Abstract:
BACKGROUND:Contemporary use of dual antiplatelet therapy and consistency with guideline recommendations in acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI) have not been well characterized. METHODS:The COAPT was a prospective, observational, multicenter, longitudinal study of patients with myocardial infarction (MI) undergoing PCI. Baseline characteristics, treatment patterns, processes of care, factors associated with switching to and from novel adenosine diphosphate receptor inhibitors (ADPris), and in-hospital outcomes are described. RESULTS:Among 2,179 MI patients undergoing PCI during their index hospitalization, 1,328 (60.9%) had ST elevation. Initial ADPri use included clopidogrel in 1,812 (83.2%), prasugrel in 125 (5.7%), and ticagrelor in 242 (11.1%). At discharge, 1,597 patients (73.4%) were prescribed clopidogrel, 220 (10.1%) prasugrel, and 358 (16.5%) ticagrelor. Switching between ADPri therapies during the index hospitalization occurred in 15.3%, 22.4%, and 25.2% of patients initially started on clopidogrel, prasugrel, and ticagrelor, respectively. Most switches over the 15-month study period occurred during the index admission (16.8% of patients vs 4.4% switches postdischarge). Major adverse cardiovascular events occurred in 7.5% of patients during the index hospitalization. In-hospital bleeding events occurred in 6.0% of patients and most were mild. CONCLUSIONS:Despite randomized trial evidence and guideline recommendations, only a minority of Canadian MI patients undergoing PCI initially received or were discharged on one of the newer ADPri agents. These findings suggest an opportunity to improve upon the appropriate selection of the ADPris at index hospitalization and discharge in Canadian MI patients undergoing PCI.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Déry JP,Mehta SR,Fisher HN,Zhang X,Zhu YE,Welsh RC,Lavi S,Cieza T,Henderson MA,Lutchmedial S,Siega AJ,Cheema AN,Wong BY,Kokis A,Dehghani P,Goodman SG,Canadian Observational AntiPlatelet sTudy (COAPT) Investigators.doi
10.1016/j.ahj.2016.07.014subject
Has Abstractpub_date
2016-11-01 00:00:00pages
26-34eissn
0002-8703issn
1097-6744pii
S0002-8703(16)30148-Xjournal_volume
181pub_type
杂志文章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::Since many patients with chest pain cannot exercise adequately, an alternative stress would be useful to evaluate coronary reserve. We studied the physiologic responses to epinephrine to assess its potential. We report on 39 patients with chest pain. Doses from 0.03 to 0.30 micrograms/kg/min were administered intraven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90477-5
更新日期:1983-04-01 00:00:00
abstract::Percutaneous coronary interventions have been performed for 20 years. Despite the success and progress of these interventions, abrupt vessel closure has been a dramatic adverse event of coronary interventions. Closure has frequently led to the major complications of death, myocardial infarction, and emergency coronary...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70069-3
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:New percutaneous coronary intervention (PCI) device technologies are often rapidly adopted into clinical practice, yet few studies have examined the overall impact of these new technologies on patient outcomes in community practice. METHODS:In hopes of determining temporal trends in PCI outcomes, we used da...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.05.006
更新日期:2013-08-01 00:00:00
abstract::To assess the effects of standard therapeutic interventions on the total ischemic burden, 86 patients with stable angina underwent 48 hours of ambulatory ST segment monitoring and treadmill exercise testing before and at a mean of 10 weeks after coronary artery bypass surgery (CABG) (group 1, N = 46) or percutaneous t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90495-h
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Appropriate use criteria (AUC) for stress single-photon emission computed tomography (SPECT) are only one step in appropriate use of imaging. Other steps include pretest clinical risk evaluation and optimal management responses. We sought to understand the link between AUC, risk evaluation, management, and o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.06.003
更新日期:2013-09-01 00:00:00
abstract::Ambulatory ECG recordings were obtained from 313 consecutive, totally symptom-free male subjects on whom cardiac catheterization was subsequently performed for occupational reasons. These recordings were examined for ventricular ectopy and the results were studied in relation to the findings on selective coronary angi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90405-5
更新日期:1989-06-01 00:00:00
abstract::The hearts from 10 necropsy patients with Ebstein's anomaly of the tricuspid valve were examined for abnormalities of the mitral valve. Five patients were under 1 year of age and none had an abnormal mitral valve. The other five patients were ages 18 to 72 years (mean 36 years); all had focal fibrous thickening of the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90663-3
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Childhood cancer survivors are at increased risk of cardiovascular disease (CVD), which may be associated with traditional CVD risk factors. We used CVD risk aggregation instruments to describe survivor cardiometabolic health and compared their results with sibling controls. METHODS:Traditional CVD risk fac...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.11.008
更新日期:2012-02-01 00:00:00
abstract::A new agent for use in contrast echocardiography that is capable of passing through the pulmonary circulation and opacifying the left ventricular cavity after intravenous injection was evaluated in a canine model. Air-filled albumin microbubbles were produced by sonication. A Coulter counter was used to size and count...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90754-x
更新日期:1987-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90061-0
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Many US studies have documented an association between operator volume and outcomes after percutaneous coronary intervention (PCI). No study has assessed whether this relationship exists in Canada, where PCI is performed only at a limited number of regional centers and operator volumes are higher. METHODS:A...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2005.07.033
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Despite the common practice of clopidogrel loading for coronary stenting, the time dependence and degree of platelet inhibition after this therapy are not well defined. We sought to establish an optimal clopidogrel dosing regimen for sustained platelet inhibition in stented patients. METHODS AND RESULTS:Pla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.109
更新日期:2003-02-01 00:00:00
abstract::Serum digoxin and/quinidine concentration were measured before and following the institution of quinidine therapy in 11 patients who were receiving maintenance oral digoxin therapy and who required quinidine therapy for suppression of extrasystoles. Steady-state serum digoxin concentrations after quinidine administra...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90643-3
更新日期:1982-07-01 00:00:00
abstract::In a prospective clinical trial of 195 consecutive unselected patients with acute myocardial infarction (AMI), systematic blinded clinical and echocardiographic examinations were performed by two observers on day 5. The purpose was to define low-risk patients with regard to in-hospital and 2-month mortality and predic...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(92)90963-v
更新日期:1992-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.07.029
更新日期:2004-06-01 00:00:00
abstract::To examine the relationship between the improvement of wall motion in infarcted regions after percutaneous transluminal coronary angioplasty (PTCA) and thallium-201 uptake in the delayed image of exercise thallium-201 scintigraphy before PTCA, 14 patients with anterior old myocardial infarction were studied. Exercise ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90053-c
更新日期:1993-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90099-2
更新日期:1986-04-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.06.039
更新日期:2010-09-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2003-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:1982-04-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-10-01 00:00:00
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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(85)90169-3
更新日期:1985-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90401-5
更新日期:1983-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2006.08.008
更新日期:2006-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90025-5
更新日期:1993-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.02.016
更新日期:2006-09-01 00:00:00
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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(88)90112-3
更新日期:1988-07-01 00:00:00