Effects of Hormone-Replacement Therapy on Fibrinolysis in Postmenopausal Women

Koh, Kwang Kon; Mincemoyer, Rita; Bui, Minh; Csákó, György; Pucino, Frank; Guetta, Victor; Waclawiw, Myron A.; Cannon, Richard O.

doi:10.1056/nejm199703063361002

Cited by 355 publications

(124 citation statements)

References 48 publications

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“…Th e proposed mechanism of action for these agents included shortening of the bleeding time contributing to an eff ect on hemostasis ( 213 ). However, other studies suggested that these agents may instead increase plasma fi brinolysis and lead to recurrent bleeding ( 214 ). A prospective randomized double-blind placebocontrolled crossover study performed in Belgium in 1990 created enthusiasm for hormonal treatment.…”

Section: Hormonal Therapymentioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

545

559

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Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

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Section: Hormonal Therapymentioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

545

559

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“…Assays for lipids, plasma nitrate (using the Griess reaction), malondialdehyde (MDA), E-selectin, intercellular adhesion molecule type-1 (ICAM-1), vascular cell adhesion molecule type-1 (VCAM-1), and tumor necrosis factor (TNF)-a were performed in duplicate by ELISA (R&D Systems and BIOXYTECHR LPO-586, OxisResearch) as previously described [6,10,15]. Fibrinogen was measured by the thrombin-time titration method (Thrombocheck FibR, Japan).…”

Section: Laboratory Assaysmentioning

confidence: 99%

Vascular effects of diet and statin in hypercholesterolemic patients

Koh

Son

Ahn

et al. 2004

International Journal of Cardiology

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“…PAI-1 stabilizes both arterial and venous thrombi, contributing, respectively, to coronary arterial occlusion in post-myocardial infarction (5) and venous thrombosis following post-operative recovery from orthopedic surgery (6). Plasma PAI-1 is also elevated in postmenopausal women, and has been proposed to contribute to the relative increased incidence of cardiovascular disease in this population (7). The role of PAI-1 in atherosclerosis is less well defined, but PAI-1 is found in high concentrations in vascular plaque (8), and is involved in the in vitro regulation of tissue proteolysis and smooth muscle cell migration (9).…”

mentioning

confidence: 99%

Mapping of a Conformational Epitope on Plasminogen Activator Inhibitor-1 by Random Mutagenesis

Gorlatova

Elokdah

Fan

et al. 2003

Journal of Biological Chemistry

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The mechanism for the conversion of plasminogen activator inhibitor-1 (PAI-1) from the active to the latent conformation is not well understood. Recently, a monoclonal antibody, 33B8, was described that rapidly converts PAI-1 to the latent conformation (Verhamme, I., Kvassman, J. O., Day, D., Debrock, S., Vleugels, N., Declerck, P. J., and Shore, J. D. (1999) J. Biol. Chem. 274, 17511-17517). In an attempt to understand this interaction, and more broadly to understand the mechanism of the natural transition of PAI-1 to the latent conformation, we have used random mutagenesis to identify the 33B8 epitope in PAI-1. This site involves at least 8 amino acids scattered over more than two-thirds of the linear sequence that form a compact epitope on the PAI-1 three-dimensional structure. Surface plasmon resonance studies indicate a high affinity interaction between latent PAI-1 and 33B8 that is ϳ100-fold higher than comparable binding to active PAI-1. Structural modeling results together with surface plasmon resonance analysis of parental and site-directed PAI-1 mutants with disrupted 33B8 binding suggest the existence of a specific PAI-1 intermediate structure that is stabilized by 33B8 binding. These analyses strongly suggest that this intermediate form of PAI-1 has a partial insertion of the reactive center loop into ␤-sheet A, and together, these data have significant implications for the general serpin mechanism of proteinase inhibition.

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Effects of Hormone-Replacement Therapy on Fibrinolysis in Postmenopausal Women

Cited by 355 publications

References 48 publications

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Vascular effects of diet and statin in hypercholesterolemic patients

Mapping of a Conformational Epitope on Plasminogen Activator Inhibitor-1 by Random Mutagenesis

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