Abstract:
PURPOSE:To determine the long-term mortality of patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) that are eligible versus those not eligible in randomized controlled trials (RCT), and how each exclusion criteria is associated with outcome. METHODS:Common causes of exclusion in six published RCT on intravenous antithrombotic therapy were prospectively assessed in a cohort of 452 consecutive patients with NSTEACS that were followed for up to 3 years. RESULTS:Forty-one percent of patients had one or more exclusion criteria establishing the ineligible group. These patients were older, more likely to have coronary risk factors, ischemic ECG changes, heart failure at admission, higher creatinine levels and a lower ejection fraction than eligible patients. There were no differences between both groups in the antithrombotic treatment received or in the performance of revascularization procedures during hospitalization or in the prescription of antiplatelet treatment and beta-blockers at discharge. Cumulative 3-year mortality rate was 25% in ineligible patients compared to 9% in eligible patients (p<0.001). The hazard ratio (HR) of mortality was of 9.1 (95% CI: 4.5-18.7) for severe renal dysfunction; 6.0 (3.3-11.4) for concomitant non-vascular diseases; 3.0 (1.6-5.5) for contraindications to anticoagulation; 2.5 (1.1-5.7) for heart failure; and 2.3 (1.1-4.6) for prior cerebrovascular disease. After adjusting for baseline differences, ineligible patients had a HR of total mortality of 1.88 (1.04-3.38), and of cardiac mortality of 2 (1.01-3.98). CONCLUSION:Patients with NSTEACS who are ineligible in RCT have a higher risk profile and a two-fold adjusted long-term mortality than eligible patients, especially those with comorbid conditions and those with contraindications to anticoagulation.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Bosch X,Delgado V,Verbal F,Bórquez E,Loma-Osorio P,Díez-Aja S,Miranda-Guardiola F,Sanchís Jdoi
10.1016/j.ijcard.2006.12.027subject
Has Abstractpub_date
2008-02-20 00:00:00pages
86-91issue
1eissn
0167-5273issn
1874-1754pii
S0167-5273(07)00344-0journal_volume
124pub_type
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2017-07-01 00:00:00
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journal_title:International journal of cardiology
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abstract:BACKGROUND:It is unclear whether ischemic stroke patients with known atrial fibrillation (KAF) had different outcomes than those with atrial fibrillation diagnosed after stroke (AFDAS). We aimed to explore the characteristics and outcomes in ischemic stroke patients with KAF or AFDAS. METHODS:Consecutive patients hosp...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2018-06-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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abstract::Tako-Tsubo cardiomyopathy is characterized by a transient and reversible left ventricular dysfunction possibly due to a catecholamine-mediated myocardial stunning. This form of cardiomyopathy is rarely associated with cardiogenic shock. Here we report on a patient with Tako-Tsubo cardiomyopathy induced low output fail...
journal_title:International journal of cardiology
pub_type: 信件
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abstract::We evaluated the effects of acetylstrophanthidin on baroreflex sensitivity in patients soon after an acute myocardial infarction. Baroreflex control of heart rate is frequently depressed after acute myocardial infarction and few data are available as to the effects of pharmacological intervention on this parameter. Th...
journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章
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更新日期:1993-08-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2020.09.069
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2005.05.007
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pub_type: 杂志文章
doi:10.1016/0167-5273(95)02393-b
更新日期:1995-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0167-5273(89)90053-3
更新日期:1989-07-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2013.01.262
更新日期:2013-10-03 00:00:00
abstract:OBJECTIVE:Determining the adherence to ACC/AHA/ESC 2006 guidelines and its influence on the survival of patients with atrial fibrillation. METHODS:Prospective observational study of patients discharged during 2007 from an Internal Medicine department with a main or secondary diagnose of atrial fibrillation. The stroke...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.07.098
更新日期:2014-09-20 00:00:00
abstract:BACKGROUND:P2Y12-ADP receptor blockade during percutaneous coronary intervention (PCI) is critical to prevent thrombotic events. In patients under chronic P2Y12 blockers, the use of additional loading dose (LD) before an elective PCI is debated. We aimed to investigate the rate of high on-treatment platelet reactivity ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.04.165
更新日期:2016-08-01 00:00:00
abstract::We present a case of basilar artery embolism originating from a left atrial mural thrombus. The thrombus was large and attached to the posterior left atrial wall, but decreased in size and detached forming a ball type thrombus over the next 4 days without anticoagulant and/or antifibrinolytic therapy. ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(99)00053-4
更新日期:1999-07-01 00:00:00
abstract::Calcium channel blockers, as glucocorticoids, may impair generation of NO in vivo, because of urinary nitrates deficit in spite of nitrated derivatives treatment in ischaemic heart disease patients. ...
journal_title:International journal of cardiology
pub_type: 临床试验,评论,信件
doi:10.1016/s0167-5273(97)00204-0
更新日期:1997-11-20 00:00:00
abstract:BACKGROUND:Existing trials almost exclusively used atenolol to represent the entire β-blocker class, and it is unknown whether there are intra-class differences. We compared the incidence of all-cause and cardiovascular mortality, blood pressure (BP) control and adherence levels between patients newly prescribed atenol...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.06.009
更新日期:2014-08-20 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(96)02846-x
更新日期:1997-01-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2011.05.069
更新日期:2012-03-08 00:00:00
abstract:BACKGROUND:Although β-blockers are used to prevent myocardial ischemia/reperfusion injury, the risk of heart failure has limited β-blocker therapy in patients with acute myocardial infarction. This study evaluated efficacy of intracoronary administration of the short-acting β-blocker, landiolol, during reperfusion in p...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2009.07.013
更新日期:2011-02-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2013.03.095
更新日期:2013-10-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijcard.2005.11.105
更新日期:2006-11-18 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2019.09.058
更新日期:2020-01-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 评论,信件
doi:10.1016/j.ijcard.2007.01.056
更新日期:2008-03-14 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2010.07.026
更新日期:2011-11-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2009.04.036
更新日期:2009-11-12 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ijcard.2014.11.007
更新日期:2014-12-20 00:00:00
abstract:BACKGROUND:In a randomized trial, baroreflex activation therapy (BAT) improved exercise capacity, quality of life and NT-proBNP in patients with heart failure with reduced ejection fraction (HFrEF). In view of different mechanisms underlying HFrEF, we performed a post-hoc subgroup analysis of efficacy and safety of BAT...
journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijcard.2018.04.075
更新日期:2018-09-01 00:00:00