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The Use of Anti-Platelet and/or Anticoagulant Agents in the Prevention of Large Vessel Vasculitis-Associated ischemic Complications: A Meta-Analysis

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Open Journal of Rheumatology and Autoimmune Diseases 2014年第2期4卷 114-123页

作者： James Jeong Lillian Barra Department of Medicine University of Western Ontario London Canada

Objective: To determine the effectiveness of antiplatelet and/or anticoagulant therapy (AP/AC) at reducing ischemic events in patients with Large Vessel Vasculitis (LVV). Methods: We performed a random effects meta-analysis of studies examining antiplatelet and/or anticoagulant therapy (AP/AC) and ischemic events in Takayasu’s Arteritis (TAK) or Giant Cell Arteritis (GCA). Severe ischemic events were defined as stroke, ischemic ocular manifestations and claudication symptoms. Any ischemic event included jaw claudication in addition to the above manifestations. Results: Seven studies met inclusion criteria: 1 TAK and 6 GCA. The majority of patients (>80%) were treated with ASA and treatment was initiated prior to diagnosis of LVV. Risk of severe and any ischemic event in patients with LVV treated with AP/AC versus no treatment was not significantly different (OR 0.570, 95% CI 0.243, 1.340 and OR 0.594, 95% CI 0.248, 1.421, respectively). For studies with follow-up data (26-76 months), AP/AC was protective for severe ischemic events (OR 0.18, 95% CI 0.04, 0.83). Findings were similar when excluding studies that did not account for potential confounders, such as cardiovascular risk factors. Conclusion: At follow-up, antiplatelet therapy significantly decreases ischemic events in patients with LVV. However, in most cases of GCA, the treatment was initiated prior to the diagnosis of vasculitis. The benefit of initiating anti-platelet therapy at the time of GCA diagnosis remains unclear.

关键词： Giant Cell Arteritis Takayasu’s Arteritis Large Vessel Vasculitis ischemic Aspirin Antiplatelet

Clinical study of applying fructose-1,6-diphosphate and captopril to enhance the protective effects of cardioplegia solution on ischemic myocardium

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Journal of Medical Colleges of PLA(China) 1993年第4期8卷 342-348页

作者：李彤刘维永杨景学梁继河易定华汪钢刘宗贵方福珍王伟宪 Department of Cardiovascular and Thoracic Surgery Xijing HospitalFourth Military Medical UniversityXi'an 710032

In the present experiment,fructose-1,6-diphosphate（FDP）and captopril（Cap）wereadded to the cold potassium cardioplegia solution and the levels of malondialdehyde（MDA）,cre-atine phosphokinase MB（CPK-MB）,thromboxane B（TXB2）and 6-keto-PGF1α in plasma weremeasured during open-heart surgery.Quantitative study of myocardial ultrastructure and obser-vation of cardiac resuscitation were also undertaken.The findings suggested that FDP,especiallywhen combined with Cap could significantly strengthen the protective effects of cold potassiumcardioplegia solution on ischemic myocardium.

关键词： fructose-1 6-diphosphate captopril cardioplegia solution ischemic myocardium

Low Ankle Brachial Index in Acute ischemic Stroke: Does ApoE Gene Polymorphism Have a Role?

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World Journal of Cardiovascular Diseases 2015年第2期5卷 42-47页

作者： Shaimaa El-Jaafary Mohamed El-Tamawy Hassan Hosny Mona Fathy Ehab Shaker Foad Abd-Allah Faculty of Medicine Cairo University Cairo Egypt

Background: The existence of asymptomatic peripheral arterial disease among patients with acute ischemic stroke has been studied and proved. Low ankle brachial index (ABI) is considered as a marker of atherosclerosis, and its relation to stroke severity was documented in some studies. The effect of different alleles of ApoE gene on acute ischemic stroke presentation in patients with low ABI is not known. Objective: To study the effect of ApoE gene polymorphism on stroke severity, outcome and recurrence in patients with asymptomatic peripheral arterial disease identified by low ABI. Methods: Patients with acute ischemic stroke were screened for the presence of asymp-tomatic peripheral arterial disease by estimating the ABI using a pocket Doppler ultrasound device. Assay of ApoE gene was done using the real-time PCR technique. Results: Low ABI was present in 31% of patients with acute ischemic stroke. There was no significant difference among patients with different ApoE alleles regarding the severity of their symptoms. Also, there was no significant difference among patients with normal ABI and those with abnormal ABI regarding the ApoE gene polymorphism. Conclusion: The current study showed that there was no significant relation between ApoE gene polymorphism and low ABI in ischemic stroke patients who had asymptomatic peripheral arterial disease.

关键词： Peripheral Arterial Disease ABI Acute ischemic Stroke ApoE Gene Polymorphism

Interaction between Antihypertensive Therapy Class and Pulse Pressure on Outcomes Following Acute ischemic Stroke

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International Journal of Clinical Medicine 2017年第10期8卷 543-555页

作者： Michael Lavelle Roy O. Mathew Jaspreet Arora Avinash Murthy Le Du Batyrjan Bulibek Mandeep Sidhu Mikhail Torosoff Department of Internal Medicine Columbia University New York Presbyterian Hospital New York NY USA Department of Medicine William Jennings Bryan Dorn VA Medical Center Columbia SC USA Department of Internal Medicine Albany Medical College Albany NY USA Division of Cardiology Albany Medical Center Albany NY USA

Goal: The effect of pulse pressure and interactions with type of antihypertensive therapy on mortality after acute ischemic stroke has not been previously evaluated. Materials and Methods: A retrospective cohort study was conducted to evaluate the independent and interactive effects of pulse pressure and antihypertensive class (specifically angiotensin converting enzyme inhibitor/angiotensin type 1 receptor blocker, or beta blocker) on mortality following acute ischemic stroke. Findings/Conclusions: 343 patients were identified with 49 months of follow-up. Baseline pulse pressure was 64 mmHg and age was 66.5 years. Patients were divided at a pulse pressure of 70. Patients with pulse pressure ≥ 70 were older (p ischemic stroke.

关键词： Acute ischemic Stroke Pulse Pressure Angiotensin Blockers Beta Blockers Outcomes

Review of Medical Treatment of Stable ischemic Heart Disease

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International Journal of Clinical Medicine 2014年第5期5卷 249-259页

作者： Abdulelah F. Al Mobeirek Hanan Albackr Mostafa Al Shamiri Turki B. Albacker King Fahad Cardiac Center College of Medicine King Saud University Riyadh KSA

Medical treatment is the initial treatment strategy and is the cornerstone of management in patients with stable ischemic heart disease (IHD). Many patients are not suitable for percutaneous or surgical revascularization because of unfavourable anatomy, or the presence of co-morbidities. In addition, many patients have recurrence of angina following revascularization due to restenosis or incomplete revascularization. Furthermore, randomized clinical trials comparing optimal medical treatment to revascularization have not clearly shown that myocardial revascularization is superior to optimal medical treatment. Traditional drugs for angina treatment include b-blockers, calcium channel blockers and nitrates. Newer drugs are available with different mechanisms of action and with equal efficacy that do not cause significant hemodynamic deterioration. The availability of these newer drugs expands the therapeutic potential of medical treatment to even a wider population with stable IHD. Revascularization in patients with stable ischemic heart disease has never been shown to reduce hard endpoints (death or myocardial infarction) in randomized clinical trials.

关键词： Medical Treatment Stable ischemic Heart Disease Novel Anti-ischemic Therapy Anti-Anginal Agents Coronary Artery Disease

The influence of ganglioside on the blood gas analysis and serum inflammatory cytokines in newborns with anoxic ischemic encephalopathy

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Journal of Hainan Medical University 2017年第4期23卷 133-136页

作者： Xiao-Jing Li Hai-Xia Zhu Ying-Yan Gan Jian-Ning Mai Hui-Ci Liang Department of Neurology Women and Children's Medical CenterGuang DongGuang Zhou 510120

Objective:To observe the influence of ganglioside on the blood gas analysis and serum levels of inflammatory cytokines in newborns with anoxic ischemic encephalopathy.Method: A total of 100 newborns with anoxic ischemic encephalopathy in our hospital were selected and randomly divided into 2 groups: the control group and the observation group. Conventional oxygen inhalation, reducing intracranial pressure, controlling eclampsia and neurotrophic drug treatment were given to the observation group. Treatment of ganglioside was given to the control group on the basis of observation group. Blood gas analysis and serum levels of inflammatory cytokines were detected before treatment (T0), 3 d after treatment (T1), and 7 d after treatment (T2).Result: (1) The comparison of pH, PaO2, PaCO2, SaO2 in the two groups in T0 was not statistically significant. The comparison of pH, PaO2, PaCO2, SaO2 in T0, T1, T2 was considered to be statistically significant. Among these, the result of comparision of pH, PaO2, SaO2: T0T1>T2. The pH, PaO2, SaO2 in observation group were higher, PaCO2 in observation group was lower compared with that in control group in T1 and T2. The difference was considered to be statistically significant. (2) The comparision of IL-2, IL-6, hs-CRP, TNF-α in the two groups in T0 was not statistically significant. IL-2 in the observation in T1 and T2 was higher than that in the control group, IL-6, hs-CRP, TNF-α in the observation in T1 and T2 was lower than that in the control group. The difference was considered to be statistically significant.Conclusion: Ganglioside can improve blood gas analysis indexes, decrease the serum inflammatory cytokines in newborns with anoxic ischemic encephalopathy.

关键词： Ganglioside Newborns with anoxic ischemic encephalopathy Blood gas analysis Inflammatory factor

Perinatal arterial ischemic stroke and multiple thrombo-emboli in a term newborn

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Open Journal of Pediatrics 2012年第1期2卷 73-76页

作者： Sani Bukari Abdul Hafeez Siddiqui Madhvi Rajpurkar Meera Chitlur Division of Hematology/Oncology Department of Pediatrics Children’s and Women’s Hospital University of South Alabama Mobile USA Division of Hematology/Oncology Department of Pediatrics Children’s Hospital of Michigan Wayne State University Detroit USA

The etiology of perinatal arterial ischemic strokes may be maternal, fetal or both. Venous thrombo-embolism is almost always catheter associated in new-borns. Preliminary guidelines for management of perinatal arterial ischemic strokes exist but are mostly based on adult studies. We report a unique case of perinatal arterial ischemic stroke, lower extremity arterial and inferior vena-caval thrombosis. Our patient was treated with unfractionated heparin for 10 days then switched to low molecular heparin to complete 6 months of therapy. The patient responded well to therapy and shows minimal signs of permanent neurologic deficits after 6 months.

关键词： Perinatal arterial ischemic stroke and multiple throm-bo-emboli in a term newborn

Oxidative Stress and Post-ischemic Inflammatory Response in ischemic Stroke Complicated with Diabetes Mellitus Type 2

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Journal of Biosciences and Medicines 2015年第3期3卷 94-98页

作者： Gohar Tsakanova Elina Arakelova Armine Soghoyan Violetta Ayvazyan Institute of Molecular Biology NAS RA Armenia “Surb Grigor Lusavorich” Medical Center CJSC Armenia

Oxidative stress and post-ischemic inflammatory response are the key pathogenic mechanisms of the neuronal injury caused by ischemic stroke (IS). On the other hand, Diabetes is a major risk factor for the development of stroke, increasing the susceptibility to atherosclerosis and the prevalence of atherogenic risk factors, including hypertension, obesity, and abnormal blood lipids. The aim of current study was to analyze the functional activity of oxidant-antioxidant system and post-ischemic inflammatory response in IS patients complicated and noncomplicated with diabetes mellitus type 2 (DM2). ELISA, photochemiluminescent and spectrophotometric methods were used to analyze the serum samples of IS patients complicated and noncomplicated with DM2, DM2 patients, as well as healthy subjects. The results obtained suggest that IS complicated with diabetes is characterized by higher intensity of the lipid peroxidation process as compared to IS noncomplicated with diabetes that, probably, is one of the determining factors responsible for more severe clinical course of IS patients complicated with DM2 compared to those noncomplicated with DM2. It is also shown that mechanisms of the compensatory response to oxidative stress on the level of antioxidants in IS patients complicated with diabetes differ from those detected in IS noncomplicated with diabetes. A significant increase of the levels of the five analyzed cytokines in both groups of IS patients were detected. Based on the results obtained we suggest that metabolic, molecular, and cellular level alterations are typical for long-term DM2 impair compensatory mechanisms protecting the body from oxidative stress, and that in IS complicated with DM2 the systemic inflammatory reactions and oxidative stress are more intense than in case of IS noncomplicated with DM2.

关键词： Oxidative Stress Postischemic Inflammatory Response Cytokines ischemic Stroke Diabetes Mellitus

Local cerebral blood perfusion correlates with nerve fibre integrity in transient ischemic attack patients with middle cerebral artery stenosis: a pilot study

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Health 2010年第6期2卷 528-531页

作者： Jiang Wu Ping Liu Jie Lei Jia Liu Hong-Liang Zhang 不详

Recent advances in neuroimaging contribute a lot to the accurate diagnosis and evaluation of cerebrovascular diseases. To explore the relationship among blood perfusion, metabolism and brain structure integrity, 6 Chinese transient ischemic attack (TIA) patients with middle cerebral artery (MCA) stenosis were examined by xenon-enhanced computed tomography (Xe-CT), magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) to compare cerebral blood flow (CBF) values, (choline + creatine)/ N-acetyl aspartate [(Cho + Cr)/NAA] values and fractional anisotropy (FA) values in the MCA territory. Our results showed that CBF values significantly decreased in the ipsilateral basal ganglion regions in all 5 cases with unilateral MCA stenosis, with a corresponding decrease of FA values in the same region. In conclusion, decreased blood perfusion may indicate nerve fibre damage in the dominating regions of stenosed arteries.

关键词： Transient ischemic Attack Magnetic Resonance Imaging Xenon-Enhanced Computed Tomography