Abstract:
BACKGROUND:Elderly patients with acute coronary syndromes (ACS) are at high risk for death and recurrent thrombotic events. We evaluated the efficacy and safety of intensive treatment with glycoprotein IIb/IIIa inhibitors in an elderly population, and the relationships between age, timing of administration, and clinical outcomes. METHODS:We used data from high-risk non-ST-segment elevation ACS patients randomized to early eptifibatide vs. delayed provisional use at percutaneous coronary intervention. In multivariable models, we included age×treatment interaction terms to assess whether treatment effect varied by age after adjusting for confounders. RESULTS:Of 9406 patients, 13.9% were aged <55 years; 27.6%, 55-64 years; 33.2%, 65-74 years; and 25.3%, ≥ 75 years. For each 10-year age increase, the adjusted odds ratio (OR) (95% confidence interval [CI]) for 96-hour death, myocardial infarction (MI), recurrent ischemia requiring urgent revascularization, or thrombotic bailout was 1.13 (1.04-1.23) and for 30-day death or MI was 1.13 (1.04-1.22). Increasing age was also associated with greater 1-year mortality (adjusted hazard ratio per 10 years: 1.44, 95% CI 1.30-1.60). There was no interaction between age and treatment (p interaction=0.99, 0.54, and 0.87, respectively). Increasing age was associated with more non-coronary artery bypass grafting-related TIMI major bleeding (adjusted OR and 95% CI per 10 years: 1.54 [1.24-1.92]), GUSTO moderate/severe bleeding (1.52 [1.33-1.75]), and transfusion (1.25 [1.07-1.45]). The amount by which TIMI major bleeding was increased with early vs. delayed provisional eptifibatide use was significantly greater with increasing age (p interaction=0.02), but the age×treatment interactions were not significant for GUSTO moderate/severe bleeding or transfusion (p interaction=0.33 and 0.54, respectively). CONCLUSION:Increasing age was associated with greater risk for ischemic events and more bleeding. Despite higher baseline ischemic risk in older patients, there was no preferential benefit of early vs. delayed provisional eptifibatide use for ischemic outcomes as age increased, but the incremental bleeding risk was amplified.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Lopes RD,White JA,Tricoci P,White HD,Armstrong PW,Braunwald E,Giugliano RP,Harrington RA,Lewis BS,Brogan GX Jr,Gibson CM,Califf RM,Newby LKdoi
10.1016/j.ijcard.2012.06.053subject
Has Abstractpub_date
2013-09-10 00:00:00pages
2580-7issue
6eissn
0167-5273issn
1874-1754pii
S0167-5273(12)00844-3journal_volume
167pub_type
杂志文章,多中心研究,随机对照试验abstract::The association between metabolic syndrome and coronary artery disease, either clinical or subclinical, has been well established. There is also a consensus regarding the higher prevalence of metabolic syndrome in females compared with males with coronary artery disease. However, the impact of gender on the coronary a...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2005.07.045
更新日期:2006-06-16 00:00:00
abstract:BACKGROUNDS:Nitroglycerine-induced vasodilation (NID) is usually assessed as a control test for flow-mediated vasodilation (FMD). However, NID per se is impaired in patients with high cardiovascular risk. The purpose of this study was to investigate the associations of chronic kidney disease (CKD) with NID and FMD. ME...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.10.122
更新日期:2018-03-01 00:00:00
abstract::Diagnostic reliability of indexations of peak exercise ST segment depression (DeltaST) for heart rate reserve (HRi) or chronotropic reserve (CR) to identify significant coronary artery disease (CAD) by cycle-ergometer exercise testing has not been evaluated previously. Exercise testing by upright cycle-ergometer (25 W...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2007.04.035
更新日期:2008-07-21 00:00:00
abstract:BACKGROUND:VDD pacemakers are regarded as a second choice in patients with atrio-ventricular blocks mainly due to the potential failure of atrial sensing, leading to a loss of atrio-ventricular synchrony. This single-centre study aimed to evaluate the prevalence of loss of atrial sensing and its potential determinants ...
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abstract:BACKGROUND:There is a strong reciprocal relationship between heart failure (HF) and diabetes mellitus (DM). Shared pathophysiological mechanisms might be a possible explanation. Therefore, we hypothesised that biomarkers linked to HF would also predict new-onset type 2 DM in the general population. METHODS AND RESULTS...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.10.035
更新日期:2018-01-01 00:00:00
abstract::Treatment with angiotensin converting enzyme inhibitors confers significant morbidity and mortality benefits in patients with heart failure, yet previous studies have repeatedly shown that these drugs are underutilised in general practice. To investigate why this is the case, we conducted an anonymous questionnaire su...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(96)02904-x
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abstract::The pharmacological management of atrial fibrillation (AF) requires careful consideration from a safety perspective. This article focuses primarily on maintenance therapy using antiarrhythmic drugs (AADs). The foremost safety issue for AADs is the propensity of class IA and III agents to cause torsade de pointes arrhy...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2007.11.006
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abstract:BACKGROUND:Catheter ablation (CA) has become a standard treatment for patients with atrial fibrillation (AF). However, gender-related differences associated with CA of paroxysmal AF (PAF) remain unclear. METHODS:We compared 1124 consecutive patients (mean age, 61 ± 10 years; male, n=864) with PAF scheduled for CA betw...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2012.12.101
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abstract::Coronary artery bypass grafting without cardiopulmonary bypass (CPB) is now an accepted technique of myocardial revascularization in a special subset of patients. This paper presents our total experience in 1761 cases operated on since September 1981 until April 1997 out of a total of 9164 patients revascularized with...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(97)00219-2
更新日期:1997-12-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Patients with primary hyperparathyroidism (pHPT) show an increased bioelectrical risk not related to cardiovascular complications, this risk seems to persist after surgery and this last finding is still controversial and probably related to follow-up length. METHODS:The aim of the study is to evaluate QT pa...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2008.11.067
更新日期:2010-05-28 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2003-04-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(02)00190-0
更新日期:2002-11-01 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.2016.06.188
更新日期:2016-10-01 00:00:00
abstract::A newborn with preductal coarctation and ventricular septal defect had a subaortic aneurysm which protruded into the left atrium causing intractable pulmonary oedema. The subaortic aneurysm was congenital. It was clearly identified by cross-sectional echocardiography which, in serial studies, showed it to be increasin...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1987-01-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2019.09.005
更新日期:2019-12-15 00:00:00
abstract:BACKGROUND:The optimal blood pressure (BP) target to reduce the risk of cardiovascular (CV) events remains uncertain, especially in patients with coronary artery disease (CAD). Results from the Systolic Blood Pressure Intervention Trial (SPRINT) suggest that targeting a systolic BP<120mmHg decreases the rate of death a...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.05.104
更新日期:2017-09-15 00:00:00
abstract:BACKGROUND:Adults with congenital heart disease (ACHD) are affected by atrial arrhythmias (AA). To elucidate the impact of AA on prognosis, we aimed to determine the impact of AA on death, heart failure and stroke in ACHD patients in a prospective nationwide clinical registry. METHODS:All patients aged ≥18years includ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.06.073
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Global left ventricular (LV) afterload as assessed by valvulo-arterial impedance (Zva), may be an independent predictor of mortality in patients with severe aortic stenosis (AS) and preserved LV ejection fraction (LVEF). However, its quantification using echocardiography may be subject to error measurement...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.11.180
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abstract::Clear guidelines are lacking for the management of the clinical pattern of first-episode type atrial fibrillation (AF). We retrospectively analysed the clinical evolution of patients with self-limited first episode AF identified from among from 200 patients who had been hospitalised in our cardiology ward with AF. Of ...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2006.08.090
更新日期:2007-10-01 00:00:00
abstract::The differentiation of viable from non viable myocardium is a key issue in the current era of revascularization. Several methods have been used to assess myocardial viability. The radionuclide detection of dysfunctional but viable myocardium depends upon the use of radiotracers whose uptake and trapping are related to...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(98)00066-7
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abstract:BACKGROUND:Lipid ratios are clinically useful markers of coronary artery disease (CAD) risk. The effects of rosuvastatin, atorvastatin, simvastatin, and pravastatin on lipid ratios were investigated in the Measuring Effective Reductions in Cholesterol Using Rosuvastatin TherapY (MERCURY) I trial. METHODS:This trial wa...
journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ijcard.2004.12.011
更新日期:2005-04-20 00:00:00
abstract:BACKGROUND:Chagas' cardiomyopathy (CC) is a rising etiology for heart failure (HF) that previously was restricted to some countries of Latin America. The chronic CC cases cause now a profound socio-economic impact. However this issue has not been well studied if compared to other causes of HF. The objective of this stu...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2013-10-03 00:00:00
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journal_title:International journal of cardiology
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更新日期:2013-06-05 00:00:00
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journal_title:International journal of cardiology
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更新日期:1989-06-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2010.07.013
更新日期:2011-10-20 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the prevalence of atrial fibrillation (AF) in physical laborers in rural China and identify contributing risk factors. METHODS:A cross-sectional study of 11,956 permanent residents of Liaoning Province in rural China≥35y of age (primarily physical laborers) was conducted between January and Augu...
journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2015-03-01 00:00:00
abstract:INTRODUCTION:Accurate predictors of good clinical response after MitraClip implant in patients with heart failure (HF) are still lacking. Aim of this study was to investigate the role of regurgitant fraction >50% as a marker of disproportionate functional mitral regurgitation (FMR) in identifying best responders to Mit...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2021-01-15 00:00:00