Skip header and navigation

Refine By

23 records – page 1 of 3.

Antiplatelet therapy at the time of coronary artery bypass grafting: a multicentre cohort study.

https://arctichealth.org/en/permalink/ahliterature114023
Source
Eur J Cardiothorac Surg. 2013 Aug;44(2):e133-40
Publication Type
Article
Date
Aug-2013
Author
Michael Kremke
Mariann Tang
Mikkel Bak
Katrine Lawaetz Kristensen
Karsten Hindsholm
Jan Jesper Andreasen
Vibeke Hjortdal
Carl-Johan Jakobsen
Author Affiliation
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark. michhinr@rm.dk
Source
Eur J Cardiothorac Surg. 2013 Aug;44(2):e133-40
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Aged
Analysis of Variance
Aspirin - adverse effects - therapeutic use
Blood Transfusion
Cohort Studies
Coronary Artery Bypass - adverse effects - methods - statistics & numerical data
Denmark - epidemiology
Female
Hospitals, University
Humans
Male
Middle Aged
Odds Ratio
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Postoperative Hemorrhage - chemically induced - epidemiology - therapy
Reoperation
Thrombosis - drug therapy - prevention & control
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Abstract
The purpose of this multicentre cohort study was to examine the relationship between antiplatelet therapy (APT) at the time of coronary artery bypass grafting (CABG) and postoperative bleeding complications, transfusion requirements and adverse cardiovascular events.
A matched-pair analysis was carried out on 6350 consecutive patients undergoing CABG at the three university hospitals in Western Denmark. Patients exposed to aspirin or clopidogrel within 5 days before surgery were compared with those not exposed to these drugs. The data used in the study were retrieved from the Western Denmark Heart Registry.
Of the 6350 patients enrolled, 1846 (29%) had been exposed to aspirin or clopidogrel within 5 days prior to CABG (the APT group). Matching with the remaining 4504 (71%) patients of the control group resulted in 1132 pairs of patients. Patients in the APT group had greater mean chest tube drainage volumes (946 vs 775 ml; P 1000 ml (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 0.55-1.34). Preoperative clopidogrel use, on the other hand, was associated with greater reoperation rates (10.2 vs 3.9% in the control group; P = 0.005) and was an independent predictor of severe postoperative bleeding (OR: 2.08, 95% CI: 1.55-2.80). Overall, preoperative APT had no significant effect on postoperative 30-day mortality, incidence of myocardial infarction, stroke or need for dialysis.
Preoperative APT is associated with increased bleeding and greater transfusion requirements after CABG. Clopidogrel exposure is associated with greater reoperation rates and is an independent risk factor for severe postoperative bleeding.
Notes
Comment In: Eur J Cardiothorac Surg. 2014 May;45(5):951-223897989
Comment In: Eur J Cardiothorac Surg. 2014 May;45(5):952-323882071
PubMed ID
23660554 View in PubMed
Less detail

Association of aspirin dosage to clinical outcomes after percutaneous coronary intervention: observations from the Ottawa Heart Institute PCI Registry.

https://arctichealth.org/en/permalink/ahliterature152283
Source
J Invasive Cardiol. 2009 Mar;21(3):121-7
Publication Type
Article
Date
Mar-2009
Author
Derek So
E Francis Cook
Michel Le May
Chris Glover
William Williams
Andrew Ha
Richard Davies
Michael Froeschl
Jean-Fran Cois Marquis
Edward O'Brien
Marino Labinaz
Author Affiliation
University of Ottawa Heart Institute, Cardiology, Ottawa, Ontario, Canada. dso@ottawaheart.ca
Source
J Invasive Cardiol. 2009 Mar;21(3):121-7
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon, Coronary - methods
Aspirin - adverse effects - therapeutic use
Canada
Combined Modality Therapy
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Heart Failure - therapy
Humans
Logistic Models
Male
Myocardial Infarction - prevention & control - therapy
Myocardial Ischemia - prevention & control - therapy
Outcome Assessment (Health Care)
Patient Discharge
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Prospective Studies
Recurrence - prevention & control
Registries
Retrospective Studies
Abstract
Dual antiplatelet therapy, with aspirin and a thienopyridine, is the accepted treatment after percutaneous coronary intervention (PCI). No clear evidence exists regarding the ideal dosage of aspirin. Recent guidelines recommend higher-dose aspirin because of the possible decrease in stent thrombosis. The purpose of this study was to test the hypothesis that high-dose aspirin of 325 mg decreases death and myocardial infarction (MI) compared to a lower dose of 81 mg in patients undergoing PCI.
An observational cohort study of 1,840 consecutive patients who underwent PCI was conducted. Patients who did not survive to discharge were excluded. The primary endpoint was a composite of all-cause mortality and MI at 1 year.
Nine-hundred and thirty patients (50.5%) were discharged on 325 mg of aspirin and 910 (49.5%) were discharged of 81 mg. The risk of all-cause mortality or MI was not significantly different between patients: low-dose 5.49% (50/910) vs. high-dose 4.19% (39/930); adjusted odds ratio [OR], 1.16; 95% confidence interval [CI], 0.73-1.85). In a multivariable analysis, the Charlson comorbidity score (OR, 1.37; 95% CI, 1.18-1.58) and urgent PCI (OR, 1.75; 95% CI, 1.03-3.00) were associated with increased death or MI. Among patients with drug-eluting stents, the use of low-dose aspirin did not predispose them to death or MI (adjusted OR, 1.12, 95% CI, 0.53-2.34).
In this large contemporary analysis of PCI patients, no differences in death or MI were observed at 1 year between patients discharged on low-dose aspirin 81 mg compared to patients on a higher dose.
PubMed ID
19258643 View in PubMed
Less detail

Canadian Cardiovascular Society atrial fibrillation guidelines 2010: prevention of stroke and systemic thromboembolism in atrial fibrillation and flutter.

https://arctichealth.org/en/permalink/ahliterature136939
Source
Can J Cardiol. 2011 Jan-Feb;27(1):74-90
Publication Type
Article
Conference/Meeting Material
Author
John A Cairns
Stuart Connolly
Sean McMurtry
Michael Stephenson
Mario Talajic
Author Affiliation
University of British Columbia, Vancouver, British Columbia, Canada. jacairns@medd.med.ubc.ca
Source
Can J Cardiol. 2011 Jan-Feb;27(1):74-90
Language
English
Publication Type
Article
Conference/Meeting Material
Keywords
Administration, Oral
Aged
Anticoagulants - adverse effects - therapeutic use
Aspirin - adverse effects - therapeutic use
Atrial Fibrillation - complications - drug therapy - etiology
Atrial Flutter - complications - drug therapy - etiology
Benzimidazoles - adverse effects - therapeutic use
Canada
Comorbidity
Electric Countershock
Evidence-Based Medicine
Fibrinolytic Agents - adverse effects - therapeutic use
Hemorrhage - chemically induced
Humans
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Randomized Controlled Trials as Topic
Risk factors
Stroke - prevention & control
Thromboembolism - prevention & control
Vitamin K - antagonists & inhibitors
Warfarin - adverse effects - therapeutic use
beta-Alanine - adverse effects - analogs & derivatives - therapeutic use
Abstract
The stroke rate in atrial fibrillation is 4.5% per year, with death or permanent disability in over half. The risk of stroke varies from under 1% to over 20% per year, related to the risk factors of congestive heart failure, hypertension, age, diabetes, and prior stroke or transient ischemic attack (TIA). Major bleeding with vitamin K antagonists varies from about 1% to over 12% per year and is related to a number of risk factors. The CHADS(2) index and the HAS-BLED score are useful schemata for the prediction of stroke and bleeding risks. Vitamin K antagonists reduce the risk of stroke by 64%, aspirin reduces it by 19%, and vitamin K antagonists reduce the risk of stroke by 39% when directly compared with aspirin. Dabigatran is superior to warfarin for stroke prevention and causes no increase in major bleeding. We recommend that all patients with atrial fibrillation or atrial flutter, whether paroxysmal, persistent, or permanent, should be stratified for the risk of stroke and for the risk of bleeding and that most should receive antithrombotic therapy. We make detailed recommendations as to the preferred agents in various types of patients and for the management of antithrombotic therapies in the common clinical settings of cardioversion, concomitant coronary artery disease, surgical or diagnostic procedures with a risk of major bleeding, and the occurrence of stroke or major bleeding. Alternatives to antithrombotic therapies are briefly discussed.
PubMed ID
21329865 View in PubMed
Less detail

Clopidogrel use and short-term mortality after peptic ulcer bleeding: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature136976
Source
Am J Ther. 2013 Jan;20(1):13-20
Publication Type
Article
Date
Jan-2013
Author
Morten Schmidt
Anders H Riis
Christian F Christiansen
Timothy L Lash
Henrik T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, DK-8200, Aarhus N, Denmark. msc@dce.au.dk
Source
Am J Ther. 2013 Jan;20(1):13-20
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Atherosclerosis - complications - drug therapy - mortality
Cohort Studies
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Peptic Ulcer Hemorrhage - chemically induced - complications - diagnosis - mortality
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Prognosis
Proportional Hazards Models
Registries
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Abstract
Clopidogrel therapy increases bleeding risk, but whether it influences short-term mortality after peptic ulcer bleeding (PUB) is unknown. The objective was to examine whether clopidogrel use at the time of PUB increases 30-day mortality. We conducted this cohort study in northern Denmark (population 1.7 million). We used the Danish National Patient Registry, covering all hospitals, to identify all patients with a first-ever inpatient diagnosis of endoscopically or surgically confirmed PUB between 1998 and 2008 and their comorbidities. From the prescription database in the region, we ascertained the use of clopidogrel at the time of admission (current use) or before admission (former use) and use of concurrent medications. We obtained mortality data from the Danish Civil Registration System. We used regression modeling to compute mortality rate ratios (MRRs) with 95% confidence intervals (CIs), controlling for potential confounders. We identified 6951 patients with bleeding peptic ulcers. At admission, 122 (1.8%) were current users of clopidogrel, 143 (2.1%) were former users, and 6686 (96.2%) were nonusers. Thirty-day mortality was 5.7% for current users, 7.0% for former users, and 8.0% for nonusers. The adjusted 30-day MRR was reduced in both current and former users, compared with nonusers (MRR = 0.72, 95% CI 0.34, 1.52 and MRR = 0.71, 95% CI 0.38, 1.32, respectively). There was no notable modification of the association within gender or age strata. Although the use of clopidogrel increases the risk of PUB, former use and current use of clopidogrel were not associated with increased short-term mortality after admission for this condition.
PubMed ID
21326084 View in PubMed
Less detail

Concomitant use of clopidogrel and statins and risk of major adverse cardiovascular events following coronary stent implantation.

https://arctichealth.org/en/permalink/ahliterature128016
Source
Br J Clin Pharmacol. 2012 Jul;74(1):161-70
Publication Type
Article
Date
Jul-2012
Author
Morten Schmidt
Martin B Johansen
Michael Maeng
Anne Kaltoft
Lisette O Jensen
Hans-Henrik Tilsted
Hans E Bøtker
John A Baron
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus Department of Cardiology, Aarhus, Denmark. morten.schmidt@dce.au.dk
Source
Br J Clin Pharmacol. 2012 Jul;74(1):161-70
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology - prevention & control
Cohort Studies
Cytochrome P-450 CYP3A - antagonists & inhibitors
Denmark
Drug Interactions
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects - therapeutic use
Male
Middle Aged
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Regression Analysis
Risk factors
Stents
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Time Factors
Abstract
• The CYP3A4 inhibition by lipophilic statins may attenuate the effectiveness of clopidogrel. • No studies have measured drug exposure in a time-varying manner that detects discontinuation and restart of clopidogrel and statin therapy, allowing clinical quantification of the interaction effect.
• Clopidogrel and CYP3A4-metabolizing statin use were each associated with a substantially reduced rate of major adverse cardiovascular events within 12 months after coronary stent implantation. • Although we observed an interaction between use of clopidogrel and statins, statin use vs. non-use was not associated with an increased rate of major adverse cardiovascular events in patients using clopidogrel after coronary stent implantation.
To examine whether CYP3A4-metabolizing statin use modified the association between clopidogrel use and major adverse cardiovascular events (MACE) after coronary stent implantation, using time-varying drug exposure ascertainment.
We conducted this population-based cohort study in Western Denmark (population: 3 million) using medical databases. We identified all 13 001 patients with coronary stent implantation between 2002 and 2005 and their comorbidities. During 12 months of follow-up, we tracked the use of clopidogrel and CYP3A4-metabolizing statins and the rate of MACE. We used Cox regression to compute hazard ratios (HRs) controlling for potential confounders.
The rate of MACE per 1000 person years was 104 for concomitant clopidogrel and statin use, 130 for clopidogrel without statin use, 108 for statin without clopidogrel use and 446 for no use of either drug. The adjusted HR comparing clopidogrel use with non-use was 0.68 (95% confidence interval (CI) 0.58, 0.79) among statin users and 0.34 (95% CI 0.29, 0.40) among statin non-users, yielding an interaction effect (i.e. relative rate increase) of 1.97 (95% CI 1.59, 2.44). The adjusted HR for MACE comparing statin use with non-use was 0.97 (95% CI 0.83, 1.13) among clopidogrel users and 0.49 (95% CI 0.42, 0.57) among clopidogrel non-users.
Clopidogrel and CYP3A4-metabolizing statin use were each associated with a substantially reduced rate of MACE within 12 months after coronary stent implantation. Although we observed an interaction between use of clopidogrel and statins, statin use vs. non-use was not associated with an increased rate of MACE in patients using clopidogrel after coronary stent implantation.
Notes
Cites: JAMA. 2002 Nov 20;288(19):2411-2012435254
Cites: Epidemiology. 2011 May;22(3):298-30121464649
Cites: Circulation. 2003 Jan 7;107(1):32-712515739
Cites: J Clin Epidemiol. 2003 Feb;56(2):124-3012654406
Cites: Am J Cardiol. 2003 Aug 1;92(3):285-812888133
Cites: Circulation. 2003 Aug 26;108(8):921-412925453
Cites: Eur Heart J. 2003 Oct;24(19):1744-914522569
Cites: Am J Epidemiol. 2003 Nov 1;158(9):915-2014585769
Cites: Circulation. 2003 Nov 4;108(18):2195-714568892
Cites: Circulation. 2004 Mar 23;109(11):1335-815023882
Cites: Circulation. 2004 Jun 15;109(23 Suppl 1):III50-715198967
Cites: Thromb Haemost. 2004 Sep;92(3):614-2015351859
Cites: Arch Intern Med. 2004 Oct 11;164(18):2051-715477442
Cites: Lancet. 2004 Oct 23-29;364(9444):1519-2115500897
Cites: Circulation. 1990 Oct;82(4):1193-2022401060
Cites: Lancet. 1994 Nov 19;344(8934):1383-97968073
Cites: Dan Med Bull. 1997 Sep;44(4):445-89377907
Cites: Dan Med Bull. 1999 Jun;46(3):263-810421985
Cites: Dan Med Bull. 1999 Sep;46(4):354-710514943
Cites: Eur Heart J. 2004 Nov;25(21):1898-90215522468
Cites: Heart. 2005 Jan;91(1):23-615604326
Cites: Platelets. 2004 Dec;15(8):465-7415763887
Cites: Platelets. 2005 Aug;16(5):287-9216011979
Cites: Eur J Clin Invest. 2005 Aug;35(8):476-8116101667
Cites: Thromb Haemost. 2005 Aug;94(2):438-4316113837
Cites: Am J Epidemiol. 2005 Nov 15;162(10):1016-2316192344
Cites: Am Heart J. 2006 Aug;152(2):263-916875906
Cites: Dan Med Bull. 2006 Nov;53(4):441-917150149
Cites: Am J Cardiol. 2007 Feb 1;99(3):353-617261397
Cites: J Am Coll Cardiol. 2007 Jul 24;50(4):291-517659194
Cites: Med Care. 2007 Oct;45(10 Supl 2):S131-4217909372
Cites: Thromb Haemost. 2008 Jan;99(1):174-8118217151
Cites: Am Heart J. 2008 May;155(5):954-818440347
Cites: Eur Heart J. 2008 Jul;29(13):1635-4318503057
Cites: Pharmacotherapy. 2008 Dec;28(12):1483-9419025429
Cites: QJM. 2008 Dec;101(12):915-2518676683
Cites: Pharmacoepidemiol Drug Saf. 2009 May;18(5):362-919253920
Cites: J Cardiovasc Pharmacol. 2009 May;53(5):368-7219247187
Cites: J Intern Med. 2009 Nov;266(5):457-6619549094
Cites: Zhonghua Yi Xue Za Zhi. 2009 Aug 25;89(32):2240-420095333
Cites: Expert Rev Cardiovasc Ther. 2010 Sep;8(9):1283-9520828351
Cites: J Am Coll Cardiol. 2011 Mar 15;57(11):1251-6321392639
Cites: Drug Metab Dispos. 2003 Jan;31(1):53-912485953
PubMed ID
22243420 View in PubMed
Less detail

Correlation between point-of-care platelet function testing and bleeding after coronary angiography according to two different definitions for bleeding.

https://arctichealth.org/en/permalink/ahliterature258727
Source
Am J Cardiol. 2014 Nov 1;114(9):1347-53
Publication Type
Article
Date
Nov-1-2014
Author
Manne Holm
Per Tornvall
Magnus Dalén
Jan van der Linden
Source
Am J Cardiol. 2014 Nov 1;114(9):1347-53
Date
Nov-1-2014
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - blood - drug therapy - radiography
Aged
Blood Platelets - physiology
Coronary Angiography - adverse effects
Female
Follow-Up Studies
Hemorrhage - blood - chemically induced - epidemiology
Humans
Incidence
Male
Middle Aged
Platelet Activation
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Platelet Function Tests
Prognosis
Prospective Studies
Sweden - epidemiology
Abstract
Platelet function testing could be useful when assessing the risk for bleeding during treatment with antiplatelet drugs. This has been indicated in several studies, including the Antiplatelet Therapy for Reduction of Myocardial Damage During Angioplasty-Bleeding (ARMYDA-BLEEDS) study, which demonstrated that testing with a point-of-care assay correlated with bleeding events after percutaneous coronary intervention. To standardize bleeding definitions, the Bleeding Academic Research Consortium (BARC) published a consensus report, which is in need of data-driven validation. Hence, the investigators conducted an observational, prospective, single-center study of 474 patients receiving clopidogrel and aspirin who underwent coronary angiography with or without percutaneous coronary intervention from October 2006 to May 2011. Platelet reactivity was measured with adenosine diphosphate-induced single-platelet function testing (Plateletworks) at the start of coronary angiography. The primary end point was the 30-day incidence of bleeding as defined by BARC and ARMYDA-BLEEDS. The aim of the present study was to investigate the relation between on-treatment platelet reactivity and the 30-day incidence of bleeding complications according to the BARC and ARMYDA-BLEEDS definitions. Patients in the first platelet aggregation quartile had a higher frequency of type 2 or higher BARC bleeding and ARMYDA-BLEEDS-defined bleeding
PubMed ID
25220849 View in PubMed
Less detail

The effects on plasma, red cell and platelet fatty acids of taking 12 g/day of ethyl-eicosapentaenoate for 16 months: dihomogammalinolenic, arachidonic and docosahexaenoic acids and relevance to Inuit metabolism.

https://arctichealth.org/en/permalink/ahliterature3919
Source
Prostaglandins Leukot Essent Fatty Acids. 2003 May;68(5):301-4
Publication Type
Article
Date
May-2003
Author
David Horrobin
M Rebecca Fokkema
Frits A J Muskiet
Author Affiliation
Laxdale Ltd, Kings Park House, Laurelhill Business Park, Stirling, FK7 9JQ, Scotland, UK. agreen@laxdale.co.uk
Source
Prostaglandins Leukot Essent Fatty Acids. 2003 May;68(5):301-4
Date
May-2003
Language
English
Publication Type
Article
Keywords
8,11,14-Eicosatrienoic Acid - blood
Arachidonic Acid - blood
Blood Platelets - drug effects - metabolism
Docosahexaenoic Acids - blood
Dose-Response Relationship, Drug
Eicosapentaenoic Acid - adverse effects - analogs & derivatives - blood - therapeutic use
Erythrocytes - drug effects - metabolism
Fatty Acids - blood
Humans
Lymphoma, Mantle-Cell - blood - drug therapy
Male
Middle Aged
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Time Factors
Abstract
A patient with mantle cell lymphoma took 12g/day of ethyl-eicosapentaenoate for 16 months. Compared to reference values, eicosapentaenoic and docosapentaenoic acids were elevated in plasma, red cells and platelets but docosahexaenoic acid levels were in the normal range. Arachidonic acid levels were moderately reduced but dihomogammalinolenic acid levels remained in the normal range. In spite of a long chain n-3 fatty acid intake higher than in most Inuit populations, arachidonic acid levels remained considerably higher in this patient than in the Inuit. The implications for understanding of fatty acid metabolism in humans are discussed.
PubMed ID
12711245 View in PubMed
Less detail

Efficacy of post-operative clopidogrel treatment in patients revascularized with coronary artery bypass grafting after myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature136521
Source
J Am Coll Cardiol. 2011 Mar 8;57(10):1202-9
Publication Type
Article
Date
Mar-8-2011
Author
Rikke Sørensen
Steen Z Abildstrøm
Peter R Hansen
Anders Hvelplund
Charlotte Andersson
Mette Charlot
Emil L Fosbøl
Lars Køber
Jan K Madsen
Gunnar H Gislason
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark. rs@heart.dk
Source
J Am Coll Cardiol. 2011 Mar 8;57(10):1202-9
Date
Mar-8-2011
Language
English
Publication Type
Article
Keywords
Aged
Combined Modality Therapy
Comorbidity
Coronary Artery Bypass
Denmark - epidemiology
Female
Hemorrhage - chemically induced - epidemiology
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - epidemiology - mortality - surgery
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Postoperative Period
Propensity Score
Proportional Hazards Models
Recurrence - prevention & control
Registries
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Abstract
The objective of this study was to examine the clinical efficacy of clopidogrel treatment on death and recurrent myocardial infarction (MI) among MI patients revascularized by coronary artery bypass graft surgery (CABG).
The benefit from post-operative clopidogrel in CABG-treated MI patients is largely unknown.
All patients admitted with first-time MI between 2002 and 2006, treated with CABG within 180 days after admission, were identified by nationwide administrative registers. Clopidogrel treatment was determined by claimed prescriptions after discharge from surgery. Risk of death or recurrent MI, and of a combined end point of the 2, were assessed by cumulative incidence and Cox proportional hazards model. A propensity score-matched subgroup analysis was done.
We included 3,545 patients, and of these, 957 (27.0%) were treated with clopidogrel after CABG. Mean follow-up was 466 ± 144 days. Among patients treated with clopidogrel, 39 (4.1%) died or experienced a recurrent MI, whereas that occurred in 203 (7.8%) patients without clopidogrel (log-rank p = 0.0003). Hazard ratio was 0.59 (95% confidence interval [CI]: 0.42 to 0.85) for patients treated with clopidogrel, with no-clopidogrel as reference. By propensity score, of 945 patients with or without clopidogrel treatment who were matched, death or recurrent MI occurred in 38 (4.0%) patients with clopidogrel and 57 (6.0%) without clopidogrel (log-rank p = 0.05). Corresponding hazard ratio was 0.67 (95% CI: 0.44 to 1.00) for clopidogrel users, with no-clopidogrel as reference.
Among MI patients revascularized by CABG, only 27% received clopidogrel after discharge. Clopidogrel-treated patients had a lower risk of the combined end point of death or recurrent MI. Focus on discharge clopidogrel treatment of these patients should be made.
Notes
Comment In: J Am Coll Cardiol. 2011 Aug 30;58(10):1085; author reply 1085-621867852
Comment In: J Am Coll Cardiol. 2011 Aug 30;58(10):1084-5; author reply 1085-621867851
PubMed ID
21371637 View in PubMed
Less detail

23 records – page 1 of 3.