Ticagrelor increases APC in ACS patients compared with clopidogrel by inhibiting adenosine uptake by red blood cells.

This study opens new perspectives in understanding the physiology of human EAT and its local interaction with neighbouring structures.

In the treatment of blunt traumatic thoracic aortic rupture, the immediate outcome in patients who receive endovascular stent grafts appears to be at least as good as observed after conventional surgical repair. Long-term follow-up is necessary to assess long-term effectiveness of such management.

Surgery performed very early may improve survival in patients with the most severe complicated IE. However, a greater risk of relapses and PVD should be expected when surgery is performed very early.

ECMO may be an effective salvage treatment for patients with influenza A (H1N1)-related ARDS presenting rapid refractory respiratory failure, particularly when provided by a mobile team allowing early cannulation prior to transfer to a reference centre.

During exercise, cardiac oxygen consumption increases and the resulting low oxygen level in the myocardium triggers coronary vasodilation. This response to hypoxia is controlled notably by the vasodilator adenosine and its A 2A receptor (A 2A R). According to the "spare receptor" pharmacological model, a strong A 2A R-mediated response can occur in the context of a large number of receptors remaining unoccupied, the activation of only a weak fraction of A 2A R (evaluated using K D ), which results in maximal cAMP production (evaluated using EC 50 ), and hence in maximal coronary vasodilation. In coronary artery disease (CAD), myocardial ischemia limits adaptation to exercise, which is commonly detected using the exercise stress test (EST). We hypothesized that spare A 2A R is present in CAD patients to correct ischemia. Seventeen patients with angiographically documented CAD and 17 control subjects were studied. We addressed adenosine-plasma concentration and A 2A R-expression at the mononuclear cell-surface, which reflects cardiovascular expression. The presence of spare A 2A R was tested using an innovative pharmacological approach based on a homemade monoclonal antibody with agonist properties. EST was positive in 82% of patients and in none of the controls. Adenosine plasma concentration increased by 60% at peak exercise in patients and in none of the controls (p < 0.01). Most patients (65%), and none of the controls, had spare A 2A R (identified when EC 50 /K D ≤ 0.1) and a low A 2A R-expression (mean: -37% versus controls; p < 0.01). All patients with spare A 2A R had a positive EST whereas the subjects without spare A 2A R had a negative EST (p < 0.05). Spare A 2A R is therefore associated with positive EST in CAD patients and its detection may be used as a diagnostic marker.

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Expression of AR on PBMC correlated with those measured in coronary artery and aortic tissues in CAD patients, AR activity of PBMC matched that observed in aorta, and AR expression and activity in PBMC were found reduced as compared to controls. Measuring the expression level of AR on PBMC represents a good tool to address in situ expression in coronary tissues of CAD patients.