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Sökning: onr:"swepub:oai:DiVA.org:uu-320631" > Personalising the d...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004900naa a2200493 4500
001oai:DiVA.org:uu-320631
003SwePub
008170814s2017 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3206312 URI
0247 a https://doi.org/10.1093/eurheartj/ehw6832 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Pasea, Laurau UCL, Farr Inst Hlth Informat Res, London, England.4 aut
2451 0a Personalising the decision for prolonged dual antiplatelet therapy :b development, validation and potential impact of prognosticmodels for cardiovascular events and bleeding in myocardial infarction survivors
264 c 2017-02-27
264 1b Oxford University Press (OUP),c 2017
338 a electronic2 rdacarrier
520 a Aims The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms Methods and results Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n= 12 694 patients) and validated (n= 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints. We applied trial effect estimates to determine potential benefits and harms of DAPT and the net clinical benefit of individuals. Prognostic models for cardiovascular events (c-index: 0.75 (95% CI: 0.74, 0.77)) and bleeding (c index 0.72 (95% CI: 0.67, 0.77)) were well calibrated: 3-year risk of cardiovascular events was 16.5% overall (5.2% in the lowest-and 46.7% in the highest-risk individuals), while for major bleeding, it was 1.7% (0.3% in the lowest-and 5.4% in the highest-risk patients). For every 10 000 patients treated per year, we estimated 249 (95% CI: 228, 269) cardiovascular events prevented and 134 (95% CI: 87, 181) major bleeding events caused in the highest-risk patients, and 28 (95% CI: 19, 37) cardiovascular events prevented and 9 (95% CI: 0, 20) major bleeding events caused in the lowest-risk patients. There was a net clinical benefit of prolonged DAPT in 63-99% patients depending on how benefits and harms were weighted Conclusion Prognostic models for cardiovascular events and bleeding using population-based EHRs may help to personalise decisions for prolonged DAPT 1-year following acute MI.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a Prognosis
653 a Myocardial infarction
653 a Bleeding
7001 a Chung, Sheng-Chiau UCL, Farr Inst Hlth Informat Res, London, England.4 aut
7001 a Pujades-Rodriguez, Maru UCL, Farr Inst Hlth Informat Res, London, England.;Univ Leeds, MRC Med Bioinformat Ctr, Leeds Inst Biomed & Clin Sci, Leeds LS2 9JT, W Yorkshire, England.4 aut
7001 a Moayyeri, Alirezau UCL, Farr Inst Hlth Informat Res, London, England.4 aut
7001 a Denaxas, Spirosu UCL, Farr Inst Hlth Informat Res, London, England.4 aut
7001 a Fox, Keith A. A.u Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland.;Royal Infirm Edinburgh NHS Trust, Edinburgh, Midlothian, Scotland.4 aut
7001 a Wallentin, Lars,d 1943-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)larswall
7001 a Pocock, Stuart J.u London Sch Hyg & Trop Med, Dept Med Stat, London, England.4 aut
7001 a Timmis, Adamu Barts & London Natl Inst Hlth Res Cardiovasc Biom, Barts Heart Ctr, London, England.4 aut
7001 a Banerjee, Amitavau UCL, Farr Inst Hlth Informat Res, London, England.4 aut
7001 a Patel, Riyazu UCL, Farr Inst Hlth Informat Res, London, England.4 aut
7001 a Hemingway, Harryu UCL, Farr Inst Hlth Informat Res, London, England.4 aut
7102 a UCL, Farr Inst Hlth Informat Res, London, England.b UCL, Farr Inst Hlth Informat Res, London, England.;Univ Leeds, MRC Med Bioinformat Ctr, Leeds Inst Biomed & Clin Sci, Leeds LS2 9JT, W Yorkshire, England.4 org
7730 t European Heart Journald : Oxford University Press (OUP)g 38:14, s. 1048-1055Aq 38:14<1048-1055Ax 0195-668Xx 1522-9645
8564 u https://doi.org/10.1093/eurheartj/ehw683y Fulltext
8564 u https://uu.diva-portal.org/smash/get/diva2:1131503/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 u https://academic.oup.com/eurheartj/article-pdf/38/14/1048/24120220/ehw683.pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-320631
8564 8u https://doi.org/10.1093/eurheartj/ehw683

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