Abstract:
BACKGROUND:Diabetes is associated with a high rate of events after acute coronary syndrome and percutaneous coronary intervention despite aspirin treatment. Once daily aspirin might not provide 24-hour stable biological efficacy in patients with diabetes. We compared the biological efficacy of the same daily dose of aspirin given either once (OPD) or divided twice per day in a population of diabetic patients with previous coronary artery disease. METHODS:Ninety-two consecutive diabetic patients with at least 1 criteria of time-dependent aspirin efficacy, elevated high-sensibility C-reactive protein (hs-CRP), fibrinogen, platelet count, or active smoking were prospectively included. Consecutive patients were randomly treated with 150-mg aspirin daily given either OPD (150 mg in the morning) or twice per day (75 mg in the morning and 75 mg in the evening) in a crossover study. The main outcome was platelet reactivity to arachidonic acid (0.5 mg/mL) measured by light transmission aggregometry at trough level before morning aspirin intake. RESULTS:Mean maximum aggregation intensity triggered by arachidonic acid was 19.7% ± 15.4% on OPD and 11.9% ± 10.4% on twice per day (P < .0001). Biological resistance (maximum aggregation intensity ≥20%) was observed in 42% of patients on OPD and 17% on twice per day (P < .001). Of the 39 patients with biological resistance on OPD, 24 (62%) overcame resistance on twice per day. Of the 16 resistant on twice per day, only 1 patient (6%) overcame resistance on OPD. Results were concordant with global evaluation of platelet reactivity by Platelet Function Analyzer-100. A better twice per day efficacy was independent of clopidogrel cotreatment. CONCLUSION:In a population of diabetic patients with coronary artery disease and a high risk of time-dependent aspirin resistance, aspirin divided twice per day can significantly decrease the rate of biological loss of efficacy at trough level.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Dillinger JG,Drissa A,Sideris G,Bal dit Sollier C,Voicu S,Manzo Silberman S,Logeart D,Drouet L,Henry Pdoi
10.1016/j.ahj.2012.06.008subject
Has Abstractpub_date
2012-10-01 00:00:00pages
600-606.e1issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(12)00439-5journal_volume
164pub_type
杂志文章,随机对照试验abstract:CLINICAL SCENARIO:A 67-year-old man is referred to your cardiology clinic complaining of worsening angina and dyspnea on exertion. Physical examination reveals a harsh grade IV/VI late-peaking crescendo-decresendo systolic murmur, loudest at the upper sternal border. The aortic closure sound is diminished. Echocardiogr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.05.031
更新日期:2004-07-01 00:00:00
abstract::Previous studies have suggested that the contractility of isolated heart muscle removed from rabbits made hypercholesterolemic is decreased. As part of a study evaluating the effects of high-lipid diets on aortic atherosclerosis, we evaluated the contractility of perfused rabbit hearts. Six rabbits were placed on a hi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90049-2
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. METHODS:STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg syst...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2009.07.020
更新日期:2009-10-01 00:00:00
abstract::Twelve cirrhotic patients with portal hypertension and esophageal varices were treated with nadolol for 1 month, and the effects on renal and hepatic hemodynamics and function were studied. A significant decrease in cardiac output, portohepatic gradient, and effective hepatic blood flow was found, whereas mean arteria...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90602-1
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:A high fasting glucose level may be a marker not only for microvascular complications, but also for macrovascular complications. We evaluated the clinical significance of a high fasting glucose level (> or =110 mg/dL), detected either at baseline or during follow-up, in the Bezafibrate Infarction Prevention ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2003.09.013
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Drug-eluting stents (DES) are increasingly used for the treatment of coronary artery disease. An optimized DES performance is desirable to successfully treat various challenging coronary lesions in a broad population of patients. In response to this demand, third-generation DES with an improved deliverabilit...
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.2012.02.001
更新日期:2012-04-01 00:00:00
abstract::Nitrates are widely used for the management of congestive heart failure (CHF), as well as angina pectoris. In both situations, nitrates significantly increase exercise capacity. The mechanism of this beneficial effect is unclear, especially in CHF. Isosorbide dinitrate reduces pulmonary capillary wedge pressure (PCWP)...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(85)90494-6
更新日期:1985-07-01 00:00:00
abstract::As Q wave and ST segment elevation in leads V1 to V3 may be due either to right ventricular infarction (RVI) or to anterior left ventricular infarction (ALVI), 72 autopsy patients with acute myocardial infarction who had had conventional 12-lead ECG records were studied to determine the accuracy of these ECG criteria,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90304-2
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher refusal rates in black individuals. Decision support can assist with...
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.2019.10.011
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Noninvasive methods are needed for the identification of women at highest risk for coronary artery disease (CAD) who might benefit most from aggressive preventive therapy. Identification of brachial artery atherosclerosis, which correlates with coronary artery atherosclerosis, may be useful to estimate or st...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.121735
更新日期:2002-05-01 00:00:00
abstract::Although the cardiac manifestations of Lyme disease may be diverse, in general they are treatable with currently available therapies. A high index of suspicion is required to make a diagnosis, especially for patients who may lack a suggestive history of tick exposure or residence in an endemic region. Lyme disease-rel...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(91)90589-a
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:High mortality rates were reported in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary interventions (PPCI) "off-hours." The objective of this study was to evaluate this issue in a more recent population of patients with STEMI treated with PPCI in a high-volume ter...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.04.025
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Automated implantable cardioverter-defibrillators (ICDs) have become standard therapy for patients at high risk for sudden cardiac death. Linked data allow examination of trends in use and long-term survival after ICD implantation in an adult population. METHODS:Linked state-wide person-based data on hospit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.02.007
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Systolic wall motion abnormality (WMA) after acute myocardial infarction (AMI) is a major determinant of outcome; the presence and importance of diastolic WMA after AMI are unknown. We therefore sought to detect diastolic WMA using color kinesis and to assess its relation to neurohormonal activation and its ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.11.024
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Implantable cardioverter defibrillators (ICDs) effectively prevent sudden cardiac death, but selection of appropriate patients for implantation is complex. We evaluated whether risk stratification based on risk of sudden cardiac death alone was sufficient to predict the effectiveness and cost-effectiveness o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125501
更新日期:2002-09-01 00:00:00
abstract::The plasma concentration of atrial natriuretic polypeptide (ANP) was measured in nine patients with essential hypertension during two grades of exercise tests performed in the supine position on a bicycle ergometer. The plasma ANP concentration significantly increased from 97.0 +/- 19.2 pg/ml to 107.6 +/- 23.7 pg/ml (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90159-7
更新日期:1988-10-01 00:00:00
abstract::The method for evaluating right ventricular and pulmonary artery systolic pressures by subtracting the systolic pressure gradient across the ventricular septal defect from the cuff systolic blood pressure is documented. To confirm the reliability and accuracy of this method, simultaneous continuous wave Doppler echoca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90116-q
更新日期:1993-04-01 00:00:00
abstract::This study investigated the correlation between cardiac abnormalities and cytosine-thymine-guanine (CTG) trinucleotide repeat expansion in patients with myotonic dystrophy (MD). We studied 18 patients with the adult form of classical MD and 18 age-matched control subjects. In patients with MD, left ventricular systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70137-6
更新日期:1997-08-01 00:00:00
abstract::Although it has been shown that early cardiac rejection can be visualized by radioimmunoscintigraphy targeting major histocompatibility complex class II antigen, the use of antibodies that bind to a polymorphic determinant of class II antigen has certain disadvantages for clinical application. This investigation was d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90050-7
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:In adults with an atrial septal defect (ASD) transcatheter closure leads to an improvement of peak oxygen uptake (VO2), but the kinetics of recovery of VO2 after maximal exercise in this patient population and the impact of transcatheter ASD closure have never been investigated. METHODS:Twenty consecutive p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.11.013
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Heart rate recovery (HRR) is a marker of vagal tone that is associated with survival, but little is known about the effects of exercise training on HRR in patients with heart failure (HF). METHODS:Twenty-four patients with HF were randomized to a 2-month residential rehabilitation program or to usual care. ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.02.038
更新日期:2007-06-01 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
abstract::Contrast bidimensional echocardiographic (2DE) studies were performed in eight patients with d-transposition of the great vessels in the postoperative period of the Senning technique. Contrast was injected into a peripheral vein of all patients, and into the arterial atrium in five in the postoperative period. The 2DE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90552-0
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Dyspnea is a complex system with multiple etiologies, including myocardial ischemia ("anginal equivalent"). Few studies have examined the utility of stress testing to detect coronary artery disease in this setting. The purpose of this study was to examine the prevalence, severity, and prognostic value of per...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.03.002
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Previous studies have suggested that thrombolysis is used less often in blacks than in whites. However, whether the greater prevalence of contraindications or less specific electrocardiographic manifestations of myocardial infarction (MI) account for this difference is unclear. METHODS AND RESULTS:We studie...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.107173
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:We sought to determine the relationship of adverse diastolic remodeling (ie, worsening diastolic or persistent restrictive filling) with infarct scar characteristics, and to evaluate its prognostic value after ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Severe diastolic dysfunction (restr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.05.020
更新日期:2016-10-01 00:00:00
abstract::Antiplatelet therapy has been shown to significantly reduce the risk of serious vascular events in high-risk patients, including those with a prior acute ischemic event. The long-term use of antiplatelet agents is a key component of secondary prevention measures following acute coronary syndromes, including ST-segment...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.10.014
更新日期:2010-12-01 00:00:00
abstract::The long-term prognosis of patients successfully resuscitated from cardiac arrest who do not have acute precipitating factors and in whom ventricular arrhythmias cannot be induced during baseline electrophysiologic testing is controversial. The purpose of this investigation was to evaluate the long-term risk of recurr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90245-s
更新日期:1990-12-01 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::Changes in conduction times induced by ischemia (delta CT) have been shown to be quantitatively related to genesis of spontaneous ischemic ventricular fibrillation (VF). We studied conduction delay encountered by premature impulses in epicardium and endocardium in both anterograde and retrograde directions during isch...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90308-2
更新日期:1981-09-01 00:00:00