Abstract:
BACKGROUND:Dual antiplatelet therapy with aspirin and clopidogrel is currently recommended in off-pump coronary artery bypass (OPCAB). However, no data exist concerning platelet reactivity on clopidogrel after OPCAB. The aim of this study was to assess the relationship between platelet reactivity and late major adverse cardiovascular events (MACEs) after OPCAB. METHODS:In this prospective, single-center, observational study, on-clopidogrel platelet reactivity was measured using a point-of-care assay (VerifyNow system; Accumetrics Inc, San Diego, CA) in 859 patients who underwent OPCAB with 1 or more vein grafts. The primary end point was late MACEs (30 days-1 year) including cardiac death, nonfatal myocardial infarction, and target vessel revascularization. Receiver operating characteristic curve analysis was used to estimate the cutoff value of P2Y12 reaction units (PRUs) for MACEs. RESULTS:The optimal cutoff value for posttreatment reactivity for the incidence of late MACEs was ≥188 PRU (area under the curve 0.72, 95% CI 0.68-0.75, P = .002). The incidence of late MACEs was significantly higher in the high platelet reactivity (HPR; ≥188 PRU) group than in the low platelet reactivity (<188 PRU) group (3.6% vs. 1.4%, P = .040). Kaplan-Meier analysis revealed 1-year MACE-free survival rates of 98.4% ± 0.5% and 95.9% ± 1.3% in the low platelet reactivity and HPR groups, respectively (P = .034). According to a Cox regression hazard model, HPR was an independent risk factor for late MACE-free survival (hazard ratio 3.51, 95% CI 1.27-9.69, P = .015). CONCLUSION:High residual platelet reactivity after clopidogrel administration is strongly associated with 1-year MACE-free survival. Routine measurement of platelet reactivity and thorough monitoring of patients with HPR after OPCAB are warranted.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Youn YN,Yi G,Lee S,Joo HC,Yoo KJdoi
10.1016/j.ahj.2014.01.016subject
Has Abstractpub_date
2014-06-01 00:00:00pages
818-25issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(14)00090-8journal_volume
167pub_type
杂志文章abstract:BACKGROUND:High-intensity interval training has been shown to be superior to moderate continuous exercise training in improving exercise capacity and endothelial function in patients with coronary artery disease. The objective of this study was to evaluate this training model on in-stent restenosis following percutaneo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.08.021
更新日期:2009-11-01 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::Myocarditis Disease Unit (MDU) is a functional multidisciplinary network designed to offer multidisciplinary assistance to patients with myocarditis. More than 300 patients coming from the whole Country are currently followed up at a specialized multidisciplinary outpatient clinic. Following the pandemic outbreak of t...
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pub_type: 信件
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更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Patients with diabetes have an increased incidence and severity of ischemic heart disease, which leads to an increased requirement for coronary revascularization. Comparative information regarding mode of revascularization--coronary artery bypass graft surgery surgery (CABG) or percutaneous coronary interven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.001
更新日期:2005-01-01 00:00:00
abstract::The results of valve replacement in 150 patients with Lillehei-Kaster aortic and mitral prostheses followed for 20 to 40 months are reviewed. Actuarial analysis showed 78 per cent cummulative thromboembolic-free rate three years following mitral valve replacement and 89 per cent following aortic valve replacement. Fiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80469-9
更新日期:1977-09-01 00:00:00
abstract::Intracoronary streptokinase (SK) was administered to 11 patients with evolving acute transmural myocardial infarction 5.5 +/- 0.4 hours from the onset of symptoms. Ten patients (91%) had total coronary occlusion, and one had subocclusion of the vessel corresponding to the ECG site of infarction. Intracoronary nitrogly...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90646-3
更新日期:1981-12-01 00:00:00
abstract::In the Cardiovascular Measurement System (CMS) the edge-detection algorithm, which was primarily designed for the Philips digital cardiac imaging system (DCI), is applied to cinefilms. Comparative validation of CMS and DCI was performed in vitro and in vivo with intracoronary insertion of stenosis phantoms in anesthet...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)91045-g
更新日期:1993-08-01 00:00:00
abstract::Minnesota codes (MC), expressing Q-QS, ST segment, and T wave abnormalities in ECGs taken during the acute event and at a 1-year follow-up were studied in 256 survivors of myocardial infarction (MI). On the 1-year ECGs large Q waves (MC 1.1) were more common in patients with a history of previous MI than in those with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90141-9
更新日期:1986-02-01 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:BACKGROUND:Pregnancy is increasingly common in women with congenital heart disease (CHD), but little is known about long-term cardiovascular outcome after pregnancy in these patients. We studied the incidence of cardiovascular events 1-year postpartum and compared cardiac function prepregnancy and 1-year postpartum in ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2014.11.010
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Inflammation has been suggested as a factor in the initiation and maintenance of atrial fibrillation (AF). Several observational studies have suggested that statins, presumably through their anti-inflammatory properties, decrease the risk of AF. METHODS:We analyzed 2 large, randomized trials, PROVE IT-TIMI ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.024
更新日期:2008-02-01 00:00:00
abstract::Thallium-201 redistribution pattern after exercise was related to rest and exercise left ventricular regional and global function, measured by radionuclide ventriculography, in 61 patients, 50 with coronary artery disease (CAD). Sixteen patients had exclusively transient thallium defects, suggesting ischemia: in this ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90608-6
更新日期:1981-06-01 00:00:00
abstract::A retrospective analysis of our experience with intraprocedural thrombus complicating percutaneous transluminal coronary angioplasty (PTCA) was undertaken. Of 983 PTCA procedures reviewed, 62 (6.3%) were complicated by thrombus. Patients were managed conservatively (group I, n = 18), with redilation (group II, n = 17)...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90912-f
更新日期:1992-07-01 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::There are selective blocking agents (antagonists) for alpha receptors and beta receptors. These blocking agents prevent the response to injected agonists and neurogenically released norepinephrine. The principal cardiovascular response to alpha blockade is postural hypotension with reflexly induced cardiac stimulation...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80020-8
更新日期:1976-12-01 00:00:00
abstract::Sixty-nine patients receiving atrioventricular sequential (DVI) pacemakers are compared to 67 patients receiving ventricular demand (VVI) pacemakers for control of the symptoms of sinus node dysfunction. The populations were similar with comparable preparing incidences of each assayed symptom and number of symptoms pe...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90162-4
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Today most patients with congenital heart disease survive childhood to be cared for by adult cardiologists. The number of physicians that should be trained to manage these lesions is unknown because we do not know the number of patients. METHODS:To answer this question, the expected numbers of infants with ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.05.003
更新日期:2004-03-01 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::In January 1997, experts from the United States, Europe, and Japan gathered at Stanford University to review their collective experience with intracoronary and noncoronary stenting and to identify and prioritize issues requiring further clinical investigation. This report summarizes the discussions that took place dur...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(98)70004-3
更新日期:1998-10-01 00:00:00
abstract::The occurrence of thrombotic events is central to the course of polycythemia vera. Myocardial, cerebral, peripheral, and pulmonary infarctions are frequent and are consequences of throbmoses in small and medium caliber arteries. Thrombosis in large caliber arteries is a rare event. Thrombosis within the chambers of th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90667-5
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVES:To define the incidence and cumulative risk of atrial fibrillation (AF) in a population-based cohort of whites and African Americans. BACKGROUND:African-Americans reportedly have a lower risk of AF than whites despite their higher exposure to AF risk factors. However, precise estimates of AF incidence in Af...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.05.010
更新日期:2009-07-01 00:00:00
abstract::The relationship between coronary artery size and left ventricular (LV) muscle mass was studied in 10 control subjects and in 10 patients with chronic mitral regurgitation before and 28 +/- 15 months after mitral valve surgery. Left and right coronary artery size was determined by quantitative coronary arteriography. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90659-w
更新日期:1993-11-01 00:00:00
abstract::Our experience with the use of five new antiarrhythmic drugs for treating life-threatening arrhythmias in children will be briefly reviewed. Prevention of recurrent episodes of atrial flutter with digoxin and local anesthetic antiarrhythmic drugs often is only moderately successful, benefiting 65% of patients. Amiodar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90027-5
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:A substantial percentage of patients have undiagnosed diabetes. We investigated the demographic characteristics and cardiometabolic profiles of subjects with undiagnosed diabetes. METHODS:A cross-sectional study with nationally representative samples of 25490 subjects aged ≥ 20 years from the KHNANES 2008 t...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.07.024
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Although cross-sectional studies have identified lifestyle factors associated with high-density lipoprotein cholesterol (HDL-C), no studies have examined the association between changes in lifestyle factors and long-term changes in HDL-C. METHODS:We examined the association between changes in lifestyle fact...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.12.015
更新日期:2011-04-01 00:00:00
abstract::Progress in our understanding diabetic angiopathy has been slow, but we are now learning a number of lessons of interest to the cardiologist. Diabetic angiopathy is a collective term for conditions specific to the diabetic state and related to its duration more than to patient age. The angiopathy produces calcificatio...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(78)90053-4
更新日期:1978-09-01 00:00:00
abstract:BACKGROUND:It has been reported that mineralocorticoid receptor antagonist improves the prognosis of chronic heart failure (CHF). Recently, hemoglobin A₁(c) (HbA₁(c)) levels have been reported to be an independent risk factor for mortality in CHF, suggesting the important role of insulin resistance in CHF. We compared ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2010.04.024
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) experience higher rates of in-stent restenosis and greater benefit from drug-eluting stents implant at the time of percutaneous coronary intervention (PCI), necessitating prolonged dual anti-platelet therapy (DAPT). While DAPT reduces risk of ischemic events post-PCI, it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.09.010
更新日期:2016-12-01 00:00:00
abstract::We compared the effects of IV digoxin (0.04 mg/kg) and nitroprusside (NP) (1.2 and 1.8 microgram/kg/min) on left ventricular (LV) performance in six preinstrumented conscious dogs with 3 and 6 hours after digoxin administration (serum level, 3.5 +/- 0.6 ng/ml), there were no changes in heart rate, LV systolic (LVSP) a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90335-0
更新日期:1982-04-01 00:00:00
abstract::Therapeutics involves the careful balance between treatment disadvantages and advantages--the so-called risk-benefit ratio. Even after 20 years beta-blockers must be selected carefully to suit the patient's needs. This review examines several problems associated with beta-blockade. Generally, beta1-cardioselectivity i...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(88)90130-5
更新日期:1988-11-01 00:00:00