The left anterior descending （LAD） coronary artery is the main vessel of human coronary circulation, and life-threa- tening consequences are seen when flow in this area is im- paired, Noninvasive measurement of coro...The left anterior descending （LAD） coronary artery is the main vessel of human coronary circulation, and life-threa- tening consequences are seen when flow in this area is im- paired, Noninvasive measurement of coronary flow re- serve （CFR）, defined as the ratio of maximal to baseline coronary blood flow, has been repeatedly shown to be a feasible technique by ultrasound transthoracic Doppler （TTD） both in the LAD and, with some limitations, in the posterior descending （PD） coronary artery.展开更多
Several definitions of post percutaneous coronary intervention(PCI)thrombocytopenia(TC)were formulated.Recent studies demonstrated that a relative drop in platelet count≥25%is the most appropriate criterion.By this d...Several definitions of post percutaneous coronary intervention(PCI)thrombocytopenia(TC)were formulated.Recent studies demonstrated that a relative drop in platelet count≥25%is the most appropriate criterion.By this definition a population is detected that is exposed not only to increased risk of hemorrhagic complications but also to increased risk of ischemic events,which may appear a paradox.In patients with acute coronary syndromes undergoing PCI,several conditions might be associated with TC:cardiopulmonary bypass and the presence of extra corporeal membrane oxygenators,intra aortic balloon pump(IABP),cardiogenic shock,thrombolytic drugs and anticoagulant or antiplatelet drugs.Several studies demonstrated that TC and ischemic outcomes are related although it is unclear whether this is a direct relationship or TC is just a secondary effect of another cryptic protagonist.It is suggested that further investigations determine whether there is a real link between TC,a probably welldefined covariate,and ischemic outcomes or whether IABP is the joining link between these two variables and whose presence needs in any case be considered in multivariable statistics.Post-PCI TC could be only a secondary effect of IABP use.On turn,the prolonged use of heparin necessarily accompanying the use of IABP,and producing a paradoxical pro-thrombotic TC,might also be implicated.展开更多
文摘The left anterior descending （LAD） coronary artery is the main vessel of human coronary circulation, and life-threa- tening consequences are seen when flow in this area is im- paired, Noninvasive measurement of coronary flow re- serve （CFR）, defined as the ratio of maximal to baseline coronary blood flow, has been repeatedly shown to be a feasible technique by ultrasound transthoracic Doppler （TTD） both in the LAD and, with some limitations, in the posterior descending （PD） coronary artery.
文摘Several definitions of post percutaneous coronary intervention(PCI)thrombocytopenia(TC)were formulated.Recent studies demonstrated that a relative drop in platelet count≥25%is the most appropriate criterion.By this definition a population is detected that is exposed not only to increased risk of hemorrhagic complications but also to increased risk of ischemic events,which may appear a paradox.In patients with acute coronary syndromes undergoing PCI,several conditions might be associated with TC:cardiopulmonary bypass and the presence of extra corporeal membrane oxygenators,intra aortic balloon pump(IABP),cardiogenic shock,thrombolytic drugs and anticoagulant or antiplatelet drugs.Several studies demonstrated that TC and ischemic outcomes are related although it is unclear whether this is a direct relationship or TC is just a secondary effect of another cryptic protagonist.It is suggested that further investigations determine whether there is a real link between TC,a probably welldefined covariate,and ischemic outcomes or whether IABP is the joining link between these two variables and whose presence needs in any case be considered in multivariable statistics.Post-PCI TC could be only a secondary effect of IABP use.On turn,the prolonged use of heparin necessarily accompanying the use of IABP,and producing a paradoxical pro-thrombotic TC,might also be implicated.
