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Global thrombosis test for assessing thrombotic status and efficacy of antithrombotic diet and other conditions. Future Sci OA 2022; 8:FSO788. [PMID: 35251699 PMCID: PMC8890116 DOI: 10.2144/fsoa-2021-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Because of the high mortality from myocardial infarction and stroke, there is a great demand for finding novel methods of diagnosis, prevention and treatment of these diseases. Most of the current tests measure important determinants of thrombosis such as platelet function, coagulation and fibrinolysis in isolation; therefore, a global test measuring the actual thrombotic status would be more useful in clinical conditions. We obtained considerable experience by using the global thrombosis test, which determines the actual thrombotic status by taking into account the measured platelet reactivity, coagulation and fibrinolytic activities. In animal experiments, we found significant correlation between the ex vivo global thrombosis test measurements and the in vivo thrombotic status. The published evidence for the benefit of an antithrombotic diet with regular physical exercise is also described. There is a great concern in the general population how to detect the risk of thrombotic events and prevent the high mortality from stroke, myocardial infarction, sudden death and cancer-associated thrombosis. Our experience on antithrombotic fruits and vegetables intake and regular exercise assessed by the global thrombosis test suggested a potentially unique way of preventing these life-threatening diseases. In addition, global thrombosis testing may offer some benefit in detecting risk of thrombotic of forthcoming thrombotic events in cancer and COVID-19 virus-infected patients.
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Gorog DA, Yamamoto J. Global Thrombosis Test: Occlusion Is Attributable to Shear-Induced Platelet Thrombus Formation. TH OPEN 2022; 5:e591-e597. [PMID: 34984319 DOI: 10.1055/s-0041-1741108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022] Open
Affiliation(s)
- Diana A Gorog
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom.,Clinical Pharmaceutical and Biological Science, School of Life and Medical Science, University of Hertfordshire, United Kingdom
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3
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Gorog DA, Yamamoto J. Global Thrombosis Test: Occlusion Is Attributable to Shear-Induced Platelet Thrombus Formation. TH OPEN 2021. [PMID: 34984319 PMCID: PMC8847114 DOI: 10.1055/a-1704-1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Diana A. Gorog
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom
- Clinical Pharmaceutical and Biological Science, School of Life and Medical Science, University of Hertfordshire, United Kingdom
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Song JC, Yang LK, Zhao W, Zhu F, Wang G, Chen YP, Li WQ. Chinese expert consensus on diagnosis and treatment of trauma-induced hypercoagulopathy. Mil Med Res 2021; 8:25. [PMID: 33840386 PMCID: PMC8040221 DOI: 10.1186/s40779-021-00317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/25/2021] [Indexed: 11/29/2022] Open
Abstract
Trauma-induced coagulopathy (TIC) is caused by post-traumatic tissue injury and manifests as hypercoagulability that leads to thromboembolism or hypocoagulability that leads to uncontrollable massive hemorrhage. Previous studies on TIC have mainly focused on hemorrhagic coagulopathy caused by the hypocoagulable phenotype of TIC, while recent studies have found that trauma-induced hypercoagulopathy can occur in as many as 22.2-85.1% of trauma patients, in whom it can increase the risk of thrombotic events and mortality by 2- to 4-fold. Therefore, the Chinese People's Liberation Army Professional Committee of Critical Care Medicine and the Chinese Society of Thrombosis, Hemostasis and Critical Care, Chinese Medicine Education Association jointly formulated this Chinese Expert Consensus comprising 15 recommendations for the definition, pathophysiological mechanism, assessment, prevention, and treatment of trauma-induced hypercoagulopathy.
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Affiliation(s)
- Jing-Chun Song
- Department of Critical Care Medicine, the 908th Hospital of Joint Logistics Support Forces of Chinese PLA, Nanchang, 330002, China.
| | - Li-Kun Yang
- Department of Neurosurgery, the 904th Hospital of Joint Logistics Support Forces of Chinese PLA, Wuxi, 214044, Jiangsu, China
| | - Wei Zhao
- Division of Vascular and Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Feng Zhu
- Department of Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200120, China
| | - Gang Wang
- Department of Critical Care Medicine, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710001, China
| | - Yao-Peng Chen
- Department of Blood Transfusion, the 923th Hospital of Joint Logistics Support Forces of Chinese PLA, Nanning, 530021, China
| | - Wei-Qin Li
- Department of Critical Care Medicine, General Hospital of Eastern Theater Command of Chinese PLA, Nanjing, 210002, China.
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Rahman SM, Hlady V. Microfluidic assay of antiplatelet agents for inhibition of shear-induced platelet adhesion and activation. LAB ON A CHIP 2021; 21:174-183. [PMID: 33242045 DOI: 10.1039/d0lc00756k] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We have developed a microfluidic system to perfuse whole blood through a flow channel with an upstream stenotic region and a downstream protein capture region. This flow-based system was used to assay how effectively antiplatelet agents suppress shear-induced platelet adhesion and activation downstream of the stenotic region. Microcontact printing was used to covalently attach one of three platelet binding proteins [fibrinogen, collagen, or von Willebrand factor (vWf)] to the surface of the downstream capture region. Whole blood with an antiplatelet agent was transiently exposed to an upstream high wall shear rate (either 4860 s-1 or 11 560 s-1), and subsequently flowed over the downstream capture region where the platelet adhesion was measured. Several antiplatelet agents (acetylsalicylic acid, tirofiban, eptifibatide, anti-vWf, and anti-GPIbα) were evaluated for their efficacy in attenuating downstream adhesion. Following antibody blocking of vWf or GPIbα, downstream platelet activation was also assessed in perfused blood by flow cytometry using two activation markers (active GPIIb/IIIa and P-selectin). Acetylsalicylic acid demonstrated its inability to diminish shear-induced platelet adhesion to all three binding proteins. GPIIb/IIIa inhibitors (tirofiban and eptifibatide) significantly reduced platelet adhesion to fibrinogen. Antibody blocking of vWf or GPIbα effectively diminished platelet adhesion to all three capture proteins as well as platelet activation in perfused blood, indicating an essential role of vWf-GPIbα interaction in mediating shear-induced platelet aggregation.
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Affiliation(s)
- Shekh Mojibur Rahman
- Department of Chemical Engineering, University of Utah, Salt Lake City, UT 84112, USA
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6
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Iwasaki M, Murakami M, Ijiri Y, Shimizu M, Yamamoto J. Are all wines made from various grape varieties beneficial in the prevention of myocardial infarction and stroke? Future Sci OA 2020; 7:FSO649. [PMID: 33437515 PMCID: PMC7787155 DOI: 10.2144/fsoa-2020-0098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim: Epidemiologic studies support the assumption (French paradox hypothesis) that drinking red wine is beneficial in the prevention of cardiovascular diseases. Our recent works however cast doubt on such claim. Earlier we have shown that the antithrombotic activity of various fruits and vegetables mainly depends on their varieties. For this reason, several varieties of red and white grapes were tested for antithrombotic effect in animal experiments. Results: Antithrombotic effect of 45 red and white grape varieties were assessed in the present study. Out of the 45, one red grape variety showed antithrombotic effect, while the majority of red and white grape varieties enhanced thrombosis. Conclusion: Most red and white grape varieties enhanced thrombotic activity of blood. Red wine is widely believed to prevent heart attack and stroke as claimed by a French Paradox hypothesis. Antithrombotic effect of 45 grape varieties was measured in the present study. Only very few red and white varieties inhibited the experimentally induced thrombosis while the majority of the tested varieties enhanced thrombotic activity of blood. Thus, our findings challenge the prevailing claims of the French Paradox.
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Affiliation(s)
- Masahiro Iwasaki
- Division of Nutrition & Metabolism, Original Nutrition Co., Ltd, Osaka 532-0002, Japan
| | | | - Yoshinobu Ijiri
- Department of Health and Nutrition, Osaka Shoin Women's University, Osaka 577-8550, Japan
| | - Muneshige Shimizu
- Department of Fisheries, School of Marine Science and Technology, Tokai University, Shizuoka 424-8610, Japan
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Krasteva MP, Lau KK, Mordasini P, Tsang ACO, Heldner MR. Intracranial Atherosclerotic Stenoses: Pathophysiology, Epidemiology, Risk Factors and Current Therapy Options. Adv Ther 2020; 37:1829-1865. [PMID: 32270364 PMCID: PMC7467483 DOI: 10.1007/s12325-020-01291-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Indexed: 01/03/2023]
Abstract
Intracranial atherosclerotic stenoses (ICAS) are one of the most common causes of first and recurrent cerebrovascular ischaemic events worldwide, with highest prevalence in Asian, Hispanic and African populations. Clinical trials have improved the understanding of epidemiology, risk factors and imaging characteristics of patients with ICAS. Current therapeutic approaches concerning these patients include management of risk factors, best medical therapy, potentially endovascular and rarely surgical therapy. In our review, we elucidate the current epidemiology and evidence in evaluation of risk factors and therapeutic options for providing favourable outcome for patients with ICAS.
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Affiliation(s)
- Marina Petrova Krasteva
- Department of Neurology, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Pasquale Mordasini
- Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Anderson Chun On Tsang
- Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Mirjam Rachel Heldner
- Department of Neurology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
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8
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Shear rate-dependent thrombosis/fibrinolysis tests using non-anticoagulated blood could be useful in the prevention of thrombotic disorders. Future Sci OA 2019; 5:FSO357. [PMID: 30820342 PMCID: PMC6391630 DOI: 10.4155/fsoa-2018-0092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 10/16/2018] [Indexed: 12/04/2022] Open
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9
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Prevention of thrombotic disorders by antithrombotic diet and exercise: evidence by using global thrombosis tests. Future Sci OA 2018; 4:FSO285. [PMID: 29682320 PMCID: PMC5905641 DOI: 10.4155/fsoa-2017-0104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/02/2018] [Indexed: 12/28/2022] Open
Abstract
Prevention of thrombotic disorders has priority over treatment. There are only two pathologically relevant tests which are suitable for measuring the overall thrombotic status both in experimental conditions and in humans. The Global Thrombosis Test (GTT) and the Global Parallel-Plate Thrombosis Test can detect the pathologically relevant global thrombotic status. These tests have been successfully used for monitoring the effect of antithrombotic drugs and for developing novel antithrombotic agents. By using GTT, varieties of fruits, vegetables, and regular physical exercise have been tested for the effect on global thrombotic status. This review discusses the published evidence for the benefit of diet of selected fruit and vegetable varieties and doing regular physical exercise on improving thrombotic status. Future clinical trials monitored by GTT or Global Parallel-Plate Thrombosis Test could decide on the effectiveness of an experimentally proven antithrombotic diet with regular physical exercise in the prevention of thrombotic diseases.
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10
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Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition). Reg Anesth Pain Med 2017; 43:225-262. [DOI: 10.1097/aap.0000000000000700] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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11
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Ikarugi H, Yamamoto J. The exercise paradox may be solved by measuring the overall thrombotic state using native blood. Drug Discov Ther 2017; 11:15-19. [PMID: 28202881 DOI: 10.5582/ddt.2016.01077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
While exercise is widely believed to prevent atherothrombotic diseases, it occasionally causes sudden death. This exercise paradox may be due to the inadequate testing of the thrombotic and thrombolytic status. A recently developed shear-induced thrombosis/endogenous fibrinolysis test performed with non-anticoagulated blood samples allows the assessment of the thrombotic state of an individual both at rest and after exercise. This sensitive and physiologically relevant test may help to solve the aforementioned exercise paradox.
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Abstract
Platelets play an important, but often under-recognized role in cardiovascular disease. For example, the normal response of the platelet can be altered, either by increased pro-aggregatory stimuli or by diminished anti-aggregatory substances to produce conditions of increased platelet activation/aggregation and occur in active cardiovascular disease states both on a chronic (e.g. stable angina pectoris) and acute basis (e.g. acute myocardial infarction). In addition, platelet hyperaggregability is also associated with the risk factors for coronary artery disease (e.g. smoking, hypertension, and hypercholesterolaemia). Finally, the utility of an increasing range of anti-platelet therapies in the management of the above disease states further emphasizes the pivotal role platelets play in the pathogenesis of cardiovascular disease. This paper provides a comprehensive overview of the normal physiologic role of platelets in maintain homeostasis, the pathophysiologic processes that contribute to platelet dysfunction in cardiovascular disease and the associated role and benefits of anti-platelet therapies.
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Affiliation(s)
- Scott Willoughby
- Cardiology Unit, The Queen Elizabeth Hospital, Adelaide University, Adelaide, South Australia, Australia
| | - Andrew Holmes
- Cardiology Unit, The Queen Elizabeth Hospital, Adelaide University, Adelaide, South Australia, Australia
| | - Joseph Loscalzo
- The Whitaker Cardiovascular Institute and Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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13
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Valerio L, Tran PL, Sheriff J, Brengle W, Ghosh R, Chiu WC, Redaelli A, Fiore GB, Pappalardo F, Bluestein D, Slepian MJ. Aspirin has limited ability to modulate shear-mediated platelet activation associated with elevated shear stress of ventricular assist devices. Thromb Res 2016; 140:110-117. [PMID: 26938158 DOI: 10.1016/j.thromres.2016.01.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 01/25/2016] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
Abstract
Continuous flow ventricular assist devices (cfVADs) while effective in advanced heart failure, remain plagued by thrombosis related to abnormal flows and elevated shear stress. To limit cfVAD thrombosis, patients utilize complex anti-thrombotic regimens built upon a foundation of aspirin (ASA). While much data exists on ASA as a modulator of biochemically-mediated platelet activation, limited data exists as to the efficacy of ASA as a means of limiting shear-mediated platelet activation, particularly under elevated shear stress common within cfVADs. We investigated the ability of ASA (20, 25 and 125 μM) to limit shear-mediated platelet activation under conditions of: 1) constant shear stress (30 dynes/cm(2) and 70 dynes/cm(2)); 2) dynamic shear stress, and 3) initial high shear exposure (70 dynes/cm(2)) followed by low shear exposure - i.e. a platelet sensitization protocol, utilizing a hemodynamic shearing device providing uniform shear stress in vitro. The efficacy of ASA to limit platelet activation mediated via passage through a clinical cfVAD system (DeBakey Micromed) in vitro was also studied. ASA reduced platelet activation only under conditions of low shear stress (38% reduction compared to control, n=10, p<0.004), with minimal protection at higher shear stress and under dynamic conditions (n=10, p>0.5) with no limitation of platelet sensitization. ASA had limited ability (25.6% reduction in platelet activation rate) to modulate shear-mediated platelet activation induced via cfVAD passage. These findings, while performed under "deconstructed" non-clinical conditions by utilizing purified platelets alone in vitro, provide a potential contributory mechanistic explanation for the persistent thrombosis rates experienced clinically in cfVAD patients despite ASA therapy. An opportunity exists to develop enhanced pharmacologic strategies to limit shear-mediated platelet activation at elevated shear levels associated with mechanical circulatory support devices.
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Affiliation(s)
- Lorenzo Valerio
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy; Department of Cardiothoracic Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Milan, Italy.
| | - Phat L Tran
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Jawaad Sheriff
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - William Brengle
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Ram Ghosh
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Wei-Che Chiu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Alberto Redaelli
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Gianfranco B Fiore
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Federico Pappalardo
- Department of Cardiothoracic Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Milan, Italy
| | - Danny Bluestein
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Marvin J Slepian
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, AZ, USA; Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
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Yamamoto J, Ijiri Y, Tamura Y, Iwasaki M, Murakami M, Okada Y. Reevaluation of antithrombotic fruits and vegetables: great variation between varieties. Drug Discov Ther 2016; 10:129-40. [DOI: 10.5582/ddt.2016.01043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Yoshinobu Ijiri
- Faculty of Health and Nutrition, Osaka Shoin Women’s University
| | | | - Masahiro Iwasaki
- Division of Nutrition and Metabolism, Original Nutrition Co., Ltd
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15
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Schrottmaier WC, Kral JB, Badrnya S, Assinger A. Aspirin and P2Y12 Inhibitors in platelet-mediated activation of neutrophils and monocytes. Thromb Haemost 2015; 114:478-89. [PMID: 25904241 DOI: 10.1160/th14-11-0943] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/28/2015] [Indexed: 01/19/2023]
Abstract
Platelets are key players in haemostasis and represent a pivotal link between inflammation, immunity and atherogenesis. Depending on the (patho)physiological environment platelets modulate various leukocyte functions via release of inflammatory mediators and direct cell-cell interactions. Elevated levels of circulating platelet-leukocyte aggregates are found in patients suffering from several thrombotic or inflammatory conditions. Platelet-monocyte and platelet-neutrophil interaction can trigger pro- and anti-inflammatory responses and modulate effector functions of all leukocyte subpopulations. These platelet-mediated immune responses have implications for the progression of cardiovascular diseases and also play a crucial role during infections, cancer, transplantations and other inflammatory diseases of several organs. Antiplatelet therapy including the COX inhibitor aspirin and/or ADP receptor P2Y12 inhibitors such as clopidogrel, prasugrel and ticagrelor are the therapy of choice for various cardiovascular complications. Both aspirin and P2Y12 inhibitors attenuate platelet-leukocyte interactions, thereby also modulating immune responses. This may have beneficial effects in some pathological conditions, while it might be detrimental in others. This review aims to summarise the current knowledge on platelet-leukocyte interactions and the impact of aspirin and P2Y12 inhibition on platelet-mediated immune responses and to give an overview on the effects of antiplatelet therapy on platelet-leukocyte interplay in various diseases.
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Affiliation(s)
| | | | | | - Alice Assinger
- Dr. Alice Assinger, Centre for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, A-1090 Vienna, Austria, Tel.: +43 1 40160 31405, E-mail:
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16
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Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications. Reg Anesth Pain Med 2015; 40:182-212. [DOI: 10.1097/aap.0000000000000223] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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17
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Yamamoto J, Tamura Y, Ijiri Y, Iwasaki M, Murakami M, Matsuo O. Evaluation of antithrombotic effect: Importance of testing components and methodologies. Drug Discov Ther 2015; 9:258-66. [DOI: 10.5582/ddt.2015.01043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Yukinori Tamura
- Department of Physiology and Regenerative Medicine, Faculty of Medicine, Kinki University
| | - Yoshinobu Ijiri
- Department of Health and Nutrition, Faculty of Health and Nutrition, Osaka Shoin Women’s University
| | - Masahiro Iwasaki
- Division of Metabolism and Clinical Nutrition, Kansai Electric Power Hospital
| | - Masahiro Murakami
- Laboratory of Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University
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Tamura Y, Inoue A, Ijiri Y, Naemura A, Yamamoto J. Short- and long-term treatment with folic acid suppresses thrombus formation in atherogenic mice in vivo. ACTA ACUST UNITED AC 2014; 21:169-75. [PMID: 24866841 DOI: 10.1016/j.pathophys.2014.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 11/19/2022]
Abstract
In the present study, we examined the effects of short- and long-term treatment with folic acid (FA) on thrombus formation in vivo in atherogenic mice to explore a novel agent for the prevention of atherothrombotic disease. Apolipoprotein E and low-density lipoprotein receptor double deficient (ApoE(-/-)LDLR(-/-)) mice were orally administrated a single bolus of FA (20mg/kg) or fed an atherogenic diet with or without FA (0.02, 0.5, and 1.5mg/kg) for 12 weeks. Thrombus formation and endothelial function were assessed in vivo using the He-Ne laser-induced carotid artery thrombus formation test and the flow-mediated vasodilation method. Platelet reactivity was assessed ex vivo using haemostatometry. Short-term treatment with FA markedly increased plasma folate levels and significantly suppressed laser-induced thrombus formation in apoE(-/-)LDLR(-/-) mice. Short-term treatment with FA suppressed platelet reactivity in apoE(-/-)LDLR(-/-) mice, but FA treatment did not affect endothelial function or plasma homocysteine levels. Long-term treatment with FA increased plasma folate levels dose-dependently. Thrombus formation and endothelial dysfunction were suppressed by treatment with 0.5 and 1.5mg/kg of FA, respectively, but not with 0.02mg/kg of FA, whereas platelet reactivity was not altered by treatment with any dose of FA. Long-term treatment with all doses of FA decreased the plasma homocysteine levels in apoE(-/-)LDLR(-/-) mice, although this result was not consistent with its anti-thrombotic action. In conclusion, our data showed that short- and long-term treatment with FA could suppress in vivo thrombus formation in an atherogenic setting, independent of its hypohomocysteinemic action.
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Affiliation(s)
- Yukinori Tamura
- Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, 589-8511, Japan.
| | - Ayumi Inoue
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, 518 Arise, Igawadani-cho, Nishi-ku, Kobe, 651-2180, Japan
| | - Yoshinobu Ijiri
- Department of Health and Nutrition, Faculty of Liberal Arts, Osaka Shoin Women's University, 4-2-26 Hishiya-nishi, Higashi-Osaka, 577-8550, Japan
| | - Aki Naemura
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, 518 Arise, Igawadani-cho, Nishi-ku, Kobe, 651-2180, Japan
| | - Junichiro Yamamoto
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, 518 Arise, Igawadani-cho, Nishi-ku, Kobe, 651-2180, Japan
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Ooe H, Kato M, Hyodo K, Nakashima K, Ashigai H, Kato K, Sasaki T, Fukushima Y, Giddings JC, Yamamoto J. Antithrombotic Effects of Different Strains of Lactic Acid Bacteria. Health (London) 2014. [DOI: 10.4236/health.2014.618280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Lee G, Lee SE, Hong YM, Sohn S. Is high-dose aspirin necessary in the acute phase of kawasaki disease? Korean Circ J 2013; 43:182-6. [PMID: 23613695 PMCID: PMC3629244 DOI: 10.4070/kcj.2013.43.3.182] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 10/11/2012] [Accepted: 10/16/2012] [Indexed: 11/11/2022] Open
Abstract
Background and Objectives We sought to determine whether high-dose aspirin is necessary for the acute therapy of Kawasaki disease (KD) in the intravenous immunoglobulin (IVIG) era. Subjects and Methods Two groups of KD patients treated during the different periods were included. Study group (n=51, treated with IVIG without concomitant use of aspirin in the acute phase) was compared with control group (n=129, treated with IVIG plus high-dose aspirin) with regard to the response to IVIG, duration of fever after IVIG completion, time to C-reactive protein (CRP) <3 mg/dL, and the incidence of coronary artery lesions (CALs). Results There was no difference between the groups in age, sex, and duration of fever before treatment. Pre-IVIG laboratory measures also did not differ from each other. IVIG-resistant cases were 8 (15.7%) in study group and 22 (17.1%) in control group (p=1.000). Mean duration of fever after IVIG completion in IVIG-responsive patients was 13.3±13.5 hours in study group compared to 6.2±8.3 hours in control group (p=0.000). The mean time to decrease in CRP was 4.0±1.7 days in study group and 4.1±2.2 days in control group (p=0.828). There were 2 (3.9%) patients with CALs in study group and 10 (7.8%) in control group (p=0.514). Conclusion Although high-dose aspirin shortens the duration of fever, treatment without aspirin in the acute phase has no influence on the response to IVIG, resolution of inflammation, or the development of CALs. In the IVIG era, high-dose aspirin may provide little benefit to the treatment in the acute phase of KD.
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Affiliation(s)
- Goni Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Mokdong Hospital, Seoul, Korea
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21
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Yamamoto J, Ohno H, Hyodo K, Onishi M, Giddings JC. The antithrombotic activity of mini-type tomatoes is dependent on the particular variety and the stage of harvest. Lycopene content does not contribute to antithrombotic activity. Health (London) 2013. [DOI: 10.4236/health.2013.54090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Morishita M, Naemura A, Tamura Y, Yamaya H, Tsuda Y, Okada Y, Okada K, Matsuo O, Yamamoto J. Mechanism of the experimental antithrombotic effect of some apple varieties involves enhanced endogenous thrombolytic activity. Interv Med Appl Sci 2012. [DOI: 10.1556/imas.4.2012.3.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Prevention of arterial thrombotic diseases has high priority in developed countries. As inappropriate diet is known to enhance the risk for acute thrombotic events, a regular diet with experimentally proven antithrombotic effect might be a beneficial way of prevention. The present study is part of a series of investigations testing fruits and vegetables for antithrombotic activity. The Global Thrombosis Test was used to screen sixteen different apple varieties for antiplatelet and thrombolytic activities. The in vitro effective varieties were further investigated using the laser-induced thrombosis model in mice. In order to investigate the mechanism, hemostatometry and flow-mediated vasodilation test (FMV) were performed. Apple varieties were grouped into subclasses according to their antithrombotic activity. AP-2, AP-13, AP-14 and AP-15 showed significant antithrombotic effect both in vitro and in vivo. AP-8 was antithrombotic in vitro but could not determine in vivo because of the shortage of the sample. The antithrombotic effect was mainly due to activation of endogenous thrombolytic mechanism. The mechanism of such enhanced thrombolysis was investigated using a synthetic inhibitor highly specific to plasmin, polyclonal IgG to t-PA and u-PA, and testing the antithrombotic effect in t-PA knockout mice. Antithrombotic activity was prevented by the synthetic plasmin inhibitor and IgG against t-PA but not against u-PA. There was no antithrombotic activity in t-PA knockout mice. Intake of antithrombotic apple filtrate did not affect FMV and platelet reactivity. The antithrombotic effect was heat stable at 100 °C for 10 min. These results suggest that the mechanism of antithrombotic activity involves an increased t-PA release from the vascular endothelium and an inhibition of plasminogen activator inhibitor (PAI-1) release from activated platelets. The present findings justify including antithrombotic apple varieties in an antithrombotic diet.
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Affiliation(s)
- Mai Morishita
- 1 Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan
| | - Aki Naemura
- 1 Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan
| | - Yukinori Tamura
- 2 Departments of Clinical Innovative Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideaki Yamaya
- 3 Pomology Division of Apple Experiment Station, Aomori Agriculture and Forestry Research Center, Aomori, Japan
| | - Yuko Tsuda
- 4 Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Yoshio Okada
- 4 Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Kiyotaka Okada
- 5 Faculty of Medicine, Kinki University, Osakasayama, Japan
| | - Osamu Matsuo
- 5 Faculty of Medicine, Kinki University, Osakasayama, Japan
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Eikelboom JW, Hirsh J, Spencer FA, Baglin TP, Weitz JI. Antiplatelet drugs: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e89S-e119S. [PMID: 22315278 DOI: 10.1378/chest.11-2293] [Citation(s) in RCA: 252] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The article describes the mechanisms of action, pharmacokinetics, and pharmacodynamics of aspirin, dipyridamole, cilostazol, the thienopyridines, and the glycoprotein IIb/IIIa antagonists. The relationships among dose, efficacy, and safety are discussed along with a mechanistic overview of results of randomized clinical trials. The article does not provide specific management recommendations but highlights important practical aspects of antiplatelet therapy, including optimal dosing, the variable balance between benefits and risks when antiplatelet therapies are used alone or in combination with other antiplatelet drugs in different clinical settings, and the implications of persistently high platelet reactivity despite such treatment.
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Affiliation(s)
- John W Eikelboom
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada.
| | - Jack Hirsh
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada
| | - Frederick A Spencer
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada
| | - Trevor P Baglin
- Department of Haematology, Addenbrooke's NHS Trust, Cambridge, England
| | - Jeffrey I Weitz
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada
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Yamamoto J, Masuda M, Hyodo K, Iwasaki M. Experimental antithrombotic effect of potatoes harvested in the autumn. Health (London) 2012. [DOI: 10.4236/health.2012.42017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Prevention of arterial thrombotic diseases has a high priority in developed countries. An inappropriate diet is known to enhance the risks for acute thrombotic events, and nutritional products experimentally shown to be antithrombotic, might contribute beneficial effects. The present study forms part of a series of investigations into the antithrombotic effect of various foods and vegetables. Roasted and crushed whole grains from six varieties of sesame seeds were added to the diet of mice. Antithrombotic activity was measured in the carotid artery in vivo, using a He-Ne laser-induced thrombosis technique after 12 weeks. Col/Chichibu/Maruteru-2/1995 and T016 varieties showed significant antithrombotic activity, whilst 00037803 was prothrombotic. The acute effects of purified ingredients, sesamin, sesamolin and sesamol, given orally or intra-arterially, were also examined after a single dose. The most effective ingredient was sesamol, followed by sesamolin and sesamin. Daily intake of specific antithrombotic sesame whole grains or purified active ingredients might help to prevent atherothrombotic diseases.
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Hyodo K, Horii I, Nishino M, Giddings JC, Yamamoto J. The antithrombotic effects of onion filtrates in rats and mice. Health (London) 2011. [DOI: 10.4236/health.2011.36055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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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Yamamoto J, Taka T, Nakajima S, Ueda M, Sugimoto E, Sasaki Y, Muraki T, Seki J, Watanabe S. A shear-inducedin vitroplatelet function test can assess clinically relevant anti-thrombotic effects. Platelets 2010. [DOI: 10.1080/09537109909169182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Affiliation(s)
- Udaya S Tantry
- Sinai Center for Thrombosis Research, Baltimore, MD, USA
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Abstract
There is insufficient knowledge about secondary prevention after coronary artery bypass grafting (CABG). Most of it is gathered from patients suffering from myocardial infarction and angina pectoris, only a minority of whom have undergone CABG. Whereas it seems clear that these patients should give up smoking and reduce low-density lipoprotein (LDL) cholesterol, there is uncertainty about the optimal antiplatelet regimen and antithrombotic treatment. There are some data indicating the benefit of behaviour modification. There is room for improvement and more knowledge when it comes to secondary prevention after CABG.
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Affiliation(s)
- Johan Herlitz
- Division of Cardiology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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Braun M, Kramann J, Strobach H, Schrör K. Incomplete Inhibition of Platelet Secretion by Low-dose Aspirin. Platelets 2009; 5:325-31. [DOI: 10.3109/09537109409006441] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dunbabin D, Sandercock P, Collaboration AT. Antiplatelet Therapy in the Treatment and Prevention of Vascular Disease: Some Clear Answers, Some New Questions. Platelets 2009; 5:3-12. [DOI: 10.3109/09537109409006035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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34
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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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Shimizu M, Sawashita N, Morimatsu F, Ichikawa J, Taguchi Y, Ijiri Y, Yamamoto J. Antithrombotic papain-hydrolyzed peptides isolated from pork meat. Thromb Res 2009; 123:753-7. [DOI: 10.1016/j.thromres.2008.07.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Revised: 06/05/2008] [Accepted: 07/08/2008] [Indexed: 11/30/2022]
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Abstract
The prevention of arterial thrombotic disease has a high priority in developed countries. An inappropriate diet is known to enhance the risk for acute thrombotic events and a regular diet with proven antithrombotic effects might be a beneficial way to prevent disease. The present study was undertaken as a part of a series of investigations to examine vegetables and fruits for antithrombotic activity. A shear-induced in vitro platelet reactivity/thrombolysis method [Global Thrombosis Test, formerly Gorog Thrombosis Test] was used to screen 15 different varieties of carrot for antiplatelet and thrombolytic activities. Effective varieties were further investigated using an in vivo, laser-induced thrombosis model in mice. The different carrot varieties demonstrated a variable effect on thrombosis in vitro and in vivo. In particular, a variety designated SAKATA-0421 exerted an antithrombotic effect in vivo independent from heat treatment of the filtrate at 100 degrees C for 10 min. There was no significant correlation between antithrombotic activity and the levels of polyphenolics and any other biochemical parameter, including antioxidant activity, alpha-carotene and beta-carotene, alpha-tocopherol and ascorbic acid. Different varieties of carrot demonstrated a range of antithrombotic and prothrombotic activities. After oral intake, the particular heat resistant variety (SAKATA-0421) showed antithrombotic effect in vivo possibly due to antiplatelet reactivity and/or spontaneous thrombolytic activity. The present study added a new variety to the list of antithrombotic fruits and vegetables.
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37
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Patrono C, Baigent C, Hirsh J, Roth G. Antiplatelet drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133:199S-233S. [PMID: 18574266 DOI: 10.1378/chest.08-0672] [Citation(s) in RCA: 346] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This article about currently available antiplatelet drugs is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). It describes the mechanism of action, pharmacokinetics, and pharmacodynamics of aspirin, reversible cyclooxygenase inhibitors, thienopyridines, and integrin alphaIIbbeta3 receptor antagonists. The relationships among dose, efficacy, and safety are thoroughly discussed, with a mechanistic overview of randomized clinical trials. The article does not provide specific management recommendations; however, it does highlight important practical aspects related to antiplatelet therapy, including the optimal dose of aspirin, the variable balance of benefits and hazards in different clinical settings, and the issue of interindividual variability in response to antiplatelet drugs.
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Affiliation(s)
- Carlo Patrono
- From the Catholic University School of Medicine, Rome, Italy.
| | - Colin Baigent
- Clinical Trial Service Unit, University of Oxford, Oxford, UK
| | - Jack Hirsh
- Hamilton Civic Hospitals, Henderson Research Centre, Hamilton, ON, Canada
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38
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Naemura A, Ura M, Yamashita T, Arai R, Yamamoto J. Long-term intake of rosemary and common thyme herbs inhibits experimental thrombosis without prolongation of bleeding time. Thromb Res 2008; 122:517-22. [DOI: 10.1016/j.thromres.2008.01.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Revised: 01/04/2008] [Accepted: 01/21/2008] [Indexed: 11/30/2022]
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Satake T, Kamiya K, An Y, Oishi Nee Taka T, Yamamoto J. The anti-thrombotic active constituents from Centella asiatica. Biol Pharm Bull 2007; 30:935-40. [PMID: 17473438 DOI: 10.1248/bpb.30.935] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The in vitro effects of a methanol extract from the aerial parts of Centella asiatica on shear-induced platelet activation and coagulation were assessed after oral administration to rats, by subjecting non-anticoagulated blood to haemostatometry. 3,5-Di-O-caffeoyl quinic acid, 1,5-di-O-caffeoyl quinic acid, 3,4-di-O-caffeoyl quinic acid, 4,5-di-O-caffeoyl quinic acid, and chlorogenic acid, together with asiaticoside, kaempferol, quercetine, kaempferol-3-O-beta-D-glucoside and quercetin-3-O-beta-D-glucoside were all isolated from the methanol extract. Amongst these, only 3,5-di-O-caffeoylquinic acid showed significant inhibition of shear-induced platelet activation and dynamic coagulation. The reactive curve of the inhibitory effect on the platelet reaction and the dynamic coagulation showed a bell-shape.
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Affiliation(s)
- Toshiko Satake
- Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
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40
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Naemura A, Ohira H, Ikeda M, Koshikawa K, Ishii H, Yamamoto J. An experimentally antithrombotic strawberry variety is also effective in humans. PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2007; 35:398-404. [PMID: 17230043 DOI: 10.1159/000097696] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Accepted: 11/22/2006] [Indexed: 11/19/2022]
Abstract
Prevention of arterial thrombotic diseases is of high priority in developed countries. As inappropriate diet is regarded as an important risk factor of thrombotic events, daily intake of an antithrombotic diet may offer a convenient and effective way of prevention. Earlier we used animal models of thrombosis to find fruits and vegetables with potential antithrombotic activity. Among various strawberry varieties tested, a particular variety (KYSt-4, Nohime) showed a significant antithrombotic effect. The aim of the present investigation was to extend this study to humans, by testing the experimentally active KYSt-4 and inactive KYSt-10 variety for effectiveness in humans after oral intake. Filtrates of strawberries were prepared and administered orally. Thrombotic status was tested by a novel global test (Gorog Thrombosis Test). The strawberry variety (KYSt-4; Nohime) which earlier inhibited experimental thrombosis showed antithrombotic effects in humans, while the experimentally inactive variety (KYSt-10) as well as the relevant control (water) were ineffective.
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Affiliation(s)
- Aki Naemura
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, Nishi-ku, Kobe, Japan
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41
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Undas A, Brummel-Ziedins KE, Mann KG. Antithrombotic properties of aspirin and resistance to aspirin: beyond strictly antiplatelet actions. Blood 2007; 109:2285-92. [PMID: 17148593 PMCID: PMC1852201 DOI: 10.1182/blood-2006-01-010645] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Accepted: 04/27/2006] [Indexed: 12/19/2022] Open
Abstract
Aspirin is effective in the prevention of cardiovascular events in high-risk patients. The primary established effect of aspirin on hemostasis is to impair platelet aggregation via inhibition of platelet thromboxane A(2) synthesis, thus reducing thrombus formation on the surface of the damaged arterial wall. Growing evidence also indicates that aspirin exerts additional antithrombotic effects, which appear to some extent unrelated to platelet thromboxane A(2) production. Aspirin can reduce thrombin generation with the subsequent attenuation of thrombin-mediated coagulant reactions such as factor XIII activation. Aspirin also acetylates lysine residues in fibrinogen resulting in increased fibrin clot permeability and enhanced clot lysis as well as directly promoting fibrinolysis with high-dose aspirin. The variable effectiveness of aspirin in terms of clinical outcomes and laboratory findings, which has been termed aspirin resistance, may be related to these additional antithrombotic effects that are altered when associated with common genetic polymorphisms such as the Leu33Pro beta(3)-integrin or Val34Leu factor XIII mutations. However, the clinical relevance of these observations is still unclear. Elucidation of the actual impacts of aspirin other than antiaggregation effects could be important in view of the widespread use of this drug in the prevention of thrombotic manifestations of atherosclerosis.
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Affiliation(s)
- Anetta Undas
- Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland
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42
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Yamamoto J, Naemura A, Ura M, Ijiri Y, Yamashita T, Kurioka A, Koyama A. Testing various fruits for anti-thrombotic effect: i. Mulberries. Platelets 2007; 17:555-64. [PMID: 17127483 DOI: 10.1080/09537100600759295] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Prevention of arterial thrombotic disease has high priority in developed countries. As inappropriate diet predispose to acute thrombotic events, regular intake of an antithrombotic diet may be a convenient and effective way of prevention. The present study was performed to examine antithrombotic effect of mulberry varieties. A shear-induced in vitro platelet reactivity/thrombolysis test (Gorog Thrombosis Test) was used to screen for antiplatelet and thrombolytic activities. In case of effectiveness, it was followed by an in vivo test of laser-induced thrombosis in mice. Antioxidant capacity was assessed by superoxide anion and radical scavenging activities. Total polyphenolics, anthocyanin and citrate contents were also measured. The tested varieties showed different effect in vitro on platelet reactivity and endogenous thrombolytic activity. Varieties inhibiting platelet reactivity were antithrombotic in vivo regardless inhibition or enhancement of thrombolysis. Those mulberry varieties, which enhanced platelet reactivity in vitro, were prothrombotic only if inhibitory activity on endogenous thrombolysis coexisted with the platelet effect. Antioxidant activities and polyphenolics content did not affect platelets and the overall thrombotic status. However, antioxidant activities and polyphenolics content significantly correlated with the endogenous thrombolytic activity. These data showed that mulberry varieties can be grouped into subclasses with either anti- or prothrombotic activities. Antioxidant activities and polyphenolic contents do not affect platelets but may enhance endogenous thrombolysis, thus causing an overall antithrombotic effect.
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Affiliation(s)
- Junichiro Yamamoto
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan.
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43
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Ijiri Y, Naemura A, Yamashita T, Ikarugi H, Meguro S, Tokimitsu I, Yamamoto J. Mechanism of the Antithrombotic Effect of Dietary Diacylglycerol in Atherogenic Mice. PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2007; 35:380-7. [PMID: 17230040 DOI: 10.1159/000097693] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Accepted: 07/17/2006] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We have shown earlier that diacylglycerol (DAG) but not triacylglycerol (TAG) inhibited thrombus formation. The aim of the present study was to investigate the mechanism of this antithrombotic effect of DAG. MATERIALS AND METHODS Four different diets, the (1) Western-style high-fat diet (HFD) containing 20% lipid and 0.05% cholesterol (w/w), (2) TAG-rich and (3) DAG-rich HFDs containing 20% lipid and 0.05% cholesterol, but all lipid replaced by TAG or DAG oil with very similar fatty acid composition and the (4) Japanese-style low-fat diet (LFD) containing 7% oil but no cholesterol were given to apolipoprotein E and low-density lipoprotein (LDL) receptor double-deficient mice. Atherogenicity was assessed by morphology, mapping the whole aorta and measuring the total area of lipid-stained lesions. Endothelial function was measured by the flow-mediated vasodilation test. Platelet reactivity was assessed from native blood sample by a shear-induced platelet function test (hemostatometry). Serum lipoprotein profile was measured by HPLC. RESULTS Both the Western-style and the TAG-rich HFDs have accelerated atherosclerosis. In contrast, DAG-rich HFD inhibited the atherosclerotic process to an extent comparable with the Japanese-style LFD. There was no significant difference in platelet and coagulant activity between the studied diet groups. DAG-rich but not the TAG-rich HFD significantly suppressed serum LDL cholesterol level. CONCLUSIONS The present findings suggest that the mechanism of antithrombotic and anti-atherogenic effect of DAG may involve the protection of the vascular endothelium from injury and lowered serum LDL cholesterol.
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Affiliation(s)
- Yoshinobu Ijiri
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan
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Ikonomidis I, Lekakis J, Vamvakou G, Loizou S, Revela I, Andreotti F, Kremastinos DT, Nihoyannopoulos P. Aspirin reduces anticardiolipin antibodies in patients with coronary artery disease. Eur J Clin Invest 2006; 36:839-43. [PMID: 17087777 DOI: 10.1111/j.1365-2362.2006.01733.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Anticardiolipin antibodies (aCL) have been found to be elevated in patients with coronary artery disease (CAD) and have been associated with an adverse outcome owing to their prothrombotic activity. The aim of this study was to investigate the effect of aspirin treatment on aCL levels in patients with chronic CAD. MATERIALS AND METHODS Forty patients with chronic CAD scheduled for elective coronary artery bypass graft surgery (CABG) and 40 healthy controls participated in the study. Patients were treated with 300 mg of aspirin once daily (o.d.) for the first 12 days and placebo for the following 12 days before CABG in a double-blind, cross-over trial. Immunoglobulin (Ig) G-, IgM-, IgA-aCL and C-reactive protein (CRP) levels were measured in the controls and at the end of each treatment period in the patients with CAD. RESULTS The IgA- and IgG-aCL levels were greater in patients with CAD than in the controls. Compared with the placebo, IgA, IgG subtypes and CRP levels were reduced after aspirin treatment (P = 0.001, P = 0.02, P = 0.04, respectively). The percentage reduction of IgA- and IgG-aCL was related to the percentage reduction of CRP after aspirin (P < 0.05). CONCLUSION Aspirin treatment with 300 mg o.d. reduced the serum levels of IgA and IgG subtypes in patients with chronic CAD in parallel to a reduction in CRP. These findings offer an additional pathophysiological mechanism of the beneficial effects of aspirin in patients with chronic CAD.
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Affiliation(s)
- I Ikonomidis
- Second Cardiology Department, Attikon University Hospital, University of Athens, N Chalkidona, Athens, Greece.
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Sawashita N, Naemura A, Shimizu M, Morimatsu F, Ijiri Y, Yamamoto J. Effect of dietary vegetable and animal proteins on atherothrombosis in mice. Nutrition 2006; 22:661-7. [PMID: 16567078 DOI: 10.1016/j.nut.2006.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2005] [Revised: 01/25/2006] [Accepted: 02/08/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It is believed that vegetable and fish, but not animal, proteins prevent thrombosis. The present study compared the effect of long-term intake of purified vegetable and animal proteins (casein, pork, egg white, chicken, white and red fish, soybean, and potato) and powders from whole vegetable and animal meats (soybean, pork, chicken, and horse mackerel) on thrombotic tendency. METHODS Western-style high-fat diets with various proteins were given to mice deficient in apolipoprotein-E and low-density lipoprotein receptor for 8 or 12 wk. Thrombotic tendency was assessed by a laser-induced thrombosis test, severity of atherosclerosis was assessed by morphometric analysis of the aortic lesions, and reactivity of platelets was measured by a shear-induced platelet function test. RESULTS There was no difference in thrombotic tendency between the vegetable and animal protein diets with the exception of pork protein, which showed a prothrombotic effect. The latter was not observed in animals kept on a high-protein diet. Thrombotic tendency was not affected by preparation of dietary powders from whole pork, chicken, or horse mackerel meats and casein (control), all of which contained the same percentages of protein and lipid. In contrast, soybean powder showed an antithrombotic effect, which was mainly due to an inhibition of atherogenesis rather than to platelet inhibition. CONCLUSION Neither the purified animal nor the vegetable protein diet affected thrombotic tendency. Soybean powder inhibited atherothrombosis mainly by inhibiting the atherosclerotic process.
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Affiliation(s)
- Naoko Sawashita
- Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan
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Naemura A, Mitani T, Ijiri Y, Tamura Y, Yamashita T, Okimura M, Yamamoto J. Anti-thrombotic effect of strawberries. Blood Coagul Fibrinolysis 2006; 16:501-9. [PMID: 16175010 DOI: 10.1097/01.mbc.0000184737.50594.a8] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Because of the high mortality, prevention of arterial thrombotic disease has top priority in developed countries. As inappropriate diet is known to predispose to acute thrombotic events, regular intake of an anti-thrombotic diet may offer a convenient and effective method of prevention. As part of a systematic investigation into the anti-thrombotic effect of fruits and vegetables, strawberry varieties were tested in this study. An in vitro platelet function test (haemostatometry) was used for screening strawberry filtrates. Those that showed significant antiplatelet effect were further assessed with a laser-induced thrombosis test in mice. Measurement of flow-mediated vasodilation in the femoral artery of mice reflected the effect on the vascular endothelium. Correlation between the effects on platelet reactivity in vitro and the antioxidant activity (hypoxanthine/xanthine oxidase test) or phenolic compound content was assessed. Strawberry varieties KYSt-4 (Nohime), KYSt-11 (Kurume IH-1) and KYSt-17 (Kurume 58) showed significant antiplatelet activity both in vitro and, after oral administration, in vivo. Both KYSt-11 and KYSt-17, but not KYSt-4, significantly reduced flow-mediated vasodilation; that is, caused endothelial dysfunction. Antiplatelet activities were heat stable. Significant correlation was found between antiplatelet and antioxidant activities (P=0.049, R=0.23) or total phenolic compounds (P=0.0096, R=0.36). Of the tested strawberry varieties, KYSt-4, KYSt-11 and KYSt-17 showed significant anti-thrombotic effect. The dual mechanism of the effect may involve a direct inhibition of both platelet function and antioxidant activities.
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Affiliation(s)
- Aki Naemura
- Laboratory of Physiology, Faculty of Nutrition and High Technology Research Centre, Kobe Gakuin University, Kobe, Japan
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Aoki R, Ikarugi H, Naemura A, Ijiri Y, Yamashita T, Yamamoto J. Endothelial dysfunction precedes atherosclerotic lesions and platelet activation in high fat diet-induced prothrombotic state. Thromb Res 2006; 117:529-35. [PMID: 15916796 DOI: 10.1016/j.thromres.2005.04.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Revised: 04/02/2005] [Accepted: 04/14/2005] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Earlier we have demonstrated a prothrombotic state in spontaneously atherogenic rodents kept on Western-style high fat diet. The aim of the present study was to investigate the cellular mechanism of such prothrombotic state. MATERIALS AND METHODS Two kinds of diets, Western-style high fat diet containing 20% fat (w/w) and 0.05% cholesterol (w/w) and low fat diet containing 7% fat without cholesterol based on AIN93G, were added to diet-sensitive apolipoprotein E and low-density lipoprotein receptor double deficient male mice for 12 or 18 weeks from 6 weeks of age. Atherosclerosis was assessed by morphometry of the aortic wall or lipid-stained lesions. Endothelial function was measured by flow-mediated vasodilation (FMV) of the femoral artery. Platelet reactivity was measured ex vivo by a shear-induced platelet aggregation test. RESULTS AND CONCLUSIONS 12 weeks feeding of mice with high fat diet significantly impaired FMV, as compared with mice fed with low fat diet (P<0.05). In contrast, there was no significant difference in the lipid-stained areas and in the reactivity of platelets between the two groups. 18 weeks feeding with high fat diet significantly impaired FMV (P<0.05) and enhanced both lipid-stained areas (P<0.05) and platelet reactivity (P<0.01). These findings show that in high fat diet-induced prothrombotic state, endothelial dysfunction precedes both the morphologically detectable lesions and the enhancement of platelet reactivity.
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Affiliation(s)
- Rumiko Aoki
- Laboratory of Physiology, Faculty of Nutrition, and High-Technology Research Centre, Kobe Gakuin University, Kobe 651-2180, Japan
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Tantry US, Bliden KP, Gurbel PA. Resistance to antiplatelet drugs: current status and future research. Expert Opin Pharmacother 2005; 6:2027-45. [PMID: 16197357 DOI: 10.1517/14656566.6.12.2027] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Platelet reactivity and activation are important factors during the development of atherothrombotic processes and subsequent ischaemic complications. Pharmacological agents that suppress platelet function are proved to be the most efficient in the prevention and treatment of thrombotic complications. As the activation of platelets during thrombus generation involves many complex and redundant pathways, simultaneous use of different antiplatelet drugs that are directed against different targets have been effective in reducing adverse clinical events. The main antiplatelet drugs are aspirin (which inhibits thromboxane synthesis), thienopyridines (which block P2Y12 receptors) and glycoprotein IIb/IIIa antagonists (which block glycoprotein IIb/IIIa receptors). In recent years, resistance or nonresponsiveness to antiplatelet therapy has been reported and, more importantly, are linked to the occurrence of adverse cardiovascular events. New treatment strategies to overcome nonresponsiveness are being sought. A focus on the development of simple, reproducible and user friendly point-of-care methods to determine aspirin/clopidogrel responsiveness should be undertaken to assist clinicians in tailoring antiplatelet therapy to the individual patient.
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Affiliation(s)
- Udaya S Tantry
- Sinai Center for Thrombosis Research, Hoffberger Building, Suite 56, 2401 W. Belvedere Ave, Baltimore, MD 21215, USA
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Yamamoto J, Yamada K, Naemura A, Yamashita T, Arai R. Testing various herbs for antithrombotic effect. Nutrition 2005; 21:580-7. [PMID: 15850964 DOI: 10.1016/j.nut.2004.09.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2004] [Accepted: 09/03/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Prevention of arterial thrombotic diseases has high priority in developed countries. Because people who eat inappropriate food are prone to thrombotic events, regular intake of an antithrombotic diet may offer a convenient and effective way of prevention. The aim of the present study was to find herbs that have antithrombotic effects. METHODS Herbs were crushed and centrifuged and the juice obtained was filtered. The effect of filtrate on platelet-rich thrombus formation was assessed by a shear-induced in vitro platelet function test (hemostatometry). Filtrates showing significant antithrombotic activity were further assessed by using a laser-induced in vivo thrombosis test in mice. The effect of orally administered herb filtrates on flow-mediated vasodilation was also measured. RESULTS Common thyme and rosemary showed significant antithrombotic activity in vitro and in vivo. Neither herb affected flow-mediated vasodilation. CONCLUSION Some herbs possess antithrombotic effects in experimental models of thrombosis. The mechanism of the antithrombotic effect of common thyme and rosemary may involve a direct inhibitory effect on platelets.
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Affiliation(s)
- Junichiro Yamamoto
- Laboratory of Physiology, Faculty of Nutrition and High Technology Research Center, Kobe Gakuin University, Kobe, Japan.
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Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Kasner SE, Benesch CG, Sila CA, Jovin TG, Romano JG. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005; 352:1305-16. [PMID: 15800226 DOI: 10.1056/nejmoa043033] [Citation(s) in RCA: 1128] [Impact Index Per Article: 59.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Atherosclerotic intracranial arterial stenosis is an important cause of stroke. Warfarin is commonly used in preference to aspirin for this disorder, but these therapies have not been compared in a randomized trial. METHODS We randomly assigned patients with transient ischemic attack or stroke caused by angiographically verified 50 to 99 percent stenosis of a major intracranial artery to receive warfarin (target international normalized ratio, 2.0 to 3.0) or aspirin (1300 mg per day) in a double-blind, multicenter clinical trial. The primary end point was ischemic stroke, brain hemorrhage, or death from vascular causes other than stroke. RESULTS After 569 patients had undergone randomization, enrollment was stopped because of concerns about the safety of the patients who had been assigned to receive warfarin. During a mean follow-up period of 1.8 years, adverse events in the two groups included death (4.3 percent in the aspirin group vs. 9.7 percent in the warfarin group; hazard ratio for aspirin relative to warfarin, 0.46; 95 percent confidence interval, 0.23 to 0.90; P=0.02), major hemorrhage (3.2 percent vs. 8.3 percent, respectively; hazard ratio, 0.39; 95 percent confidence interval, 0.18 to 0.84; P=0.01), and myocardial infarction or sudden death (2.9 percent vs. 7.3 percent, respectively; hazard ratio, 0.40; 95 percent confidence interval, 0.18 to 0.91; P=0.02). The rate of death from vascular causes was 3.2 percent in the aspirin group and 5.9 percent in the warfarin group (P=0.16); the rate of death from nonvascular causes was 1.1 percent and 3.8 percent, respectively (P=0.05). The primary end point occurred in 22.1 percent of the patients in the aspirin group and 21.8 percent of those in the warfarin group (hazard ratio, 1.04; 95 percent confidence interval, 0.73 to 1.48; P=0.83). CONCLUSIONS Warfarin was associated with significantly higher rates of adverse events and provided no benefit over aspirin in this trial. Aspirin should be used in preference to warfarin for patients with intracranial arterial stenosis.
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Affiliation(s)
- Marc I Chimowitz
- Department of Neurology, School of Medicine, Emory University, Atlanta, USA.
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