9 research outputs found
Antithrombotic Therapy in Carotid Artery Disease
The management of asymptomatic atherosclerotic carotid artery disease
and the role of antithrombotic therapy is of increasing importance for
stroke prevention. Non-invasive imaging of carotid plaques can identify
high-risk plaque features that are associated with the risk of plaque
rupture. Carotid plaque necrosis, hemorrhage, fibrous cap thinning, and
the presence of foam cells have all been correlated with the risk of
rupture and onset of neurological symptoms in patients with carotid
stenosis. Antiplatelets are currently recommended for patients with a
history of ischemic stroke and/or significant carotid artery stenosis,
with aspirin and clopidogrel being the most widely used and studied
agents. The role of dual antiplatelet therapy remains controversial.
Moreover, there is scarce evidence on the role of newer anticoagulant
agents in stable patients with carotid artery stenosis. In this review
article, we discuss the pathophysiology of carotid atherosclerosis, the
use of non-invasive imaging for detecting the vulnerable carotid plaque
and summarize the existing clinical evidence on the use of antiplatelet
and antithrombotic agents in carotid artery disease
The Use of Genotoxicity Endpoints as Biomarkers of Low Dose Radiation Exposure in Interventional Cardiology
<jats:p>The effect of the reportedly low ionizing radiation doses, such as those very often delivered to patients in interventional cardiology, remains ambiguous. As interventional cardiac procedures may have a significant impact on total collective effective dose, there are radiation protection concerns for patients and physicians regarding potential late health effects. Given that very low doses (&amp;lt;100 mSv) are expected to be delivered during these procedures, the purpose of this study was to assess the potency and suitability of current genotoxicity biomarkers to detect and quantitate biological effects essential for risk estimation in interventional cardiology. Specifically, the biomarkers γ-H2AX foci, dicentric chromosomes, and micronuclei, which underpin radiation-induced DNA damage, were studied in blood lymphocytes of 25 adult patients before and after interventional cardiac procedures. Even though the mean values of all patients as a group for all three endpoints tested show increased yields relative to baseline following medical exposure, our results demonstrate that only the γ-H2AX biomarker enables detection of statistically significant differences at the individual level (<jats:italic>p</jats:italic>&amp;lt; 0.001) for almost all patients (91%). Furthermore, 24 h after exposure, residual γ-H2AX foci were still detectable in irradiated lymphocytes. Their decline was found to vary significantly among the individuals and the repair kinetics of γ-H2AX foci was found to range from 25 to 95.6% of their maximum values obtained.</jats:p>
The Use of Genotoxicity Endpoints as Biomarkers of Low Dose Radiation Exposure in Interventional Cardiology
The effect of the reportedly low ionizing radiation doses, such as those
very often delivered to patients in interventional cardiology, remains
ambiguous. As interventional cardiac procedures may have a significant
impact on total collective effective dose, there are radiation
protection concerns for patients and physicians regarding potential late
health effects. Given that very low doses (<100 mSv) are expected to be
delivered during these procedures, the purpose of this study was to
assess the potency and suitability of current genotoxicity biomarkers to
detect and quantitate biological effects essential for risk estimation
in interventional cardiology. Specifically, the biomarkers gamma-H2AX
foci, dicentric chromosomes, and micronuclei, which underpin
radiation-induced DNA damage, were studied in blood lymphocytes of 25
adult patients before and after interventional cardiac procedures. Even
though the mean values of all patients as a group for all three
endpoints tested show increased yields relative to baseline following
medical exposure, our results demonstrate that only the gamma-H2AX
biomarker enables detection of statistically significant differences at
the individual level (p < 0.001) for almost all patients (91%).
Furthermore, 24 h after exposure, residual gamma-H2AX foci were still
detectable in irradiated lymphocytes. Their decline was found to vary
significantly among the individuals and the repair kinetics of
gamma-H2AX foci was found to range from 25 to 95.6% of their maximum
values obtained