Biomedical subjects

Erdal Cavusoglu

Publications and source records attributed to Erdal Cavusoglu.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Anticoagulation strategies for patients undergoing percutaneous coronary intervention: unfractionated heparin, low-molecular-weight heparins, and direct thrombin inhibitors.

Low-molecular-weight heparins and direct thrombin inhibitors are emerging as alternative anticoagulants to unfractionated heparin in patients undergoing percutaneous coronary intervention (PCI). This paper reviews the pharmacologic properties of these newer antithrombotic agents and evaluates the clinical data demonstrating their use in patients undergoing PCI.

Acute Disease↗

PubMedDate not supplied

Contrast-associated nephropathy.

Contrast-associated nephropathy (CaN) has become a major cause of iatrogenic acute renal failure, especially with the increasing use of radiographic contrast media in both diagnostic and interventional procedures. CaN is the third most common cause of iatrogenic acute renal failure, and is associated with increased morbidity and in-hospital mortality. CaN typically presents as an acute rise in serum creatinine levels, usually within 48 hours after exposure to contrast media. Renal medullary ischemia secondary to contrast-induced vasoconstriction is now believed to be the most likely cause of CaN, although direct renal tubular cytotoxicity does appear to play a role. The occurrence of CaN is directly related to the number of coexisting clinical risk factors. Among the many risk factors, preexisting renal impairment, the presence of diabetes mellitus and the volume of the contrast agent administered are the most important. The most effective means of reducing the incidence of CaN is through prevention, by first identifying the risk factors and then attempting to correct for them before the administration of contrast material. Although the earliest and most well-tested preventive measure, namely intravenous hydration, continues to be the most effective way to prevent CaN, recent studies have provided many new preventive modalities. The growing use of these new agents, such as acetylcysteine, endothelin blockers, and most recently fenoldopam, has increased the options available for the prevention of CaN.

Acetylcysteine↗

PubMedDate not supplied

Clopidogrel in the management of ischemic heart disease.

Ischemic heart disease (IHD) represents a pathophysiologic continuum consisting of stable angina, unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. Patients who develop a change in their usual stable pattern of ischemia are classified as having an acute coronary syndrome, which includes patients with unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. Such progression from a stable to an unstable state is believed to result from disruption of an atherosclerotic plaque with subsequent platelet aggregation and thrombus formation. This, in turn, leads to the clinical manifestations of unstable angina, MI or death. Because platelets play a central role in the thrombotic complications of atherosclerosis, antiplatelet agents have been the cornerstone of the therapy for IHD. Aspirin has been the traditional antiplatelet agent, and remains the mainstay of treatment for all forms of IHD. However, aspirin is a weak antiplatelet agent and is often poorly tolerated by many patients. Clopidogrel is a new antiplatelet agent of the thienopyridine class. Clopidogrel, when used alone, and especially in combination with aspirin, has been shown to improve outcomes in patients with IHD across a variety of syndromes. However, combination therapy with aspirin and clopidogrel has been associated with an increased risk of bleeding. Therefore, despite improved outcomes, further studies are required to determine the optimal duration and dosage regimen of such combination therapy to maximize its risk-benefit ratio.

Angioplasty, Balloon, Coronary↗