Abstract:
BACKGROUND:Female sex independently predicts bleeding risk after percutaneous coronary intervention (PCI). Bivalirudin is safer than abciximab plus heparin in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Thus, a greater benefit of bivalirudin in women would be expected. METHODS:We performed a sex-based analysis of the patients with NSTEMI (n = 1,721, 399 women) enrolled in the ISAR-REACT 4 trial and randomized to receive bivalirudin or abciximab plus heparin. Main outcome was a 30-day composite of death, large recurrent myocardial infarction, urgent target vessel revascularization, or major bleeding. Secondary outcome was 1-year composite of death, myocardial infarction, or target vessel revascularization. RESULTS:No difference in the main outcome was observed in groups with bivalirudin or abciximab plus heparin: 12.6% versus 15.5% (hazard ratio [HR] 0.81, 95% CI 0.48-1.37) among women and 10.6% versus 9.5% (HR 1.12, 95% CI 0.77-1.64) among men. Major bleeding occurred in 4.5% in the bivalirudin group versus 7.5% in the abciximab plus heparin group (HR 0.60, 95% CI 0.26-1.39) among women and 2.0% versus 3.8% (HR 0.52, 0.27-1.02) among men. At 1 year, the secondary outcome was observed in 24.1% in the bivalirudin group versus 28.7% in the abciximab plus heparin group among women, HR of 0.80 (95% CI 0.55-1.17), and in 20.6% and 19.0%, respectively, HR of 1.10 (95% CI 0.86-1.40) among men. CONCLUSION:Despite a higher peri-PCI bleeding risk in women, bivalirudin is as effective as and safer than abciximab plus heparin in women and men with NSTEMI undergoing PCI.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Mehilli J,Neumann FJ,Ndrepepa G,King L,Schulz S,Maimer Rodrigues da Cunha F,Jochheim D,Byrne RA,Hausleiter J,Ott I,Massberg S,Kastrati A,Pache Jdoi
10.1016/j.ahj.2012.12.021subject
Has Abstractpub_date
2013-04-01 00:00:00pages
537-43issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(13)00062-8journal_volume
165pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The magnitude of benefit of cardiac resynchronization therapy (CRT) varies significantly among its recipients; approximately 30% of CRT patients do not report clinical improvement. Optimization of CRT pacing parameters can further improve cardiac function, both acutely and chronically. Echocardiographic opti...
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.2012.02.007
更新日期:2012-05-01 00:00:00
abstract::Age is a recognized risk factor for coronary artery disease, but the relationship between age and silent ischemia is not well understood. We analyzed the data from 35 rest/stress radionuclide ventriculography examinations in patients with documented ischemic coronary artery disease who had experienced 1 mm ST segment ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90156-r
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Lipid lowering through statin therapy significantly reduces the risk of cardiovascular events. The ENHANCE study is an international 2-year, randomized, double-blind, controlled trial designed to test the hypothesis that treatment of hypercholesterolemia by use of 2 complementary agents, ezetimibe (a specifi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.06.024
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Several studies have shown that patency of the epicardial vessel does not guarantee optimal myocardial perfusion in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI). The aim of the current study was to identify clinical and angiographic correlates of unsuccessful...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.044
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:The initial white cell counts in patients with acute myocardial infarction (AMI) may reflect the stage of AMI evolution, and may also be related to the efficacy of thrombolytic agents in recanalizing occluded epicardial arteries. METHODS:In 312 patients with a first AMI, we divided the initial white cell co...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1067/mhj.2003.64
更新日期:2003-01-01 00:00:00
abstract::A 47-year-old man presented with exertional angina. Selective coronary arteriography showed complete systolic segmental occlusion of the left anterior descending coronary artery producing milking effect. Permanent relief of symptoms was achieved by surgical excision of myocardial bridges. Postoperative angiography per...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90118-0
更新日期:1980-08-01 00:00:00
abstract::Terazosin is a new, long-acting, selective, postsynaptic alpha 1-adrenergic receptor antagonist with a chemical structure similar to that of prazosin. In this article the pharmacokinetics of terazosin are reviewed, and the incidence of adverse events in a dose-response study and a meta-analysis of 20 placebo-controlle...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/0002-8703(91)90809-v
更新日期:1991-09-01 00:00:00
abstract::This study was designed to investigate the hypothesis that mitral valve prolapse (MVP) can be induced after diuresis in women without the abnormality who have characteristic body habitus. Fifteen tall, slim, healthy female volunteers with a normal cardiac findings, echocardiogram, and history were investigated after m...
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(92)90068-7
更新日期:1992-12-01 00:00:00
abstract::The effects of atrial pacing on the signal-averaged electrocardiogram were studied in 14 patients with remote myocardial infarction and a history of cardiac arrest or sustained ventricular tachycardia (group I) and in 13 patients with coronary artery disease and no history of sustained ventricular tachyarrhythmia (gro...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80077-8
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:In adults, the most common cause of out-of-hospital cardiac arrests (OHCA) is acute coronary artery occlusion. If an immediate coronary angiogram (CAG) is recommended for survivors presenting a ST segment elevation on the electrocardiogram (ECG) performed after resuscitation, there is still a debate regardin...
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.2020.01.006
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Familial hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disease of the sarcomere. Molecular genetic studies have shown that familial HCM involves mutations in 8 different genes that encode proteins of the myofibrillar apparatus. METHODS:We thoroughly searched these genes to ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.112487
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Previous research suggests that after coronary artery bypass graft (CABG) surgery, women fare worse than men. This study investigates sex differences in depression during recovery from CABG surgery. METHODS:We followed 137 patients (72 men, 65 women) undergoing elective isolated first CABG surgery between J...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.05.005
更新日期:2005-11-01 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
abstract:BACKGROUND:Limited information is available about recent trends in the incidence and death rates from atrial fibrillation (AF) complicating acute myocardial infarction (AMI). The purpose of this study was to examine the impact and trends over time of AF complicating initial AMI. METHODS:We conducted a longitudinal stu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.120410
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:False positive rate (FPR) of the current basic life support (BLS) termination of resuscitation (TOR) rule in out-of-hospital cardiac arrest (OHCA) patients (not witnessed; no return of spontaneous circulation prior to transport; and no shocks were delivered) has been ethically challenging. We validated the c...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2019.04.003
更新日期:2019-07-01 00:00:00
abstract::To assess the relation between myocardial ischemia, ventricular arrhythmias (VA), and left ventricular (LV) dysfunction, we evaluated 74 patients with coronary artery disease (CAD) using radionuclide angiography (to determine the resting ejection fraction [EF]), resting thallium-201 scintigraphy (to ascertain the exte...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90588-5
更新日期:1985-02-01 00:00:00
abstract::It is unclear how agents designed to promote angiogenesis in the human heart affect the arteriographic appearance of the collateral circulation. Possible changes in collateral vessels include new collateral vessels arising from epicardial arteries, new branches emanating from existing collateral vessels, wider or long...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70473-4
更新日期:1999-01-01 00:00:00
abstract::To assess the influence of viscosity and iodine concentration, three matched and standardized left coronary arteriograms were obtained in 20 patients using iopamidol (Isovue-370), ioversol (Optiray-320), and iohexol (Omnipaque-350). The order of contrast media was randomized and the administration of contrast was doub...
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(92)90760-s
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Compared with men, women have more evidence of myocardial ischemia with no obstructive coronary artery disease. Although low endogenous estrogen levels are associated with endothelial dysfunction, the role of low-dose hormone therapy has not been fully evaluated. We postulate that a 12-week duration of low-d...
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.2010.03.024
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Whether low-molecular-weight heparin (LMWH) is superior to unfractionated heparin (UFH) in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) remains unclear. METHODS:A total of 3,372 STEMI patients wh...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2009.12.041
更新日期:2010-04-01 00:00:00
abstract::We attempted to predict successful myocardial reperfusion and salvage in acute myocardial infarction (AMI) by using measurements of plasma superoxide dismutase (SOD), a plasma free-radical scavenger, activity. Forty-nine patients with AMI were studied within 6 hours of symptoms onset. In group 1 (n = 26), primary perc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90163-5
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Recent randomized clinical trials have suggested a benefit of an invasive management strategy in patients with acute coronary syndromes. However, the broader use and impact of the invasive management approach has not been established for patients with acute coronary syndromes beyond the relatively narrow pat...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.122517
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Diastolic dysfunction is common immediately after coronary artery bypass surgery (CABG). The duration of this phenomenon is unknown. Intravenous calcium is frequently administered during separation from cardiopulmonary bypass (CPB). We sought to determine whether intravenous calcium influences perioperative ...
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(02)94786-1
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study showed that cholesterol-lowering therapy prevented further events in patients with coronary heart disease and average cholesterol levels. The aim of this subgroup analysis was to assess the effects of pravastatin in women. METHOD...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,meta分析
doi:10.1067/mhj.2003.1
更新日期:2003-04-01 00:00:00
abstract::A new mechanically rotated 20 MHz intravascular ultrasound guide wire (0.032 inch) with a transducer core was placed through the central lumen of a peripheral arterial balloon-expandable stent. Using an anesthetized canine model, 11 stents were then deployed into the iliac or femoral arteries. Eight stents were succes...
journal_title:American heart journal
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Some studies have reported that patients with mitral valve prolapse syndrome (MVPS) also have a disorder in the autonomic or neuroendocrine function, which can cause a host of related symptoms. A potential role of the renin-angiotensin system in the pathogenesis of MVPS has been addressed. However, the role ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.26
更新日期:2003-01-01 00:00:00
abstract::There are many similarities between the clinical features of viral heart disease and of rheumatic carditis, as defined in the revised Jones criteria for the diagnosis of rheumatic fever. Because of this, it is likely that viral heart disease has been, and still is, diagnosed as rheumatic. This situation can be avoided...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80137-8
更新日期:1976-05-01 00:00:00
abstract::Recent developments have highlighted the challenges facing cardiovascular clinical research in global contemporary practice, particularly in North America, including shifting priorities for drug development targets, increasing regulatory requirements, and expensive operational approaches for conducting randomized clin...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2015.03.002
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:It has been shown that transient increase in left ventricular stiffness, assessed by Doppler-derived early filling deceleration time, occurs during the first 24 to 48 hours after myocardial infarction but returns to normal within several days. It has been reported that hyperbaric oxygen treatment has a favor...
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.2004.02.009
更新日期:2004-07-01 00:00:00
abstract::The objectives of this study were to assess current practice patterns in pharmacotherapy for congestive heart failure at an academic medical center and to analyze temporal trends in management of congestive heart failure from 1990 to 1995. Records of all patients discharged from the hospital in 1990 or 1995 with a pri...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70309-6
更新日期:1998-03-01 00:00:00