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Achieving cholesterol targets by individualizing starting doses of statin according to baseline low-density lipoprotein cholesterol and coronary artery disease risk category: the CANadians Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (CanACTFAST) study.

https://arctichealth.org/en/permalink/ahliterature145456
Source
Can J Cardiol. 2010 Feb;26(2):80-6
Publication Type
Article
Date
Feb-2010
Author
Ehud Ur
Anatoly Langer
Simon W Rabkin
Cristina-Dana Calciu
Lawrence A Leiter
Author Affiliation
University of British Columbia, Vancouver, BC, Canada.
Source
Can J Cardiol. 2010 Feb;26(2):80-6
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Cholesterol, LDL - blood - drug effects
Coronary Artery Disease - blood - etiology - prevention & control
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Heptanoic Acids - administration & dosage
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Hypercholesterolemia - blood - complications - drug therapy
Male
Middle Aged
Pyrroles - administration & dosage
Risk factors
Treatment Outcome
Abstract
Despite an increasing body of evidence on the benefit of lowering elevated levels of low-density lipoprotein cholesterol (LDL-C), there is still considerable concern that patients are not achieving target LDL-C levels.
The CANadians Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (CanACTFAST) trial tested whether an algorithm-based statin dosing approach would enable patients to achieve LDL-C and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio targets quickly.
Subjects requiring statin therapy, but with an LDL-C level of 5.7 mmol/L or lower, and triglycerides of 6.8 mmol/L or lower at screening participated in the 12-week study, which had two open-label, six-week phases: a treatment period during which patients received 10 mg, 20 mg, 40 mg or 80 mg of atorvastatin based on an algorithm incorporating baseline LDL-C value and cardiovascular risk; and patients who achieved both LDL-C and TC/HDL-C ratio targets at six weeks continued on the same atorvastatin dose. Patients who did not achieve both targets received dose uptitration using a single-step titration regimen. The primary efficacy outcome was the proportion of patients achieving target LDL-C levels after 12 weeks.
Of 2016 subjects screened at 88 Canadian sites, 1258 were assigned to a study drug (1101 were statin-free and 157 were statin-treated at baseline). The proportion of subjects who achieved LDL-C targets after 12 weeks of treatment was 86% (95% CI 84% to 88%) for statin-free patients and 54% (95% CI 46% to 61%) for statin-treated patients. Overall, 1003 subjects (80%; 95% CI 78% to 82%) achieved both lipid targets.
Algorithm-based statin dosing enables patients to achieve LDL-C and TC/HDL-C ratio targets quickly, with either no titration or a single titration.
Notes
Cites: CMAJ. 2000 May 16;162(10):1441-710834048
Cites: Atherosclerosis. 2007 Mar;191(1):135-4616643923
Cites: JAMA. 2001 May 16;285(19):2486-9711368702
Cites: Am Heart J. 2001 Jun;141(6):949-5611376309
Cites: Am J Med. 2001 Aug 15;111(3):185-9111530028
Cites: JAMA. 2002 Jul 24-31;288(4):462-712132976
Cites: Am J Cardiol. 2003 Jul 1;92(1):79-8112842255
Cites: CMAJ. 2003 Oct 28;169(9):921-414581310
Cites: JAMA. 2004 Mar 3;291(9):1071-8014996776
Cites: Lancet. 1994 Nov 19;344(8934):1383-97968073
Cites: N Engl J Med. 1996 Oct 3;335(14):1001-98801446
Cites: J Am Coll Cardiol. 1998 Sep;32(3):665-729741509
Cites: Am Heart J. 2004 Dec;148(6):1028-3315632889
Cites: Am Heart J. 2005 Jan;149(1):e115660024
Cites: N Engl J Med. 2005 Apr 7;352(14):1425-3515755765
Cites: Lancet. 2005 Oct 8;366(9493):1267-7816214597
Cites: Can J Cardiol. 2005 Nov;21(13):1187-9316308595
Cites: Am J Cardiol. 2006 Jan 1;97(1):61-716377285
Cites: Am Heart J. 2006 May;151(5):969-7516644313
Cites: Am J Med. 2006 Aug;119(8):676-8316887414
Cites: Can J Cardiol. 2006 Sep;22(11):913-2716971976
Cites: Circulation. 2007 Feb 13;115(6):700-717283260
Cites: Atherosclerosis. 2000 Oct;152(2):489-9610998478
PubMed ID
20151053 View in PubMed
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Age-related differences in the management and outcome of patients with acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature170984
Source
Am Heart J. 2006 Feb;151(2):352-9
Publication Type
Article
Date
Feb-2006
Author
Raymond T Yan
Andrew T Yan
Mary Tan
Chi-Ming Chow
David H Fitchett
Frank L Ervin
James Y M Cha
Anatoly Langer
Shaun G Goodman
Author Affiliation
Division of Cardiology, Terrence Donnelly Heart Centre, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Source
Am Heart J. 2006 Feb;151(2):352-9
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Angina, Unstable - mortality - therapy
Canada
Comorbidity
Epidemiologic Methods
Evidence-Based Medicine - statistics & numerical data
Female
Fibrinolytic Agents - administration & dosage
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Myocardial Revascularization - methods - utilization
Registries
Syndrome
Thrombolytic Therapy - utilization
Treatment Outcome
Abstract
Age-related differences in patients with an acute coronary syndrome (ACS) have not been well characterized in prior observational studies that often included only certain age groups or subjects with myocardial infarction (MI).
We stratified 4627 patients admitted with an ACS across 9 provinces between 1999 and 2001 enrolled in the Canadian ACS Registry into 3 age groups ( or = 75 years) to evaluate differences in clinical characteristics, management, and 1-year outcome.
Older patients more frequently had previous angina, MI, or heart failure and were less likely to have positive cardiac markers, ST elevation, and Q-wave MI or to receive thrombolytics, beta-blockers, and cholesterol-lowering and antiplatelet agents in hospital, at discharge, and at 1 year. In multivariable analyses controlling for patient factors, every decade increase in age was independently associated with reduced use of coronary angiography (odds ratio [OR] 0.79, 95% CI 0.74-0.84, P
PubMed ID
16442898 View in PubMed
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Applying the evidence: do patients with stroke, coronary artery disease, or both achieve similar treatment goals?

https://arctichealth.org/en/permalink/ahliterature152667
Source
Stroke. 2009 Apr;40(4):1417-24
Publication Type
Article
Date
Apr-2009
Author
Gustavo Saposnik
Shaun G Goodman
Lawrence A Leiter
Raymond T Yan
David H Fitchett
Neville H Bayer
Amparo Casanova
Anatoly Langer
Andrew T Yan
Author Affiliation
Division of Cardiology, Canadian Heart Research Centre and Terrence Donnelly Heart Centre, University of Toronto, Canada. saposnikg@smh.toronto.on.ca
Source
Stroke. 2009 Apr;40(4):1417-24
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - therapeutic use
Blood pressure
Canada - epidemiology
Coronary Artery Disease - drug therapy - epidemiology
Evidence-Based Medicine
Female
Fibrinolytic Agents - therapeutic use
Guideline Adherence
Humans
Hypolipidemic Agents - therapeutic use
Lipids - blood
Male
Middle Aged
Multivariate Analysis
Outpatients - statistics & numerical data
Prospective Studies
Registries
Risk factors
Sex Distribution
Stroke - drug therapy - epidemiology
Treatment Outcome
Abstract
The importance of early and aggressive initiation of secondary prevention strategies for patients with both coronary artery disease (CAD) and cerebrovascular disease (CVD) is emphasized by multiple guidelines. However, limited information is available on cardiovascular protection and stroke prevention in an outpatient setting from community-based populations. We sought to evaluate and compare differences in treatment patterns and the attainment of current guideline-recommended targets in unselected high-risk ambulatory patients with CAD, CVD, or both.
This multicenter, prospective, cohort study was conducted from December 2001 to December 2004 among ambulatory patients in a primary care setting. The prospective Vascular Protection and Guidelines-Oriented Approach to Lipid-Lowering Registries recruited 4933 outpatients with established CAD, CVD, or both. All patients had a complete fasting lipid profile measured within 6 months before enrollment. The primary outcome measure was the achievement of blood pressure (BP)
PubMed ID
19213947 View in PubMed
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Are Canadian guidelines for cholesterol lowering in high-risk patients optimal?

https://arctichealth.org/en/permalink/ahliterature176367
Source
Can J Cardiol. 2005 Jan;21(1):85-90
Publication Type
Article
Date
Jan-2005
Author
David H Fitchett
Lawrence A Leiter
Jean-Claude Tardif
Shaun Goodman
Anatoly Langer
Author Affiliation
Canadian Heart Research Centre, Toronto, Ontario. fitchettd@smh.toronto.on.ca
Source
Can J Cardiol. 2005 Jan;21(1):85-90
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Heptanoic Acids - administration & dosage
Humans
Hypercholesterolemia - diagnosis - drug therapy
Hypolipidemic Agents - administration & dosage
Male
Maximum Tolerated Dose
Practice Guidelines as Topic
Pravastatin - administration & dosage
Prognosis
Pyrroles - administration & dosage
Quebec
Randomized Controlled Trials as Topic
Risk assessment
Sensitivity and specificity
Severity of Illness Index
Treatment Outcome
Abstract
Recent Canadian lipid guidelines recommend that all high-risk patients receive medication to reduce low density lipoprotein cholesterol (LDL-C) below 2.5 mmol/L. The recently published Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) and Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) studies compared strategies of cholesterol lowering with atorvastatin 80 mg versus pravastatin 40 mg. Atorvastatin halted the progression of atherosclerosis (whereas atherosclerosis progressed in the patients receiving pravastatin), and resulted in a 16% reduction in the primary composite end point (all-cause death, myocardial infarction, unstable angina, revascularization and stroke) compared with the pravastatin-treated group. In the PROVE IT trial, LDL-C was reduced by atorvastatin to 1.6 mmol/L and by pravastatin to 2.46 mmol/L. Although lower LDL-C levels are one explanation for the improved outcomes with atorvastatin, pleiotropic differences of the two statins, such as their effects on inflammation and coagulation, cannot be excluded. Until trials are completed that compare outcomes from LDL-C lowering to different targets with the same statin, it is premature to recommend changes to the current Canadian guidelines. However, future recommendations may suggest much lower LDL-C targets than those currently recommended.
PubMed ID
15685308 View in PubMed
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Clinical implications of a next-day follow-up electrocardiogram in patients with non-ST elevation acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature154677
Source
Am Heart J. 2008 Oct;156(4):797-803
Publication Type
Article
Date
Oct-2008
Author
Salem Alkaabi
Fahad Baslaib
Amparo Casanova
Andrew T Yan
David Fitchett
Aurora Mendelsohn
Jano Y Nikhil
Anatoly Langer
Shaun G Goodman
Author Affiliation
Terrence Donnelly Heart Centre, Division of Cardiology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Source
Am Heart J. 2008 Oct;156(4):797-803
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - epidemiology - mortality
Aged
Canada
Confounding Factors (Epidemiology)
Continuity of Patient Care
Electrocardiography
Female
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Prognosis
Prospective Studies
Registries
Survival Analysis
Abstract
The prognostic value of admission ST-segment changes in patients with non-ST elevation acute coronary syndromes (NSTE ACS) is well established; however, the value of a next-day follow-up electrocardiogram (ECG) is unclear.
We evaluated ST-depression (ST(downward arrow)) and Q-wave status on the admission and 24 to 36-hour follow-up ECG in 2,743 patients in a prospective Canadian ACS registry.
Of patients with ST(downward arrow) > or =1 mm on admission (n = 533 [19.4%]), 366 (68.7%) normalized their ST segment on follow-up ECG. Among patients without ST(downward arrow) on admission (n = 2,110), 97 (4.4%) developed new ST(downward arrow) at follow-up. Patients with normalized ST(downward arrow) at follow-up had higher 1-year myocardial infarction (MI) (10.1% vs 5.7%, odds ratio [OR] 1.77, 95% CI 1.12-2.81, P = .015) and death/MI rates (19.5% vs 10.2%, OR 1.69, 95% CI 1.18-2.41, P = .004), respectively, as compared to those who never had ST(downward arrow). Patients with persistent ST(downward arrow) had higher 1-year MI (10.8% vs 5.7%, OR 1.95, 95% CI 1.09-3.51, P = .025) and death/MI rates (25.6% vs 10.2%, OR 1.78, 95% CI 1.13-2.79, P = .013), respectively. In multivariable analysis, ST(downward arrow) on baseline ECG was an independent predictor of 1-year mortality; however, ST(downward arrow) on the follow-up ECG did not provide additional prognostic value. There were no differences in outcomes between the 4 different Q-wave status groups.
Although dynamic and persistent ST(downward arrow) are associated with worse unadjusted outcome in patients with NSTE ACS, there was no incremental prognostic value of a follow-up ECG evaluating ST depression and/or Q-wave status beyond that already provided by the initial ECG together with established prognostic factors.
PubMed ID
18926163 View in PubMed
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Clinical outcomes and cost implications of routine early PCI after fibrinolysis: one-year follow-up of the Trial of Routine Angioplasty and Stenting after Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction (TRANSFER-AMI) study.

https://arctichealth.org/en/permalink/ahliterature115154
Source
Am Heart J. 2013 Apr;165(4):630-637.e2
Publication Type
Article
Date
Apr-2013
Author
Akshay Bagai
Warren J Cantor
Mary Tan
Wesley Tong
Andre Lamy
David Fitchett
Eric A Cohen
Shamir R Mehta
Bjug Borgundvaag
John Ducas
Michael Heffernan
Vladimír D┼żavík
Laurie Morrison
Brian Schwartz
Charles Lazzam
Anatoly Langer
Shaun G Goodman
Author Affiliation
Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada.
Source
Am Heart J. 2013 Apr;165(4):630-637.e2
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon, Coronary - economics
Canada
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - economics - therapy
Myocardial Reperfusion - economics - methods
Stents
Thrombolytic Therapy
Treatment Outcome
Abstract
In patients with ST-elevation myocardial infarction treated with fibrinolysis, routine early percutaneous coronary intervention (r-PCI) improves clinical outcomes at 30 days compared with a more standard approach of performing early PCI only for failed fibrinolysis (s-PCI).
We report prespecified secondary clinical outcomes and cost implications of r-PCI compared with s-PCI from the Canadian TRANSFER-AMI trial. Average cost per patient in each arm was calculated based on a microcosting approach. Bootstrap method (5,000 samples) was used to calculate standard errors and 95% CI.
At 1 year, rates of death or reinfarction (10.3% vs 11.6%, P = .50), hospital readmission (15.4% vs 16.5%, P = .64) and subsequent revascularization after index hospitalization (6.9% vs 8.7%, P = .30) were similar between the r-PCI and s-PCI arms. The difference in cost per patient between r-PCI and s-PCI was CAD $1,003 (95% CI, -$247 to $2,211). Since a greater proportion of patients were transported by air (vs land) in the r-PCI arm (9.4% vs 3%), and the ratio of abciximab to eptifibatide use was higher in the r-PCI arm compared with s-PCI (2:1 vs 4:5), we undertook additional post hoc cost scenario analyses. In a scenario where patients are transported by land only and eptifibatide is used as the sole GPIIb/IIIa inhibitor, the difference in cost per patient between r-PCI and s-PCI was estimated to be CAD $108 (95% CI, -$1,114 to $1,344).
At 1 year, there is no difference in the clinical composite outcome of death or reinfarction between r-PCI and s-PCI strategies. Greater cost with r-PCI, although statistically insignificant, is economically important.
PubMed ID
23537982 View in PubMed
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Clinical trial--derived risk model may not generalize to real-world patients with acute coronary syndrome.

https://arctichealth.org/en/permalink/ahliterature176739
Source
Am Heart J. 2004 Dec;148(6):1020-7
Publication Type
Article
Date
Dec-2004
Author
Andrew T Yan
Philip Jong
Raymond T Yan
Mary Tan
David Fitchett
Chi-Ming Chow
Matthew T Roe
Karen S Pieper
Anatoly Langer
Shaun G Goodman
Author Affiliation
Terrence Donnelly Heart Centre, Division of Cardiology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Source
Am Heart J. 2004 Dec;148(6):1020-7
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angina, Unstable - diagnosis - mortality
Canada
Clinical Trials as Topic
Female
Hospital Mortality
Humans
Male
Middle Aged
Models, Statistical
Myocardial Infarction - diagnosis - mortality
Prognosis
Prospective Studies
ROC Curve
Registries
Risk Assessment - methods
Risk factors
Abstract
Accurate risk stratification can guide clinical decision-making in the management of acute coronary syndromes (ACS). However, the applicability of risk models to the general ACS population remains unclear. The purpose of this study was to validate and compare a modified international clinical trial and a registry-based risk model in a contemporary, less selected ACS population.
In the prospective, observational Canadian ACS Registry, 4627 patients with ACS were enrolled from 51 centers. Baseline patient data were recorded on standardized case report forms. We evaluated risk models derived from the Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) and the Global Registry of Acute Cardiac Events (GRACE) predicting in-hospital death among patients with non-ST-elevation ACS. Model discrimination was measured by the c-statistic, and calibration was assessed graphically and by the Hosmer-Lemeshow goodness-of-fit test.
In-hospital mortality rates were 2.4% overall and 1.5% among the patients with non-ST-elevation ACS (n = 2925; 63.2%) in our validation cohort. Both the in-hospital PURSUIT and GRACE risk models showed similar and good prognostic discrimination (c-statistics = 0.84 and 0.83, respectively; P = .69 for difference). The GRACE model also demonstrated good calibration (Hosmer-Lemeshow P = .40). In contrast, calibration in the PURSUIT model was poor (Hosmer-Lemeshow P
PubMed ID
15632888 View in PubMed
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Contemporary management of dyslipidemia in high-risk patients: targets still not met.

https://arctichealth.org/en/permalink/ahliterature168032
Source
Am J Med. 2006 Aug;119(8):676-83
Publication Type
Article
Date
Aug-2006
Author
Andrew T Yan
Raymond T Yan
Mary Tan
Daniel G Hackam
Kori L Leblanc
Heather Kertland
Jennifer L Tsang
Shahin Jaffer
Martin L Kates
Lawrence A Leiter
David H Fitchett
Anatoly Langer
Shaun G Goodman
Author Affiliation
Canadian Heart Research Centre and Terrence Donnelly Heart Centre, Division of Cardiology, Toronto, Ontario, Canada.
Source
Am J Med. 2006 Aug;119(8):676-83
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Aged
Canada - epidemiology
Cholesterol, HDL - blood
Cross-Sectional Studies
Dyslipidemias - drug therapy - epidemiology
Female
Humans
Hypolipidemic Agents - therapeutic use
Lipoproteins, LDL - blood
Male
Middle Aged
National Health Programs
Practice Guidelines as Topic
Risk factors
Abstract
Our objective was to evaluate treatment patterns and the attainment of current National Cholesterol Education Program (NCEP)-recommended lipid targets in unselected high-risk ambulatory patients.
Between December 2001 and December 2004, the prospective Vascular Protection and Guidelines Oriented Approach to Lipid Lowering Registries recruited 8056 outpatients with diabetes, established cardiovascular disease (CVD), or both, who had a complete lipid profile measured within 6 months before enrollment. The primary outcome measure was treatment success, defined as the achievement of LDL-cholesterol
PubMed ID
16887414 View in PubMed
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Enoxaparin and percutaneous coronary intervention: a Canadian perspective.

https://arctichealth.org/en/permalink/ahliterature174575
Source
Can J Cardiol. 2005 May 1;21(6):501-7
Publication Type
Article
Date
May-1-2005
Author
David Fitchett
Robert Welsh
Anatoly Langer
Shaun Goodman
Author Affiliation
St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. fitchettd@smh.toronto.on.ca
Source
Can J Cardiol. 2005 May 1;21(6):501-7
Date
May-1-2005
Language
English
Publication Type
Article
Keywords
Angina, Unstable - therapy
Angioplasty, Balloon
Anticoagulants - blood - therapeutic use
Attitude of Health Personnel
Canada
Dose-Response Relationship, Drug
Drug Administration Schedule
Enoxaparin - blood - therapeutic use
Humans
Myocardial Infarction - therapy
Physician's Practice Patterns
Pilot Projects
Platelet Aggregation Inhibitors - therapeutic use
Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors
Questionnaires
Abstract
The low molecular weight heparin enoxaparin is commonly used in the management of patients with non-ST segment elevation acute coronary syndromes (ACS). It is perceived that there is variable acceptance of the use of enoxaparin in patients with ACS in conjunction with percutaneous coronary intervention (PCI) by Canadian interventional cardiologists, as well as diverse approaches to the procedural (ie, PCI) management of anticoagulation.
A survey assessing physician and centre demographics, as well as the opinion and approach to the use of enoxaparin in patients undergoing PCI, was developed. All 141 interventional cardiologists performing PCI in Canada were sent the survey, with a 52% response rate. The majority (64%) of respondents were comfortable performing PCI during enoxaparin treatment, but almost one-half (46.5%) stated a preference to have a point-of-care measurement of the anticoagulation level during the procedure. Various 'top-up' protocols are used across the country, including fixed-dose intravenous (IV) enoxaparin, weight-adjusted IV enoxaparin, fixed-dose IV unfractionated heparin, weight-adjusted IV unfractionated heparin and IV unfractionated heparin titrated to a target activated clotting time. Although the median time threshold for administering a 'top-up' dose of anticoagulation matched current recommendations, there was a wide variation ranging from 2 h to 10 h (median 8 h).
Although the majority of Canadian interventional cardiologists were comfortable performing PCI in patients treated with enoxaparin, the survey demonstrated various levels of confidence and a diverse range of 'top-up' anticoagulation procedures. Nationwide guidelines for the management of anticoagulation in patients with ACS undergoing PCI with enoxaparin should be developed from the best available clinical and research evidence to limit potential patient risk of inadequate or excessive anticoagulation. This is especially relevant in view of the association between switching among anticoagulant therapies and an increased bleeding risk in patients undergoing early cardiac catheterization and PCI that was found in the recently reported Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial.
PubMed ID
15917879 View in PubMed
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Factors influencing underutilization of evidence-based therapies in women.

https://arctichealth.org/en/permalink/ahliterature136392
Source
Eur Heart J. 2011 Jun;32(11):1337-44
Publication Type
Article
Date
Jun-2011
Author
Raffaele Bugiardini
Andrew T Yan
Raymond T Yan
David Fitchett
Anatoly Langer
Olivia Manfrini
Shaun G Goodman
Author Affiliation
Dipartimento di Medicina Interna, Cardioangiologia, Epatologia (Padiglione 11), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. raffaele.bugiardini@unibo.it
Source
Eur Heart J. 2011 Jun;32(11):1337-44
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - drug therapy
Adrenergic beta-Antagonists - therapeutic use
Aged
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Canada
Cardiac Catheterization - utilization
Cardiovascular Agents - therapeutic use
Delivery of Health Care - statistics & numerical data
Evidence-Based Medicine - statistics & numerical data
Female
Humans
Hypolipidemic Agents - therapeutic use
Male
Middle Aged
Prospective Studies
Sex Factors
Abstract
Aims Previous studies have reported differences in the use of cardiovascular medications for acute coronary syndromes (ACSs) according to the sex of the patient. We analysed which clinical factors are associated with underutilization of evidence-based therapies in women. Methods and results From the Canadian Registry of ACS I and II, 6558 patients (4471 men and 2087 women) with a final diagnosis of ACS were selected for the current analysis. Covariates were chosen using the approach described by Blackstone. The final selected model included 23 patient clinical variables. Women were less likely than men to receive beta-blockers (75.76 vs. 79.24%; P
Notes
Comment In: Eur Heart J. 2011 Jun;32(11):1313-521393339
PubMed ID
21383003 View in PubMed
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31 records – page 1 of 4.