April 2002

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Volume 14 Issue 4
Frequency and Costs of Ischemic and Bleeding Complications After Percutaneous Coronary Interventions: Rationale for New Antithro
Recent advances in catheter technology and antithrombotic therapy have led to a continuous improvement in outcomes of percutaneous coronary intervention (PCI). These improved outcomes have been associated with broadening of the indications for PCI, w…
Frequency and Costs of Ischemic and Bleeding Complications After Percutaneous Coronary Interventions: Rationale for New Antithro
Continued from previous page Bleeding complications in practice. Demographics and definitions. As mentioned previously, data from multi- and single-center registries of PCI report much higher bleeding complication rates than those seen in clinical t…
Overcoming Heparin Limitations in High-Risk Percutaneous Coronary Intervention: The Alternative Strategy — Replacing Heparin wit
Adverse outcomes of PCI include myocardial ischemia and necrosis, the need for endovascular or surgical reintervention, and occasionally death.1–3 Routine pharmacologic therapy includes antiplatelet and antithrombotic agents. Heparin has been the sta…
Overcoming Heparin Limitations in High-Risk Percutaneous Coronary Intervention: The Alternative Strategy — Replacing Heparin wit
Continued from previous page Overcoming heparin limitations in PCI with direct thrombin inhibitors Direct thrombin inhibitors, i.e., univalent agents such as argatroban, and bivalent agents such as lepirudin (Refludan®), desirudin (Revasc®) and biv…
The Implications of Renal Impairment Among Patients Undergoing Percutaneous Coronary Intervention
ABSTRACT: The clinical implications of even mild impairment of renal function in percutaneous coronary interventions (PCI) have, to date, been poorly appreciated. The progressive loss of renal function is marked by the onset of a thrombo-inflammatory…
Thrombocytopenia and Outcome in Invasive Cardiology (Part I)
Since Andreas Gruentzig first introduced coronary angioplasty in 1977, clinicians have been driven to lower the risks associated with the procedure and improve patient outcomes. Improvements in catheter technology as well as the clinician’s pharmaceu…
Thrombocytopenia and Outcome in Invasive Cardiology (Part II)
Continued from previous page Mechanism for thrombocytopenia with IIb/IIIa antagonists. A conclusive explanation for the occurrence of thrombocytopenia in conjunction with GP IIb/IIIa receptor antagonism has not been provided; however, immune mediati…
Increasing Benefit, Reducing Risk: Focusing on Hemorrhagic Complications in Percutaneous Coronary Intervention
Despite technologic and therapeutic advances, both ischemic and hemorrhagic complications remain the most common risks associated with percutaneous coronary interventions (PCI). Contemporary PCI trials typically focus on reducing ischemic events with…
Building a Stronger Foundation: Improved Antithrombin Therapy with Bivalirudin in Percutaneous Coronary Intervention
Heparin has served an important role in percutaneous coronary interventions (PCI) as the standard antithrombin agent since the procedure was first introduced. Modifications in heparin therapy and technological advancements have improved procedure-rel…
Acute Coronary Syndromes: A Focus on Thrombin
Acute coronary syndromes (ACS) are usually caused by thrombosis superimposed on disrupted atherosclerotic plaque.1 Intracoronary thrombi, which form under high shear conditions, are composed of platelet aggregates held together by fibrin strands. Thr…