Thrombosis research
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Thrombosis research · Oct 2012
Evaluation of ticagrelor pharmacodynamic interactions with reversibly binding or non-reversibly binding P2Y(12) antagonists in an ex-vivo canine model.
As ticagrelor, clopidogrel and cangrelor therapies may be used in the same clinical setting, their potential pharmacodynamic interactions are of interest. Hence, we investigated possible interactions between these agents in dogs using a variety of switching protocols. ⋯ The extent of the pharmacodynamic drug-drug interactions observed between clopidogrel and cangrelor or ticagrelor apparently depends on the level of receptor occupancy when clopidogrel is administered. Importantly, no significant pharmacodynamic interaction occurred between ticagrelor/clopidogrel when clopidogrel was given at clinical trough IPA levels with ticagrelor. No significant pharmacodynamic interaction occurred with cangrelor and ticagrelor.
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Thrombosis research · Oct 2012
ReviewMicroparticles in vascular disorders: how tissue factor-exposing vesicles contribute to pathology and physiology.
Coagulation is initiated by tissue factor (TF). Coagulant TF is constitutively expressed by extravascular cells, but there is increasing evidence that TF can also be present within the blood, in particular during pathological conditions. ⋯ Remarkably, high levels of coagulant TF-exposing vesicles are present in other body fluids such as saliva and urine of healthy persons, suggesting that these vesicles play a physiological role. We postulate that the presence of TF-exposing vesicles in body fluids as saliva and urine provides an additional source of coagulant TF that promotes coagulation, thereby reducing blood loss and contributing to host defence by reducing the risk of microorganisms entering the "milieu intérieur".
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Thrombosis research · Oct 2012
Antithrombotic agents and invasive procedures--hematologist point of view.
The management of a patient treated with an antithrombotic agent who requires an invasive procedure remains challenging. There are antidotes neither for the antiplatelet agents nor the new anticoagulants. A good knowledge of basic pharmacology of these drugs and the help of a hematologist within a multidisciplinary approach are essential. The potential interest of laboratory tests and the use of reversal agents, and the transfusion of plasma and platelets will be discussed.
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Thrombosis research · Sep 2012
Multicenter Study Controlled Clinical TrialEmergency reversal of anticoagulation: the real use of prothrombin complex concentrates: a prospective multicenter two year French study from 2006 to 2008.
Prothrombin complex concentrate (PCC) for reversal of vitamin K antagonist (VKA) is the main therapeutic option in cases of life-threatening bleeding. Clinical use of PCC is poorly documented. ⋯ A suitable treatment was administered in 26% of patients. A PCC dose of 20-30 IU/kg seems adequate in most cases to reverse VKA activity, but both higher and lower doses achieve similar effects. Considerable progress is required to improve PCC administration and control of treatment efficacy, and to shorten time to diagnosis.