Antiplatelet Therapy in ACS and A-Fib

Description

Platelets play a critical role in the pathophysiology of acute coronary syndromes (ACS) and thromboembolic complications associated with atrial fibrillation. Anticoagulant and antiplatelet therapies are central to the treatment of ACS and atrial fibrillation. Over the last several decades, a better understanding of the pathogenesis of coronary heart disease and atrial fibrillation has led to refinements in antithrombotic strategies and clinical outcomes.With this in mind, some of the issues outlined in this book are new insights in genetic testing and modification of individualized antiplatelet therapy based on rapid bedside platelet analyzers. Most importantly, the current update of pros and cons of novel antiplatelet agents such as prasugrel and ticagrelor are provided in detail. Conventional antiplatelet strategies with aspirin and clopidogrel are also discussed. Special attention is devoted to experimental antiplatelet agents like PAR-1 thrombin receptor antagonists or aptamers.The ability to focus on different diseases beyond ACS, including heart failure and atrial fibrillation, distinguishes this publication. Each chapter was written by top experts in the field and scientists with the utmost authority and expertise to provide cardiologists, internists, and clinical pharmacologists with the latest updates.

Informations

• Publié par: S. Karger AG
• Date de parution: 13 août 2012
• Nombre de lectures: 0
• EAN13: 9783318021691
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Antiplatelet Therapy in ACS and A-Fib
Advances in Cardiology
Vol. 47
Series Editor
Jeffrey S. Borer  New York, n.y.
 
Antiplatelet Therapy in ACS and A-Fib
Volume Editors
Victor L. Serebruany  Towson, Md.
Dan Atar  Oslo
20 figures, 6 in color and 16 tables, 2012
_________________________
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Victor L. Serebruany, MD Heart Drug™ Research Laboratories Johns Hopkins University Osier Medical Building 7600 Osier Drive, Suite 307 Towson, MD 21204(USA)
Dan Atar, MD Professor and Head Department of Cardiology Oslo University Hospital, Ullevål Kirkeveien 166 N-0407 Oslo (Norway)
Library of Congress Cataloging-in-Publication Data
Antiplatelet therapy in ACS and A-Fib / volume editors, Victor L. Serebruany, Dan Atar.
p.; cm. -- (Advances in cardiology, ISSN 0065-2326; v. 47)
Includes bibliographical references and index.
ISBN 978-3-318-02168-4 (hard cover: alk. paper) -- ISBN 978-3-318-02169-1 (electronic version)
I. Serebruany, Victor L. II. Atar, Dan. III. Series: Advances in cardiology ; v. 47.0065-2326
[DNLM: 1. Platelet Aggregation Inhibitors-therapeutic use. 2. Acute Coronary Syndrome-drug therapy. 3. Atrial Fibrillation--drug therapy. 4. Blood Platelets-physiology. W1 AD53C v.47 2012 / QV 180]
 
616.1’2806-dc23
2012018134
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and PubMed/MEDLINE.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2012 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 0065-2326
e-ISSN 1662-2839
ISBN 978-3-318-02168-4
e-ISBN 978-3-318-02169-1
 
Contents
Introduction
Serebruany, V.L. (Towson, Md.); Atar, D. (Oslo)
Impact of Antiplatelet Therapy in Heart Disease
Renda, G.; de Caterina, R. (Chieti)
Antiplatelet Therapy in Acute Coronary Syndrome and Atrial Fibrillation: Aspirin
Tanguay, J.-F. (Montreal, Que.)
Clopidogrel in Coronary Artery Disease: Update 2012
Huber, K. (Vienna)
Prasugrel
Tello-Montoliu, A.;Tomasello, S.D.; Angiolillo, D.J. (Jacksonville, Fla.)
Antiplatelet Therapy in Acute Coronary Syndromes: Ticagrelor
Husted, S. (Herning)
Dipyridamole in Antithrombotic Treatment
Eisert, W.G. (Hannover)
Protease-Activated Receptor-1 Inhibitors: A Novel Class of Antiplatelet Agents for the Treatment of Patients with Acute Coronary Syndrome
Leonardi, S. (Durham, N.C./Pavia);Tricoci, P.; Becker, R.C. (Durham, N.C.)
Genetic Considerations
Price, M.J. (La Jolla, Calif.)
Stents and Antiplatelet Therapy
Fassa, A.-A. (Paris); Urban, P. (Geneva)
Bleeding and the Use of Antiplatelet Agents in the Management of Acute Coronary Syndromes and Atrial Fibrillation
Vavalle, J.P.; Rao, S.V. (Durham, N.C.)
Antiplatelet Therapy in Stroke Prevention
Apostolakis, S. (Birmingham); Marín, F. (Murcia); Lip, G.Y.H. (Birmingham)
Challenges in Atrial Fibrillation
Pisters, R.; ten Cate, H.; Crijns, H.J. (Maastricht)
Conclusion
Atar, D. (Oslo);Serebruany, V.L. (Towson, Md.)
Author Index
Subject Index
 
Serebruany VL, Atar D (eds): Antiplatelet Therapy in ACS and A-Fib. Adv Cardiol. Basel, Karger, 2012, vol 47, pp 1–4
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Introduction
Victor L. Serebruany a Dan Atar b
a Heart Drug™ Research Laboratories, Johns Hopkins University, Towson, Md., USA; b Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
The advent of anticoagulation started in the winter of 1921. Farmers on the prairies of USA and Canada used to feed their cows wet sweet clover ( fig.1 ) that had been harvested during summer and kept in storage. The livestock was mysteriously diminished by internal and external bleedings. The veterinarians coined the expression ‘sweet clover disease’. One of them, Francis William Schofield ( fig.2 ), who was a veterinary pathologist in Alberta, hypothesized in 1921 that the disease was caused by the cows feeding on decayed hay from the sweet clover plant [ 1 ].
At that time, it was known that sweet clover contains coumarin, but it was perceived as a non-disease-causing component. In fact, coumarin confers the typical sweet vanilla smell in clover hay, but at the same time elicits a bitter taste.
It took many more years before the mystery of sweet clover disease was solved. In 1940, Karl Paul Link ( fig.3 ) and coworkers found that coumarin is oxidized to 4-hydro-coumarin in wet, moldy (i.e. Aspergillus -contaminated) hay. The 4-hydro-coumarin is then dimerized by formaldehyde, generated in the molding hay, to dicoumarol.
In 1948, Link and his team of researchers found the most potent derivative of dicoumarol: 3-(2-acetyl-1-phenylethyl)-4-hydroxycoumarin. The patent rights were immediately assigned to the funding source of Link’s ongoing research: the Wisconsin Alumni Research Foundation. Using their initials as a simple abbreviation, they called the compound warfarin. Ironically, warfarin was initially launched as ‘the perfect rat poison’.
Despite this ambiguous beginning, warfarin was soon deployed as an anticoagulant in medicine, and remained an unchanged therapeutic agent for anticoagulation for over 60 years.
Very similarly, the history of antiplatelet agents dates back over a considerable timespan. It was already known in ancient Greece that the bark from the willow tree had analgetic properties. Indeed, this and other plant extracts (i.e. plants from the genus Spiraea ) do contain salicylic acid, the active analgetic principle. The first to synthesize acetylsalicylic acid was the French chemist Charles Fredric Gerhardt in 1853. However, he did not associate this substance with any medicinal use. It was not until 1897 that a group of chemists at the German pharmaceutical company Bayer synthesized the substance from a different plant, the meadowsweet ( Spiraea ulmaria; fig. 4 ). It is disputed who the true inventor of this medicinal product is: while the official Bayer records indicate the creator to be Felix Hoffmann, the Jewish chemist Arthur Eichengrün ( fig.5 ) is thought to be the true inventor of this drug, but the charts on his proceedings are thought to have been subsequently removed by the Nazi regime. This compound received the name Aspirin from Bayer. It has been sold worldwide since 1899 and is one of the best selling drugs in the history of medicine. Importantly, since the 1960s, growing evidence has lent support to the treatment of atherosclerotic disease (i.e. myocardial infarction, stroke, etc.) by Aspirin as its antithrombotic property as well as its late outcome benefit in these conditions have become more evident.

Fig. 1. The sweet clover plant ( Melilotus officinalis ). Copyright © Sergey Chushkin, iStockphoto.

Fig. 2. Francis William Schofield (1889-1970).

Fig. 3. Karl Paul Gerhardt Link (1901-1978).

Fig. 4. The meadowsweet plant ( Spiraea ulmaria ).

Fig. 5. Arthur Eichengrün (1867-1949).
In the present book, we look into the latest developments of antiplatelet therapies in a variety of conditions. We are proud to have gathered a worldwide renowned faculty for this task. We do hope that this book brings a wealth of updated insights to its readership.
References
1 Schofield FW: Damaged sweet clover: the cause of a new disease in cattle simulating hemorrhagic septicemia and black leg. J Am Vet Med Assoc 1924;64:553–575.
2 Link KP: The discovery of dicumarol and its sequels. Circulation 1959;19:97–107.
Victor L. Serebruany, MD Heart Drug™ Research Laboratories Johns Hopkins University Osler Medical Building 7600 Osler Drive, Suite 307 Towson, MD 21204 (USA) E- Mail [e-mail]
Dan Atar, MD Professor and Head Department of Cardiology Oslo University Hospital, Ullevål Kirkeveien 166 N-0407 Oslo (Norway) E-Mail [e-mail]
 
Serebruany VL, Atar D (eds): Antiplatelet Therapy in ACS and A-Fib. Adv Cardiol. Basel, Karger, 2012, vol 47, pp 5–19
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