Abstract:
BACKGROUND:Relationships between long-term use and level of dual antiplatelet therapy and outcomes after drug-eluting stent implantation are not well established. METHODS:This is a retrospective cohort study of 9,256 patients receiving drug-eluting stents between January 2003 and August 2006. We classified patients according to tertiles of clopidogrel use during the 12 months after stent implantation. We used inverse probability weighting to account for differential selection into levels of clopidogrel use and logistic regression to estimate propensity scores for levels of clopidogrel use. We used Cox proportional hazards models to estimate effects of level of clopidogrel use on risk of bleeding events, death, and death or nonfatal myocardial infarction. RESULTS:There were 3,102 patients in the high-use group, 3,069 in the medium-use group, and 3,085 in the low-use group. Compared with the high-use group, risk of death or nonfatal myocardial infarction was greater in the medium-use group (hazard ratio [HR] 1.46, 95% CI 1.09-1.99, P = .01) and the low-use group (HR 1.59, 95% CI 1.18-2.14, P = .002). The risk of bleeding events was lower in the medium-use group (HR 0.84, 95% CI 0.71-0.98, P = .03) and the low-use group (HR 0.77, 95% CI 0.65-0.90, P = .002). CONCLUSIONS:Higher clopidogrel use 12 months after drug-eluting stent implantation was associated with a greater risk of subsequent bleeding events. Lower use was associated with a greater risk of death or nonfatal myocardial infarction.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Petersen JL,Barron JJ,Hammill BG,Cziraky MJ,Anstrom KJ,Wahl PM,Eisenstein EL,Krucoff MW,Califf RM,Schulman KA,Curtis LHdoi
10.1016/j.ahj.2009.11.031subject
Has Abstractpub_date
2010-03-01 00:00:00pages
462-470.e1issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(09)00956-9journal_volume
159pub_type
杂志文章abstract:BACKGROUND:The long-term fate of patent irradiated segments at 6 months after beta-radiation therapy has not been sufficiently evaluated. METHODS:Two-year follow-up angiography was performed in 52 patients with patent irradiated segments at 6 months after beta-radiation with a rhenium 188-mercaptoacetyltriglycine-fill...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.02.011
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS:From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the Un...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.07.022
更新日期:2018-02-01 00:00:00
abstract::The American Cancer Society's prospective study of 1 million Americans was analyzed to determine whether coronary heart disease (CHD) mortality rates by cigarette smoking in blacks differed from those in whites. More than 22,000 blacks were followed up for nearly 200,000 person-years in the 12-year study, 1960-1972. A...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90675-6
更新日期:1984-09-01 00:00:00
abstract::Plasma catecholamine levels were determined in 26 cases of uncomplicated myocardial infarction within 24 hours of onset of acute chest pain. Blood samples were collected at time of entry and at 4-hour intervals during the 48 hours following admission. Average values of plasma catecholamines within 1 hour of onset of p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90278-3
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:The follow-up of patients with mitral and tricuspid regurgitation is important for their clinical treatment. We aimed to evaluate the reproducibility of the flow convergence method in mitral and tricuspid regurgitation. METHODS:The proximal flow convergence region was imaged with color Doppler ultrasound sc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.11.006
更新日期:2004-04-01 00:00:00
abstract::Left ventricular ejection fraction and regional wall motion were assessed by multigated equilibrium radionuclide ventriculography within 24 hours of onset of first acute transmural myocardial infarction (MI) in 32 patients. Abnormal left ventricular wall motion was noted in all 16 patients with anterior infarction and...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90644-0
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Multiple genetic loci are associated with clinical cardiovascular (CV) disease and individual CV risk factors. Individuals with ideal levels of all major CV risk factors have very low risk for CV disease morbidity or mortality. Ideal levels of risk factors can be attained by lifestyle modifications; however,...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2015.12.022
更新日期:2016-05-01 00:00:00
abstract::Cardiopulmonary resuscitation-generated coronary perfusion pressure and intracoronary flow velocity was studied with high-fidelity pressure transducers and an intracoronary Doppler catheter in 11 swine undergoing closed-chest manual cardiopulmonary resuscitation. Retrograde coronary blood flow in the mid left anterior...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90622-x
更新日期:1994-09-01 00:00:00
abstract::Economic assessment can be incorporated into clinical trials to evaluate and compare the costs and benefits of different health care programs. In this article the three main types of evaluation are discussed: cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. The measurement of direct and i...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(05)80059-6
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:The pectoral approach to implantation of cardioverter defibrillators (ICDs) has become a standard in defibrillator therapy because of reduced generator size, weight, and volume. But the size of these devices is still comparable to the size of the early conventional antibradycardia pacemakers that were associ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70270-4
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:We evaluated ethnic differences in the 10-year risk of myocardial infarction or coronary death derived from Framingham risk equation and in a composite measure of emerging cardiovascular disease risk factors in women and whether statistical adjustments for educational attainment, geographic location, and lif...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.08.027
更新日期:2005-06-01 00:00:00
abstract::Even though congestive heart failure is extremely common, the mechanisms responsible for the clinical manifestations remain a puzzle. The central and autonomic (sympathetic) nervous systems are responsible for a large part of the clinical manifestations. The role of the nervous system in CHF is discussed briefly. It i...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90471-4
更新日期:1978-02-01 00:00:00
abstract::To determine the frequency and significance of left ventricular wall motion abnormalities in patients without clinical evidence of myocardial infarction, we reviewed the two-dimensional echocardiograms of 252 patients who had no history or electrocardiographic evidence of myocardial infarction and who subsequently und...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90666-6
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:Bleeding is associated with adverse outcome in acute coronary syndromes. However, the precise pathophysiologic mechanisms have not been elucidated. We sought to determine the relationship between bleeding and myocardial ischemia detected by concurrent continuous electrocardiogram (ECG) monitoring and their i...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.05.022
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:The impact of valve prosthesis-patient mismatch on long-term outcome after aortic valve replacement estimated by various variables such as projected indexed effective orifice area and internal geometric orifice area obtained from in vivo or in vitro published data is still controversial. METHODS:The effecti...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.037
更新日期:2008-06-01 00:00:00
abstract::An angioplasty catheter was developed to allow measurement of absolute coronary blood flow during interventional procedures. This method uses electrical impedance changes induced by a 0.5 ml bolus of 5% dextrose solution and indicator-dilution principles. The indicator is injected through a port located just proximal ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90184-j
更新日期:1991-03-01 00:00:00
abstract::Atrial depressurization time measurement by Doppler ultrasound can be used to quantify stenotic mitral valve area. In this report, we present the results of a blinded trial comparing the standard Doppler method for "pressure half-time" (A) and another Doppler method we devised (B) for measurement of atrial depressuriz...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(87)90045-7
更新日期:1987-04-01 00:00:00
abstract::Valve area and cardiac output were determined with magnetic resonance (MR) velocity mapping in 12 patients with aortic stenosis. Heart catheterization, Doppler echocardiography, and indicator dilution were performed for comparison. Left ventricle could be catheterized in only nine patients; in these cases, MR measured...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90669-z
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Peak exercise oxygen consumption (peak VO2) is an important discriminator of survival in patients with systolic heart failure and is used to select ambulatory patients for transplantation. The major trials assessing the relationship between peak VO2 and survival have used a variety of low-level exercise prot...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.117508
更新日期:2001-09-01 00:00:00
abstract:AIMS:Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evalu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2017.08.012
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Afterload reduction decreases volume overload on the left ventricle and may thereby delay the need for valve replacement in chronic asymptomatic aortic regurgitation. The aims of this randomized double-blind, placebo-controlled trial were to examine short- and long-term hemodynamic effects of felodipine in c...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(00)90046-2
更新日期:2000-04-01 00:00:00
abstract::Acute ventricular septal rupture in the setting of acute myocardial infarction continues to present clinicians with a difficult therapeutic dilemma. The role of surgical intervention and its timing remains unresolved. A collaborative study from three institutions was undertaken to examine various clinical outcomes in ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0002-8703(88)90458-9
更新日期:1988-11-01 00:00:00
abstract::The aim of this study was to examine the effect of ventricular fibrillation and a subsequent defibrillation shock on ventricular excitability and refractoriness in human beings. We studied 16 consecutive patients with implantable cardioverter-defibrillators undergoing follow-up studies. The pre- and post-shock pacing ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90086-1
更新日期:1996-06-01 00:00:00
abstract::High degree AV block occurred in 144 of 843 patients consecutively admitted because of acute inferior myocardial infarction and was associated with more extensive myocardial damage and a higher mortality rate, as compared to those without AV block. Patients with power failure at the time of appearance of high degree A...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90308-7
更新日期:1980-01-01 00:00:00
abstract::A longitudinal study was performed in nine nonhydropic and nine hydropic fetuses with supraventricular tachycardia (SVT). First, because of a lack of reference methods in utero, the validity of spatial (length and area) and temporal parameters for semiquantitative grading of atrioventricular (AV) valve regurgitation b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90997-n
更新日期:1993-05-01 00:00:00
abstract::We retrospectively contrasted the medical outcome of patients removed from the heart transplant consideration list because of clinical improvement with that of transplant recipients. Of 60 patients awaiting transplantation, 18 were removed from the list (group A), and 42 required transplant or died (group B). Group A ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90462-7
更新日期:1996-12-01 00:00:00
abstract::Since many patients with chest pain cannot exercise adequately, an alternative stress would be useful to evaluate coronary reserve. We studied the physiologic responses to epinephrine to assess its potential. We report on 39 patients with chest pain. Doses from 0.03 to 0.30 micrograms/kg/min were administered intraven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90477-5
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The pathogenesis of human coronary artery disease (CAD) is likely to require the transcription of many different genes. We report here the differential gene expression profiling of human CAD using copy DNA (cDNA)/nylon array hybridization techniques. METHODS AND RESULTS:Human coronary arteries...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.025
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Although recent data support an early invasive management in acute coronary syndromes (ACS), overall evidence appears conflicting. We performed a metaregression to explore the impact of intracoronary stenting and aggressive antiplatelet treatment on the risk/benefit ratio of an early invasive approach. METH...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2004.10.026
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:The study rationale was to compare the biomarker profile of metalloproteinases (MMPs) and inflammation markers (IMs) in patients requiring revascularization with that of patients with long-term, clinically quiescent coronary artery disease (CAD). METHODS:Seventy-eight patients with symptomatic CAD (S-CAD) (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.08.021
更新日期:2008-01-01 00:00:00