Abstract:
AIMS:We sought to assess the effect of clopidogrel on clinical events 1 year after discharge in survivors of ST-elevation myocardial infarction (STEMI) in clinical practice. METHODS AND RESULTS:We analysed data of consecutive survivors of acute STEMI and either concomitant therapy with aspirin or aspirin plus clopidogrel at discharge, who were prospectively enrolled in the Acute Coronary Syndromes (ACOS) registry between July 2000 and November 2002. A total of 5886 (3795 with and 2091 without clopidogrel) patients were included into this analysis. Patients were divided into three groups according to the initial reperfusion therapy: no reperfusion therapy (n=1445), fibrinolysis (n=1734), or primary PCI (n=2707). The multivariable analysis for 12+2 month mortality after discharge using the propenstiy score with adjustment for baseline characteristics and treatments (age, sex, diabetes mellitus, hypertension, prior MI, hyperlipidaemia, renal insufficiency, cardiogenic shock, heart rate, systolic blood pressure, anterior infarct location, reduced left ventricular function, elective revascularization, beta-blockers, statins, ACE-inhibitors) showed that mortality was significantly lower in the aspirin plus clopidogrel group compared with the aspirin group in the total group and patients with reperfusion therapy [total group odds ratio (OR) 0.48, 95% confidence interval (CI) 0.48-0.61; no reperfusion therapy OR 0.96, 95% CI 0.65-1.45; fibrinolysis OR 0.53, 95% CI 0.32-0.87; primary percutaneous coronary intervention OR 0.38, 95% CI 0.23-0.62]. CONCLUSION:In clinical practice, adjunctive therapy with clopidogrel, in addition to aspirin, in survivors after STEMI is associated with a reduction in 1-year mortality in patients treated with early reperfusion therapy.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Zeymer U,Gitt AK,Jünger C,Heer T,Wienbergen H,Koeth O,Bauer T,Mark B,Zahn R,Gottwik M,Senges J,Acute COronary Syndromes (ACOS) registry investigators.doi
10.1093/eurheartj/ehl317subject
Has Abstractpub_date
2006-11-01 00:00:00pages
2661-6issue
22eissn
0195-668Xissn
1522-9645pii
ehl317journal_volume
27pub_type
杂志文章,多中心研究abstract:Aims:Primary prevention implantable cardioverter defibrillators (ICDs) are established therapy for reducing mortality in patients with left ventricular systolic dysfunction and ischaemic heart disease (IHD). However, their efficacy in patients without IHD has been controversial. We undertook a meta-analysis of the tota...
journal_title:European heart journal
pub_type: 杂志文章,meta分析,评审
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abstract:AIMS:This study investigated the functional outcome of wall-thinned, akinetic myocardium after revascularization and evaluated the accuracy of dobutamine echocardiography in predicting post-revascularization functional recovery with the assessment of end-diastolic wall thickness in chronic ischaemic patients. METHODS ...
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更新日期:1997-05-01 00:00:00
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doi:10.1093/eurheartj/4.suppl_d.19
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abstract::To investigate the antianginal efficacy and tolerability of felodipine, a new dihydropyridine calcium antagonist, 20 patients with stable exertional angina, not completely controlled by beta-blocker monotherapy, entered a randomized, double-blind, placebo-controlled, crossover study. Patients on standard beta-blocker ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1990-11-01 00:00:00
abstract::Myocardial dyssynergy does not necessarily indicate myocardial necrosis in patients with coronary artery disease. The differentiation between viable and non-viable tissue is of great clinical importance in order to make the most appropriate clinical decision in the individual patient. Several techniques are used to as...
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更新日期:1997-06-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a060453
更新日期:1994-12-01 00:00:00
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journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a062518
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-10-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/11.suppl_i.49
更新日期:1990-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究
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journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a014843
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