Sökning: onr:"swepub:oai:DiVA.org:uu-319436" >
Outcomes after plan...
Outcomes after planned invasive or conservative treatment strategy in patients with non-ST-elevation acute coronary syndrome and a normal value of high sensitivity troponin at randomisation : A Platelet Inhibition and Patient Outcomes (PLATO) trial biomarker substudy.
-
Giannitsis, Evangelos (författare)
-
- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
-
- James, Stefan K, 1964- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
-
visa fler...
-
- Bertilsson, Maria (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
-
- Siegbahn, Agneta, 1947- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Koagulation och inflammationsvetenskap
-
Storey, Robert F (författare)
-
Husted, Steen (författare)
-
Cannon, Christopher P (författare)
-
Armstrong, Paul W (författare)
-
Steg, Philippe G (författare)
-
Katus, Hugo A (författare)
-
visa färre...
-
(creator_code:org_t)
- 2016-04-04
- 2017
- Engelska.
-
Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 2048-8726 .- 2048-8734. ; 6:6, s. 500-510
- Relaterad länk:
-
https://urn.kb.se/re...
-
visa fler...
-
https://doi.org/10.1...
-
visa färre...
Abstract
Ämnesord
Stäng
- AIMS: Current guidelines for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) recommend early invasive treatment in intermediate-to-high risk patients based on medical history, electrocardiogram (ECG) and elevated troponin. Patients with normal levels of cardiac troponin measured with a high-sensitivity method (cTnT-hs) might not benefit from early invasive procedures.METHODS AND RESULTS: In this Prospective Randomized Platelet Inhibition and Patient Outcomes (PLATO) blood-core substudy, 1232 patients presented with NSTE-ACS had a high sensitivity cardiac troponin T (cTnT-hs) level <99(th) percentile (<14 ng/l) at randomisation. The outcomes in relation to a planned invasive (n=473) vs planned conservative treatment (n=759), were evaluated by adjusted Cox proportional hazard analyses. In patients with a normal cTnT-hs at randomisation, regardless of randomised treatment, a planned invasive vs conservative treatment was associated with a 2.3-fold higher risk (7.3% vs 3.4%, p=0.0028) for cardiovascular (CV) death or myocardial infarction (MI), driven by higher rates of procedure-related MI (3.4% vs 0.1%), while there were no differences in rates of CV death (1.3% vs 1.3%, p=0.72) or spontaneous MI (3.0% vs 2.1%, p=0.28). There were significantly more major bleeds (hazard ratio (HR) 2.98, p<0.0001), mainly due to coronary artery bypass graft (CABG)-related (HR 4.05, p<0.0001) and non-CABG procedural-related major bleeding events (HR 5.31, p=0.0175), however there were no differences in non-procedure-related major bleeding (1.5% vs 1.9%, p=0.45). Findings were consistent for patients with a normal cTnI-hs at randomisation.CONCLUSIONS: In patients with NSTE-ACS and normal cTnT-hs, a planned early invasive treatment strategy was associated with increased rates of procedure-related MI and bleeding but no differences in long-term spontaneous MI, non-procedure-related bleeding or mortality.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Acute coronary syndrome
- biological markers
- blood platelets
- myocardial infarction
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
-
Giannitsis, Evan ...
-
Wallentin, Lars, ...
-
James, Stefan K, ...
-
Bertilsson, Mari ...
-
Siegbahn, Agneta ...
-
Storey, Robert F
-
visa fler...
-
Husted, Steen
-
Cannon, Christop ...
-
Armstrong, Paul ...
-
Steg, Philippe G
-
Katus, Hugo A
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
-
och Kardiologi
- Artiklar i publikationen
-
European Heart J ...
- Av lärosätet
-
Uppsala universitet