Abstract:
BACKGROUND:Despite dual antiplatelet therapy, the rate of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) remains high. Ex vivo tests of clopidogrel resistance can predict MACE after PCI. The purpose of this study is to evaluate the clinical impact of adjusting phosphorylation analysis in patients with clopidogrel resistance undergoing PCI. HYPOTHESIS:We hypothesized that VASP-guided clopidogrel maintenance doses, compared to fixed doses, improved clinical outcome. METHODS:This monocentric, prospective, randomized study was performed on 306 patients undergoing PCI. Patients were randomized to a control group (n = 156) and to a vasodilator-stimulated phosphoprotein (VASP)-guided group (n = 150). In the VASP-guided group, patients received adjusted maintenance doses of clopidogrel to obtain platelet reactivity index (PRI) of <50% during 1 year after PCI. The primary endpoint was the rate of MACE. The secondary endpoints were major and minor bleeding. RESULTS:All patients completed the PCI procedure and 298 patients completed follow-up. The control and VASP-guided groups had similar demographic, clinical, and angiographic characteristics. In the VASP-guided group, PRI was significantly decreased (from 72.1% ± 11.4% to 27.7% ± 8.4%; P = 0.001) in 128 patients (87.1% of all participants). During the 1-year follow-up, 14 MACEs were recorded in the VASP-guided group and 30 MACEs were recorded in the control group (9.3% vs 20.4%, respectively; P = 0.008). There was no difference in the rate of major and minor bleeding in the VASP-guided group compared with the control group (12.9% vs 16.6%; P = 0.06). CONCLUSIONS:Modifying clopidogrel maintenance doses according to platelet reactivity monitoring decreases the rate of MACE after PCI without increasing bleeding in patients with clopidogrel resistance during 1-year follow-up.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Wang XD,Zhang DF,Zhuang SW,Lai Ydoi
10.1002/clc.20884subject
Has Abstractpub_date
2011-05-01 00:00:00pages
332-8issue
5eissn
0160-9289issn
1932-8737journal_volume
34pub_type
杂志文章,随机对照试验abstract::To clarify the clinical significance of the negative U wave during acute myocardial ischemia, the appearance of the U wave and ST-segment elevation on electrocardiography during percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending artery (LAD group: 11 patients) or right coronary arter...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140311
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:The maximal negative dP/dt [max (-)dP/dt] and time constant (T) are useful indices for evaluating left ventricular (LV) relaxation, but they require invasive procedures. HYPOTHESIS:The purpose of this study was to obtain max (-)dP/dt and T using the continuous-wave Doppler aortic regurgitation velocity curv...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190907
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Inadequate cardiovascular disease (CVD) knowledge has been cited to account for the imperfect decline in CVD among women over the last 2 decades. HYPOTHESIS:Due to concerns that at-risk women might not know the leading cause of death or symptoms of a heart attack, our goal was to assess the relationship bet...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20992
更新日期:2012-01-01 00:00:00
abstract::Cardiac anatomy and rhythm were evaluated in the fetuses of 18 pregnant women (between 20 and 42 weeks of gestation) referred because of abnormal fetal heart rate or rhythm. Utilizing a 3 MHz two-dimensional scan head with M-mode capability, M-mode recordings were obtained at paper speeds of 50 and 100 mm/s from 16 fe...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080102
更新日期:1985-01-01 00:00:00
abstract::A case of aortic ball valve prosthesis malfunction is described in which the poppet became alternately stuck in the open and closed position. The patient experienced chest pain followed by pulmonary edema and cardiac arrest. Malfunction of prosthetic valve was diagnosed on echocardiogram and cardiopulmonary resuscitat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960051105
更新日期:1982-11-01 00:00:00
abstract::In order to test the comparative sensitivities of first-pass radionuclide and digital subtraction ventriculography in detecting wall motion abnormalities during exercise, 29 patients referred for coronary angiography were submitted to both types of stress ventriculograms. Resting and exercise ventriculograms by both t...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960090906
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Overt hypothyroidism has been found to be associated with cardiovascular disease. Moreover, subclinical hypothyroidism is a strong indicator of risk for aortic atherosclerosis and myocardial infarction. HYPOTHESIS:We hypothesized that variation of thyroid function within the normal range may influence the p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960261205
更新日期:2003-12-01 00:00:00
abstract::While the prevalence of cardiovascular risk factors has decreased in the United States in recent years, cardiovascular disparities by sex and race persist. Among the factors contributing to these disparities is the physical environment in which individuals live. Neighborhood characteristics, ranging from air pollution...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23107
更新日期:2019-01-01 00:00:00
abstract::The AFFIRM study showed no clear survival advantage for a rhythm versus rate control strategy in patients with atrial fibrillation (AF). However, rhythm control with antiarrhythmic drugs (AADs) is appropriate in a large number of patients with AF. The American College of Cardiology/ American Heart Association/European...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960290303
更新日期:2006-03-01 00:00:00
abstract::It has been debated whether dilated cardiomyopathy seen in patients with acquired immune deficiency syndrome is caused by the virus itself or by the combination of other factors such as presence of opportunistic pathogens and/or severe immunosuppression. This paper describes the first reported case of a patient with h...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200815
更新日期:1997-08-01 00:00:00
abstract::In this editorial, I would like to share some thoughts about clinical studies, including value and limitations using as an example a recently published randomized clinical trial. Randomized and non-randomized clinical trials, epidemiologic studies, and registries guide our clinical practice. They are good but not perf...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.20598
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:There is a growing body of evidence that advanced glycation end products (AGE) and their receptor (RAGE) system are implicated in chronic kidney disease (CKD). We have previously found that a long-acting calcium channel blocker, azelnidipine, but not amlodipine, improves renal injury in CKD patients. However...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.20885
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Evaluation of chest pain accounts for millions of costly Emergency Department (ED) visits and hospital admissions annually. Of these, approximately 10-20% are myocardial infarctions (MI). HYPOTHESIS:Patients with chest pain whose initial electrocardiogram (ECG) is normal do not require hospital admission fo...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20141
更新日期:2007-11-01 00:00:00
abstract::In this report, a rare case of tricuspid stenosis uncomplicated by other valve lesions is presented, with clinical, hemodynamic, echocardiographic, and angiographic studies. The patient was markedly incapacitated, mostly as a result of a restricted cardiac output. Tricuspid commissurotomy was performed, with a stenoti...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060406
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:There is limited data on electrocardiographic (ECG) abnormalities and their prognostic significance in women with peripartum cardiomyopathy (PPCM). We sought to characterize ECG findings in PPCM and explore the association of ECG findings with myocardial recovery and clinical outcomes. HYPOTHESIS:We hypothe...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.23171
更新日期:2019-05-01 00:00:00
abstract::Thrombotic obstruction of aortic bioprostheses is rare. Few cases have been reported involving the use of the Carpentier-Edwards (CE) prosthesis, the Hancock bioprosthesis, or the Medtronic Intact porcine valve. Thrombolytic therapy for mechanical valve thrombosis has been used frequently even though it is known to ca...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160215
更新日期:1993-02-01 00:00:00
abstract::Rapid assessment of patients presenting with acute chest pain is essential, in order to distinguish between those who have a life-threatening condition, such as myocardial infarction or unstable angina, and the substantial proportion who do not have an acute coronary syndrome. It is thus of vital importance that relia...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960231306
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI. METHOD AND RESULTS:A total of 259 consecutive p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20060
更新日期:2007-03-01 00:00:00
abstract::Hyperkalemia was associated with complete heart block in one patient that resolved by first showing right anterior hemiblock). Then the right bundle branch block resolved, leaving the marked left axis deviation that was present before the hyperkalemic episode. Another patient with hyperkalemia had right bundle branch ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960040110
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Internal cardioversion of atrial fibrillation with direct current energy has become an increasingly employed technique for patients who fail external cardioversion. HYPOTHESIS:The purpose of this study was to determine whether internal cardioversion could be avoided by careful attention to cardioversion tec...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960240716
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Early recurrence of atrial fibrillation (ERAF) after catheter ablation is common and has been thoroughly studied. However, very late recurrence of atrial fibrillation (VLRAF) is rarely researched, and its characteristics have not been determined. HYPOTHESIS:The aim of this study was to investigate the clini...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20340
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:In clinical cardiology, heart rate variability is a putative index of autonomic cardiovascular function. Signs of reduced vagal activity are not only associated with an enhanced risk of sudden cardiac death, but such impaired heart rate variability became a new predictor of sudden cardiac death and other mor...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960200710
更新日期:1997-07-01 00:00:00
abstract::Atrial septal aneurysm in the otherwise normal heart is a very rare and usually asymptomatic condition. A midsystolic click was described as the only clinical manifestation so far. A low-pitched early-to-midsystolic acoustic phenomenon in a 39-year-old woman corresponding with maximal leftward motion of the aneurysmat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150713
更新日期:1992-07-01 00:00:00
abstract::To determine whether exercise-induced ischemia impairs left ventricular diastolic filling in the postischemic period in humans, 101 men (mean age 57 +/- 10 years) were studied before and 2 h after a symptom-limited thallium-201 tomographic treadmill with pulsed Doppler echocardiography of mitral valve inflow. In the p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150409
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:Intravenous inotropic intervention in congestive heart failure is generally associated with a poor prognosis and is largely used as a "bridge" to mechanical support or heart transplantation. HYPOTHESIS:We hypothesized that the inotropic support afforded by dobutamine may serve as a bridge to the introductio...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960240311
更新日期:2001-03-01 00:00:00
abstract::We report a patient with controlled atrial fibrillation-flutter (AFF) and mitral stenosis who developed a marked increase in atrioventricular conduction during an infusion of low dose dopamine with development of hemodynamic compromise. This side effect has not been previously described in humans. Dopamine infusion sh...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960101114
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:ST-segment depression during acute myocardial infarction (AMI) is known to herald serious hemodynamic complications. Since the mechanism of this dependence is not clear, we reinvestigated the old concept of papillary muscle infarction (PMI) as a cause of marked ST depression. METHODS:Autopsie...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190514
更新日期:1996-05-01 00:00:00
abstract::Constrictive pericarditis is a fibrotic process involving both layers of the pericardium and is known to give rise to obstruction to blood flow in the right heart. We report a patient with constrictive pericarditis who had echocardiographic features of mitral stenosis caused by a fibrocalcific mass lesion involving th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190615
更新日期:1996-06-01 00:00:00
abstract::We investigated 26 patients admitted to our catheterization laboratory with a diagnosis of acute myocardial infarction. In each case acute revascularization was unsuccessful, but the diagnosis was confirmed by angiography. In 11 patients with an uncomplicated course of acute myocardial infarction magnetic resonance im...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960091102
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:QT interval shortens with exercise. Some of this shortening is due to an increase in heart rate, and some is due to other effects of exercise, probably mostly neuroendocrine effects. Data from subjects with cardiac transplants have suggested that non-heart rate-related changes in QT interval on exercise are ...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960220805
更新日期:1999-08-01 00:00:00