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Biomarkers in Relat...
Biomarkers in Relation to the Effects of Ticagrelor in Comparison With Clopidogrel in Non-ST-Elevation Acute Coronary Syndrome Patients Managed With or Without In-Hospital Revascularization A Substudy From the Prospective Randomized Platelet Inhibition and Patient Outcomes (PLATO) Trial
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- Wallentin, Lars (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Lindholm, Daniel (författare)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Siegbahn, Agneta (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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- Wernroth, Lisa (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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Becker, Richard C. (författare)
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Cannon, Christopher P. (författare)
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Cornel, Jan H. (författare)
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Himmelmann, Anders (författare)
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Giannitsis, Evangelos (författare)
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Harrington, Robert A. (författare)
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Held, Claes (författare)
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Husted, Steen (författare)
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Katus, Hugo A. (författare)
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Mahaffey, Kenneth W. (författare)
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Steg, Ph. Gabriel (författare)
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Storey, Robert F. (författare)
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James, Stefan K. (författare)
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(creator_code:org_t)
- 2014
- 2014
- Engelska.
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Ingår i: Circulation. - 0009-7322 .- 1524-4539. ; 129:3, s. 293-303
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background Risk stratification and the use of specific biomarkers have been proposed for tailoring treatment in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). We investigated the prognostic importance of high-sensitivity troponin T (hs-TnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and growth differentiation factor-15 (GDF-15) in relation to randomized treatment (ticagrelor versus clopidogrel) and management strategy (with or without revascularization) in the NSTE-ACS subgroup of the Platelet Inhibition and Patient Outcomes (PLATO) trial. Methods and Results Of 18 624 patients in the PLATO trial, 9946 had an entry diagnosis of NSTE-ACS and baseline blood samples available. During index hospitalization, 5357 were revascularized, and 4589 were managed without revascularization. Hs-TnT, NT-proBNP, and GDF-15 were determined and assessed according to predefined cutoff levels. Median follow-up was 9.1 months. Increasing levels of hs-TnT were associated with increasing risk of cardiovascular death, myocardial infarction, and stroke in medically managed patients (P<0.001), but not in those managed invasively. NT-proBNP and GDF-15 levels were associated with the same events independent of management strategy. Ticagrelor versus clopidogrel reduced the rate of cardiovascular death, myocardial infarction, and stroke in patients with NSTE-ACS and hs-TnT 14.0 ng/L in both invasively and noninvasively managed patients; in patients with hs-TnT <14.0 ng/L, there was no difference between ticagrelor and clopidogrel in the noninvasive group Conclusions Hs-TnT, NT-proBNP, and GDF-15 are predictors of cardiovascular death, myocardial infarction, and stroke in patients with NSTE-ACS managed noninvasively, and NT-proBNP and GDF-15 also in those managed invasively. Elevated hs-TnT predicts substantial benefit of ticagrelor over clopidogrel both in invasively and noninvasively managed patients, but no apparent benefit was seen at normal hs-TnT. Clinical Trial Registration URL:http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
Nyckelord
- acute coronary syndrome
- biological markers
- blood platelets
- myocardial infarction
- troponin
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Wallentin, Lars
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Lindholm, Daniel
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Siegbahn, Agneta
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Wernroth, Lisa
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Becker, Richard ...
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Cannon, Christop ...
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visa fler...
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Cornel, Jan H.
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Himmelmann, Ande ...
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Giannitsis, Evan ...
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Harrington, Robe ...
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Held, Claes
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Husted, Steen
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Katus, Hugo A.
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Mahaffey, Kennet ...
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Steg, Ph. Gabrie ...
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Storey, Robert F ...
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James, Stefan K.
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- Artiklar i publikationen
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Circulation
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Uppsala universitet