Abstract:
AIMS:There have been no large observational studies attempting to identify predictors of major bleeding in patients with acute coronary syndromes (ACS), particularly from a multinational perspective. The objective of our study was thus to develop a prediction rule for the identification of patients with ACS at higher risk of major bleeding. METHODS AND RESULTS:Data from 24045 patients from the Global Registry of Acute Coronary Events (GRACE) were analysed. Factors associated with major bleeding were identified using logistic regression analysis. Predictive models were developed for the overall patient population and for subgroups of patients with ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina. The overall incidence of major bleeding was 3.9% (4.8% in patients with STEMI, 4.7% in patients with NSTEMI and 2.3% in patients with unstable angina). Advanced age, female sex, history of bleeding, and renal insufficiency were independently associated with a higher risk of bleeding (P<0.01). The association remained after adjustment for hospital therapies and performance of invasive procedures. After adjustment for a variety of potential confounders, major bleeding was significantly associated with an increased risk of hospital death (adjusted odds ratio 1.64, 95% confidence interval 1.18, 2.28). CONCLUSIONS:In routine clinical practice, major bleeding is a relatively frequent non-cardiac complication of contemporary therapy for ACS and it is associated with a poor hospital prognosis. Simple baseline demographic and clinical characteristics identify patients at increased risk of major bleeding.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Moscucci M,Fox KA,Cannon CP,Klein W,López-Sendón J,Montalescot G,White K,Goldberg RJdoi
10.1016/s0195-668x(03)00485-8subject
Has Abstractpub_date
2003-10-01 00:00:00pages
1815-23issue
20eissn
0195-668Xissn
1522-9645pii
S0195668X03004858journal_volume
24pub_type
杂志文章,多中心研究abstract:AIMS:The object of this study is to analyse the trends in coronary events in Finland during 1993-2002, correcting for the effect of troponins. METHODS AND RESULTS:A population-based myocardial infarction register recorded all coronary events (n=14 782) in four geographical areas of Finland during 1993-2002. Correction...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehl120
更新日期:2006-10-01 00:00:00
abstract:AIM:Ventricular fibrillation (VF), the main cause of sudden cardiac death (SCD), occurs most frequently in the acute phase of myocardial infarction: a certain fraction of VF, however, develops in an apparently healthy heart, referred as idiopathic VF. The contribution of perturbation in the fast conduction system in th...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv449
更新日期:2016-05-07 00:00:00
abstract:AIMS:Obesity is a recognized risk factor for atrial fibrillation (AF), partly because of the association between body mass index (BMI) and atrial volume. We aimed to determine whether other factors relating to body size were related to AF. METHODS AND RESULTS:Data were derived from a random population sample of 6903 m...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehp076
更新日期:2009-05-01 00:00:00
abstract::We have studied regional left ventricular (LV) wall motion with M-mode, cross-sectional (2D) echocardiography and LV angiography in 50 patients with a recent myocardial infarction. Regional LV wall motion was evaluated according to a 9-segment model. 2D echocardiography permitted information from all, M-mode echocardi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061703
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess the independent contribution of left bundle branch block (LBBB) on long-term mortality in a large cohort with symptomatic heart failure (HF) requiring hospitalization. METHODS AND RESULTS:We studied a prospective cohort of 21 685 cases of symptomatic HF requiring hosp...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm262
更新日期:2007-10-01 00:00:00
abstract::Hereditary factors may have a part to play in the development of bicuspid aortic valve. This report concerns a pair of identical twins, probably monozygotic, who required aortic valve replacement as a result of aortic stenosis occurring in bicuspid aortic valves. This supports the contention that there may be a geneti...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062276
更新日期:1987-03-01 00:00:00
abstract:AIMS:We investigated the role of asymmetric dimethylarginine (ADMA) for clinical outcome of patients with unstable angina. METHODS AND RESULTS:Forty-five patients with stable angina, 36 patients with unstable angina, and 40 healthy controls were included in this study. Coronary artery disease (CAD) patients were prosp...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi287
更新日期:2005-09-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitors suppress plasma concentrations of the sodium retaining hormones angiotensin II and aldosterone. This action should potentiate the natriuretic and diuretic effects of loop diuretics. Some studies indicate, however, that the introduction of angiotensin-converting enzyme inhibitor...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.8.924
更新日期:1991-08-01 00:00:00
abstract:AIMS:White matter hyperintensities (WMH) progress with age and hypertension, but the key period of exposure to elevated blood pressure (BP), and the relative role of systolic BP (SBP) vs. diastolic BP (DBP), remains unclear. This study aims to determine the relationship between WMH and concurrent vs. past BP. METHODS ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa756
更新日期:2020-11-26 00:00:00
abstract:AIMS:We evaluated the feasibility and the acute performance of the everolimus-eluting bioresorbable vascular scaffolds (BVS) for the treatment of patients presenting with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS:The present investigation is a prospective, single-arm, single-centre study,...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht546
更新日期:2014-03-01 00:00:00
abstract::Increased QT dispersion, which has been proposed as a marker of ventricular repolarization inhomogeneity, may predispose to ventricular arrhythmias. Data on QT dispersion in patients with congestive heart failure are scarce. In this study, conventional 12-lead ECGs were recorded in 135 consecutive patients with conges...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014843
更新日期:1996-02-01 00:00:00
abstract::Pulmonary disease is common in patients with heart failure, through shared risk factors and pathophysiological mechanisms. Adverse pulmonary vascular remodelling and chronic systemic inflammation characterize both diseases. Concurrent chronic obstructive pulmonary disease presents diagnostic and therapeutic challenges...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/eht192
更新日期:2013-09-01 00:00:00
abstract::We describe a patient with a large intramyocardial hydatid cyst lying in the postero-lateral segment of the left ventricle near the atrioventricular groove level which ruptured into the pericardial sac, resulting in cardiac tamponade. Cross-sectional echocardiographic examination from a modified four-chamber apical vi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.7.819
更新日期:1988-07-01 00:00:00
abstract:AIMS:Here, we aimed to determine the therapeutic effect of longevity-associated variant (LAV)-BPIFB4 gene therapy on atherosclerosis. METHODS AND RESULTS:ApoE knockout mice (ApoE-/-) fed a high-fat diet were randomly allocated to receive LAV-BPIFB4, wild-type (WT)-BPIFB4, or empty vector via adeno-associated viral vec...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz459
更新日期:2020-07-07 00:00:00
abstract::Experience accumulated from several large trials strongly suggests that beta-blockers should be used for the management of chronic heart failure[87]. It is appropriate to add beta-blockade to conventional therapy such as diuretics, ACE inhibitors and digoxin, as this was the approach used in the major trials. It is ap...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a014745
更新日期:1996-11-01 00:00:00
abstract::During the long-term follow-up of patients with hypertrophic cardiomyopathy (HCM), some patients develop left ventricular (LV) wall motion abnormalities in the absence of fixed coronary artery disease. The purpose of this study is to clarify which clinical features in patients with HCM seem to influence gradual develo...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.12.1629
更新日期:1993-12-01 00:00:00
abstract:AIMS:Previous studies have suggested that a high body mass index (BMI) is associated with an improved outcome in congestive heart failure (CHF). However, the studies addressing this problem have not included enough patients with non-systolic heart failure to evaluate how left ventricular systolic function interacts wit...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi022
更新日期:2005-01-01 00:00:00
abstract:AIMS:Reperfusion injury following acute myocardial infarction impacts not only on the myocardium but also on the coronary microcirculation, and microembolization from the culprit lesion contributes to microvascular obstruction. Prior experimental studies have not accounted for microembolization in ischaemia/reperfusion...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs434
更新日期:2013-11-01 00:00:00
abstract::From a clinicopharmacological standpoint, the urinary excretory potency of diuretics should be assessed comparatively, on the basis of placebo-controlled changes in 24 h natriuresis, following single oral doses administered to healthy adult subjects who are in steady-state habitual external sodium balance. The potency...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/eurheartj/13.suppl_g.15
更新日期:1992-12-01 00:00:00
abstract:AIMS:Metalloproteinases are proteolytic enzymes, which decompose the extracellular matrix, influence cardiac remodelling, and are inhibited by tissue inhibitor of metalloproteinases (TIMPs). Little is known about the prognostic impact of the TIMP-1/matrix metalloproteinase complex in patients with future cardiovascular...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi582
更新日期:2006-01-01 00:00:00
abstract::The efficacy and safety of catheter ablation of accessory pathways (AP) was studied in 79 children (age, 4-16 years), using DC shocks (n = 25) or radiofrequency energy (n = 54). All patients had documented arrhythmias including ventricular fibrillation in four. Organic heart disease was present in four patients. AP lo...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060476
更新日期:1994-02-01 00:00:00
abstract:AIMS:Older people increasingly constitute a large proportion of the acute coronary syndrome (ACS) population. We examined the relationship of age with receipt of more intensive management and secondary prevention medicine. Then, the comparative association of intensive management (reperfusion/angiography) over a conser...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu039
更新日期:2014-06-14 00:00:00
abstract::In untreated congestive heart failure, aldosterone plasma concentrations are elevated in proportion to the severity of the disease and are further increased by the use of diuretic treatment. Angiotensin II, plasma potassium concentration, and corticotropin are the major stimulators of aldosterone synthesis. During ang...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/16.suppl_n.98
更新日期:1995-12-01 00:00:00
abstract::In a prospective trial in 124 patients with acute myocardial infarction, Holter and surface ECG recordings were obtained simultaneously and compared for their ability to assess thrombolysis-induced ST segment changes. Accuracy in predicting patency of the infarct-related artery was evaluated in both methods. Success o...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060114
更新日期:1992-12-01 00:00:00
abstract:AIMS:No-reflow after a primary percutaneous coronary intervention (PCI) is associated with a high incidence of left ventricular (LV) failure and a poor prognosis. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and an important modulator of neutrophil function. Elevated systemic ET-1 levels ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl119
更新日期:2006-08-01 00:00:00
abstract::To investigate the haemodynamic changes after physical training in patients with left ventricular aneurysm, 60 uncomplicated patients, mean age 51 +/- 10 years, underwent a maximal ergometric test in the supine position with haemodynamic monitoring (Swan-Ganz catheter) 37 +/- 10 days from acute myocardial infarction a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_f.11
更新日期:1988-04-01 00:00:00
abstract:AIMS:We addressed a potential mechanism of myocardial dysfunction following coronary microembolization at the level of myofibrillar proteins. METHODS AND RESULTS:Anaesthetized pigs underwent intracoronary infusion of microspheres. After 6 h, the microembolized areas (MEA) had decreased systolic wall thickening to 38 +...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi751
更新日期:2006-04-01 00:00:00
abstract:AIMS:The coefficient of variation is a popular measure for describing the amount of repeat variability present in ECG measurements from recording to recording. However, it can be misleading. The aim of the present study was to assess repeat variation (reclassification) in computer measured ECG criteria, i.e. positive t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0741
更新日期:1998-02-01 00:00:00
abstract::To assess possible clinical and angiographic factors associated with acute coronary events following PTCA, we performed quantitative angiography in 168 consecutive patients who had undergone successful angioplasty in a native vessel (94 for stable angina, 74 for unstable angina), and who were restudied (24 +/- 15 week...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061051
更新日期:1995-08-01 00:00:00
abstract:AIMS:Several factors are known to increase risk for cerebrovascular disease and dementia, but there is limited evidence on associations between multiple vascular risk factors (VRFs) and detailed aspects of brain macrostructure and microstructure in large community-dwelling populations across middle and older age. METH...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz100
更新日期:2019-07-21 00:00:00