Sökning: onr:"swepub:oai:DiVA.org:uu-393326" > Clinical consequenc...
Fältnamn | Indikatorer | Metadata |
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000 | 04278naa a2200373 4500 | |
001 | oai:DiVA.org:uu-393326 | |
003 | SwePub | |
008 | 190927s2019 | |||||||||||000 ||eng| | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3933262 URI |
024 | 7 | a https://doi.org/10.1016/j.ahj.2019.05.0042 DOI |
040 | a (SwePub)uu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Sharma, Abhinavu 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 USA4 aut |
245 | 1 0 | a Clinical consequences of bleeding among individuals with a recent acute coronary syndrome :b Insights from the APPRAISE-2 trial |
264 | 1 | b MOSBY-ELSEVIER,c 2019 |
338 | a print2 rdacarrier | |
520 | a 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. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng |
700 | 1 | a Hagström, Emilu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper4 aut0 (Swepub:uu)emhag677 |
700 | 1 | a Wojdyla, Daniel M.u Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA4 aut |
700 | 1 | a Neely, Megan L.u Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA4 aut |
700 | 1 | a Harrington, Robert A.u Stanford Univ, Div Cardiol, Stanford Sch Med, Stanford, CA 94305 USA4 aut |
700 | 1 | a Wallentin, Lars,d 1943-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper4 aut0 (Swepub:uu)larswall |
700 | 1 | a Alexander, John H.u Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA4 aut |
700 | 1 | a Goodman, Shaun G.u Univ Toronto, St Michaels Hosp, Terrence Donnelly Heart Ctr, Toronto, ON, Canada4 aut |
700 | 1 | a Lopes, Renato D.u Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA4 aut |
710 | 2 | a 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 USAb Uppsala kliniska forskningscentrum (UCR)4 org |
773 | 0 | t American Heart Journald : MOSBY-ELSEVIERg 215, s. 106-113q 215<106-113x 0002-8703x 1097-6744 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-393326 |
856 | 4 8 | u https://doi.org/10.1016/j.ahj.2019.05.004 |
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