Nonantithrombotic Medical Options in Acute Coronary Syndromes

Soukoulis, Victor; Boden, William E.; Smith, Sidney C.; O’Gara, Patrick T.

doi:10.1161/circresaha.114.302804

Cited by 17 publications

(15 citation statements)

References 125 publications

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“…1 Myocardial infarction happens due to the ischemia of the ventricular wall for atherosclerotic or non-atherosclerotic (stress cardiomyopathy, cocaine ingestion, spontaneous coronary dissection, intense vaso constriction) reasons. 2 The reduced blood supply leads to the hypertrophy and necrosis of cardiomyocytes within 15 min. 3 The regenerative repair of the infarct is challenging since the cardiomyocytes are terminally differentiated cells with a turnover ratio of 1% per year.…”

Section: Introductionmentioning

confidence: 99%

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Influence of matrix and bulk behaviour of an injectable hydrogel on the survival of encapsulated cardiac cells

2015

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Cytocompatibility, suitable porosity, higher equilibrium water content and tissue like elasticity are the demanding criteria required to design a hydrogel for cell encapsulation and delivery. Here a mechanically stable cell supporting synthetic hydrogel was fabricated from poly(propylene fumarate-coethylene glycol)/PEGDA by redox initiating polymerisation for cell encapsulation. A hydrogel prepared with 93.5% poly(propylene fumarate-co-ethylene glycol) and 6.5% PEGDA acquired matrix and bulk characteristics of equilibrium water content (EWC) 84.45 AE 0.80%, freezable water content 67.93%, Young modulus 212.2 AE 0.02 kPa and pore diameter 88.64 AE 18.96 mm. This hydrogel with higher free water content, favourable pore dimensions and mechanical strength was used to encapsulate cardiomyoblasts. The encapsulated cardiomyoblasts were showing increasing viability from 3-30 days with viable green fluorescence. The matrix and bulk characteristics of the hydrogel are favourable and elicited uniform, green fluorescing, live cardiomyoblasts (H9c2) inside with 150% cell viability (MTT assay) and uniform ECM protein distribution after 30 days. The slow in vitro degradation of the hydrogel in physiological-like conditions is favourable for the delivery and retention of the encapsulated cells at the injection site.

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Section: Introductionmentioning

confidence: 99%

“…4 The existing therapeutic interventions can reduce the oxygen consumption of remaining cardiomyocytes but are not efficient to reduce the infarct size. 2 This may spread the ventricular remodeling to the non-infarcted area which leads to wall thinning and cardiac rupture.…”

Section: Introductionmentioning

confidence: 99%

Influence of matrix and bulk behaviour of an injectable hydrogel on the survival of encapsulated cardiac cells

2015

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“…Польза от применения нитратов иначе как в качестве антиангинальных препаратов пациентам с ОКС, в особенности лицам старших возрастных групп, до сих пор вызывает дискуссию. По данным V. Soukoulis и соавт., назначения нитратов следует избегать у пациентов с дисфункцией правого желудочка, их не следует применять в лечении тех больных, которые в предыдущие 24-48 ч применяли силденафил или тадалафил вследствие выраженной гипотензии при сочетании данных препаратов [30]. Данные РКИ показали, что использование нитратов в качестве препаратов, уменьшающих преднагрузку на сердце, не обеспечивает значимого снижения показателя смертности и частоты возникновения неблагоприятных сердечнососудистых событий [31].…”

Section: препараты нитроглицеринаunclassified

Acute coronary syndrome in elderly: aspects of patient management

et al. 2019

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Coronary heart disease is the leading cause of death worldwide. Over the past few decades, life expectancy has increased, which has led to an aging population in developed countries, so the average age of patients with acute coronary syndrome (ACS) has steadily increased in recent decades. The inclusion of elderly and senile patients in randomized clinical trials does not reflect the age-related association of these diseases. However, antithrombotic therapy and interventional treatment are the basis of treatment in patients with ACS of any age, including the elderly. For older patients, there may be a mismatch between chronological and biological age. The question of how close the treatment of elderly patients with ACS is to the level of current recommendations and whether it is possible to apply them unconditionally in this group of patients does not have a definite answer. Current recommendations and the underlying randomized clinical trials are focused on any one disease, whereas in the elderly in most cases multimorbid pathology occurs. In general, elderly patients with ACS should be treated using the same methods as younger patients, however, the presence of comorbid diseases in an elderly patient naturally increases the risk of complications, makes the patient’s prognosis heavier, significantly affects treatment tactics, limits the possibility of using conventional approaches when choosing a drug therapy.

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“…1 Failure of a reperfusion in an ischaemic area in spite of removal of the physical obstruction by primary PCI is termed as no-reflow phenomenon (Morishima I et al and Soukoulis V et al). 2,3 Reperfusion injury is another strong factor that results in such poor outcomes following PCI (Lønborg JT). 4 Nicorandil is a drug that opens ATP-sensitive potassium channel (Sato T et al) 5 and has been shown to improve vasodilatation of small arterioles (Ishiyama T et al).…”

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confidence: 99%

Does Periprocedural Nicorandil Improve Cardiovascular Outcomes in Acute Myocardial Infarction? - Meta-Analysis

Goenka¹,

George²,

Karthikeyan³

2016

jebmh

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BACKGROUND Nicorandil in conjunction with Percutaneous Coronary Intervention (PCI) has shown to improve the coronary reflow. It is not known if use of Nicorandil could lead to improvement in short and long-term cardiovascular outcomes. MATERIALS AND METHODS Literature evaluation was done to determine the efficacy of Nicorandil in improving the cardiovascular outcomes in Acute Myocardial Infarction (AMI) patients in the setting of PCI. The search terms used were Nicorandil and AMI and PCI using MEDLINE and Science Direct. Study Design-A systematic review and meta-analysis. RESULTS Thirteen randomised clinical trials were identified. Nicorandil significantly reduced in-hospital outcomes (RD: 0.16; 95%, CI:-0.23 to-0.09; I 2 : 95%; p<0.00001; FE model). There was a reduction in the number of patients with thrombolysis in myocardial infarction (TIMI flow ≤2) grade (RD: 0.06; 95%, CI:-0.09 to-0.02; I 2 : 95%; p=0.002; FE model). There was no significant difference in the major adverse cardiovascular events between Nicorandil and controls when assessed between 30 days to 8 months after discharge. CONCLUSION While Nicorandil clearly appears to have a benefit in improving in-hospital cardiovascular outcomes, it remains to be seen if this could translate into improved long-term cardiovascular outcomes.

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Nonantithrombotic Medical Options in Acute Coronary Syndromes

Cited by 17 publications

References 125 publications

Influence of matrix and bulk behaviour of an injectable hydrogel on the survival of encapsulated cardiac cells

Influence of matrix and bulk behaviour of an injectable hydrogel on the survival of encapsulated cardiac cells

Acute coronary syndrome in elderly: aspects of patient management

Does Periprocedural Nicorandil Improve Cardiovascular Outcomes in Acute Myocardial Infarction? - Meta-Analysis

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