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 also increases risk of bleeding. Whether bleeding rates differ among patients with and without DM, receiving long-term DAPT is unknown. METHODS:Among patients who underwent PCI and were maintained on DAPT for 1 year in a multicenter US registry, we assessed patient-reported bleeding over one year following PCI in patients with and without DM. Multivariable, hierarchical Poisson regression was used to evaluate the association of DM with bleeding during follow-up. RESULTS:Among 2334 PCI patients from 10 US hospitals (mean age 64, 54% ACS), 32.6% had DM. In unadjusted analyses, patients with DM had fewer bleeding events over the year following PCI (DM vs no DM: BARC = 1: 78.0% vs 87.7%, P < .001; BARC ≥2: 4.3% vs 5.3%, P = .33). Following adjustment, patients with (vs without DM) had a lower risk of BARC ≥1 bleeding during follow-up (relative risk [RR] 0.89, 95% CI 0.83-0.96). This decreased bleeding risk persisted after removing bruising from the endpoint definition. CONCLUSIONS:In a real-world PCI registry, patients with DM experienced lower risk of bleeding risk on DAPT. As patients with DM also derive greater ischemic benefit from drug-eluting stents, which requires prolonged DAPT, our findings suggest that the balance between benefit and risk of this therapeutic approach may be even more favorable in patients with DM than previously considered.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Grodzinsky A,Arnold SV,Wang TY,Sharma P,Gosch K,Jones PG,Bhatt DL,Steg PG,McGuire DK,Cohen DJ,Spertus JA,Chhatriwalla AK,Lind M,Graham G,Kosiborod Mdoi
10.1016/j.ahj.2016.09.010subject
Has Abstractpub_date
2016-12-01 00:00:00pages
111-118eissn
0002-8703issn
1097-6744pii
S0002-8703(16)30206-Xjournal_volume
182pub_type
杂志文章abstract::Urodilatin [ANP-95-126] is a new natriuretic peptide of renal origin not subjected to tolerance in experimental congestive heart failure (CHF). To evaluate its therapeutic potentials in CHF, we investigated the efficacy of a prolonged infusion of urodilatin (15 ng/kg/min for 10 hours) in 12 patients with CHF (New York...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Peripheral endothelial dysfunction (ED) quantified by the determination of flow-mediated dilation (FMD%) of the brachial artery with the use of high-resolution ultrasound is an early marker of atherosclerosis. Although a positive correlation with coronary artery disease (CAD) has been reported, the unanswere...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70189-4
更新日期:1999-10-01 00:00:00
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journal_title:American heart journal
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doi:10.1016/0002-8703(78)90369-1
更新日期:1978-03-01 00:00:00
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journal_title:American heart journal
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更新日期:2010-04-01 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
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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
doi:10.1016/j.ahj.2005.07.003
更新日期:2006-06-01 00:00:00
abstract::The long-term efficacy and safety of flecainide (100 to 200 mg twice a day) were evaluated in 21 patients with high-grade, chronic ventricular arrhythmias who responded to and tolerated flecainide at a preliminary evaluation (200 mg, single oral dose). Antiarrhythmic response was evaluated at 3 days and 3, 6, 12, 18, ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90404-3
更新日期:1989-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90229-3
更新日期:1988-12-01 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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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(97)70020-6
更新日期:1997-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90308-2
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pub_type: 信件
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更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The ACUTE Trial studied a transesophageal echocardiography (TEE)-guided strategy compared with a conventional strategy for management of patients with atrial fibrillation undergoing direct current cardioversion. The primary aim was to determine if patient functional capacity, measured by the Duke Activity St...
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doi:10.1016/j.ahj.2004.08.014
更新日期:2005-02-01 00:00:00
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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
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90222-6
更新日期:1989-11-01 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/s0002-8703(99)70142-0
更新日期:1999-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(90)90009-m
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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...
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pub_type: 杂志文章
doi:10.1016/j.ahj.2005.05.005
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pub_type: 杂志文章,多中心研究
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更新日期:2006-09-01 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:2017-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1993-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90747-w
更新日期:1993-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(80)90284-7
更新日期:1980-07-01 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
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更新日期:2005-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.07.021
更新日期:2011-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.09.020
更新日期:2014-02-01 00:00:00
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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
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2021.01.014
更新日期:2021-01-25 00:00:00