Search: onr:"swepub:oai:DiVA.org:uu-393326" >
Clinical consequenc...
-
Sharma, AbhinavDuke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA;McGill Univ, Div Cardiol, Hlth Ctr, Montreal, PQ, Canada;Stanford Univ, Div Cardiol, Stanford Sch Med, Stanford, CA 94305 USA
(author)
Clinical consequences of bleeding among individuals with a recent acute coronary syndrome : Insights from the APPRAISE-2 trial
- Article/chapterEnglish2019
Publisher, publication year, extent ...
-
MOSBY-ELSEVIER,2019
-
printrdacarrier
Numbers
-
LIBRIS-ID:oai:DiVA.org:uu-393326
-
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-393326URI
-
https://doi.org/10.1016/j.ahj.2019.05.004DOI
Supplementary language notes
-
Language:English
-
Summary in:English
Part of subdatabase
Classification
-
Subject category:ref swepub-contenttype
-
Subject category:art swepub-publicationtype
Notes
-
Background Patients with a recent acute coronary syndrome (ACS) receiving oral antiplatelets and anticoagulants are at risk for bleeding and subsequent adverse non-bleeding-related events. Methods In this post hoc analysis, we evaluated 7,392 high-risk patients (median follow-up 241 days) with a recent ACS randomized to apixaban or placebo in APPRAISE-2. Clinical events during a 30-day period after Thrombolysis in Myocardial Infarction (TIMI) major/minor bleeding were analyzed using unadjusted and adjusted Cox proportional-hazards models. Results In total, 153 (2.1%) patients experienced TIMI major/minor bleeding during follow-up. Bleeding risk for patients on triple therapy (apixaban, thienopyridine, and aspirin) was increased compared with those on dual therapy (apixaban plus aspirin: hazard ratio [HR] 2.02, 95% CI 1.08-3.79; thienopyridine plus aspirin: HR 1.99, 95% CI 1.41-2.83). Those receiving apixaban/aspirin had similar bleeding risk compared with those receiving thienopyridine/aspirin (HR 1.01, 95% CI 0.53-1.95). Patients who experienced TIMI major/minor bleeding had an increased risk of 30-day all-cause mortality (HR 24.7, 95% CI 15.34-39.66) and ischemic events (HR 6.7, 95% CI 3.14-14.14). Conclusions In a contemporary cohort of high-risk patients after ACS, bleeding was associated with a significantly increased risk of subsequent ischemic events and mortality regardless of antithrombotic or anticoagulant strategy. Patients receiving apixaban plus aspirin had a similar bleeding risk compared with those receiving thienopyridine plus aspirin. Interventions to improve outcomes in patients after ACS should include strategies to optimize the reduction in ischemic events while minimizing the risk of bleeding.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
-
Hagström, EmilUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper(Swepub:uu)emhag677
(author)
-
Wojdyla, Daniel M.Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA
(author)
-
Neely, Megan L.Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA
(author)
-
Harrington, Robert A.Stanford Univ, Div Cardiol, Stanford Sch Med, Stanford, CA 94305 USA
(author)
-
Wallentin, Lars,1943-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper(Swepub:uu)larswall
(author)
-
Alexander, John H.Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA
(author)
-
Goodman, Shaun G.Univ Toronto, St Michaels Hosp, Terrence Donnelly Heart Ctr, Toronto, ON, Canada
(author)
-
Lopes, Renato D.Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA
(author)
-
Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA;McGill Univ, Div Cardiol, Hlth Ctr, Montreal, PQ, Canada;Stanford Univ, Div Cardiol, Stanford Sch Med, Stanford, CA 94305 USAUppsala kliniska forskningscentrum (UCR)
(creator_code:org_t)
Related titles
-
In:American Heart Journal: MOSBY-ELSEVIER215, s. 106-1130002-87031097-6744
Internet link
Find in a library
To the university's database
- By the author/editor
-
Sharma, Abhinav
-
Hagström, Emil
-
Wojdyla, Daniel ...
-
Neely, Megan L.
-
Harrington, Robe ...
-
Wallentin, Lars, ...
-
show more...
-
Alexander, John ...
-
Goodman, Shaun G ...
-
Lopes, Renato D.
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Cardiac and Card ...
- Articles in the publication
-
American Heart J ...
- By the university
-
Uppsala University