Disruption of P2X4 purinoceptor and suppression of the inflammation associate…

There are no effective therapeutic drugs for cerebral aneurysms, partly because the pathogenesis remains unresolved. Chronic inflammation of the cerebral arterial wall plays an important role in aneurysm formation, but it is not clear what triggers the inflammation. The authors have observed that vascular endothelial P2X4 purinoceptor is involved in flow-sensitive mechanisms that regulate vascu…

Trends in long-term prognosis after acute coronary syndrome

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Cardiac Shock Care Centers

Despite advances over the past decade, the incidence of cardiogenic shock secondary to acute myocardial infarction has increased, with an unchanged mortality near 50%. Recent trials have not clarified the best strategies in treatment. While dedicated cardiac shock centers are being established, there are no standardized agreements on the utilization of mechanical circulatory support and the tim…

Anticoagulation in CKD and ESRD

In this review we discuss the evolving literature of anticoagulation in the context of the nephrology patient. Whereas CKDrnpatients with atrial fibrillation, should be anticoagulated, the benefit of anticoagulation for those on dialysis remains controversialrndue to an increased risk of bleeding. The availability of direct oral anticoagulants offers new options for thosernwith CKD. Until studi…

GISSI-2: A factorial randomised trial of alteplase versus streptokinase and h…

A multicentre, randomised, open trial with a 2 x 2 factorial design was conducted to compare the benefits and risks of two thrombolytic agents, streptokinase (SK, 1·5 MU infused intravenously over 30-60 min) and alteplase (tPA, 100 mg infused intravenously over 3 h) in patients with acute myocardial infarction admitted to coronary care units within 6 h from onset of symptoms. The patients were…

ISIS-3: a randomised comparison of streptokinase vs tissue plasminogen activa…

41 299 patients entering 914 hospitals up to 24 h (median 4 h) after the onset of suspected acute myocardial infarction were randomised between streptokinase (SK: 1·5 MU infused over about 1 h), tissue plasminogen activator (tPA, duteplase: 0·60 MU/kg infused over about 4 h), or anisoylated plasminogen-streptokinase activator complex (APSAC, anistreplase: 30 U over about 3 min).

ESC Guidelines for the management of acute myocardial infarction in patients …

Guidelines summarize and evaluate all available evidence—at the time of the writing process—on a particular issue, with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means

Relationship of treatment delays and mortality in patients undergoing fibrino…

Treatment delays may result in different clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who receive fibrinolytic therapy vs primary percutaneous coronary intervention (PCI). The aim of this analysis was to examine how treatment delays relate to 6-month mortality in reperfusion-treated patients enrolled in the Global Registry of Acute Coronary Events (GRACE)

An international randomized trial comparing four thrombolytic strategies for …

The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was designed to compare new, aggressive thrombolytic strategies with standard thrombolytic regimens in the treatment of acute myocardial infarction. Our hypothes…