Low
response to clopidogrel has been associated with increased risk of stent thrombosis and ischemic events, particularly in the context of stable heart disease treated PCI32765 by percutaneous coronary intervention.\n\nObjective: To stratify medium-term prognosis of an acute coronary syndrome (ACS) population by platelet aggregation.\n\nMethods: We performed a prospective longitudinal study of 70 patients admitted for an ACS between May and August 2009. Platelet function was assessed by ADP-induced platelet aggregation using a commercially available kit (Multiplate (R) analyzer) at discharge. The primary endpoint was a combined outcome of mortality, non-fatal myocardial infarction, or unstable angina, with a median follow-up of 136.0 (79.0-188.0) days.\n\nResults: The median value of platelet aggregation was 16.0 U (11.0-22.5 U) with a maximum of 41.0 U and a minimum of 4.0
U (normal value according to the manufacturer: 53-122 U). After ROC curve analysis with respect to the combined endpoint (AUC 0.72), we concluded that a value of 18.5 U conferred a sensitivity of 75.0% and a specificity of 68% to that result. We therefore created CA4P cell line two groups based on that level: group A – platelet aggregation <18.5 U, n = 44; and group B – platelet aggregation >= 18.5 U, n = 26. The groups were similar with respect to demographic data (age 60.5 [49.0-65.0] vs. 62.0 [49.0-65.0] years, p = 0.21), previous cardiovascular history, and admission diagnosis. There were no associations between left ventricular ejection fraction, GRACE risk score, or length of hospital stay and platelet aggregation. The groups were also similar with respect to antiplatelet, anticoagulant, proton pump inhibitor (63.6 vs. 46.2%, p = MLN4924 price 0.15) and statin therapy. The variability in platelets and hemoglobin was also similar between groups. Combined event-free survival was higher in group A (96.0 vs. 76.7%, log-rank p<0.01). Platelet aggregation higher than 18.5 U was an independent predictor of the combined event (HR 6.75, 95% CI 1.38-32.90, p = 0.02).\n\nConclusion: In our ACS population platelet aggregation
at discharge was a predictor of medium-term prognosis. (C) 2011 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.”
“Ayurveda traces its origins to contributions of mythological and real physicians that lived millennia earlier. In many respects, Western medicine also had similar origins and beliefs, however, the introduction of anatomical dissection and progressive application of scientific evidence based practices have resulted in divergent paths taken by these systems. We examined the lives, careers, and contributions made by nine ancient Indian physicians. Ancient texts, translations of these texts, books, and biographical works were consulted to obtain relevant information, both for Indian traditional medicine as well as for Western medicine.