Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Prothrombotic Processes and Myocardial Infarction Risk

Dézsi, Csaba András; Szentes, Veronika

doi:10.1007/s40256-016-0185-0

Cited by 16 publications

(19 citation statements)

References 58 publications

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“…In the case presented here, the decreased systolic blood pressure is likely to be the result of an obstruction of the inflow into the left ventricle due to the oscillating mass in the left atrium and the following decreased diastolic filling. Although arterial hypotension might be a reason to discontinue benazepril, it was further given due to its antithrombotic effects [ 26 ]. Simultaneously, phonocardiography and echocardiography were used in human patients suffering from mitral stenosis combined with a free-floating left atrial thrombus.…”

Section: Discussionmentioning

confidence: 99%

The Rare Occurrence of a Left Atrial Thrombus in a Dog

Otto¹,

Hopfner²

2020

Case Reports in Veterinary Medicine

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Intracardiac thrombi are rare in dogs. If they occur, they are mostly seen in the right atrium while only two case reports describing a mural left atrial thrombus in dogs are available. This case report describes a 14-year-old mixed-breed bitch that was presented at the clinic because of dyspnoea. The dog suffered from alopecia for about three years and displayed polyuria and polydipsia for a number of months. Clinical examination revealed intensified inspiratory and expiratory respiratory sounds and various heart sounds. Chest X-ray showed cardiomegaly (VHS 11) and a mixed bronchoalveolar lung pattern of the caudal lung. A transthoracic echocardiography was performed and showed a moderate mitral regurgitation, a highly dilated left atrium, a low-grade pulmonary insufficiency, and a minimal aortic and tricuspid insufficiency. Additionally, a free-floating ball thrombus was found in the left atrium. Hyperadrenocorticism was indicated by an ACTH stimulation test. The previous medical therapy of the referring veterinarian consisted of benazepril and furosemide and was complemented by clopidogrel. The pet owners declined any further clinical diagnostics and therapy. The dog died 19 days later. This is the first reported case of a dog with a free-floating left atrial thrombus. Specific therapeutic strategies for intracardiac thrombi in the dog are currently not available, and therefore, every patient should be treated individually.

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Section: Discussionmentioning

confidence: 99%

The Rare Occurrence of a Left Atrial Thrombus in a Dog

Otto¹,

Hopfner²

2020

Case Reports in Veterinary Medicine

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“… 55 ARBs reduce cardiovascular oxidative stress, reverse endothelial dysfunction, and decrease inflammatory and oxidative renal damage in patients with diseases associated with RAS dysregulation, such as hypertension and diabetes. 205 , 206 ARBs have mitigated the severity of experimental myocarditis 110 and have been shown to upregulate AT2 in vascular endothelial cells. 52 Moreover, AT1 blockade may shunt existing AII to activate AT2, yielding anti-inflammatory effects.…”

Section: Conclusion: Taking Aim At Rasmentioning

confidence: 99%

“… 52 Moreover, AT1 blockade may shunt existing AII to activate AT2, yielding anti-inflammatory effects. 205 , 206 …”

Section: Conclusion: Taking Aim At Rasmentioning

confidence: 99%

<p>COVID’s Razor: RAS Imbalance, the Common Denominator Across Disparate, Unexpected Aspects of COVID-19</p>

Czick¹,

Shapter²,

Shapter³

2020

DMSO

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A modern iteration of Occam’s Razor posits that “the simplest explanation is usually correct.” Coronavirus Disease 2019 involves widespread organ damage and uneven mortality demographics, deemed unexpected from what was originally thought to be “a straightforward respiratory virus.” The simplest explanation is that both the expected and unexpected aspects of COVID-19 share a common mechanism. Silent hypoxia, atypical acute respiratory distress syndrome (ARDS), stroke, olfactory loss, myocarditis, and increased mortality rates in the elderly, in men, in African-Americans, and in patients with obesity, diabetes, and cancer—all bear the fingerprints of the renin-angiotensin system (RAS) imbalance, suggesting that RAS is the common culprit. This article examines what RAS is and how it works, then from that baseline, the article presents the evidence suggesting RAS involvement in the disparate manifestations of COVID-19. Understanding the deeper workings of RAS helps one make sense of severe COVID-19. In addition, recognizing the role of RAS imbalance suggests potential routes to mitigate COVID-19 severity.

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“…In particular, ACEIs have been shown to mitigate endothelial dysfunction, reduce vascular inflammation, moderate prothrombotic activity, and normalize the fibrinolytic response. 2,3 Most hypertensive patients with SCAD require combination therapy with two to three antihypertensive agents to reach their target blood pressure. In view of the demonstrated efficacy of these agents in reducing cardiovascular morbidity and mortality, recent therapeutic guidelines (European Society of Cardiology 2013) 1 recommend the use of ACEIs and CCBs, which have confirmed anti-atherosclerotic activity.…”

Section: Key Risk Factors For Stable Coronary Artery Diseasementioning

confidence: 99%

“…In particular, ACEIs have been shown to mitigate endothelial dysfunction, reduce vascular inflammation, moderate prothrombotic activity, and normalize the fibrinolytic response. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Treatment with triple combination of atorvastatin, perindopril, and amlodipine in patients with stable coronary artery disease: A subgroup analysis from the PAPA-CAD study

Dézsi

2018

J Int Med Res

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BackgroundIn patients with stable coronary artery disease, aspirin, a statin, and an angiotensin-converting enzyme inhibitor are recommended as first-line agents for secondary prevention. Subgroup analyses of the previously published Hungarian Perindopril plus Amlodipine in PAtients with Coronary Artery Disease (PAPA-CAD) non-interventional trial demonstrated that the addition of the metabolically beneficial, fixed combination of perindopril + amlodipine to atorvastatin further improves the patient’s lipid profile.MethodsThe PAPA-CAD study, a 6-month open-label, prospective, multicenter, observational/non-interventional survey evaluated data accumulated from patients with hypertensive patients with stable coronary artery disease. The herein-reported subgroup analysis was conducted using the findings from those 1130 patients, who were taking atorvastatin in addition to the fixed combination of perindopril + amlodipine at the time of all four study visits (i.e., at baseline and 1, 3, and 6 months later).ResultsIn the subgroup of patients taking atorvastatin as an add-on agent, 82.5% reached the target blood pressure of 140/90 mmHg compared with 78.8% of those not taking a statin. The addition of atorvastatin to the fixed combination of perindopril + amlodipine resulted in further significant improvements of key metabolic parameters.ConclusionThis subgroup analysis confirmed that favorable synergism exists among perindopril, amlodipine, and atorvastatin.

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Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Prothrombotic Processes and Myocardial Infarction Risk

Cited by 16 publications

References 58 publications

The Rare Occurrence of a Left Atrial Thrombus in a Dog

The Rare Occurrence of a Left Atrial Thrombus in a Dog

<p>COVID’s Razor: RAS Imbalance, the Common Denominator Across Disparate, Unexpected Aspects of COVID-19</p>

Treatment with triple combination of atorvastatin, perindopril, and amlodipine in patients with stable coronary artery disease: A subgroup analysis from the PAPA-CAD study

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