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Sökning: L773:2048 8734 OR L773:2048 8726 > Prognostic impact o...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005301naa a2200493 4500
001oai:DiVA.org:uu-401549
003SwePub
008200108s2019 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4015492 URI
0247 a https://doi.org/10.1177/20488726198780752 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Thomas, Mark R.u Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield , UK.; Institute of Cardiovascular Sciences and UHB and SWBH NHS Trusts, University of Birmingham , UK.4 aut
2451 0a Prognostic impact of baseline inflammatory markers in patients with acute coronary syndromes treated with ticagrelor and clopidogrel.
264 c 2019-12-23
264 1b Oxford University Press (OUP),c 2019
338 a print2 rdacarrier
520 a BACKGROUND: Inflammation plays a major role in the pathophysiology of coronary artery disease. We aimed to determine whether baseline inflammatory markers were associated with clinical outcomes and the observed superiority of ticagrelor compared to clopidogrel in patients with acute coronary syndromes in the PLATO study.METHODS: Blood samples were collected from 16,400 patients within 24 hours of the onset of acute coronary syndrome, at the time of random assignment to ticagrelor or clopidogrel in the PLATO study and prior to invasive procedures. The differential white blood cell count and plasma levels of C-reactive protein, interleukin-6 and interleukin-10 were determined and their relationships with clinical outcomes were assessed according to quartiles and using continuous models. The substudy primary endpoint was a composite of cardiovascular death and myocardial infarction.RESULTS: Compared to the lowest quartile, the risk of the primary endpoint was significantly elevated in patients in the highest quartile of white blood cell count (hazard ratio (HR) 1.30; P=0.01), neutrophil count (HR 1.33; P=0.007), monocyte count (HR 1.24; P=0.004), C-reactive protein (HR 1.93; P<0.001) and interleukin-6 (HR 2.29; P<0.001). This was predominantly driven by an association with cardiovascular death. Following adjustment for clinical characteristics, troponin, cystatin C and N-terminal pro-brain-type natriuretic peptide, only white blood cell count and neutrophil count maintained a significant association with the primary endpoint. Ticagrelor had a consistent relative cardiovascular benefit compared to clopidogrel in each quartile of each of the inflammatory markers.CONCLUSIONS: Acute coronary syndrome patients with elevated levels of baseline inflammatory markers are at increased risk of adverse cardiovascular events, particularly cardiovascular death. The consistent cardiovascular benefit of ticagrelor compared to clopidogrel tended to confer a greater absolute risk reduction in patients with the highest levels of inflammatory markers, as they were at highest risk.
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
653 a CRP
653 a P2Y12 inhibitor
653 a Ticagrelor
653 a antiplatelet therapy
653 a clopidogrel
653 a inflammation
653 a white blood cell
7001 a James, Stefan,d 1964-u Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)stjam367
7001 a Becker, Richard C.u University of Cincinnati College of Medicine , USA4 aut
7001 a Himmelmann, Andersu AstraZeneca Research and Development , Gothenburg, Sweden.4 aut
7001 a Katus, Hugo A.u Medizinishe Klinik, Universitätsklinikum Heidelberg , Germany.4 aut
7001 a Cannon, Christopher P.u TIMI Study Group, Brigham and Women’s Hospital , USA.4 aut
7001 a Steg, Philippe Gabrielu Département Hospitalo-Universitaire FIRE , Hôpital Bichat, France.; Université Paris-Diderot, Sorbonne-Paris Cité , France.; NHLI Imperial College, Royal Brompton Hospital , UK.4 aut
7001 a Siegbahn, Agneta,d 1947-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi,UCR4 aut0 (Swepub:uu)agsie424
7001 a Ghukasyan, Tateviku Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)tatgh570
7001 a Storey, Robert F.u Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield , UK.4 aut
7001 a Wallentin, Lars,d 1943-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)larswall
7102 a Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield , UK.; Institute of Cardiovascular Sciences and UHB and SWBH NHS Trusts, University of Birmingham , UK.b Institutionen för medicinska vetenskaper4 org
7730 t European Heart Journald : Oxford University Press (OUP)g 10:2, s. 153-163q 10:2<153-163x 2048-8726x 2048-8734
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-401549
8564 8u https://doi.org/10.1177/2048872619878075

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