| 1 | Clinical importance of aspirin and clopidogrel resistance显示文摘Aspirin and clopidogrel are important components of medical therapy for patients with acute coronary syndromes, for those who received coronary artery stents and in the secondary prevention of ischaemic stroke. Despite their use, a significant number of patients experience recurrent adverse ischaemic events. Interindividual variability of platelet aggregation in response to these antiplatelet agents may be an explanation for some of these recurrent events, and small trials have linked 'aspirin and/or clopidogrel resistance', as measured by platelet function tests, to adverse events. We systematically reviewed all available evidence on the prevalence of aspirin/clopidogrel resistance, their possible risk factors and their association with clinical outcomes. We also identified articles showing possible treatments. After analyzing the data on different laboratory methods, we found that aspirin/clopidogrel resistance seems to be associated with poor clinical outcomes and there is currently no standardized or widely accepted definition of clopidogrel resistance. Therefore, we conclude that specific treatment recommendations are not established for patients who exhibit high platelet reactivity during aspirin/clopidogrel therapy or who have poor platelet inhibition by clopidogrel. | Gergely Feher Andrea Feher Gabriella Pusch Katalin Koltai Antal Tibold Beata Gasztonyi Elod Papp Laszlo Szapary Gabor Kesmarky Kalman Toth | 2010 | World Journal of Cardiology2010，2，7： | 36 |
| 2 | Pulmonary embolization as primary manifestation of hepatocellular carcinoma with intracardiac penetration: A case report显示文摘Intracardiac manifestation of hepatocellular carcinoma (HCC) is a rare condition and an uncommon finding even at autopsy. Pulmonary tumor embolism as a presenting feature of HCC has been published only twice previously.In our case report, a 63-year-old man presented with high fever and six episodes of recurrent pneumonias during the last half year. Echocardiography was performed, a solid mass was found in the right atrium. Transesophageal echocardiography proved a tumor mass in the inferior vena cava (ⅣC) extending into the right atrium, abdominal ultrasound revealed tumor mass in the ⅣC and a solid tumor in the liver. Combined liver and heart surgery was attempted in order to remove the tumor mass from both the liver and the right atrium. Acute cor pulmonale occurred during tumor removal from the right atrium and the patient expired. In addition to local factors the possibility of embolization should arise in the background of recurrent pneumonia. Occult carcinoma must be included in possible causes of recurrent pulmonary embolism. Searching for primary malignancy should include HCC as frequent cause of hypercoagulability. In case of HCC, echocardiography is suggested because of the possibility of expansion in MC or right atrium and tumor-embolization. | Elod Papp Zsuzsanna Keszthelyi Nagy Karoly Kalmar Lajos Papp Csaba Weninger Tamas Tornoczky Endre Kalman Kalman Toth Tamas Habon | 2005 | World Journal of Gastroenterology2005，11，15： | 4 |
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