It is with pride and gratitude that we reflect on the remarkable 10-year journey of European Journal of Arrhythmia & Electrophysiology. With the vital contributions of all of our esteemed authors, reviewers and editorial board members, the journal has served as a platform for groundbreaking research, clinical insights and news that have helped shape the […]
Published Online:
Aug 20th 2018 Heart International. 2016;11(1):e10-e16
DOI: https://doi.org/10.5301/heartint.5000229
Select a Section…
1
Abstract
Overview
Background. Thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) remains the only approved
medication for acute ischemic stroke, but incurs significant bleeding risks. Therefore, approaches to
combine lower doses of thrombolytic therapy with other effective drugs aim at improving efficacy and reducing
bleeding rates. We examined the safety and therapeutic effects of various dosings of rtPA, either alone or combined
with glycoprotein VI-Fc fusion protein (GPVI-Fc, Revacept) on experimental stroke in mice. Methods and results. The effect of filament-induced intracerebral thrombus formation and embolization was
investigated after a one-hour occlusion of the middle cerebral artery.
In accordance with previous studies, treatment with 10 mg/kg rtPA significantly improved functional outcome, cerebral
infarct size and edema, but also resulted in markedly increased intracranial bleeding volumes. In contrast, low
doses of rtPA (0.1 or 0.35 mg/kg body weight) did not change outcome parameters. However, addition of 1 mg/kg
Revacept to 0.35 mg/kg rtPA led to improved reperfusion compared to rtPA alone. Moreover, these combined treatments
resulted in improved grip strength, compared to the respective dose of rtPA alone. Infarct-surrounding edema
improved after combined treatments, but not after respective single rtPA dosings. Intracranial bleeding volumes were
below controls after all low-dose rtPA therapies, given either alone or combined with Revacept. Conclusions. In contrast to using the equally effective full dose of rtPA, intracranial bleeding was not increased by
low-dose rtPA combined with Revacept. Therefore, addition of Revacept to low-dose rtPA does not incur safety
risks, but improves efficacy of treatment.
In this article, we review prior and recent landmark studies that have directed the treatment of cancer-associated thrombosis (CAT), discuss specific factors that influence anticoagulant choice, and explore ongoing trials that may impact treatment in the future. Older data estimated less than 1% of patients with malignancy developed venous thromboembolism (VTE), but more recent data […]
The factor Xa (FXa) inhibitors apixaban, rivaroxaban and edoxaban, together with the thrombin inhibitor dabigatran, are collectively referred to as non-vitamin K antagonist (or direct) oral anticoagulants (NOACs). FXa inhibitors are widely used for stroke prevention in patients with nonvalvular ...
Rivaroxaban is a direct factor Xa inhibitor indicated to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF), treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE). Furthermore, it is prescribed for ...
Latest articles videos and clinical updates - straight to your inbox
Sign UpSign Up
Login
Sign Up FREE
Log into your Touch Account
Earn and track your CME credits on the go, save articles for later, and follow the latest congress coverage.
Register now for FREE Access
Register for free to hear about the latest expert-led education, peer-reviewed articles, conference highlights, and innovative CME activities.