Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151814 (coronary occlusion)
 3,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine the importance of a prothrombotic state in the pathogenesis of coronary occlusion in young infarct patients, assessment of risk factor profile and thrombotic tendency was undertaken in 25 young male patients (age less than 45 yr) who were shown at angiography, following myocardial infarction, to have occlusion of a single coronary. Comparison was made with a control group of symptomatic males aged greater than 55 yr, who at angiography had significant disease in two or more coronary arteries (multi-vessel disease control group). At the time of the study more patients in the single-vessel disease study group smoked cigarettes (n = 12) compared to the control group (n = 5) (p less than 0.01). Serum cholesterol and triglycerides were higher, and high density lipoprotein-cholesterol lower, in the single-vessel disease group but the difference reached significance only with the high density lipoprotein-cholesterol. Quantitative platelet aggregability was similar in the two groups. Although the level of beta-thromboglobulin, was higher in the single-vessel disease study group the difference was not significant. There were also no significant differences between these groups in levels of fibrinogen, Factor XII and alpha-2 antiplasmin. Patients in the multi-vessel disease group, however, had increased Factor VII levels (p less than 0.01). There were no significant differences between the two groups in fibrinolytic potential or in levels of antithrombin III. Coronary occlusion in the young appears likely to be due primarily to an arterial (plaque) related event as opposed to an abnormal coagulation response to minor arterial plaque damage.
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PMID:Young infarct patients with single-vessel occlusion do not have an underlying prothrombotic state to explain their coronary occlusion. 142 52

Heparin is a highly sulfated polysaccharide consisting of a repeating disaccharide structure as found in other glycosaminoglycanes. The intravenous and subcutaneous formulation of the drug is routinely used for its well-known, time-honored antithrombotic effect. However, available evidences linking heparin to angiogenesis raise the possibility of a therapeutically relevant antiischemic effect of the drug. Molecular biology data show that in a hypoxic milieu heparin could facilitate angiogenesis through interactions with a family of polypeptide growth factor mitogens that stimulate endothelial cell proliferation. Experimental data suggest that heparin can augment collateral circulation when combined with other potentially angiogenetic factors, such as repeated ischemia, coronary occlusion, or physical exercise. Clinical data, although very initial, encompassing a total of only 41 heparin-treated patients with coronary artery disease, suggest that heparin facilitates collateral development stimulated by exercise-induced myocardial ischemia in humans. According to the heparin-collateral hypothesis, the mechanism of action of heparin as an antiischemic medication would be independent of its anticoagulant action. The molecular targets of heparin are Factor Xa and IIa for antithrombotic action, heparin-binding growth factors (including fibroblast growth factor and vascular endothelial growth factor) for angiogenesis. The antithrombotic effect is not linked to a cellular target, whereas the angiogenetic effect directly stimulates endothelial cells. The molecular cofactor required for effect is antithrombin III for antithrombosis, and possibly endogenous adenosine for angiogenesis. The therapeutic effect is achieved within minutes or hours for antithrombosis, and within weeks or months for angiogenesis.
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PMID:The coronary angiogenetic effect of heparin: experimental basis and clinical evidence. 937 49

Argatroban, a direct thrombin inhibitor, is used clinically because of its safe and effective antithrombotic action. This drug of low molecular weight shows reversible inhibition of thrombin irrespective of whether thrombin is fibrin-bound or soluble. Optimal anticoagulant effects can easily be attained by monitoring with the activated partial thromboplastin time or whole-blood activated clotting time when a therapeutic range of argatroban equivalent to that of heparin is used. The antithrombotic action is simply detected with a chromogenic substrate assay. The clinical use of the drug in Japan was approved for the treatment of chronic peripheral arterial obstructive disease and acute ischemic stroke. For coronary artery disease in patients with deficiency of antithrombin activities attributable to either antithrombin III or heparin cofactor II deficiency, argatroban is effective as an anticoagulant. Acute coronary occlusion during and after percutaneous transluminal coronary angioplasty can be treated by argatroban as an alternative to heparin. The presence of platelets activated by a trace amount of thrombin is evidenced by modified methods of platelet aggregometry in acute ischemic stroke. Therefore, argatroban can render the platelets insensitive against the platelet hyperaggregation enhanced by thrombin.
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PMID:Development of argatroban, a direct thrombin inhibitor, and its clinical application. 946 23