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31.
  • Bikdeli, Behnood, et al. (author)
  • Individual Patient Data Pooled Analysis of Randomized Trials of Bivalirudin versus Heparin in Acute Myocardial Infarction : Rationale and Methodology
  • 2020
  • In: Thrombosis and Haemostasis. - : Georg Thieme Verlag KG. - 0340-6245 .- 2567-689X. ; 120:2, s. 348-361
  • Journal article (peer-reviewed)abstract
    • Background Individual randomized controlled trials (RCTs) of periprocedural anticoagulation with bivalirudin versus heparin during percutaneous coronary intervention (PCI) have reported conflicting results. Study-level meta-analyses lack granularity to adjust for confounders, explore heterogeneity, or identify subgroups that may particularly benefit or be harmed.Objective To overcome these limitations, we sought to develop an individual patient-data pooled database of RCTs comparing bivalirudin versus heparin.Methods We conducted a systematic review to identify RCTs in which ≥1,000 patients with acute myocardial infarction (AMI) undergoing PCI were randomized to bivalirudin versus heparin.Results From 738 identified studies, 8 RCTs met the prespecified criteria. The principal investigators of each study agreed to provide patient-level data. The data were pooled and checked for accuracy against trial publications, with discrepancies addressed by consulting with the trialists. Consensus-based definitions were created to resolve differing antithrombotic, procedural, and outcome definitions. The project required 3.5 years to complete, and the final database includes 27,409 patients (13,346 randomized to bivalirudin and 14,063 randomized to heparin).Conclusion We have created a large individual patient database of bivalirudin versus heparin RCTs in patients with AMI undergoing PCI. This endeavor may help identify the optimal periprocedural anticoagulation regimen for patient groups with different relative risks of adverse ischemic versus bleeding events, including those with ST-segment and non-ST-segment elevation MI, radial versus femoral access, use of a prolonged bivalirudin infusion or glycoprotein inhibitors, and others. Adherence to standardized techniques and rigorous validation processes should increase confidence in the accuracy and robustness of the results..
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32.
  • Blanchet, Xavier, et al. (author)
  • Inflammatory role and prognostic value of platelet chemokines in acute coronary syndrome
  • 2014
  • In: Thrombosis and Haemostasis. - 0340-6245. ; 112:6, s. 1277-1287
  • Journal article (peer-reviewed)abstract
    • Activated platelets and neutrophils exacerbate atherosclerosis. Platelets release the chemokines CXCL4, CXCL4L1 and CCL5, whereas myeloperoxidase (MPO) and azurocidin are neutrophil-derived. We investigated whether plasma levels of these platelet and neutrophil mediators are affected by the acute coronary syndrome (ACS), its medical treatment, concomitant clinical or laboratory parameters, and predictive for the progression of coronary artery disease (CAD). In an observational study, the association of various factors with plasma concentrations of platelet chemokines and neutrophil mediators in 204 patients, either upon admission with ACS and 6 hours later or without ACS or CAD, was determined by multiple linear regression. Mediator release was further analysed after activation of blood with ACS-associated triggers such as plaque material. CXCL4, CXCL4L1, CCL5, MPO and azurocidin levels were elevated in ACS. CXCL4 and CCL5 but not CXCL4L1 or MPO were associated with platelet counts and CRP. CXCL4 (in association with heparin treatment) and MPO declined over 6 hours during ACS. Elevated CCL5 was associated with a progression of CAD. Incubating blood with plaque material, PAR1 and PAR4 activation induced a marked release of CXCL4 and CCL5, whereas CXCL4L1 and MPO were hardly or not altered. Platelet chemokines and neutrophil products are concomitantly elevated in ACS and differentially modulated by heparin treatment. CCL5 levels during ACS predict a progression of preexisting CAD. Platelet-derived products appear to dominate the inflammatory response during ACS, adding to the emerging evidence that ACS per se may promote vascular inflammation.
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  • Result 31-40 of 442
Type of publication
journal article (354)
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other publication (1)
Type of content
peer-reviewed (335)
other academic/artistic (107)
Author/Editor
Blomback, M (33)
Zöller, Bengt (29)
Schulman, S (28)
Hjemdahl, P (25)
Dahlbäck, Björn (22)
Hamsten, A (21)
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Silveira, A. (18)
Bremme, K (18)
Wallen, NH (15)
Herwald, Heiko (14)
Siegbahn, Agneta (13)
Jern, Christina, 196 ... (13)
Wadenvik, Hans, 1955 (12)
Swedenborg, J (12)
Lindahl, Tomas (11)
Lindahl, Tomas, 1954 ... (10)
Wiman, B (10)
Storey, Robert F. (10)
Berntorp, Erik (9)
Eriksson, P (9)
Huber, Kurt (9)
Wallentin, Lars (9)
Sundquist, Kristina (8)
Svensson, Peter (8)
Tornvall, P (8)
Lindmarker, P (8)
Sundquist, Jan (8)
Li, N (8)
Lethagen, Stefan (8)
Lip, Gregory Y H (8)
Bergqvist, D (7)
Erlinge, David (7)
Eriksson, Bengt I., ... (7)
Hedner, Ulla (6)
Daleskog, M (6)
Halldén, Christer (6)
Bokarewa, MI (6)
Grip, L (5)
Mörgelin, Matthias (5)
Bergqvist, David (5)
Melander, Olle (5)
Siegbahn, A (5)
Olsson, Bob, 1969 (5)
Svensson, Peter J. (5)
Strandberg, Karin (5)
Li, NL (5)
Ljung, Rolf (5)
De Caterina, Raffael ... (5)
Siegbahn, Agneta, 19 ... (5)
Stanne, Tara M, 1979 (5)
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Karolinska Institutet (192)
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University of Gothenburg (48)
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Kristianstad University College (9)
Royal Institute of Technology (5)
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Chalmers University of Technology (5)
Linnaeus University (4)
Stockholm University (3)
Swedish University of Agricultural Sciences (2)
Halmstad University (1)
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Language
English (441)
Swedish (1)
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Medical and Health Sciences (208)
Natural sciences (6)
Engineering and Technology (2)
Humanities (2)
Agricultural Sciences (1)

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