Acute coronary syndrome and

Fondaparinux, the factor Xa-binding pentasaccharide (Arixtra, MW 1,728 Da), is prepared synthetically, unlike UFH, LMWH and danaparoid, which are obtained from animal sources. Despite only inactivating free factor Xa, clinical trials indicate that fondaparinux is an effective antithrombotic agent, both for venous thromboembolism prophylaxis and treatment, as well as for acute coronary syndrome and ST elevation myocardial infarction [4]. 

The major goals for the treatment of ischemic heart disease are to prevent acute coronary syndromes and death, alleviate acute symptoms of myocardial ischemia, prevent recurrent symptoms of myocardial ischemia, and avoid or minimize adverse treatment effects. 

Newby LK, Ohman EM, Christenson RH, et al. Benefit of glycoprotein llb/llla inhibition in patients with acute coronary syndromes and troponin T-positive status the PARAGON-B troponin-T substudy. Circulation 2001 103 2891-2896. 

Kereiakes DJ, Montalescot G, Antman EM, et al. Low-molecular-weight heparin therapy for non-ST-elevation acute coronary syndromes and during percutaneous coronary intervention an expert consensus. Am Heart J 2002 144 615-624. 

Moatti D, Seknadji P Galand C, et al, Polymorphisms of the tissue factor pathway inhibitor (TFPI) gene in patients with acute coronary syndromes and in healthy subjects impact of the V264M substitution on plasma levels of TFPI. Arterioscler Thromb Vase Biol 1999 19 862-869. 

The introduction of stents in interventional cardiology has added a new dimension in the management of acute coronary syndrome and related disorders. Moreover, stents are now commonly used in the management of vascular and... 

The troponin assay has prognostic information that can determine mortality risk in acute coronary syndrome and define which patients may benefit from aggressive medical therapy and early coronary revascularisation. 

A retrospective chart review was conducted to explore metamfetamine-associated acute coronary syndromes in patients who presented to the emergency room at a University Center between 1994 and 1996 (1). There were 36 admissions, three of which were repeat patients. Nine of these patients had acute coronary syndrome. Of these, one had an acute anterior Q wave myocardial infarction with cardiac arrest, seven had non-Q wave myocardial infarctions, and one had unstable angina. There were potentially life-threatening cardiac complications in three subjects (8%). The authors suggested that acute coronary syndromes and life-threatening complications associated with the use of metamfetamine are not uncommon, as evidenced by their experience in this study. 

Ahmed S, Cannon CP, Murphy SA, Braunwald E. Acute coronary syndromes and diabetes is intensive lipid lowering beneficial Results of the PROVE IT-TIMI 22 trial. Eur. Heart J. 2006 27 2323-2329. 

The anthors postnlated that the combination of two sym-pathomrmetics had cansed acute coronary artery vasospasm. This is the first report linking amfebntamone to acute coronary syndrome, and one of a few cases associated with pseudoephedrine. It is also possible that erythromycin, which this patient was also taking, could have impaired the hepatic metabolism of amfebntamone. 

Crouch ED, Watson LE. Intravenous immunoglobulin-related acute coronary syndrome and coronary angiography in idiopathic thrombocytopenic purpura—a case report and literature review. Angiology 2002 53(1) 113-17. 

Chronic inflammation is an important component in the development and progression of atherosclerosis, and numerous epidemiological studies have demonstrated, that increased serum CRP concentrations are positively associated with a risk of future coronary events, such as coronary artery disease, cerebrovascular disease, or peripheral arterial disease/ " It has also been shown to be predictive of future events in patients with acute coronary syndromes and in patients with stable angina and coronary artery stents. 

Figure 44-25 Odds ratios for death and myocardial infarction in short- and long-term followup among cardiac troponin-positive versus cardiac troponin-negative patients with non-ST segment elevation acute coronary syndromes, and for a subset of patients with unstable angina. (From Ottani F, Galvani /M, N/co//n/ FA, Ferrini D, Pozzati A, Di Pasquaie G, et at. Elevated cardiac troponin levels predict the risk of adverse outcome in patients with acute coronary syndromes. Am Heart J 2000 140 917-27.)...

Atherosclerotic plaque rupture is a key event in the pathogenesis of acute coronary syndromes and during coronary interventions. Atherosclerotic plaque rupture does not always result in complete thrombotic occlusion of the entire epicardial coronary artery with subsequent acute myocardial infarction, but may in milder forms result in the embolization of atherosclerotic and thrombotic debris into the coronary microcirculation. 

G. Heusch, Emerging importance of alpha-adrenergic coronary vasoconstriction in acute coronary syndromes and its genetic background, J Am Coll Cardiol 41, 195-196 (2003). 

Mehta SR, Yusuf S. Short- and long-term oral antiplatelet therapy in acute coronary syndromes and percutaneous coronary intervention. J Am Coll Cardiol 2003 41 79S-88S. 

Used mainly in acute coronary syndromes and post-angioplasty... 

Impressive advancements in the treatment of acute coronary syndromes and congestive heart failure have been introduced in recent years. This has relied on a better understanding of the underlying pathogenesis... 

ADP, thromboxane A2, fibrin, and serotonin. Prostacyclin (PGI2) from endothelial cells and cAMP are naturally occurring compounds that inhibit platelet aggregation. Clopidogrel and ticlopi-dine are antagonists of ADP that are used both in acute coronary syndromes and as alternatives to ASA for prophylaxis post-MI and for transient ischemic attacks (TLAs). 

There is extensive evidence that changes in plasma OxPL/apoB ratios, measured using the murine monoclonal antibody E06 (Tsimikas 2006b Tsimikas and Witztum 2001) may reflect the extent of atherosclerotic disease burden (Tsimikas et al. 2005,2006). It was shown that OxPL/apoB levels are increased in patients with coronary, carotid or femoral artery disease, acute coronary syndromes and after percutaneous coronary intervention (Tsimikas et al. 

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