ANTICOAGULANT THERAPY IN ACUTE CORONARY SYNDROMES AND ISCHEMIC STROKE
DOI:
https://doi.org/10.56782/pps.74Keywords:
acute coronary syndrome, ischemic stroke, antithrombotic therapy, anticoagulant therapyAbstract
Cardiovascular diseases, including acute coronary syndromes and ischemic stroke, present a serious problem to modern medicine. In Europe, they lead to 4 million deaths each year. In both diseases the main cause of ischemia is vascular occlusion. Therefore, treatment relies on drugs with a similar antithrombotic action, and includes antiplatelet and anticoagulant therapy. Anticoagulants are used to prevent thromboembolic events by inhibiting the activity of enzymes of the coagulation cascade. They include: vitamin K antagonists, thrombin inhibitors (indirect and direct) and inhibitors of factor Xa. In this paper, the current state of the field of anticoagulant therapy is discussed, as it pertains to patients with acute coronary syndrome and ischemic stroke. In addition, the differences and similarities in the treatment algorithms for these conditions are described.
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Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Eur Heart J. 2016, 37(42), 3232-3245. DOI: https://doi.org/10.1093/eurheartj/ehw334
Mooe T, Eriksson P, Stegmayr B. Stroke. 1997, 28, 762-767. DOI: https://doi.org/10.1161/01.STR.28.4.762
Barritt DW, Jordan. SC. Lancet. 1960, 1, 1309-1312. DOI: https://doi.org/10.1136/bmj.1.5182.1309
Schulman S. Best Pract Res Clin Haematol. 2012, 25, 361-377. DOI: https://doi.org/10.1016/j.beha.2012.06.003
Hart RG, Pearce LA, Aguilar MI. Ann Intern Med. 2007, 146, 857-867. DOI: https://doi.org/10.7326/0003-4819-146-12-200706190-00007
Fuji T, Wang CJ, Fujita S, Kawai Y, Nakamura M, Kimura T, Ibusuki K, Ushida H, Abe K, Tachibana S. Thromb Res, 2014, 134, 1198-1204. DOI: https://doi.org/10.1016/j.thromres.2014.09.011
Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S, Flaker G, Avezum A, Hohnloser SH, Diaz R, Talajic M, Zhu J, Pais P, Budaj A, Parkhomenko A, Jansky P, Commerford P, Tan RS, Sim KH, Lewis BS, Van Mieghem W, Lip GY, Kim JH, Lanas-Zanetti F, Gonzalez-Hermosillo A, Dans AL, Munawar M, O'Donnell M, Lawrence J, Lewis G, Afzal R, Yusuf S; AVERROES Steering Committee and Investigators. N Engl J Med. 2011, 364, 806-817. DOI: https://doi.org/10.1056/NEJMoa1007432
Go AS, Hylek EM, Chang Y, Phillips KA, Henault LE, Capra AM, Jensvold NG, Selby JV, Singer DE. JAMA. 2003, 290, 2685-2692. DOI: https://doi.org/10.1001/jama.290.20.2685
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD, Wallentin L; RE-LY Steering Committee and Investigators. N Engl J Med. 2009, 361, 1139-1151.
Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, Breithardt G, Halperin JL, Hankey GJ, Piccini JP, Becker RC, Nessel CC, Paolini JF, Berkowitz SD, Fox KA, Califf RM; ROCKET AF Investigators. N Engl J Med. 2011, 365, 883-891. DOI: https://doi.org/10.1056/NEJMoa1009638
Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R, Easton JD, Ezekowitz JA, Flaker G, Garcia D, Geraldes M, Gersh BJ, Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P, Jansky P, Lewis BS, Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt FW, Zhu J, Wallentin L; ARISTOTLE Committees and Investigators. N Engl J Med. 2011, 365, 981-992. DOI: https://doi.org/10.1056/NEJMoa1107039
Harrington RA, Becker RC, Cannon CP, Gutterman D, Lincoff AM, Popma JJ, Steg G, Guyatt GH, Goodman SG; American College of Chest Physicians. Antithrombotic therapy for non-ST-segment elevation acute coronary syndromes: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008, 133, 670S-707S. DOI: https://doi.org/10.1378/chest.08-0691
Kobayashi A, Członkowska A. Farmakoterapia w psychiatrii i neurologii. 2005, 1, 5-18.
Wiszniewska M, Kobayashi A, Członkowska A. Polski Przegląd Neurologiczny. 2012, 8(4), 161-175.
Yang E. Vasc Health Risk Manag. 2014, 10, 507-522.
Tanako-Esposito C, Chung. Cleve Clin J Med. 2015, 82(1), 49-63. DOI: https://doi.org/10.3949/ccjm.82a.14002
Sahib P, Pradesh H. Suppl J Assoc Physicians India. 2014, 62, 10-18.
Kosińska J, Billing-Marczak K, Krotkiewski M. Medycyna Rodzinna. 2008, 2, 48-60.
Hirsh J, Dalen JE, Anderson DR, Poller L, Bussey H, Ansell J, Deykin D. Chest. 2001, 119, 1-7. DOI: https://doi.org/10.1378/chest.119.1_suppl.8S
Terecoasa E., Tiu C. Huertas N., Alonso de Leciñana M. Romanian Journal of Neurology. 2012, 11(2), 13-23.
Cheng-Ching E, Samaniego EA, Naravetla BR, Zaidat OO, Hussain MS. Neurology. 2012, 79, 68-76. DOI: https://doi.org/10.1212/WNL.0b013e3182695871
Chandrasekar S, Loomba R, Shah P, Arora R. Am J Ther. 2013, 20(1), 61-66. DOI: https://doi.org/10.1097/MJT.0b013e31820543a3
Lip GY, Lane DA. Am J Med. 2010, 123(9), 785-789. DOI: https://doi.org/10.1016/j.amjmed.2010.01.031
Rothberg MB, Celestin C, Fiore LD, Lawler E, Cook JR. Ann Intern Med. 2005, 16, 143(4), 241-250. DOI: https://doi.org/10.7326/0003-4819-143-4-200508160-00005
Zhang P, Li J, Wu C, Huang X, Li L, Zhang W, Shen C. Herz. 2017, 42(3), 295-306. DOI: https://doi.org/10.1007/s00059-016-4470-0
Andreotti F, Testa L, Biondi-Zoccai GG, Crea F. Eur Heart J. 2006, 27(5), 519-526. DOI: https://doi.org/10.1093/eurheartj/ehi485
Fiedler KA, Maeng M, Mehilli J, Schulz-Schüpke S, Byrne RA, Sibbing D, Hoppmann P, Schneider S, Fusaro M, Ott I, Kristensen SD, Ibrahim T, Massberg S, Schunkert H, Laugwitz KL, Kastrati A, Sarafoff N. J Am Coll Cardiol. 2015, 28, 65(16), 1619-1629. DOI: https://doi.org/10.1016/j.jacc.2015.02.050
Nowacki P, Bajer-Czajkowska A. Polski Przegląd Neurologiczny. 2008, 4(3), 147-152.
Stroke Prevention in Atrial Fibrillation Study. Circulation. 1991, 84(2), 527-539. DOI: https://doi.org/10.1161/01.CIR.84.2.527
Halperin JL, Hart RG, Kronmal RA, McBride R, Pearce LA, Sherman DG. Lancet. 1994, 343, 687-691.
Mazurek J, Blaszkowska A, Rymaszewska J. Nowiny Lekarskie. 2013, 82(1), 83-88.
Bijak M, Bobrowski M. Postępy Nauk Medycznych. 2010, 10, 819-825.
Oldgren J, Budaj A, Granger CB, Khder Y, Roberts J, Siegbahn A, Tijssen JG, Van de Werf F, Wallentin L. Eur Heart J. 2011, 32(22), 2781-2789. DOI: https://doi.org/10.1093/eurheartj/ehr113
Dobrowolski P, Kosiński P, Filipiak K. J. Choroby Serca i Naczyń. 2007, 4(3), 130-136.
Alban S. Eur J Clin Invest 2005, 35(1), 12-20. DOI: https://doi.org/10.1111/j.0960-135X.2005.01452.x
Murphy SA, Gibson CM, Morrow DA, Van de Werf F, Menown IB, Goodman SG, Mahaffey KW, Cohen M, McCabe CH, Antman EM, Braunwald E. Eur Heart J. 2007, 28(17), 2077-2086. DOI: https://doi.org/10.1093/eurheartj/ehm224
Whiteley WN, Adams HP, Bath PMW, Berge E, Sandset MP, Dennis M, Murray GD, Womg K-SL, Sandercock PAG. Lancet Neurology. 2013, 12(6), 539-545. DOI: https://doi.org/10.1016/S1474-4422(13)70079-6
Ringleb PA, Bousser MG, Ford G, Bath P, Brainin M, Caso V, Cervera A, Chamorro A, Cordonnier C, Csiba L, Davalos A, Diener HC, Ferro J, Hacke W, Hennerici M, Kaste M, Langhorne P, Leys KD, Lodder J, Markus HS, Mas JL, Mattle HP, Muir K, Norrving B, Obach V, Paolucci S, Ringelstein EB, Schellinger PD, Sivenius J, Skvortsova V, Sunnerhagen KS, Thomassen L, Toni D, von Kummer R, Wahlgren NG, Walker MF, Wardlaw J. Cerebrovascular Diseases. 2008, 25, 457-507.
Owecki MK, Kozubski W. Udar Mózgu. 2007, 9(2), 79-88.
Di Nisio M, Middeldorp S, Buller HR. N Engl J Med. 2005, 353, 1028-1040. DOI: https://doi.org/10.1056/NEJMra044440
Rynkiewicz M, Rogulska U, Czernicki J. Przegląd Medyczny Uniwersytetu Rzeszowskiego i Narodowego Instytutu Leków w Warszawie. 2011, 2, 325-339.
Lee CJ, Ansell JE. Br J Clin Pharmacol. 2011, 72(4), 581-592. DOI: https://doi.org/10.1111/j.1365-2125.2011.03916.x
Drzewoski J, Watała C. Choroby Serca i Naczyń. 2011, 8(4), 197-208.
Eikelboom JS, Wallentin L, Yusuf S, Ezekowitz MD, Reilly PA, Brueckmann M, Clemens A, Connolly SJ. J Thromb Haemost. 2010, 1, 1438-1439. DOI: https://doi.org/10.1111/j.1538-7836.2010.03803.x
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD, Wallentin L. N Engl J Med. 2009, 17, 361(12), 1139-1151. DOI: https://doi.org/10.1056/NEJMoa0905561
Ng KH, Sharma M, Benavente O, Gioia L, Field TS, Hill MD, Coutts SB, Butcher K, DATAS-2 Investigators. Int J Stroke. 2017, 1, 1747493017711947.
Sun Q, Chang S, Lu S, Zhang Y, Chang Y. Clin Ther. 2017, doi: 10.1016/j.clinthera.2017.04.008. DOI: https://doi.org/10.1016/j.clinthera.2017.04.008
Smith SA. J Vet Emerg Crit Care. 2009, 19(1), 3-10.
Toschi V, Lettino M. Br J Clin Pharmacol. 2011, 72(4), 563-580. DOI: https://doi.org/10.1111/j.1365-2125.2011.04001.x
Mega JL, Braunwald E, Mohanavelu S, Burton P, Poulter R, Misselwitz F, Hricak V, Barnathan ES, Bordes P, Witkowski A, Markov V, Oppenheimer L, Gibson CM. Lancet. 2009, 4, 374(9683), 29-38. DOI: https://doi.org/10.1016/S0140-6736(09)60738-8
Mega JL, Braunwald E, Wiviott SD, Bassand JP, Bhatt DL, Bode C, Burton P, Cohen M, Cook-Bruns N, Fox KA, Goto S, Murphy SA, Plotnikov AN, Schneider D, Sun X, Verheugt FW, Gibson CM, ATLAS ACS 2–TIMI 51 Investigators. N Engl J Med. 2012, 5, 366(1), 9-19. DOI: https://doi.org/10.1056/NEJMoa1112277
Gioia LC, Kate M, Sivakumar L, Hussain D, Kalashyan H, Buck B, Bussiere M, Jeerakathil T, Shuaib A, Emery D, Butcher K. Stroke. 2016, 47(7), 1917-1919. DOI: https://doi.org/10.1161/STROKEAHA.116.013491
Alexander JH, Lopes RD, James S, Kilaru R, He Y, Mohan P, Bhatt DL, Goodman S, Verheugt FW, Flather M, Huber K, Liaw D, Husted SE, Lopez-Sendon J, De Caterina R, Jansky P, Darius H, Vinereanu D, Cornel JH, Cools F, Atar D, Leiva-Pons JL, Keltai M, Ogawa H, Pais P, Parkhomenko A, Ruzyllo W, Diaz R, White H, Ruda M, Geraldes M, Lawrence J, Harrington RA, Wallentin L. N Engl J Med. 2011, 25, 365(8), 699-708. DOI: https://doi.org/10.1056/NEJMoa1105819
Fanaroff AC, Hasselblad V, Roe MT, Bhatt DL, James SK, Steg PG, Gibson CM, Ohman EM. Int J Cardiol. 2017, 15, 241:87-96. [w pracy nr 70] DOI: https://doi.org/10.1016/j.ijcard.2017.03.046
Steg PG, Mehta SR, Pollack CV Jr, Bode C, Cohen M, French WJ, Hoekstra J, Rao SV, Ruzyllo W, Ruiz-Nodar JM, Sabaté M, Widimsky P, Kiss RG, Navarro Estrada JL, Hod H, Kerkar P, Guneri S, Sezer M, Ruda M, Nicolau JC, Cavallini C, Ebrahim I, Petrov I, Kim JH, Jeong MH, Ramos Lopez GA, Laanmets P, Kovar F, Gaudin C, Fanouillere KC, Minini P, Hoffman EB, Moryusef A, Wiviott SD, Sabatine MS. JAMA. 2013, 18, 310(11), 1145-1155.
Gao C, Boylan B, Bougie D, Gill JC, Birenbaum J, Newman DK, Aster RH, Newman PJ. J Clin Invest. 2009, 119, 19(3), 504-511. DOI: https://doi.org/10.1172/JCI36745
Kennedy B, Gargoum FS, Kennedy L, Khan F, Curran DR, O’Connor TM. Curr Med Chem. 2012, 19(20), 3388-3416. DOI: https://doi.org/10.2174/092986712801215847
Panucci CJ, Rondina MT. Surgery 2016, 3, pii: S0039-6060(16)30420-2.
Simoons ML, Bobbink IW, Boland J, Gardien M, Klootwijk P, Lensing AW, Ruzyllo W, Umans VA, Vahanian A, Van De Werf F, Zeymer U, PENTUA Investigators. J Am Coll Cardiol. 2004, 16, 43(12), 2183-2190. DOI: https://doi.org/10.1016/j.jacc.2004.02.051
Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators, Yusuf S, Mehta SR, Chrolavicius S, Afzal R, Pogue J, Granger CB, Budaj A, Peters RJ, Bassand JP, Wallentin L, Joyner C, Fox KA. N Engl J Med. 2006, 6, 354(14), 1464-1476.
Bundhun PK, Shaik M, Yuan J. BMC Cardiovasc Disord. 2017, 8, 17(1), 116. DOI: https://doi.org/10.1186/s12872-017-0552-z
Hackett CT, Ramanathan RS, Malhotra K, Quigley MR, Kelly KM, Tian M, Protetch J, Wong C, Wright DG, Tayal AH. Thromb Res. 2015, 135(2), 249-254. DOI: https://doi.org/10.1016/j.thromres.2014.11.041
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