Invasive treatment of patients with refractory angina in remote areas without surgical back-up results in significant in-hospital stabilization and a reduction in major events in-hospital and at 30 days. Coronary angioplasty in stand-alone units and air-transfer of these patients seems safe.
The increased aggregatory response of platelets to PAF and the low plasma levels of HDL-cholesterol and HDL-associated PAF-AH activity in patients with unstable angina may contribute to the severe atherosclerosis and to acute thrombosis found in these patients. Abciximab therapy may protect platelets from PAF action in vivo the first days after drug administration, but it fails to permanently restore the enhanced aggregatory response observed.
Objective The aim of this study was to investigate the possible ( ) [ ( )] associations between lipoprotein a Lp a concentrations or ( ) apolipoprotein a isoforms and the mode of clinical presentation ( ) ( of coronary heart disease CHD acute thrombotic event or ) not .Methods A total of 131 CHD patients and 71 age-and ( gender-matched individuals without known CAD free of ) symptoms of heart disease were enrolled in the study. CHD patients were classified into patients with a history of an acute ( ) coronary syndrome ACS, n = 94 and patients with stable ( ) () angina SA, n = 37 . Lp a levels were measured with an ELISA ( ) method, whereas apolipoprotein a isoform analysis was ( ) performed in all patients and 33 controls by electrophoresis in 1.5% SDS-agarose gels followed by immunoblotting. Isoform ( ) size was expressed as the number of kringle 4 K4 repeats. ( ) [ Results ACS patients had higher Lp a plasma levels 21.9 ( ) ] ( 0.8-84.1 mg / dl and a greater proportion of elevated G 30 ) ( ) ( ) mg / dl Lp a concentrations 25.5% compared with SA [ ( ) patients 9.2 0.8-50.5 mg / dl, P -0.01 and 10.8%, ] [ ( ) P -0.05 and controls 8.0 0.8-55.0 mg / dl, P -0.01 and ] 11.2%, P -0.05 , while there were no differences between ( ) SA patients and controls. The median apolipoprotein a -isoform ( ) size was 26 K4. In 17 10% patients we could not detect any ( ) apolipoprotein a isoform bands by immunoblotting. ACS ( patients had a higher proportion of isoforms -26 K4 low ) ( molecular weight than SA patients 56/ 85 vs. 12/ 33, ) ( ) P -0.005 and controls 10/ 29, P -0.005 .Conclusions CAD patients with a history of ACS have higher ( ) Lp a plasma levels and a significantly higher proportion of low ( ) molecular weight apolipoprotein a isoforms compared with patients with SA or to controls.
The clinical efficacy and safety of the generic CB is similar to that of the innovator CHS salt, thus, it can be routinely used in the secondary prevention of atherothrombotic events for a period of at least 6 months. (Salts of Clopidogrel: Investigation to ENsure Clinical Equivalence, SCIENCE study Clinical Trials.gov Identifier: NCT02126982).
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