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Alternatives to clopidogrel for acute coronary syndromes:Prasugrel or ticagrelor?

World Journal of Cardiology 2010年第6期2卷 131-134页

作者： Giuseppe Biondi-Zoccai Marzia Lotrionte fiorenzo gaita Division of Cardiology University of TurinSan Giovanni Battista "Molinette" Hospital Unit for Heart Failure and Cardiac Rehabilitation Catholic University

Clopidogrel is a mainstay in the treatment of patients with acute coronary syndromes or those receiving endovascular ***,its efficacy has been challenged in the recent past by studies suggesting variable individual responsiveness and by new,more potent competitors,such as prasugrel and ticagrelor. But what is the actual body of evidence in support of clopidogrel?Is there any dark side of the moon?What is the role of prasugrel,which has already been approved in Europe and in the United States?And what will be the future role of ticagrelor,when approved for routine clinical practice?We hereby concisely summarize the scope of this clinical choice,providing arguments in favor and against each of the three antiplatelet agents:clopidogrel,prasugrel,and ticagrelor.

关键词： Acute coronary syndrome Clopidogrel Prasugrel Ticagrelor

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Transcatheter aortic valve implantation in a 54-year-old patient with aggressive HIV

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World Journal of Clinical Cases 2014年第4期2卷 97-99页

作者： Stefano Salizzoni Fabrizio D’Ascenzo Claudio Moretti Stefano Bonora Andrea Calcagno Pierluigi Omedè Chiara Montrucchio Enrico Cerrato Chiara Colaci Imad Sheiban Sebastiano Marra Mauro Rinaldi fiorenzo gaita Division of Cardiac Surgery Città della Salute e della Scienza10126 Turin Italy Department of Internal Medicine Division of Cardiology University of Turin S. Giovanni Battista "Molinette" Hospital10126 Turin Italy Division of Infectious Disease Amedeo di Savoia Hospital10126 Turin Italy

We report a case of a 54-year-old patient who was denied surgical replacement for severe aortic stenosis because of complicated acquired immunodeficiency syndrome and who successfully underwent transcatheter aortic va... 详细信息

关键词： Severe aortic stenosis Acquired immunodeficiency syndrome Transcatheter aortic valve implantation Heart team Periprocedural complications

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Berberine behind the thriller of marked symptomatic bradycardia

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World Journal of Cardiology 2013年第7期5卷 261-264页

作者： Margherita Cannillo Simone Frea Cristina Fornengo Elisabetta Toso Giancarlo Mercurio Stefania Battista fiorenzo gaita Division of Cardiology Cardio-vascular DepartmentAOU S.Giovanni Battista di Torino and University of Torino10100 TorinoItaly Emergency Department AOU S.Giovanni Battista di Torino and University of Torino10100 TorinoItaly

Berberine is used in traditional Chinese medicine for the treatment of congestive heart failure, hypertension, diabetes, and dyslipidaemia and has a good safety profile. We report a case of a 53-year-old sportsman referred to our hospital for the onset of fatigue and dyspnoea upon exertion after he started berberine to treat hypercholesterolaemia. An electrocardiogram showed sinus bradycardia (45 bpm), first-degree atrioventricular block, and competitive junctional rhythm. An ergometric stress test showed slightly reduced chronotropic competence and the presence of runs of competitive junctional rhythm, atrial tachycardia, and sinus pauses in the recovery. After 10 d of wash-out from berberine, the patient experienced a complete resolution of symptoms, and an ergometric stress test showed good chronotropic competence. An electrocardiogram Holtershowed a latent hypervagotonic state. This is the first case report that shows that berberine could present certain side effects in hypervagotonic people, even in the absence of a situation that could cause drug accumulation. Therefore, berberine's use should be carefully weighed in hypervagotonic people due to the drug's bradycardic and antiarrhythmic properties, which could became proarrhythmic, exposing patients to potential health risks.

关键词： Berberine Bradyarrhythmia Side effect Hypervagotonia Hypercholesterolaemia Electrocardiogram

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