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Interval From Initiation of Prasugrel to Coronary Angiography in Patients With Non-ST-Segment Elevation Myocardial Infarction
J. Silvain, T. Rakowski, B. Lattuca, Z. Liu, L. Bolognese, P. Goldstein, C. Hamm, JF. Tanguay, J. Ten Berg, P. Widimsky, D. Miller, JJ. Portal, JP. Collet, E. Vicaut, G. Montalescot, D. Dudek, ACCOAST Investigators,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie, práce podpořená grantem
NLK
Free Medical Journals
od 1983 do Před 1 rokem
Open Access Digital Library
od 1998-01-01
- MeSH
- časové faktory MeSH
- elektrokardiografie MeSH
- infarkt myokardu bez ST elevací diagnóza mortalita terapie MeSH
- inhibitory agregace trombocytů aplikace a dávkování MeSH
- koronární angiografie metody MeSH
- koronární angioplastika metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- následné studie MeSH
- prasugrel hydrochlorid aplikace a dávkování MeSH
- příčina smrti trendy MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: In the ACCOAST (A Comparison of Prasugrel at PCI or Time of Diagnosis of Non-ST Elevation Myocardial Infarction) trial, the prasugrel pre-treatment strategy versus placebo was associated with excess bleeding complications and no improved ischemic outcome in non-ST-segment elevation myocardial infarction (MI). Whether patients with the longest pre-treatment duration had an ischemic benefit is unknown. OBJECTIVES: This pre-specified analysis of the ACCOAST trial aimed to assess the effect of pre-treatment duration with prasugrel (time from randomization to angiography) on outcomes. METHODS: Within the 4,033 patients randomized in the ACCOAST trial, pre-treatment duration was available in 4,001 patients (99.2%). The population of the trial was divided into quartiles of pre-treatment duration (0.1 to 2.5 h, 2.5 to 3.9 h, 3.9 to 13.6 h, and >13.6 h) with an evaluation of the primary efficacy endpoint of cardiovascular death, MI, stroke, urgent revascularization or glycoprotein IIb/IIIa inhibitor bailout use. Secondary efficacy outcomes including cardiovascular death, MI, or stroke; all-cause death; stent thrombosis and safety outcomes (all coronary artery bypass graft [CABG] or non-CABG TIMI [Thrombolysis In Myocardial Infarction] major bleeding) were also evaluated at 7 days. RESULTS: The primary efficacy outcome of cardiovascular death, MI, stroke, urgent revascularization or glycoprotein IIb/IIIa inhibitor bailout use did not differ between the quartiles of pre-treatment duration in the trial population (p = 0.17 for interaction). None of the secondary efficacy outcomes were found to be dependent on pre-treatment duration. The safety outcome of all CABG or non-CABG TIMI major bleeding did not differ between the quartiles of pre-treatment duration (p = 0.37 for interaction). CONCLUSIONS: In non-ST-segment elevation MI patients, the excess risk of bleeding and the absence of ischemic benefit were consistent across the quartiles of increasing duration of prasugrel pre-treatment. (A Comparison of Prasugrel at PCI or Time of Diagnosis of Non-ST Elevation Myocardial Infarction [ACCOAST]; NCT01015287).
Cardiovascular and Neurological Department Azienda Ospedaliera Arezzo Italy
Department of Cardiology Peking Union Medical College Hospital Beijing China
Department of Cardiology St Antonius Hospital Nieuwegein the Netherlands
Eli Lilly and Company Indianapolis Indiana
Institute of Cardiology Jagiellonian University Medical College Krakow Poland
Methodology and Statistical Unit Centre Hospitalier Universitaire Lariboisière Paris France
Montreal Heart Institute Montreal University Montreal Quebec Canada
SAMU and Emergency Department Lille University Hospital Lille France
Citace poskytuje Crossref.org
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