemorrhage and the evolution of thrombosis. To evaluate these processes, we use 4 models of coagulation ranging from 1) studies of blood exiting from microvascular wounds in humans through 2) minimally altered whole blood induced to clot by tissue factor (TF) to 3) reconstitution of the blood coagulation proteome with purified components and to 4) mathematical descriptions of the chemical processes and dynamics that occur. The integration of these 4 models permits comprehensive analyses of the blood coagulation system and predictions of its behavior under normal and pathologic conditions. Data accumulated thus far have led to advances in our understanding of 1) the processes occurring during the initiation and propagation phases of thrombin generation, 2) the roles for individual proteins involved in blood coagulation and its regulation, 3) defects in thrombin generation and clot formation in hemophilia, 4) actions and limitations of pharmacologic agents used to control hemorrhage, thrombosis, and chronic cardiovascular disease, and 5) the relationship between genotypic and phenotypic features of an individual's plasma proteome and his/her immediate and long-term thrombotic risk.
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150
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Boncler M, Gresner P, Nocun M, Rywaniak J, Dolnik M, Rysz J, Wilk R, Czyz M, Markuszewski L, Banach M, Watala C. Elevated cholesterol reduces acetylsalicylic acid-mediated platelet acetylation. Biochim Biophys Acta Gen Subj 2007; 1770:1651-9. [DOI: 10.1016/j.bbagen.2007.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 08/30/2007] [Accepted: 09/04/2007] [Indexed: 11/25/2022]
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