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Current Vascular Pharmacology

Adriano Alatri, Lucia Mazzolai
Bleeding represents the most important complication of antithrombotic treatment, including anticoagulant and antiplatelet therapies. A number of scores were proposed to evaluate the risk of bleeding both for anticoagulant and antiplatelet treatment. In the last decade, 5 bleeding risk scores were published for use in atrial fibrillation patients, and 3 scores for patients receiving anticoagulants for venous thromboembolism therapy or prophylaxis. In addition, 3 scores were recently developed to assess in-hospital or short-term bleeding risk in patients receiving antiplatelet therapy after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI)...
February 11, 2019: Current Vascular Pharmacology
Marco De Carlo, Marco Angelillis, Riccardo Liga
Lower extremity artery disease (LEAD) represents a major public health burden, affecting hundreds of millions people worldwide. Although risk-factor modification, exercise training and medical treatment are the mainstay of the management of LEAD, endovascular or surgical revascularisation is recommended when there is the risk of limb amputation and when drug-resistant claudication severely affects patient lifestyle. Over recent years, the number of peripheral vascular interventions (PVI) has soared worldwide, driven by the improvements in endovascular techniques and devices...
February 6, 2019: Current Vascular Pharmacology
Mislav Vrsalovic, Victor Aboyans
Lower extremity artery disease (LEAD) is a marker of a more advanced atherosclerotic process often affecting multiple vascular beds beyond the lower limbs, with a consequent increased risk for all-cause and cardiovascular mortality. Antithrombotic therapy is the cornerstone of management of these patients to prevent ischaemic cardiovascular and limb events and death. In patients with symptomatic LEAD, the efficacy of aspirin has been established long ago for the prevention of cardiovascular events. In the current guidelines, clopidogrel may be preferred over aspirin following its incremental ability to prevent cardiovascular events, while ticagrelor is not superior to clopidogrel in reducing cardiovascular outcomes...
February 6, 2019: Current Vascular Pharmacology
Aida Habib, Giovanna Petrucci, Bianca Rocca
Under physiological conditions, peripheral arteries release endogenous vascular-protective and anti-thrombotic agents. Endothelial cells actively synthesize vasoactive mediators, which regulate vascular tone and platelet reactivity thus preventing thrombosis. Atherosclerosis disrupts this homeostasis and favours thrombosis by triggering pro-thrombotic responses in the vessels, platelet activation, aggregation as well as vasoconstriction, phenomena that ultimately lead to symptomatic lumen restriction or complete occlusion In the present review, we will discuss the homeostatic role of arterial vessels in releasing vascular-protective agents, such as nitric oxide and prostacyclin, the role of pro- and anti-thrombotic vascular receptors as well as the contribution of circulating platelets and coagulation factors in triggering the pro-thrombotic response(s)...
February 6, 2019: Current Vascular Pharmacology
Cecilie Budolfsen, Julie Faber, Daniela Grimm, Marcus Krüger, Johann Bauer, Markus Wehland, Manfred Infanger, Nils Erik Magnusson
Cancer treatment is an area of continuous improvement. Therapy is becoming more targeted and the use of anti-angiogenic agents in multiple cancers, specifically tyrosine kinase inhibitors (TKIs), has demonstrated prolonged survival outcomes compared with previous drugs. Therefore, they have become a well-established part of treatment. Despite good results, there is a broad range of moderate to severe adverse effects associated with treatment. Hypertension (HTN) is one of the most frequent adverse effects and has been associated with favourable outcomes (in terms of cancer treatment) of TKI treatment...
January 30, 2019: Current Vascular Pharmacology
Andromachi Reklou, Niki Katsiki, Asterios Karagiannis, Vasilios Athyros
Arterial stiffness (AS) is considered an independent predictor of cardiovascular disease (CVD) events. Among lipid lowering drugs, statins have a beneficial effect on AS, independent of their hypolipidaemic effect. Based on 3 meta-analyses and other studies, this effect is compound- and dose-related. Potent statins at high doses are more effective than less powerful statins. Ezetimibe (± statin) also seems to decrease AS in patients with dyslipidaemia. Fibrates have no effect on AS. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have data that beneficially affect all AS risk factors, suggesting a beneficial effect on artery compliance...
January 20, 2019: Current Vascular Pharmacology
Claudio Cantin, Jorge E Jalil, Juan F Bulnes, Ulises Novoa, Paul MacNab, Iván Godoy, Samuel Córdova, Luigi Gabrielli, María Paz Ocaranza
BACKGROUND: Angiotensin II is a potent activator of the Rho-kinase (ROCK) pathway, through which it exerts some of its adverse vasoconstrictor effects. Clinical evidence on the effects of blocking the angiotensin II receptor 1 on ROCK activity in hypertensive patients is scarce. OBJECTIVE: To demonstrate that ROCK activity in peripheral blood mononuclear cells (PBMC) in patients with essential hypertension is reduced earlier than previously observed, along with blood pressure (BP) lowering on treatment with olmesartan...
January 20, 2019: Current Vascular Pharmacology
Genovefa Kolovou, Gerald F Watts
No abstract text is available yet for this article.
January 16, 2019: Current Vascular Pharmacology
Janina Stepinska, Izabela Wojtkowska, Lieven Annemans, Nicolas Danchin, Stuart J Pocock, Frans Van de Werf, Jesús Medina, Hector Bueno
OBJECTIVE: To analyse characteristics, management and outcomes of patients with acute coronary syndromes (ACS) receiving chronic oral anticoagulant (OAC) therapy enrolled in the EPICOR (long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients) prospective, international, observational study of antithrombotic management patterns in ACS survivors (NCT01171404). METHOD: This post-hoc analysis evaluated the association between OAC use at baseline (OACb) and time from hospital admission to percutaneous coronary intervention (PCI) (tHA-PCI), pre-PCI thrombolysis in myocardial infarction (TIMI) 3 flow, stent type, length of hospitalisation, and clinical endpoints; death, non-fatal MI, and non-fatal stroke, a composite of these ± bleeding, over 2 years' follow-up...
December 27, 2018: Current Vascular Pharmacology
Agnieszka Baranowska-Bik, Wojciech Bik
Insulin was discovered in 1922 by Banting and Best. Since that time, extensive research on the mechanisms of insulin activity and action has continued. Currently, it is known that the role of insulin is much greater than simply regulating carbohydrate metabolism. Insulin in physiological concentration is also necessary to maintain normal vascular function. Insulin resistance is defined as a pathological condition characterized by reduced sensitivity of skeletal muscles, liver, and adipose tissue, to insulin and its downstream metabolic effects under normal serum glucose concentrations...
November 28, 2018: Current Vascular Pharmacology
Charilaos Triantafyllou, Maria Nikolaou, Ignatios Ikonomidis, Giorgos Bamias, Ioannis Papaconstantinou
Inflammatory bowel diseases (IBD), largely represented by Crohn's disease (CD) and ulcerative colitis (UC), alter gastrointestinal physiology and mucosal immunity through a complex inflammatory process. These diseases can lead to significant arterial endothelial dysfunction. There is also evidence linking IBD with a modification of cardiac structure and function. A growing body of research has associated IBD with an acceleration of arterial stiffness and atherosclerosis and an increased risk of cardiovascular (CV) morbidity and mortality...
November 28, 2018: Current Vascular Pharmacology
Mišo Šabovič, Daniel Petrovič
No abstract text is available yet for this article.
2019: Current Vascular Pharmacology
D P Mikhailidis
No abstract text is available yet for this article.
2019: Current Vascular Pharmacology
Alfonso Mate, Antonio J Blanca, Rocío Salsoso, Fernando Toledo, Pablo Stiefel, Luis Sobrevia, Carmen M Vázquez
Pregnancy hypertensive disorders such as preeclampsia (PE) are strongly correlated with insulin resistance, a condition in which the metabolic handling of D-glucose is deficient. In addition, the impact of preeclampsia is enhanced by other insulin resistant disorders, including polycystic ovary syndrome and obesity. For this reason, there is a clear association among maternal insulin resistance, polycystic ovary syndrome, obesity and the development of PE. However, whether PE is a consequence or the cause of these disorders is still unclear...
November 14, 2018: Current Vascular Pharmacology
Vasiliki Katsi, Spyridon Maragkoudakis, Maria Marketou, Costas Tsioufis, Fragkiskos Parthenakis, Dimitrios Tousoulis
In recent years, the Angiotensin-(1-7)/Mas receptor [Ang-(1-7)/Mas] sub-branch of the Renin-Angiotensin System (RAS) in the brain, as well as Angiotensin Type 2 Receptors (AT2R), have attracted scientific interest, as there is evidence that they constitute an essential pathway in cardiovascular regulation, in health and in disease. By acting centrally, the Ang-(1-7)/Mas axis - that has been termed 'the axis of good'- can exert blood pressure-lowering effects, while also favourably altering baroreflex sensitivity and noradrenergic neurotransmission...
November 5, 2018: Current Vascular Pharmacology
Megan K Ford, John R Cohn
This paper provides an overview of the pathogenesis, presentation and diagnosis of clopidogrel hypersensitivity. The majority of clopidogrel hypersensitivity cases are due to a T cell mediated Gell and Coombs Type IV reaction. History, histology, and patch testing have shown consistency with a T cell mediated mechanism. Clopidogrel reactions most commonly present as a mild delayed maculopapular erythematous rash 5 to 10 days after introduction of the drug, and do not always require discontinuation of the drug...
October 31, 2018: Current Vascular Pharmacology
Lucas Moritz Wiggenhauser, Jens Kroll
Endothelial dysfunction is an initial pathophysiological mechanism of vascular damage and is further recognized as an independent predictor of a negative prognosis in diabetes-induced micro- and macrovascular complications. Insight into the capability of zebrafish to model metabolic disease like obesity and type II diabetes has increased and new evidence on the induction of vascular pathologies in zebrafish through metabolic disease is available. Here, we raise the question, if zebrafish can be utilized to study the initial impairments of vascular complications in metabolic disorders...
October 30, 2018: Current Vascular Pharmacology
Jeffrey Bulva, Ronald A Simon
The purpose of this section is to educate the reader on how to successfully manage patients with a hypersensitivity reaction to clopidogrel using desensitization protocol based on various published protocols. Additionally we will define drug desensitization, describe the possible mechanism of how desensitization may function, alternative medication. The indications/contraindications for desensitization will be reviewed. The different published clopidogrel desensitization protocols will be discussed. Based on those protocols, we recommend a protocol we feel is safe and efficacious...
October 30, 2018: Current Vascular Pharmacology
Abdulla Shehab, Akshaya Srikanth Bhagavathula, Khalid Al-Rasadi, Fayez Alshamsi, Juma Al Kaab, Khalid Bin Thani, Ridha Mustafa
BACKGROUND: The prevalence of traditional risk factors such as diabetes mellitus (DM) and obesity are increasing in patients with acute coronary syndrome (ACS). Furthermore, outcomes after ACS are worse in patients with DM. The high prevalence of DM and an early age at onset of ACS have been described in prior publications from the Gulf Coast Database. AIM: We aimed to define the effect of DM on total mortality following ACS presentation at 30-days and 1 year based on the Gulf COAST registry database...
October 23, 2018: Current Vascular Pharmacology
Khalid Al-Rasadi, Khalid F Alhabib, Faisal Al-Allaf, Khalid Al-Waili, Ibrahim Al-Zakwani, Ahmad AlSarraf, Wael Almahmeed, Nasreen AlSayed, Mohammad Alghamdi, Mohammed A Batais, Turky H Almigbal, Fahad Alnouri, Abdulhalim Kinsara, Ashraf Hammouda, Zuhier Awan, Heba Kary, Omer A Elamin, Fahad Zadjali, Mohammed Al-Jarallah, Abdullah Shehab, Hani Sabbour, Haitham Amin, Hani Altaradi
AIM: To determine the prevalence, genetic characteristics, current management and outcomes of familial hypercholesterolaemia (FH) in the Gulf region. METHOD: Adult (18-70 years) FH patients were recruited from 9 hospitals and centres across 5 Arabian Gulf countries. The study was divided into 4 phases and included patients from 3 different categories. In Phase 1, suspected FH patients (category 1) were collected according to the lipid profile and clinical data obtained through hospital record systems...
October 5, 2018: Current Vascular Pharmacology
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