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  • Budaj, Andrzej (author)

Improving clinical outcomes by reducing bleeding in patients with non-ST-elevation acute coronary syndromes

  • Article/chapterEnglish2009

Publisher, publication year, extent ...

  • 2008-08-18
  • Oxford University Press (OUP),2009
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-104735
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104735URI
  • https://doi.org/10.1093/eurheartj/ehn358DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • AIMS: Bleeding in patients with coronary artery disease has been linked with adverse outcomes. We examined the incidence and outcomes after bleeding in 20 078 patients with acute coronary syndromes (ACS) enrolled in the OASIS-5 trial who were treated with fondaparinux or the low-molecular weight heparin, enoxaparin. METHODS AND RESULTS: Nine hundred and ninety (4.9%) patients developed major bleeding and 423 (2.1%) developed minor bleeding. Fondaparinux compared with enoxaparin reduced fatal bleeding [0.07 vs. 0.22%, relative risk (RR) 0.30, 95% CI: 0.13-0.71], non-fatal major bleeding (2.2 vs. 4.2%, RR 0.52, 95% CI: 0.44-0.61), minor bleeding (1.1 vs. 3.2%, RR 0.34, 95% CI: 0.27-0.42), and need for transfusion (1.8 vs. 3.1%, RR 0.56, 95% CI: 0.47-0.61) during the first 9 days. One of every six deaths during the first 30 days occurred in patients who experienced bleeding. Cox proportional hazards model revealed that major bleeding was associated with about a four-fold increased hazard of death, myocardial infarction, or stroke during the first 30 days and about a three-fold increased hazard during 180 days of follow up. CONCLUSION: Bleeding in patients with ACS is a powerful determinant of fatal and non-fatal outcomes. Reducing the risk of bleeding using a safer anticoagulant strategy during the first 9 days is associated with substantial reductions in morbidity and mortality.

Subject headings and genre

  • MEDICINE
  • MEDICIN

Added entries (persons, corporate bodies, meetings, titles ...)

  • Eikelboom, John W. (author)
  • Mehta, Shamir R. (author)
  • Afzal, Rizwan (author)
  • Chrolavicius, Susan (author)
  • Bassand, Jean-Pierre (author)
  • Fox, Keith A. A. (author)
  • Wallentin, Lars,1943-Uppsala universitet,Institutionen för medicinska vetenskaper,UCR(Swepub:uu)larswall (author)
  • Peters, Ron J. G. (author)
  • Granger, Christopher B. (author)
  • Joyner, Campbell D. (author)
  • Yusuf, Salim (author)
  • Uppsala universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Related titles

  • In:European Heart Journal: Oxford University Press (OUP)30:6, s. 655-610195-668X1522-9645

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