Treating patients with acute coronary syndromes with aggressive antiplatelet therapy (from the Global Registry of Acute Coronary Events)
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Authors
Lim, Michael J.Eagle, Kim A.
Gore, Joel M.
Anderson, Frederick A. Jr.
Dabbous, Omar H.
Mehta, Rajendra H.
Granger, Christopher B.
Fox, Keith A. A.
Spencer, Frederick A.
Goldberg, Robert J.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineCenter for Outcomes Research
Document Type
Journal ArticlePublication Date
2005-09-29Keywords
AgedAngina, Unstable
Drug Therapy, Combination
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction
Platelet Aggregation Inhibitors
Platelet Glycoprotein GPIIb-IIIa Complex
effects
Pyridines
Health Services Research
Metadata
Show full item recordAbstract
Few data exist on the use of aggressive combination therapy with thienopyridines and glycoprotein IIb/IIIa inhibitors in higher risk patients with an acute coronary syndrome (ACS). The aim of this study was to characterize the combined use of these agents and the associated hospital outcomes in patients with ACS enrolled in the multinational Global Registry of Acute Coronary Events. Data from 8,081 patients with non-ST-segment elevation myocardial infarction or unstable angina were analyzed. Of these patients, 5,070 (62.7%) received aspirin and a thienopyridine, and the remainder received aspirin, a thienopyridine, and a glycoprotein IIb/IIIa blocker. The presence of a non-ST-segment elevation myocardial infarction; a history of diabetes or coronary artery bypass surgery; performance of in-hospital catheterization, percutaneous coronary intervention, or coronary artery bypass grafting; and in-hospital use of heparin were independent predictors of the use of triple antiplatelet therapy with aspirin, thienopyridines, and glycoprotein IIb/IIIa blockers. Increased diastolic blood pressure and increased serum creatinine were associated with a failure to prescribe triple therapy. An increased risk of major bleeding during hospitalization was associated with the use of triple antiplatelet therapy (odds ratio 1.6, 95% confidence interval 1.2 to 2.2). Aggressive antiplatelet therapy was used in approximately 2 of every 5 patients presenting with an ACS. Triple therapy was associated with the performance of catheterization and/or percutaneous coronary intervention, as well as high-risk patient features. Although no differences in hospital death rates were evident in patients receiving triple therapy, this population was at significantly increased risk of major bleeding episodes during hospitalization.Source
Am J Cardiol. 2005 Oct 1;96(7):917-21. Link to article on publisher's siteDOI
10.1016/j.amjcard.2005.05.047Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27249PubMed ID
16188516Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.amjcard.2005.05.047