Platelet activation in response to atherosclerotic plaque

Platelet activation in response to atherosclerotic plaque Apoptosis inhibitor rupture or endothelial cell detachment can result in pathologic thrombus formation and acute ischemic events. Current oral antiplatelet agents, aspirin and adenosine diphosphate (ADP) receptor antagonists, are effective

but associated with bleeding as they target activation pathways critical for protective hemostasis and pathologic thrombosis. Each inhibits a single platelet activation pathway and does not impact activation by thrombin. The lack of complete inhibition of platelet function allows continued thrombus formation and recurrent thrombotic events. Inhibition of the protease-activated receptor 1 (PAR-1) stimulated by thrombin offers a rational strategy to achieve more comprehensive platelet inhibition when used in combination with standard-of-care, dual antiplatelet therapy. We expect that this new approach may mitigate bleeding risk, because PAR-1 is not essential for hemostasis.”
“Objective: To report the time of delay in thrombolysis of massive and submassive pulmonary embolism (PE). Methods: We enrolled 83 consecutive patients with massive and submassive PE from 8 hospitals between June 2006 and March 2009. We recorded the delay between symptom onset and thrombolysis. The clinical findings related to early thrombolysis (delay <= 2 days) were analyzed.

Results: Median of the delay in thrombolysis was 8 days with 82% over 2 days, 53% over 7 days, and 6% over 25 days. Compared to the late thrombolysis (delay > 2 days), patients with

early thrombolysis more frequently had murmurs at the tricuspid area (26.7% vs 6.1%, P = .053), less frequently had cough (20% vs 59.7%, P = .005) and increased P2 (pulmonic component of second heart sound; 33.3% vs 61.2%, P = .049), and more patients were thrombolysed in off-hours (86.7% vs 57.4%, P = .034). Conclusion: The time of delay in thrombolysis is too long and the symptoms and signs between early and late thrombolysis groups may differ.”
“Owing to its unique host cell-dependent development cycle, Chlamydia pneumoniae occupies an intracellular niche that enables the bacterium to survive and to multiply, secluded from both the extracellular and the cytoplasmic environments. Within its separate chlamydial inclusion, it is able to genetically switch between a replicative and a persisting FRAX597 non-replicative state, linking the pathogen to acute as well as chronic diseases. Although its role in acute respiratory infection has been established, a potential link between chronic vascular infection with C. pneumoniae and the development of atherosclerosis remains enigmatic, in particular because chronic chlamydial infection cannot be eradicated by antibiotics. C. pneumoniae has developed numerous mechanisms to establish an adequate growth milieu involving the type III secretion-mediated release of chlamydial effector proteins that interact with cellular structures and reprogram host cell regulatory pathways.

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