• MeSH
• adherence k farmakoterapii * MeSH
• akutní koronární syndrom diagnostické zobrazování   mortalita   terapie   MeSH
• balónková koronární angioplastika škodlivé účinky   metody   MeSH
• hodnocení rizik MeSH
• inhibitory agregace trombocytů terapeutické užití   MeSH
• koronární stenóza diagnostické zobrazování   mortalita   terapie   MeSH
• lidé MeSH
• míra přežití MeSH
• prognóza MeSH
• selhání zařízení * MeSH
• stupeň závažnosti nemoci MeSH
• trombóza diagnostické zobrazování   farmakoterapie   etiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• inhibitory agregace trombocytů MeSH

BACKGROUND: Silent brain infarcts can be detected on magnetic resonance imaging (MRI) in ~22% of patients after coronary angioplasty and stenting (CS). The effect of periprocedural sonolysis on the risk of new brain infarcts during CS was examined. METHODS: Patients undergoing elective CS were allocated randomly to a bilateral sonolysis group (70 patients, 58 men; mean age, 59.9 years) or a control group (74 patients, 45 men; mean age, 65.5 years). Neurologic examination, cognitive function tests, and brain MRI were performed prior to intervention and at 24 h after CS. Neurologic examination and cognitive function tests were repeated at 30 days after CS. RESULTS: No significant differences were observed in the number of patients with new infarcts (25.7 vs. 18.9%, P = 0.423), the number of lesions (1.3 ± 1.0 vs. 2.9 ± 5.3, P = 0.493), lesion volume (0.16 ± 0.34 vs. 0.28 ± 0.60 mL, P = 0.143), and the number of patients with new ischemic lesions in the insonated MCA territories (18.6vs. 17.6%, P = 0.958) between the sonolysis group and the control group. There were no cases of stroke, transient ischemic attack, myocardial infarction, or death in the two groups. Intracranial bleeding was reported only in 1 patient in the control group (0 vs. 1.4%, P = 0.888). Clock-drawing test scores at 30 days were significantly higher in the sonolysis group than in the control group (median 3.0 vs. 2.5, P = 0.031). CONCLUSIONS: Sonolysis does not reduce the risk of new brain infarcts after CS. The effect of sonolysis on number and volume of ischemic lesions and cognitive function should be assessed in further studies.

• Klíčová slova
• Angioplasty, Coronary artery, Ischemic lesion, Sonolysis, Stenting, Stroke,
• MeSH
• asymptomatické nemoci MeSH
• balónková koronární angioplastika škodlivé účinky   metody   MeSH
• elektivní chirurgické výkony škodlivé účinky   metody   MeSH
• hodnocení rizik MeSH
• kognice MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mozek diagnostické zobrazování   MeSH
• mozkový infarkt * diagnóza   etiologie   patofyziologie   psychologie   MeSH
• neurologické vyšetření metody   MeSH
• pooperační komplikace * diagnóza   etiologie   patofyziologie   psychologie   MeSH
• senioři MeSH
• trombolytická terapie * škodlivé účinky   metody   MeSH
• ultrazvuková terapie * škodlivé účinky   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Surgical revascularisation in patients with acute myocardial infarction with ST-Segment Elevation (STEMI) is usually considered as a second choice when direct angioplasty/stent fails. However, improvements in surgical technique and postoperative care may justify coronary artery bypass grafting (CABG) in STEMI. METHODS: This was a retrospective analysis of prospectively gathered data of 135 patients with acute STEMI, treated with CABG in our department from February 2008 to December 2012. Patients were divided into two groups - operated up to 6 hours (35 patients) and 6 to 24hours (100 patients) from onset of symptoms. RESULTS: Preoperatively, 18 (13%) patients were in cardiogenic shock, 10 (7.4%) had mechanical ventilation, and 36 (27%) had intra-aortic balloon counterpulsation (IABC). Mean number of distal anastomoses was 3.3 (range, 1 to 5), cardiopulmonary bypass time 122.7+52.6minutes. In hospital (30-day) mortality was 8.1% (11 patients) with no significant difference in both groups (p=0.541); 45 (33%) patients had one MACE, again with no difference in both groups (p=0.89). Risk factor analysis revealed that Killip class at admission, cardiogenic shock, preoperative need for catecholamines, ventilation and low ejection fraction are risk factors for early mortality. CONCLUSIONS: Acute CABG in patients with STEMI can be performed with good results. Risk factors for early mortality and morbidity are cardiogenic shock, poor haemodynamic status and impaired ejection fraction. Time from infarction to reperfusion did not influence the results.

• Klíčová slova
• Acute STEMI, Acute coronary bypass surgery, Surgical treatment of IHD,
• MeSH
• balónková koronární angioplastika metody   MeSH
• časové faktory MeSH
• dospělí MeSH
• hemodynamika fyziologie   MeSH
• infarkt myokardu s elevacemi ST úseků mortalita   patofyziologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití trendy   MeSH
• mortalita v nemocnicích trendy   MeSH
• následné studie MeSH
• retrospektivní studie MeSH
• revaskularizace myokardu MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: In patients with ST-segment elevation myocardial infarction (STEMI), the use of percutaneous coronary intervention (PCI) to restore blood flow in an infarct-related coronary artery improves outcomes. The use of PCI in non-infarct-related coronary arteries remains controversial. METHODS: We randomly assigned 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related coronary artery in a 1:2 ratio to undergo complete revascularization of non-infarct-related coronary arteries guided by fractional flow reserve (FFR) (295 patients) or to undergo no revascularization of non-infarct-related coronary arteries (590 patients). The FFR procedure was performed in both groups, but in the latter group, both the patients and their cardiologist were unaware of the findings on FFR. The primary end point was a composite of death from any cause, nonfatal myocardial infarction, revascularization, and cerebrovascular events at 12 months. Clinically indicated elective revascularizations performed within 45 days after primary PCI were not counted as events in the group receiving PCI for an infarct-related coronary artery only. RESULTS: The primary outcome occurred in 23 patients in the complete-revascularization group and in 121 patients in the infarct-artery-only group that did not receive complete revascularization, a finding that translates to 8 and 21 events per 100 patients, respectively (hazard ratio, 0.35; 95% confidence interval [CI], 0.22 to 0.55; P<0.001). Death occurred in 4 patients in the complete-revascularization group and in 10 patients in the infarct-artery-only group (1.4% vs. 1.7%) (hazard ratio, 0.80; 95% CI, 0.25 to 2.56), myocardial infarction in 7 and 28 patients, respectively (2.4% vs. 4.7%) (hazard ratio, 0.50; 95% CI, 0.22 to 1.13), revascularization in 18 and 103 patients (6.1% vs. 17.5%) (hazard ratio, 0.32; 95% CI, 0.20 to 0.54), and cerebrovascular events in 0 and 4 patients (0 vs. 0.7%). An FFR-related serious adverse event occurred in 2 patients (both in the group receiving infarct-related treatment only). CONCLUSIONS: In patients with STEMI and multivessel disease who underwent primary PCI of an infarct-related artery, the addition of FFR-guided complete revascularization of non-infarct-related arteries in the acute setting resulted in a risk of a composite cardiovascular outcome that was lower than the risk among those who were treated for the infarct-related artery only. This finding was mainly supported by a reduction in subsequent revascularizations. (Funded by Maasstad Cardiovascular Research and others; Compare-Acute ClinicalTrials.gov number, NCT01399736 .).

• MeSH
• balónková koronární angioplastika metody   MeSH
• frakční průtoková rezerva myokardu MeSH
• infarkt myokardu s elevacemi ST úseků patologie   terapie   MeSH
• Kaplanův-Meierův odhad MeSH
• koronární angioplastika MeSH
• lidé středního věku MeSH
• lidé MeSH
• přežití po terapii bez příznaků nemoci MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) have a high risk of acute myocardial infarction and recurrent cardiovascular events. According to the previous studies, the combination of the two conditions may have a synergistic impact on prognosis. The aim of this study was to assess the impact of stage of CKD on the outcomes of patients with DM and ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). METHODS: Study population consisted of 946 consecutive patients with STEMI who underwent PCI from January 2009 to December 2012 and were followed up until the end of 2013. The all-cause mortality during this period was evaluated in relation to DM and severe or moderate reduction in glomerular filtration rate (GFR categories G4-5, or G3; KDIGO classification). Cox regression analysis adjusted for possible confounding factors was used in statistics. RESULTS: Out of the study population (mean age 63 years, 69.6 % males), 217 (22.9 %) patients had DM. Of them, 10.6 % were in GFR category G4-5 and 32.7 % in G3. The in-hospital mortality rates in patients with DM were 34.8 % for G4-5, 18.3 % for G3, and 4.1 % in G1-2 groups. The all-cause mortality at the end of the follow-up period for diabetics within G4-5 was 2.27 -times higher compared to mortality of diabetics in G1-2 (p = 0.047, Cox regression analysis), and there was a trend toward higher mortality for G3 versus G1-2 (HR 1.64, p = 0.12). CONCLUSION: Severe chronic kidney disease (GFR category 4-5) was significantly associated with all-cause mortality of diabetics with STEMI treated with PCI; the association with severe CKD was stronger compared to moderate CKD.

• Klíčová slova
• Chronic kidney disease, Diabetes mellitus, Mortality, PCI, STE myocardial infarction,
• MeSH
• analýza přežití MeSH
• balónková koronární angioplastika metody   mortalita   MeSH
• chronická renální insuficience epidemiologie   patologie   terapie   MeSH
• diabetes mellitus diagnóza   farmakoterapie   epidemiologie   MeSH
• hodnocení rizik MeSH
• infarkt myokardu s elevacemi ST úseků diagnóza   epidemiologie   terapie   MeSH
• Kaplanův-Meierův odhad MeSH
• kohortové studie MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• mortalita v nemocnicích trendy   MeSH
• multivariační analýza MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• proporcionální rizikové modely MeSH
• retrospektivní studie MeSH
• rozložení podle pohlaví MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• věkové rozložení MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

AIM: To highlight an optimal collaborative strategy of three different levels of specialized care cardiac centres. BACKGROUND: Refractory cardiogenic shock is a life-threatening condition. A myocardial recovery is not achieved in many cases despite all efforts and subsequently the heart transplantation remains an ultimate option. Thereby, the use of extracorporeal membrane oxygenation (ECMO) followed by a ventricular assist device in staged bridging provides an attractive approach. CASE REPORT: We report on an optimal cooperation of PCI (percutaneous coronary intervention) centre with ELSO (extracorporeal life support organization) centre and transplant centre in a patient suffering from refractory cardiogenic shock due to acute myocardial infarction (RCSMI) complicated by left ventricle free wall rupture with pericardial tamponade. CONCLUSION: The interhospital collaboration can be essential in the context of patients with RCSMI. The use of ECMO enables safe interhospital transport and gains time for further diagnostic and therapeutic steps in such critically ill patients.

• Klíčová slova
• extracorporeal membrane oxygenation, left ventricle assist device, percutaneous coronary intervention, refractory cardiogenic shock in acute myocardial infarction,
• MeSH
• asistovaná cirkulace MeSH
• balónková koronární angioplastika metody   MeSH
• infarkt myokardu s elevacemi ST úseků diagnostické zobrazování   terapie   MeSH
• interinstitucionální vztahy MeSH
• kardiogenní šok diagnostické zobrazování   terapie   MeSH
• koronární jednotky MeSH
• lidé středního věku MeSH
• lidé MeSH
• mimotělní membránová oxygenace metody   MeSH
• podpůrné srdeční systémy MeSH
• poinfarktová ruptura srdce terapie   MeSH
• transplantace srdce * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Renal dysfunction is a strong independent predictor of stent thrombosis. The aim of the present study was to evaluate the strength and direction of the association between kidney function and clopidogrel efficacy. The study group consisted of consecutive patients (n = 275) who underwent stent implantation. Drug efficacy was measured using the vasodilator-stimulated phosphoprotein (VASP) index 20 ± 4 hours after clopidogrel 600 mg. Nonresponse was defined as an VASP index ≥50%. Renal function was determined using serum cystatin C. The upper reference levels are 1.12 mg/L for ≤65 years of age and 1.21 mg/L for >65 years of age. Estimated glomerular filtration was calculated using cystatin C. The median value of cystatin C was 1.16 mg/L (twenty-fifth and seventy-fifth percentiles 0.96 and 1.43); 47.63% of the study population had cystatin C above reference levels and 33.1% of patients were nonresponders to clopidogrel. No correlation was found between clopidogrel efficacy assessed with the VASP index and kidney function assessed with cystatin C (Spearman r = -0.070, p = 0.248). Based on cystatin C the proportion of nonresponders to clopidogrel was 34.4% versus 31.9% (p = 0.702) in patients with impaired renal function compared to normal renal function, respectively. The proportion of clopidogrel nonresponders did not differ (p = 0.902) among groups with normal (28.8%), mildly impaired (34.8%), moderately impaired (32.9%), and severely impaired (34.8%) renal function. In conclusion, renal function assessed by cystatin C does not predict clopidogrel efficacy. Renal dysfunction is a complex entity and its significant relation to stent thrombosis cannot be explained simply by a decrease in clopidogrel efficacy.

• MeSH
• balónková koronární angioplastika metody   MeSH
• cystatin C krev   MeSH
• fosfoproteiny krev   MeSH
• hodnoty glomerulární filtrace účinky léků   fyziologie   MeSH
• imunoanalýza MeSH
• inhibitory agregace trombocytů aplikace a dávkování   MeSH
• klopidogrel MeSH
• koronární trombóza krev   patofyziologie   prevence a kontrola   MeSH
• krevní proteiny MeSH
• lidé MeSH
• mikrofilamentové proteiny krev   MeSH
• molekuly buněčné adheze krev   MeSH
• následné studie MeSH
• nemoci koronárních tepen patofyziologie   terapie   MeSH
• prognóza MeSH
• senioři MeSH
• stenty MeSH
• tiklopidin aplikace a dávkování   analogy a deriváty   MeSH
• vyšetření funkce ledvin MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• cystatin C MeSH
• fosfoproteiny MeSH
• inhibitory agregace trombocytů MeSH
• klopidogrel MeSH
• krevní proteiny MeSH
• mikrofilamentové proteiny MeSH
• molekuly buněčné adheze MeSH
• tiklopidin MeSH
• vasodilator-stimulated phosphoprotein MeSH Prohlížeč

AIMS: The current guidelines recommend reperfusion therapy in acute myocardial infarction (AMI) with ST-segment elevation or left bundle branch block (LBBB). Surprisingly, the right bundle branch block (RBBB) is not listed as an indication for reperfusion therapy. This study analysed patients with AMI presenting with RBBB [with or without left anterior hemiblock (LAH) or left posterior hemiblock (LPH)] and compared them with those presenting with LBBB or with other electrocardiographic (ECG) patterns. The aim was to describe angiographic patterns and primary angioplasty use in AMI patients with RBBB. METHODS AND RESULTS: A cohort of 6742 patients with AMI admitted to eight participating hospitals was analysed. Baseline clinical characteristics, ECG patterns, coronary angiographic, and echocardiographic data were correlated with the reperfusion therapies used and with in-hospital outcomes. Right bundle branch block was present in 6.3% of AMI patients: 2.8% had RBBB alone, 3.2% had RBBB + LAH, and 0.3% had RBBB + LPH. TIMI flow 0 in the infarct-related artery was present in 51.7% of RBBB patients vs. 39.4% of LBBB patients (P = 0.023). Primary percutaneous coronary intervention (PCI) was performed in 80.1% of RBBB patients vs. 68.3% of LBBB patients (P< 0.001). In-hospital mortality of RBBB patients was similar to LBBB (14.3 vs. 13.1%, P = 0.661). Patients with new or presumably new blocks had the highest (LBBB 15.8% and RBBB 15.4%) incidence of cardiogenic shock from all ECG subgroups. Percutaneous coronary intervention was done more frequently (84.8%) in patients with new or presumably new RBBB when compared with other patients with blocks (old RBBB 66.0%, old LBBB 62.3%, new or presumably new LBBB 73.0%). In-hospital mortality was highest (18.8%) among patients presenting with new or presumably new RBBB, followed by new or presumably new LBBB (13.2%), old LBBB (10.1%), and old RBBB (6.4%). Among 35 patients with acute left main coronary artery occlusion, 26% presented with RBBB (mostly with LAH) on the admission ECG. CONCLUSION: Acute myocardial infarction with RBBB is frequently caused by the complete occlusion of the infarct-related artery and is more frequently treated with primary PCI when compared with AMI + LBBB. In-hospital mortality of patients with AMI and RBBB is highest from all ECG presentations of AMI. Restoration of coronary flow by primary PCI may lead to resolution of the conduction delay on the discharge ECG. Right bundle branch block should strongly be considered for listing in future guidelines as a standard indication for reperfusion therapy, in the same way as LBBB.

• MeSH
• balónková koronární angioplastika metody   MeSH
• blokáda Tawarova raménka komplikace   MeSH
• dlouhověkost MeSH
• elektrokardiografie MeSH
• infarkt myokardu komplikace   terapie   MeSH
• koronární okluze terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• reperfuze myokardu metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock. METHODS: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure). RESULTS: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 group B patients (27.5%, P = 0.24). Ejection fraction among survivors after 30 days was 44 ± 11% (A) versus 41 ± 12% (B, P = 0.205). Major bleeding occurred in 17.5% (A) versus 7.5% (B, P = 0.310). No differences (A versus B) were found in TIMI-flow and MBG after PCI. CONCLUSIONS: This study did not show any benefit from routine pre-procedural abciximab when compared with a selective abciximab use during the intervention in patients with cardiogenic shock undergoing primary PCI. However, small sample size of the trial preclude any definitive conclusion, a larger prospective, randomized, multicentered trial is needed.

• MeSH
• abciximab MeSH
• analýza přežití MeSH
• balónková koronární angioplastika metody   MeSH
• imunoglobuliny - Fab fragmenty aplikace a dávkování   MeSH
• infarkt myokardu komplikace   farmakoterapie   mortalita   patologie   MeSH
• inhibitory agregace trombocytů aplikace a dávkování   MeSH
• kardiogenní šok komplikace   farmakoterapie   mortalita   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• monoklonální protilátky aplikace a dávkování   MeSH
• prospektivní studie MeSH
• senioři MeSH
• tepový objem MeSH
• trombocytový glykoproteinový komplex IIb-IIIa antagonisté a inhibitory   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• abciximab MeSH
• imunoglobuliny - Fab fragmenty MeSH
• inhibitory agregace trombocytů MeSH
• monoklonální protilátky MeSH
• trombocytový glykoproteinový komplex IIb-IIIa MeSH

PURPOSE: The objective of our study was to identify changes in the coagulation and serum concentration of soluble P-selectin (sP-sel) after i.v. bolus of 0.75 mg/kg enoxaparin in a group of 33 patients during PCI. METHODS AND RESULTS: As compared to baseline, i.v. enoxaparin increased anti -Xa activity and FIIa inhibition together with APTT and thrombin time tests within 20 min, that persisted for 60 min. At 6 h, the results of all tests had returned to baseline. In contrast, the level of prothrombin fragments (F1 + 2) decreased persistingly for a period of 6 h (baseline 1.19 ± 0.42 nmol/l, after 20 min 1.03 ± 0.46 nmol/l, after 60 min 1.06 ± 0.43 nmol/l, after 6 h 0.95 ± 0.40 nmol/l, p < 0.001 vs. baseline for all values). In addition, i.v. enoxaparin decreased serum sP-sel level (baseline 111.80 ± 37.05 ng/ml, after 20 min 87.80 ± 33.17 ng/ml, after 60 min 86.45 ± 29.15 ng/ml, after 6 h 92.24 ± 31.34 ng/ml, p < 0.001 vs. baseline value for all). sP-sel level mildly correlated with both F Xa inhibition (r = -0.275, p < 0.05) and F1 + 2 level (r = 0.274, p < 0.05). CONCLUSION: Intravenous enoxaparin induced target F Xa inhibition (>0.6 IU/ml) for 60 min in 82% of study patients. During the 6 h of monitoring, a decrease of thrombin generation (F1 + 2) and sP-selectin levels were observed.

• MeSH
• antikoagulancia farmakologie   MeSH
• balónková koronární angioplastika metody   MeSH
• časové faktory MeSH
• enoxaparin farmakologie   MeSH
• inhibitory faktoru Xa MeSH
• injekce intravenózní MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci koronárních tepen terapie   MeSH
• P-selektin účinky léků   metabolismus   MeSH
• parciální tromboplastinový čas MeSH
• protrombin antagonisté a inhibitory   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• thrombin účinky léků   metabolismus   MeSH
• trombinový čas MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• Názvy látek
• antikoagulancia MeSH
• enoxaparin MeSH
• Factor IIa MeSH Prohlížeč
• inhibitory faktoru Xa MeSH
• P-selektin MeSH
• protrombin MeSH
• thrombin MeSH