Alcohol
Nathalie Bergeron, Patty W. Siri-Tarino, George A. Bray, Ronald M. Krauss in Nutrition and Cardiometabolic Health, 2017
In the blood clotting process (coagulation), the blood forms a clot by changing state from liquid to gel. This might result in hemostasis, where the blood loss from a damaged vessel stops, followed by a repair period. Current evidence suggests that alcohol intake is associated with a decrease in levels of fibrinogen (Brien et al. 2011), a plasma protein that plays an important role in coagulation by being transformed into an insoluble network of filamentous molecules called fibrin. Alcohol’s effect on fibrinogen is not well understood; however, a decrease in fibrinogen levels is assumed to impair the coagulation process and thereby contribute to part of the protective effects of a low to moderate alcohol intake on cardiovascular disease by decreasing the risk of thrombosis.
Drug therapy in the cardiac catheterisation laboratory: A guide to commonly used drugs
John Edward Boland, David W. M. Muller in Interventional Cardiology and Cardiac Catheterisation, 2019
Antiplatelet, anticoagulation and thrombolytic pharmacology is a mainstay of both primary and secondary prevention of acute coronary syndromes. The coagulation process begins with activation of platelets and ends with formation of a stable fibrin clot following a complex series of interactions involving vascular endothelium, platelets and circulating plasma proteins (see Chapter 4). The dominant role of platelets, thrombin and positive feedback agents such as adenosine diphosphate (ADP) provide excellent opportunities for new and improved drugs to focus on two main strategies: To reduce thrombin production and to inhibit platelet activity. Platelet aggregation is essential to coagulation, while thrombin plays a central role in platelet activation and fibrin production.
Integrative Nutritional Therapy for Cardiovascular Disease
Mary J. Marian, Gerard E. Mullin in Integrating Nutrition Into Practice, 2017
Despite the mixed findings on lipids and blood pressure, garlic seems to beneficially impact other parameters of cardiovascular health, including coagulation parameters and may have a direct effect on atherosclerosis (perhaps by reducing the oxidation of LDL). Garlic reduces blood coagulation similar to the effects of aspirin [105,106]. A randomized, double-blind, placebo-controlled clinical trial found that garlic powder reduced arteriosclerosis in both femoral and carotid arteries by 5%–18% in a group of subjects aged 50–80 years [107]. A small pilot study of 23 patients with atherosclerosis on statin therapy found that those treated with an aged garlic extract had less plaque growth over 1 year than those treated with placebo [108].
Myocardial injury after non-cardiac surgery and per operative fibrin metabolism in patients undergoing hip-fracture surgery: an observational study
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2023
Kirsten L. Wahlstrøm, Sarah Ekeloef, Ismail Gögenur, Anna-Marie B. Münster
The formation of fibrin clots represents the final step in blood coagulation. Fibrin clots composed of compact, highly branched networks with thin fibres are resistant to lysis [49]. Altered fibrin structure has consistently been reported in patients with several diseases complicated by thromboembolic events, including patients with acute or prior MI, ischemic stroke, and venous thromboembolism [50,51]. Suppression of inflammatory responses increase clot permeability and susceptibility to lysis [52]. Our study is the first to investigate the fibrin fibre properties in relation to urgent non-cardiac surgery. A recent study on elective orthognathic surgery reported a decrease in fibrin clot lysis, decreased fibrin mass-length ratio and diameter as well as increased density after surgery [53]. These properties are coherent with impaired breakdown of fibrin and thus a haemostatic system shifted towards the prothrombotic direction after surgery. However, there are several differences in the patient populations of the study on orthognathic surgery and our study. Our patients were exposed to subacute surgery, not elective procedures, our patients were older, and had noticeable cardiovascular risk factors. Additionally, the trauma our patients underwent prior to surgery might have activated the haemostatic system long before the surgical trauma.
Recent advances in the management of postmenopausal women with non-atypical endometrial hyperplasia
Published in Climacteric, 2023
Some drugs and extracts have been proven to play a key role in enhancing coagulation, reducing inflammation and reducing uterine bleeding in patients. Saururus chinensis has anti-inflammatory, antioxidant stress and anti-proliferative effects, and can be used to treat EH [73]. Celosia cristata is also used to treat menstrual pain, abdominal pain and hemoptysis [74]. In addition, there is evidence to suggest that Spatholobus suberectus has multiple functions against oxidation, viruses, bacteria, cancer and platelets [75]. Research has found that the combination of S. chinensis, C. cristata and S. suberectus has a positive effect on the treatment of EH and its related complications [76]. In addition, research has revealed the mechanism of action of S. suberectus at the molecular and gene expression levels. S. suberectus increased the expression of matrix metalloproteinase-1 mRNA and tissue inhibitor of matrix metalloproteinase-1 mRNA in the endometrium, and promoted the repair of proliferative endometrium in rats.
Orally delivered rutin in lipid-based nano-formulation exerts strong antithrombotic effects by protein disulfide isomerase inhibition
Published in Drug Delivery, 2022
Dan Chen, Yurong Liu, Peiwen Liu, Yang Zhou, Longguang Jiang, Cai Yuan, Mingdong Huang
Impairment of coagulation/fibrinolysis balance, changes in blood rheology, and damages to endothelial lining cause thrombosis, leading to serious cardiovascular diseases gradually (Furie & Furie, 2008). Microvascular occlusion in arterioles, venules, and capillaries can occur in multiple tissue beds long before the onset of circulatory thrombosis, and can result in a partial or complete organ failure (Gutterman et al., 2016). Currently available antithrombotics include agents that directly inhibit platelet functions (antiplatelet therapy) and those that intervene in the coagulation cascade (anticoagulants). The anticoagulant market has been growing rapidly since the approval of direct oral anticoagulants (DOACs), i.e. direct thrombin inhibitors and direct FXa inhibitors (Verheugt et al., 2019). Apixaban and rivaroxaban, both of which are FXa inhibitors, account for two of the top 10 best-selling drugs worldwide in 2020. However, these drugs still confront prevalent underuse in clinical practice due to concerns with the increased risk of bleeding, especially in the elderly (Mackman et al., 2020). Moreover, no antidote for direct thrombin or FXa inhibitors is clinically approved to reverse the anticoagulants in bleeding events. In addition, the combination of antiplatelet and anticoagulant therapies is usually required in patients suffering from coexisting atrial fibrillation and other vascular diseases, e.g. stent thrombosis and coronary artery disease (Moser et al., 2014).
Related Knowledge Centers
- Cell Adhesion
- Fibrin
- Hemostasis
- Endothelium
- Platelet
- Thrombus
- Blood
- Gel
- Platelet-Activating Factor
- Tissue Factor