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Sökning: onr:"swepub:oai:DiVA.org:uu-324336" > Balancing the risk ...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005740naa a2200457 4500
001oai:DiVA.org:uu-324336
003SwePub
008170616s2017 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3243362 URI
0247 a https://doi.org/10.1016/j.ahj.2017.01.0102 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Ducrocq, Gregoryu FACT, Paris, France.;Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, Paris, France.;Univ Paris Diderot, Sorbonne Paris Cite, Paris, France.;INSERM, Unite 1148, Paris, France.4 aut
2451 0a Balancing the risk of spontaneous ischemic and major bleeding events in acute coronary syndromes
264 1b MOSBY-ELSEVIER,c 2017
338 a print2 rdacarrier
520 a Background: Evaluation of antithrombotic treatments for acute coronary syndromes (ACS) requires balancing ischemic and bleeding risks to assess net benefit. We sought to compare the relative effects of ischemic and bleeding events on mortality.Methods: In the PLATelet inhibition and patient Outcomes (PLATO) trial, we compared spontaneous ischemic events (myocardial infarction or stroke) with spontaneous major bleeding events (PLATO major, Thrombolysis In Myocardial Infarction [TIMI] major, Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries [GUSTO] severe) with respect to risk of mortality using time-dependent Cox proportional hazards models. The comparison was performed using ratio of hazard ratios for mortality increase after ischemic vs bleeding events.Results: A total of 822 patients (4.4%) had >= 1 spontaneous ischemic event; 485 patients (2.6%), >= 1 spontaneous PLATO major bleed, 282 (1.5%), >= 1 spontaneous TIMI major bleed; and 207 (1.1%), >= 1 spontaneous severe GUSTO bleed. In patients who had both events, bleeding occurred first in most patients. Regardless of classification, major bleeding events were associated with increased short- and long-term mortality that were not significantly different from the increase associated with spontaneous ischemic events: ratio of hazard ratios (95% Cls) for short- and long-term mortality after spontaneous ischemic vs bleeding events: 1.46 (0.98-2.19) and 0.92 (0.52-1.62) (PLATO major); 1.26 (0.80-1.96) and 1.19 (0.58-2.24) (TIMI major), 0.72 (0.47-1.10) and 0.83 (0.38-1.79) (GUSTO severe) (all P > 0.05)Conclusions: In patients with ACS on dual antiplatelet therapy, spontaneous major bleeding events seem "prognostically equivalent" to spontaneous ischemic complications. This result allows quantitative comparisons between both actual and predicted bleeding and ischemic risks. Our findings help to better define net clinical benefit of antithrombotic treatments and more accurately estimate mortality after ischemic and bleeding events in patients with ACS.
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
7001 a Schulte, Phillip J.u Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA.;Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA.4 aut
7001 a Budaj, Andrzeju Grochowski Hosp, Postgrad Med Sch, Warsaw, Poland.4 aut
7001 a Cornel, Jan H.u Noordwest Ziekenhuisgrp, Dept Cardiol, Alkmaar, Netherlands.4 aut
7001 a Held, Claes,d 1956-u Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)clahe947
7001 a Himmelmann, Andersu AstraZeneca Res & Dev, Gothenburg, Sweden.4 aut
7001 a Hunted, Steenu Hosp Unit Wwst, Med Dept, Herning Holstebro, Denmark.4 aut
7001 a Storey, Robert F.u Univ Sheffield, Dept Cardiovasc Sci, Sheffield, S Yorkshire, England.4 aut
7001 a Cannon, Christopher P.u Brigham & Womens Hosp, Div Cardiovasc, Boston, MA 02115 USA.;Baim Inst Clin Res Boston, Boston, MA USA.4 aut
7001 a Becker, Richard C.u Univ Cincinnati, Coll Med, Heart Lung & Vasc Inst, Div Cardiovasc Hlth & Dis, Cincinnati, OH USA.4 aut
7001 a James, Stefan K.,d 1964-u Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)stjam367
7001 a Katus, Hugo A.u Univ Klinikum Heidelberg, Med Klin, Heidelberg, Germany.4 aut
7001 a Lopes, Renato D.u Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA.4 aut
7001 a Sorbets, Enunanuelu FACT, Paris, France.;Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, Paris, France.;INSERM, Unite 1148, Paris, France.;Hop Avicenne, AP HP, Bobigny, France.;Univ Paris 13, Bobigny, France.4 aut
7001 a Wallentin, Lars,d 1943-u Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)larswall
7001 a Steg, Philippe Gabrielu FACT, Paris, France.;Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, Paris, France.;Univ Paris Diderot, Sorbonne Paris Cite, Paris, France.;INSERM, Unite 1148, Paris, France.;NHLI Imperial Coll, Royal Brampton Hosp, ICMS, London, England.4 aut
7102 a FACT, Paris, France.;Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, Paris, France.;Univ Paris Diderot, Sorbonne Paris Cite, Paris, France.;INSERM, Unite 1148, Paris, France.b Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA.;Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA.4 org
7730 t American Heart Journald : MOSBY-ELSEVIERg 186, s. 91-99q 186<91-99x 0002-8703x 1097-6744
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-324336
8564 8u https://doi.org/10.1016/j.ahj.2017.01.010

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