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      I nitroderivati come agenti antipiastrinici

      review-article
      Cardiology
      S. Karger AG
      Nitrates, Nitroderivatives, Nitroglycerin, Organic nitrates, Platelets, Bleeding time, Antiplatelet drugs

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          Abstract

          Nitrates are the most widely prescribed drug category in ischemic heart disease, being able to prevent and to interrupt episodes of myocardial ischemia, alleviate anginal symptoms, exert favorable effects in acute myocardial infarction. Their vascular actions, on peripheral arteries and veins, as well as on coronary arteries, can explain most of these effects. However, nitrates also exhibit platelet-inhibiting properties, mediated by the same cellular mechanisms operating on smooth muscle cells, i.e., via stimulation of guanylate cyclase and subsequent increase in cytosolic levels of cyclic GMP. When added to platelet suspensions, nitrates inhibit platelet aggregation induced by most stimuli. These in vitro effects usually require high drug concentrations; there is evidence, however, that nitrates may inhibit platelet function also in vivo. Such evidence derives from a) ex vivo studies with platelet aggregometry; b) the appreciation of a synergism between nitrates and prostacyclin; c) the appreciation of a need, for nitrate actions in vivo, of sulfhydryl group donors, such as N-acetylcys-teine, and d) from studies on bleeding time. Antiplatelet effects of nitrates may be an explanation for the protection from cardiac death and reinfarc-tion inferred on the basis of a meta-analysis of many studies of nitrates in acute myocardial .

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-5893-8
          978-3-318-01947-6
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 84
          : Suppl 1
          : 29-42
          Affiliations
          Istituto di Fisiologia Clinica, CNR, Pisa, Italia
          Article
          176443 Cardiology 1994;84:29–42
          10.1159/000176443
          8087822
          9d59635e-53ee-43ff-b054-d47c59882f45
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          Page count
          Pages: 14
          Categories
          Paper

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Antiplatelet drugs,Bleeding time,Nitroglycerin,Nitroderivatives,Organic nitrates,Nitrates,Platelets

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