Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P00750 (PLA)
 16,800 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Percutaneous transluminal balloon coronary angioplasty (PTCA) of coronary bifurcations is associated with a low success rate, high rate of complications, and high incidence of target vessel revascularization (TVR). The strategy of systematic coronary stenting in bifurcation lesions involving a side branch >/= 2.2 mm in diameter was prospectively evaluated in a single-center observational study during a 35-month inclusion period. All patients meeting these criteria were consecutively included. Bifurcation lesions and treatment were predefined in the study. The study included 366 patients (12.1% of PTCA) with 373 bifurcation lesions, mean age 63.7 +/- 11.6 years, 79.2% male, 46.7% with unstable angina, and 8.3% acute MI. The left anterior descending/diagonal bifurcation was involved in 55.2% of cases, circumflex/marginal 22. 2%, PDA/PLA 10.4%, left main bifurcation in 6.8%, and others 5.4%. The main branch (2.78 +/- 0.42 mm reference diameter) was stented in 96.3% of cases and the side branch (2.44 +/- 0.43 mm) in 63.2% (the two branches were stented in 59.5% of cases). Procedural success was obtained in 96.3% in both branches and 99.4% in the main branch. At1-month follow-up, The major cardiac event rate (MACE) was 4.8% (death 1.1%, emergency CABG 0.6%, Q-wave MI 0.9%, acute or subacute closure 1.4%, repeat PTCA 1.1%, and non-Q-wave MI 2.3%). At 7-month follow-up, the total MACCE rate was 21.6%, including a TVR rate of 17.2%. Analysis of the 7-month outcome according to two study periods (period I, 1 January 1996 to 31 August 1997, 182 patients; period II, 1 September 1997 to 30 June 1998, 127 patients) showed that the TVR rate decreased from 20.6% to 13.8% (P = 0.04) and the MACE rate from 29.2% to 17.1% (P < 0.01) in period I and II, respectively. This was associated by univariate analysis with an increasing use of tubular stents deployed in the main branch (94.2% vs. 59.1%, P < 0.001) and kissing balloon inflation after coronary stenting (75.4% vs. 18.1%, P < 0.001). Bifurcation lesions are frequent. Procedural success of coronary stenting is high with a low rate of in-hospital MACE. TVR rate at follow-up is relatively low. In-hospital and follow-up results are influenced not only by the learning curve but also by the use of tubular stents in the main branch and final kissing balloon inflation.
Catheter Cardiovasc Interv 2000 Mar
PMID:Stenting of bifurcation lesions: classification, treatments, and results. 1114 45

Plasminogen activators may potentially influence the wound healing processes of cell migration, matrix degradation and cellular adhesion in venous ulcers by their regulation of protease activity. The aim of this study was to assess the levels of plasminogen activators in venous ulcers and to gain preliminary data from healing wounds. The concentrations of u-PA, t-PA, PAI-1 and PAI-2 antigen as well as functional u-PA were assessed in tissue homogenates from 20 chronic venous ulcers, six actively healing venous ulcers and five traumatic wounds. The concentrations of functional u-PA, u-PA antigen and PAI-1 were significantly greater and PAI-2 was significantly lower in the edge and base of chronic venous ulcers compared to adjacent intact skin (P<0.01). Healing wounds had significantly higher functional u-PA at the ulcer edge and higher u-PA antigen concentration in intact skin (P<0.05). PAI-2 levels were significantly higher in the ulcer edge and base in the healing wounds than in chronic venous ulcers (P<0.05). These findings suggest that regulation of protease activity by u-PA and PAI-2 may play a role in the impaired healing of chronic venous ulcers.
Cardiovasc Surg 2000 Aug
PMID:Lower levels of PAI-2 may contribute to impaired healing in venous ulcers - a preliminary study. 1095 63

Patients with transmural (with ST segment elevation) myocardial infarction should immediately be considered for reperfusion therapy. Fibrinolytic therapy with streptokinase, alteplase, or reteplase should be started within 30 minutes of presentation for patients without bleeding risk. Alternatively, patients at tertiary care hospitals can undergo emergency coronary angioplasty. Other lifesaving pharmacologic interventions include administering aspirin, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors. Oxygen, morphine sulfate, heparin, and nitroglycerin are also useful. No benefit has been demonstrated for calcium channel blockers, magnesium, or prophylactic lidocaine. Patients need to be closely monitored for conduction abnormalities, arrhythmias, and heart failure.
Curr Treat Options Cardiovasc Med 2000 Feb
PMID:Acute Transmural Myocardial Infarction. 1109 6

We compared the effects a novel recombinant tissue-type plasminogen activator (rt-PA) E6010 with the more conventional therapeutic agent alteplase in a new canine model of life-threatening acute pulmonary thromboembolism (APTE). Fifty milliliters of autologous blood was obtained from anesthetized, adult mongrel dogs and mixed with 10,000 units of thrombin. The left pulmonary artery, pulmonary vein, and bronchus were ligated, and previously prepared blood clots were injected via the femoral vein until the mean pulmonary artery pressure (mPA) increased to 2.5-3.0 times over baseline mPA (control). E6010 (0.4 mg/kg) or alteplase (1.33 mg/kg) was administered to other animals following inducement of APTE. In control animals, 60 min after embolization, mPA increased from 13+/-3 mm Hg to 31+/-3 mm Hg (p < 0.0001), cardiac output (CO) decreased from 1.47+/-0.35 l/min to 1.15+/-0.39 l/min (p < 0.0001), and PaO2 decreased from 101+/-31 mm Hg to 65+/-20 mm Hg (p < 0.001). E6010 significantly reduced mPA from 31+/-3 mm Hg to 25+/-4 mm Hg (p < 0.0001) 30 min after administration. In the alteplase group, however, mPA did not significantly change. At 180 min following drug administration, further reduction of mPA was significantly observed in both treatments. CO and PaO2 did not improve after either treatment. The present study indicated that E6010 more rapidly reduced pulmonary hypertension in our APTE model. Because of its rapid action, E6010 might be a promising thrombolytic agent for treatment of APTE.
Ann Thorac Cardiovasc Surg 2000 Oct
PMID:Effects of recombinant tissue-type plasminogen activator on life-threatening acute pulmonary thromboembolism in a canine model: a comparative study of e6010 and alteplase. 1117 35

The goal of this study was to examine the relationship between contrast agent type (ionic vs. nonionic) and angiographic, electrocardiographic, and clinical outcomes after thrombolytic administration. Ionic or nonionic contrast agents were selected in a nonrandomized fashion for 90-min angiography and percutaneous coronary intervention (PCI) following thrombolytic administration in the TIMI 14 trial [tissue plasminogen activator (tPA) or reteplase (rPA) vs. low-dose lytic + abciximab]. There was no relationship between contrast agent type and overall patency, rate of TIMI grade 3 flow, or corrected TIMI frame counts (CTFCs) in open culprit arteries and in post-PCI patency rates or post-PCI CTFCs. In patients treated with ionic contrast, ejection fractions at 90 min were slightly but significantly lower (56.2 +/- 16.5, n = 122, vs. 59.8 +/- 14.4, n = 322; P = 0.02), chest pain duration was longer (2.8 +/- 4.1 hr, n = 255, vs. 1.7 +/- 3.6, n = 550; P = 0.0003), and complete ST segment resolution was less frequent (41.5% vs. 50.8%; P = 0.04). While there was no difference in epicardial blood flow, ionic contrast agent use was associated with poorer ST segment resolution, longer chest pain duration, and poorer ejection fractions, perhaps as a result of microvascular dysfunction.
Catheter Cardiovasc Interv 2001 May
PMID:Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic, electrocardiographic, and clinical outcomes following thrombolytic administration in acute myocardial infarction. 1132 10

A 33-year-old woman with subacute thrombosis of the distal aorta after aorto-bi-iliac stenting had local thrombolysis with reteplase in conjunction with systemic abciximab. The infusion was given as a bolus and then continuously for 14 hr by radial artery access with two selective kissing catheters. Patency of the stented segments was achieved with this technique in conjunction with resolution of her clinical symptoms.
Catheter Cardiovasc Interv 2001 Jun
PMID:Intra-arterial thrombolysis (reteplase) and ReoPro for subacute thrombosis of the distal aorta accomplished by radial arterial access: the radial-kissing-thrombolytic technique. 1138 19

Disorders in the fibrinolytic and renin-angiotensin-aldosterone systems and excessive extracellular matrix (ECM) deposition are determinant factors in several pathologic manifestations of vascular and cardiac tissue. We used primary human vascular smooth muscle cells (VSMC) and studied the effects of losartan on angiotensin II (Ang II)-mediated (a) DNA synthesis, (b) secretion of tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1), (c) secretion of matrix metalloprotease-2 (MMP-2) activity and tissue inhibitors of MMPs (TIMPs), and (d) synthesis of glycosaminoglycans. VSMC cultures, established from human pulmonary arteries, were treated with Ang II (0.1 nM -1 microM ) and/or losartan (0.1-10 microM ), for 24 or 48 h. DNA synthesis was assessed by incorporation of 3 H-thymidine into VSMC, secreted tPA, PAI-1, and TIMPs by enzyme-linked immunosorbent assay, MMP-2 activity by gelatin zymography, and glycosaminoglycan synthesis by 3 H-glucosamine incorporation. Ang II (1 microM ) enhanced DNA synthesis and secretion of PAI-1 and glycosaminoglycans and decreased secretion of MMP-2 activity and tPA, whereas it had no effect on secretion of TIMPs and glycosaminoglycans associated with cell layers. The Ang II-mediated effects were reversed by losartan, in a concentration-dependent manner. Losartan alone increased secretion of tPA, MMP-2 activity, and TIMPs and decreased secretion of PAI-1. These results indicate that AT 1 receptors are implicated in Ang II-mediated disorders of fibrinolysis and excessive ECM deposition by VSMC.
J Cardiovasc Pharmacol 2001 Nov
PMID:Losartan inhibits the angiotensin II-induced modifications on fibrinolysis and matrix deposition by primary human vascular smooth muscle cells. 1160 18

The minimal cost algorithm (MCA) commonly used for quantitative coronary arteriography has limitations in definition of complex lesion morphology. A gradient field transform (GFT) algorithm has been designed for the better analysis of complex lesions. We compared MCA with GFT in angiograms of 125 patients in the Myocardial Infarction with Novastan and t-PA (MINT) trial. Lesion border definition was rated as one (poor), two (good), or three (very good). While MCA- and GFT-derived reference diameters (RDs) were similar, GFT yielded smaller minimal lumen diameter (MLD) than MCA by 0.22 +/- 0.31 mm (P < 0.01), and the difference between GFT- and MCA-derived MLDs increased with decreasing MLD. Mean percent diameter stenosis (% DS) was 9.1% +/- 11.1% greater by GFT (P < 0.001). Lesion border definition in simple lesions was similar (not significantly different). However, in complex lesions GFT performed better (2.49 +/- 0.61 vs. 2.11 +/- 0.74; P < 0.05). Thus, GFT appears to improve analysis of complex lesions compared to MCA. GFTs role in angiographic trials and clinical practice deserves further study.
Catheter Cardiovasc Interv 2002 Apr
PMID:Comparison of two different methods of quantitative coronary angiography in patients with acute coronary syndromes. 1194 89

This feasibility study evaluated the therapeutic potential of combined GP IIb/IIIa receptor inhibition with abciximab and low-dose fibrinolysis with reteplase for treatment of acute femoropopliteal thrombosis. The simultaneous intra-arterial administration of abciximab in conjunction with low-dose reteplase (< or = 0.5 U/hr) was safe in 13 patients; 2 patients experienced major hemorrhagic complication at a reteplase dose of 1 U/hr. The primary success rate was 100%; all patients experienced an excellent clinical response with no clinical evidence of distal embolization. No patient required repeat endovascular or surgical revascularization during mean follow-up of 9.3 months. This promising new thrombolytic strategy for the treatment of peripheral arterial occlusive disease requires further study.
Catheter Cardiovasc Interv 2002 Apr
PMID:Combined glycoprotein IIb/IIIa receptor inhibition and low-dose fibrinolysis for peripheral arterial thrombosis. 1194 91

Vascular thoracic outlet syndrome generally affects young, active, otherwise healthy patients. The diagnosis is suspected by clinical presentation, and can be confirmed with angiography or venography. Conservative management has been associated with significant morbidity and long-term residual disability. We have used a multimodal treatment protocol that includes thrombolysis, anticoagulation, surgical decompression, and interventional procedures. Catheter-directed recombinant tissue-type plasminogen activator and intravenous heparin infusion are instituted at the time of diagnosis to promote recanalization and prevent propagation of thrombus. Surgical decompression of the thoracic outlet can be readily achieved by first rib resection during the same hospitalization. Postoperative venograms are obtained in all patients. Residual stenoses can be managed with angioplasty alone in some patients but more commonly require stent placement. We believe thrombolysis, anticoagulation, surgical decompression, and percutaneous interventions act synergistically to improve results of therapy in patients with vascular thoracic outlet syndrome.
Curr Treat Options Cardiovasc Med 2002 Jun
PMID:Vascular Thoracic Outlet Syndrome. 1200 19


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