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Sökning: onr:"swepub:oai:DiVA.org:liu-53577" > Early invasive comp...

  • Swahn, EvaÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken (författare)

Early invasive compared with a selective invasive strategy in women with non-ST-elevation acute coronary syndromes : a substudy of the OASIS 5 trial and a meta-analysis of previous randomized trials

  • Artikel/kapitelEngelska2012

Förlag, utgivningsår, omfång ...

  • 2009-02-07
  • Oxford Journals,2012
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:liu-53577
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-53577URI
  • https://doi.org/10.1093/eurheartj/ehp009DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Funding agencies|Sanofi-Aventis||Organon||GlaxoSmithKline||
  • Aims The aim of this study was to compare benefits and risks of a routine invasive compared with a selective invasive strategy in women with non-ST-elevation acute coronary syndromes. Methods and results We randomly assigned 184 women, either to a routine or to a selective invasive strategy as a substudy to the OASIS 5 trial, who were followed for 2 years. Meta-analysis of data from previous randomized trials was also done. There were no significant differences between the two treatment strategies in the primary outcome death/myocardial infarction (MI)/stroke [21.0 vs. 15.4%, HR = 1.46, 95% CI (0.73-2.94)], in the secondary outcome death/MI [18.8 vs. 14.3%, HR = 1.39, 95% CI (0.67-2.88)], or separately analysed outcomes MI [12.9 vs. 13.3%, HR = 0.95, 95% CI (0.42-2.19)] or stroke [2.3 vs. 4.4%, HR = 0.67, 95% CI (0.12-3.70)]. However, there were significantly more deaths after 1 year (8.8 vs. 1.1%, HR = 9.01, 95% CI (1.11-72.90) and a higher rate of major bleeding at 30 days [8.8 vs. 1.1%, HR = 11.45, 95% CI (1.43-91.96)] in the routine invasive strategy group. A meta-analysis including 2692 women in previous randomized trials, with a gender perspective, showed no significant difference in the composite outcome death/MI, OR = 1.18, 95% CI (0.92-1.53) but a higher mortality with a routine invasive strategy for women, OR = 1.51, 95% CI (1.00-2.29). Conclusion The rate of death, MI, or stroke in women was not different in patients treated with a routine invasive strategy compared with a selective invasive strategy, but there was a concerning trend towards higher mortality. When combined with data from previous trials, there does not appear to be a benefit of an early invasive strategy in women with ACS, which differs from the results in men. These data emphasize the lack of clear evidence in favour of an invasive strategy in women and suggest caution in extrapolating the results from men to women.

Ämnesord och genrebeteckningar

  • Women
  • Non-ST-elevation acute coronary syndrome
  • Invasive strategy
  • MEDICINE
  • MEDICIN

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Alfredsson, JoakimÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken(Swepub:liu)joaal38 (författare)
  • Afzal, RizwanDepartment of Medicine, McMaster University, Hamilton, Canada (författare)
  • Budaj, AndrzejPostgraduate Medical School, Grochowski Hospital, Warsaw, Poland (författare)
  • Chrolavicius, SusanDepartment of Medicine, McMaster University, Hamilton, Canada (författare)
  • Fox, KeithCentre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK (författare)
  • Jolly, SanjitDepartment of Medicine, McMaster University, Hamilton, Canada (författare)
  • Mehta, Shamir RDepartment of Medicine, McMaster University, Hamilton, Canada (författare)
  • de Winter, RobbertDepartment of Cardiology, Academic Medical Center, Amsterdam, The Netherlands (författare)
  • Yusuf, SalimDepartment of Medicine, McMaster University, Hamilton, Canada (författare)
  • Linköpings universitetKardiologi (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:European Heart Journal: Oxford Journals33:1, s. 51-600195-668X1522-9645

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