Search

Your search keyword '"Steg, P.G."' showing total 315 results
Start Over Author "Steg, P.G."
315 results on '"Steg, P.G."'

101. Gender- and age-related differences in clinical presentation and management of outpatients with stable coronary artery disease

Author

Ferrari, R., Abergel, H., Ford, I., Fox, K.M., Greenlaw, N., Steg, P.G., Hu, D., Tendera, M., and Tardif, J.

Abstract

Introduction: Contemporary generalizable data on the demographics and management of outpatients with stable coronary artery disease (CAD) in routine clinical practice are sparse. Using the data from the CLARIFY registry we describe gender- and age-related differences in baseline characteristics and management of these patients across broad geographic regions.\ud \ud Methods: This international, prospective, observational, longitudinal registry enrolled stable CAD outpatients from 45 countries in Africa, Asia, Australia, Europe, the Middle East, and North, Central, and South America.\ud \ud Results: Baseline data were available for 33 280 patients. Mean (SD) age was 64 (10.5) years and 22.5% of patients were female. The prevalence of CAD risk factors was generally higher in women than in men. Women were older (66.6 vs 63.4 years), more frequently diagnosed with diabetes (33% vs 28%), hypertension (79% vs 69%), and higher resting heart rate (69 vs 67 bpm), and were less physically active. Smoking and a history of myocardial infarction were more common in men. Women were more likely to have angina (28% vs 20%), but less likely to have undergone revascularization procedures. CAD was more likely to be asymptomatic in older patients perhaps because of reduced levels of physical activity. Prescription of evidence-based medication for secondary prevention varied with age, with patients ≥ 75 years treated less often with beta blockers, aspirin and angiotensin-converting enzyme inhibitors than patients < 65 years.\ud \ud Conclusions: Important gender-related differences in clinical characteristics and management continue to exist in all age groups of outpatients with stable CAD.

Published
2013

102. Effect of platelet inhibition with cangrelor during PCI on ischemic events

Author

Bhatt, D.L., Stone, G.W., Mahaffey, K.W., Gibson, C.M., Steg, P.G., Hamm, C.W., Price, M.J., Leonardi, S., Gallup, D., Bramucci, E., Radke, P.W., Widimsky, P., Tousek, F., Tauth, J., Spriggs, D., McLaurin, B.T., Angiolillo, D.J., Genereux, P., Liu, T., Prats, J., Todd, M., Skerjanec, S., White, H.D., Harrington, R.A., Verheugt, F.W., Bhatt, Dl, Stone, Gw, Mahaffey, Kw, Gibson, Cm, Steg, Pg, Hamm, Cw, Price, Mj, Leonardi, S, Gallup, D, Bramucci, E, Radke, Pw, Widimský, P, Tousek, F, Tauth, J, Spriggs, D, Mclaurin, Bt, Angiolillo, Dj, Généreux, P, Liu, T, Prats, J, Todd, M, Skerjanec, S, White, Hd, Harrington, Ra, CHAMPION PHOENIX, I. n. v. e. s. t. i. g. a. t. o. r. s., Galasso, Gennaro, and Cardiology

Subjects
Male, Ticlopidine, medicine.medical_treatment, Myocardial Ischemia, Hemorrhage, Kaplan-Meier Estimate, Revascularization, Loading dose, chemistry.chemical_compound, Cangrelor, Double-Blind Method, Angioplasty, medicine, Humans, cardiovascular diseases, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, Cardiovascular diseases [NCEBP 14], business.industry, Percutaneous coronary intervention, Thrombosis, General Medicine, Middle Aged, medicine.disease, Clopidogrel, Adenosine Monophosphate, Intention to Treat Analysis, chemistry, Anesthesia, Conventional PCI, Female, Stents, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Item does not contain fulltext BACKGROUND: The intensity of antiplatelet therapy during percutaneous coronary intervention (PCI) is an important determinant of PCI-related ischemic complications. Cangrelor is a potent intravenous adenosine diphosphate (ADP)-receptor antagonist that acts rapidly and has quickly reversible effects. METHODS: In a double-blind, placebo-controlled trial, we randomly assigned 11,145 patients who were undergoing either urgent or elective PCI and were receiving guideline-recommended therapy to receive a bolus and infusion of cangrelor or to receive a loading dose of 600 mg or 300 mg of clopidogrel. The primary efficacy end point was a composite of death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis at 48 hours after randomization; the key secondary end point was stent thrombosis at 48 hours. The primary safety end point was severe bleeding at 48 hours. RESULTS: The rate of the primary efficacy end point was 4.7% in the cangrelor group and 5.9% in the clopidogrel group (adjusted odds ratio with cangrelor, 0.78; 95% confidence interval [CI], 0.66 to 0.93; P=0.005). The rate of the primary safety end point was 0.16% in the cangrelor group and 0.11% in the clopidogrel group (odds ratio, 1.50; 95% CI, 0.53 to 4.22; P=0.44). Stent thrombosis developed in 0.8% of the patients in the cangrelor group and in 1.4% in the clopidogrel group (odds ratio, 0.62; 95% CI, 0.43 to 0.90; P=0.01). The rates of adverse events related to the study treatment were low in both groups, though transient dyspnea occurred significantly more frequently with cangrelor than with clopidogrel (1.2% vs. 0.3%). The benefit from cangrelor with respect to the primary end point was consistent across multiple prespecified subgroups. CONCLUSIONS: Cangrelor significantly reduced the rate of ischemic events, including stent thrombosis, during PCI, with no significant increase in severe bleeding. (Funded by the Medicines Company; CHAMPION PHOENIX ClinicalTrials.gov number, NCT01156571.).

Published
2013

103. Expert consensus document on the use of antiplatelet agents: 2010 update

Author

Patrono, C., Andreotti, F., Arnesen, H., Badimon, L., Baigent, C., Collet, J.P., Caterina, R. de, Gulba, D., Huber, K., Husted, S., Kristensen, S.D., Morais, J., Neumann, F.J., Rasmussen, L., Siegbahn, A., Steg, P.G., Storey, E., Werf, F. van de, and Verheugt, F.W.A.

Subjects
Cardiovascular diseases [NCEBP 14]
Abstract

Item does not contain fulltext

Published
2011

105. Cardiovascular events in acute coronary syndrome patients with peripheral arterial disease treated with ticagrelor compared to clopidogrel: Data from the PLATO trials

Author

Patel, Manesh R., Becker, Richard C., Wojdyla, Daniel M., Emanuelsson, Håkan, Hiatt, William, Horrow, Jay, Husted, Steen, Steg, P.G., Storey, R.F.., Wallentin, L., and James, S.K.

Abstract

14299: Cardiovascular Events in Acute Coronary Syndrome Patients With Peripheral Arterial Disease Treated With Ticagrelor Compared to Clopidogrel: Data From the PLATO Trial Manesh R Patel1; Richard C Becker1; Daniel M Wojdyla2; Håkan Emanuelsson3; William Hiatt4; Jay Horrow5; Steen Husted6; Kenneth W Mahaffey1; Phillippe G Steg7; Robert F Storey8; Lars Wallentin9; Stefan K James10 1 Cardiology, Duke Univ, Durham, NC, 2 Cardiology, Duke Clinical Rsch Institute - Duke Univ, Durham, NC, 3 Rsch and Development, AstraZeneca, 43183 Mölndal, Sweden 4 Cardiology, Univ of Colorado, Denver, CO, 5 Cardiology, AstraZeneca, Wilmington, DE, 6 Cardiology, Aarhus Univ Hosp, DK-8000 Aarhus C, Denmark 7 Cardiology, Hopital Bichat-Claude BernadService de Cardiologie, Paris, France 8 Dept of Cardiovascular Science, Univ of Sheffield, South Yorks, United Kingdom 9 Cardiology, Uppsala Clinical Rsch Cntr, 75185 Uppsala, Sweden 10 Cardiology, Uppsala Clinical Rsch center, 75185 Uppsala, Sweden Background: Patients with peripheral artery disease (PAD) and acute coronary syndrome (ACS) are at high risk for clinical events and are often difficult to manage. We evaluated cardiovascular outcomes of ACS patients with PAD treated with ticagrelor compared with clopidogrel in the PLATO Trial. Methods: The PLATO trial was a multicenter, double-blind, randomized trial, comparing ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading dose, 75 mg daily thereafter) for the prevention of cardiovascular events in 18,624 patients admitted with ACS. A post hoc analysis of patients with PAD (n=1144) at baseline compared to those without PAD (n=17,469) was performed for clinical characteristics and outcomes with ticagrelor and clopidogrel at 12 months. Results: PAD patients were older (66 vs. 62 years, p Conclusion: Patients with ACS and PAD have a high rate of death from vascular causes, MI, or stroke. Consistent with the overall trial, ticagrelor use compared to clopidogrel in the PAD patients resulted in similar reductions in clinical events without an increase in major bleeding

Published
2011

106. Stent Thrombosis in Drug-Eluting or Bare-Metal Stents in Patients Receiving Dual Antiplatelet Therapy.

Author

Darius H., Steg P.G., Gershlick A.H., Meredith I.T., Lee D.P., Kandzari D.E., Simon D.I., Iancu A.C., Trebacz J., Mauri L., Garratt K.N., Windecker S., Tanguay J.-F., Ormiston J., Kereiakes D.J., Yeh R.W., Massaro J.M., Driscoll-Shempp P., Cutlip D.E., Darius H., Steg P.G., Gershlick A.H., Meredith I.T., Lee D.P., Kandzari D.E., Simon D.I., Iancu A.C., Trebacz J., Mauri L., Garratt K.N., Windecker S., Tanguay J.-F., Ormiston J., Kereiakes D.J., Yeh R.W., Massaro J.M., Driscoll-Shempp P., and Cutlip D.E.

Abstract

Objectives This study sought to compare rates of stent thrombosis and major adverse cardiac and cerebrovascular events (MACCE) (composite of death, myocardial infarction, or stroke) after coronary stenting with drug-eluting stents (DES) versus bare-metal stents (BMS) in patients who participated in the DAPT (Dual Antiplatelet Therapy) study, an international multicenter randomized trial comparing 30 versus 12 months of dual antiplatelet therapy in subjects undergoing coronary stenting with either DES or BMS. Background Despite antirestenotic efficacy of coronary DES compared with BMS, the relative risk of stent thrombosis and adverse cardiovascular events is unclear. Many clinicians perceive BMS to be associated with fewer adverse ischemic events and to require shorter-duration dual antiplatelet therapy than DES. Methods Prospective propensity-matched analysis of subjects enrolled into a randomized trial of dual antiplatelet therapy duration was performed. DES- and BMS-treated subjects were propensity-score matched in a many-to-one fashion. The study design was observational for all subjects 0 to 12 months following stenting. A subset of eligible subjects without major ischemic or bleeding events were randomized at 12 months to continued thienopyridine versus placebo; all subjects were followed through 33 months. Results Among 10,026 propensity-matched subjects, DES-treated subjects (n = 8,308) had a lower rate of stent thrombosis through 33 months compared with BMS-treated subjects (n = 1,718, 1.7% vs. 2.6%; weighted risk difference -1.1%, p = 0.01) and a noninferior rate of MACCE (11.4% vs. 13.2%, respectively, weighted risk difference -1.8%, p = 0.053, noninferiority p < 0.001). Conclusions DES-treated subjects have long-term rates of stent thrombosis that are lower than BMS-treated subjects. (The Dual Antiplatelet Therapy Study [DAPT study]; NCT00977938)Copyright © 2015 American College of Cardiology Foundation.

Published
2015

110. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology

Author

Bassand, J. P., Hamm, C. W., Ardissino, D., Boersma, E., Budaj, A., Fernandez-Aviles, F., Fox, K. A., Hasdai, D., Ohman, E. M., Wallentin, L., Wijns, W., Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Kristensen, Steen Dalby, Widimsky, P., McGregor, K., Sechtem, U., Tendera, M., Hellemans, I., Gomez, J. L., Silber, S., Funck-Brentano, C., Andreotti, F., Benzer, W., Bertrand, M., Betriu, A., Desutter, J., Falk, V., Ortiz, A. F., Gitt, A., Hasin, Y., Huber, K., Kornowski, R., Lopez-Sendon, J., Morais, J., Nordrehaug, J. E., Steg, P.G., Thygesen, Kristian Anton, Tubaro, M., Turbie, A. G., Verheugt, F., and Windecker, S.

Published
2007

111. Comparison of Fondaparinux and Enoxaparin in Acute Coronary Syndromes

Author

Yusuf, S., Mehta, S.R., Bassand, J.P., Budaj, A., Chrolavicius, S., Fox, K.A.A., Granger, C.B., Joyner, C., Peters, R.J.G., Wallentin, L., Avezum, A., Boden, W., Cardona, E., Ceremuzynski, L., Col, J., Commerford, P.J., Diaz, R., Faxon, D., Flather, M., Fodor, G., Franzosi, M.G., Granger, C., Halon, D., Hunt, D., Karatzas, N., Keltai, M., Kenda, M., Kim, J.H., Lanas, F., Lau, C.P., Lewis, B.S., Morais, J., Moccetti, T., Pais, P., Paolasso, E., Parkhomenko, A., Petrauskiene, B., Piegas, L., Pipilis, A., Robaayah, D., Ruda, M., Rumboldt, Zoran, Rupprecht, H.J., Sitkei, E., Steg, P.G., Swahn, E., Theroux, P., Valentin, V., Varigos, J., Weitz, J., White, H., Widimsky, P., Xavier, D., Zhu, J.R., Ameriso, S., Bonilla, C., Braekken, S., Chan, Y.K., Chen, W., Chenniappan, M., Cohen, E., Cottin, Y., Csiba, L., Czepiel, A., de Raedt, H., Finet, G., Gardinale, E., Gaxiola, E., Gorecki, A., Gregor, P., Happola, O., Heras, M., Himbert, D., Irkin, O., Isaaz, K., Iyengar, S.S., Kalvach, P., Kevers, L., Klosiewicz-Wasek , B., Laine, M., Leys, D., Lundstrom, E., Lušić, Ivo, Lutay, Y., Maggioni, A., Massaro, A., Mayosi, B.M., Moulin, T., Narendra, J., Naslund, U., Peeters, A., Penicka, M., Perakis, A., Petersen, P., Polić, S., Radhakrishnan, S., Renkin, J., Stockins, B., Sundararajan, R., Thygesen, K., Turazza, F., van Belle, E., Vik-Mo, H., Zaborski, J., Sleight, P., Anderson , J.L., Johnstone D., Hirsh, J., de Mets, D., Holmes, D.R., Meeks, B., Afzal, R., Pogue, J., Boccalon, S., Chrysler, K., Cracknell, B., Horsman, C., Hoskin, T., Jedrzejowski. B., Johnson, J., Kotlan, S., Lawrence, M., Smiley, M., Stevens, C., Yallup, R., Connolly, S., Demers, C., Devereaux, P.J., Healey, J., Lonn, E., Magloire, P., McKelvie, R., Morillo, C., Natarajan, M., Rokoss, M., Teo, K., Valettas, N., Velianou, J., Bakula, Miro, Bergovec, M, Lukin Ajvor, Miličević, Goran, Padovan, Milko, and Raguž, M.

Subjects
ST-segment elevation, high-risk patients, unfractionated heparin, myocardial infarction, collaborative metaanalysis, randomized trials, initial treatment, american-college, task-force, prevention
Abstract

The combined use of anticoagulants, antiplatelet agents, and invasive coronary procedures reduces ischemic coronary events but also increases bleeding in patients with acute coronary syndromes. We therefore assessed whether fondaparinux would preserve the anti-ischemic benefits of enoxaparin while reducing bleeding. We randomly assigned 20, 078 patients with acute coronary syndromes to receive either fondaparinux (2.5 mg daily) or enoxaparin (1 mg per kilogram of body weight twice daily) for a mean of six days and evaluated death, myocardial infarction, or refractory ischemia at nine days (the primary outcome) ; major bleeding ; and their combination. Patients were followed for up to six months. The number of patients with primary-outcome events was similar in the two groups (579 with fondaparinux [5.8 percent] vs. 573 with enoxaparin [5.7 percent] ; hazard ratio in the fondaparinux group, 1.01 ; 95 percent confidence interval, 0.90 to 1.13), satisfying the noninferiority criteria. The number of events meeting this combined outcome showed a nonsignificant trend toward a lower value in the fondaparinux group at 30 days (805 vs. 864, P=0.13) and at the end of the study (1222 vs. 1308, P=0.06). The rate of major bleeding at nine days was markedly lower with fondaparinux than with enoxaparin (217 events [2.2 percent] vs. 412 events [4.1 percent] ; hazard ratio, 0.52 ; P

Published
2006

112. Apixaban vs. warfarin with concomitant aspirin in patients with atrial fibrillation: insights from the ARISTOTLE trial

Author

Alexander, J.H., Lopes, R.D., Thomas, L., Alings, M., Atar, D., Aylward, P., Goto, S., Hanna, M., Huber, K., Husted, S., Lewis, B.S., McMurray, J.J., Pais, P., Pouleur, H., Steg, P.G., Verheugt, F.W.A., Wojdyla, D.M., Granger, C.B., Wallentin, L., Alexander, J.H., Lopes, R.D., Thomas, L., Alings, M., Atar, D., Aylward, P., Goto, S., Hanna, M., Huber, K., Husted, S., Lewis, B.S., McMurray, J.J., Pais, P., Pouleur, H., Steg, P.G., Verheugt, F.W.A., Wojdyla, D.M., Granger, C.B., and Wallentin, L.

Abstract

Item does not contain fulltext, AIMS: We assessed the effect of concomitant aspirin use on the efficacy and safety of apixaban compared with warfarin in patients with atrial fibrillation (AF). METHODS AND RESULTS: In ARISTOTLE, 18 201 patients were randomized to apixaban 5 mg twice daily or warfarin. Concomitant aspirin use was left to the discretion of the treating physician. In this predefined analysis, simple and marginal structured models were used to adjust for baseline and time-dependent confounders associated with aspirin use. Outcome measures included stroke or systemic embolism, ischaemic stroke, myocardial infarction, mortality, major bleeding, haemorrhagic stroke, major or clinically relevant non-major bleeding, and any bleeding. On Day 1, 4434 (24%) patients were taking aspirin. Irrespective of concomitant aspirin use, apixaban reduced stroke or systemic embolism [with aspirin: apixaban 1.12% vs. warfarin 1.91%, hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.39-0.85 vs. without aspirin: apixaban 1.11% vs. warfarin 1.32%, HR 0.84, 95% CI 0.66-1.07; P interaction = 0.10] and caused less major bleeding than warfarin (with aspirin: apixaban 3.10% vs. warfarin 3.92%, HR 0.77, 95% CI 0.60-0.99 vs. without aspirin: apixaban 1.82% vs. warfarin 2.78%, HR without aspirin 0.65, 95% CI 0.55-0.78; P interaction = 0.29). Similar results were seen in the subgroups of patients with and without arterial vascular disease. CONCLUSION: Apixaban had similar beneficial effects on stroke or systemic embolism and major bleeding compared with warfarin, irrespective of concomitant aspirin use.

Published
2014

114. Bivalirudin started during emergency transport for primary PCI

Author

Steg, P.G., Hof, A. van't, Hamm, C.W., Clemmensen, P., Lapostolle, F., Coste, P., Berg, J. van den, Grunsven, P. van, Eggink, G.J., Nibbe, L., Zeymer, U., Orto, M. Campo dell', Nef, H., Steinmetz, J., Soulat, L., Huber, K., Deliargyris, E.N., Bernstein, D., Schuette, D., Prats, J., Clayton, T., Pocock, S., Hamon, M., Goldstein, P., Verheugt, F.W.A., et al., Steg, P.G., Hof, A. van't, Hamm, C.W., Clemmensen, P., Lapostolle, F., Coste, P., Berg, J. van den, Grunsven, P. van, Eggink, G.J., Nibbe, L., Zeymer, U., Orto, M. Campo dell', Nef, H., Steinmetz, J., Soulat, L., Huber, K., Deliargyris, E.N., Bernstein, D., Schuette, D., Prats, J., Clayton, T., Pocock, S., Hamon, M., Goldstein, P., Verheugt, F.W.A., and et al.

Abstract

Item does not contain fulltext, BACKGROUND: Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation of treatment, optional use of glycoprotein IIb/IIIa inhibitors and novel P2Y12 inhibitors, and radial-artery PCI access use is unknown. METHODS: We randomly assigned 2218 patients with ST-segment elevation myocardial infarction (STEMI) who were being transported for primary PCI to receive either bivalirudin or unfractionated or low-molecular-weight heparin with optional glycoprotein IIb/IIIa inhibitors (control group). The primary outcome at 30 days was a composite of death or major bleeding not associated with coronary-artery bypass grafting (CABG), and the principal secondary outcome was a composite of death, reinfarction, or non-CABG major bleeding. RESULTS: Bivalirudin, as compared with the control intervention, reduced the risk of the primary outcome (5.1% vs. 8.5%; relative risk, 0.60; 95% confidence interval [CI], 0.43 to 0.82; P=0.001) and the principal secondary outcome (6.6% vs. 9.2%; relative risk, 0.72; 95% CI, 0.54 to 0.96; P=0.02). Bivalirudin also reduced the risk of major bleeding (2.6% vs. 6.0%; relative risk, 0.43; 95% CI, 0.28 to 0.66; P<0.001). The risk of acute stent thrombosis was higher with bivalirudin (1.1% vs. 0.2%; relative risk, 6.11; 95% CI, 1.37 to 27.24; P=0.007). There was no significant difference in rates of death (2.9% vs. 3.1%) or reinfarction (1.7% vs. 0.9%). Results were consistent across subgroups of patients. CONCLUSIONS: Bivalirudin, started during transport for primary PCI, improved 30-day clinical outcomes with a reduction in major bleeding but with an increase in acute stent thrombosis. (Funded by the Medicines Company; EUROMAX ClinicalTrials.gov number, NCT01087723.).

Published
2013

115. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Author

Steg, P.G., James, S.K., Atar, D., Badano, L.P., Blomstrom-Lundqvist, C., Borger, M.A., Di Mario, C., Dickstein, K., Ducrocq, G., Fernandez-Aviles, F., Gershlick, A.H., Giannuzzi, P., Halvorsen, S., Huber, K., Juni, P., Kastrati, A., Knuuti, J., Lenzen, M.J., Mahaffey, K.W., Valgimigli, M., van 't Hof, A., Widimsky, P., Zahger, D., Verheugt, F.W., et al., Steg, P.G., James, S.K., Atar, D., Badano, L.P., Blomstrom-Lundqvist, C., Borger, M.A., Di Mario, C., Dickstein, K., Ducrocq, G., Fernandez-Aviles, F., Gershlick, A.H., Giannuzzi, P., Halvorsen, S., Huber, K., Juni, P., Kastrati, A., Knuuti, J., Lenzen, M.J., Mahaffey, K.W., Valgimigli, M., van 't Hof, A., Widimsky, P., Zahger, D., Verheugt, F.W., and et al.

Abstract

Item does not contain fulltext

Published
2012

116. Stent thrombosis and major clinical events at 3 years after zotarolimus-eluting or sirolimus-eluting coronary stent implantation: a randomised, multicentre, open-label, controlled trial

Author

Camenzind, E., Wijns, W., Mauri, L., Kurowski, V., Parikh, K., Gao, R., Bode, C., Greenwood, J.P., Boersma, E., Vranckx, P., McFadden, E., Serruys, P.W., O'Neil, W.W., Jorissen, B., Leeuwen, F van, Steg, P.G., Verheugt, F.W., et al., Camenzind, E., Wijns, W., Mauri, L., Kurowski, V., Parikh, K., Gao, R., Bode, C., Greenwood, J.P., Boersma, E., Vranckx, P., McFadden, E., Serruys, P.W., O'Neil, W.W., Jorissen, B., Leeuwen, F van, Steg, P.G., Verheugt, F.W., and et al.

Abstract

Item does not contain fulltext, BACKGROUND: We sought to compare the long-term safety of two devices with different antiproliferative properties: the Endeavor zotarolimus-eluting stent (E-ZES; Medtronic, Inc) and the Cypher sirolimus-eluting stent (C-SES; Cordis, Johnson & Johnson) in a broad group of patients and lesions. METHODS: Between May 21, 2007 and Dec 22, 2008, we recruited 8791 patients from 36 recruiting countries to participate in this open-label, multicentre, randomised, superiority trial. Eligible patients were those aged 18 years or older undergoing elective, unplanned, or emergency procedures in native coronary arteries. Patients were randomly assigned to either receive E-ZES and C-SES (ratio 1:1). Randomisation was stratified per centre with varying block sizes of four, six, or eight patients, and concealed with a central telephone-based or web-based allocation service. The primary outcome was definite or probable stent thrombosis at 3 years and was analysed by intention to treat. Patients and investigators were aware of treatment assignment. This trial is registered with ClinicalTrials.gov, number NCT00476957. FINDINGS: PROTECT randomised 8791 patients, of whom 8709 provided consent to participate and were eligible: 4357 were allocated to the E-ZES group and 4352 patients to the C-SES group. At 3 years, rates of definite or probable stent thrombosis did not differ between groups (1.4% for E-ZES [predicted: 1.5%] vs 1.8% [predicted: 2.5%] for C-SES; hazard ratio [HR] 0.81, 95% CI 0.58-1.14, p=0.22). Dual antiplatelet therapy was used in 8402 (96%) patients at discharge, 7456 (88%) at 1 year, 3041 (37%) at 2 years, and 2364 (30%) at 3 years. INTERPRETATION: No evidence of superiority of E-ZES compared with C-SES in definite or probable stent thrombosis rates was noted at 3 years. Time analysis suggests a difference in definite or probable stent thrombosis between groups is emerging over time, and a longer follow-up is therefore needed given the clinical relevance of stent thrombosi

Published
2012

117. Bleeding in acute coronary syndromes and percutaneous coronary interventions: position paper by the Working Group on Thrombosis of the European Society of Cardiology

Author

Steg, P.G., Huber, K., Andreotti, F., Arnesen, H., Atar, D., Badimon, L., Bassand, J.P., De Caterina, R., Eikelboom, J.A., Gulba, D., Hamon, M., Helft, G., Fox, K.A., Kristensen, S.D., Rao, S.V., Verheugt, F.W.A., Widimsky, P., Zeymer, U., Collet, J.P., Steg, P.G., Huber, K., Andreotti, F., Arnesen, H., Atar, D., Badimon, L., Bassand, J.P., De Caterina, R., Eikelboom, J.A., Gulba, D., Hamon, M., Helft, G., Fox, K.A., Kristensen, S.D., Rao, S.V., Verheugt, F.W.A., Widimsky, P., Zeymer, U., and Collet, J.P.

Abstract

Item does not contain fulltext, Bleeding has recently emerged as an important outcome in the management of acute coronary syndromes (ACS), which is relatively frequent compared with ischaemic outcomes and has important implications in terms of prognosis, outcomes, and costs. In particular, there is evidence that patients experiencing major bleeding in the acute phase are at higher risk for death in the following months, although the causal nature of this relation is still debated. This position paper aims to summarize current knowledge regarding the epidemiology of bleeding in ACS and percutaneous coronary intervention, including measurement and definitions of bleeding, with emphasis on the recent consensus Bleeding Academic Research Consortium (BARC) definitions. It also provides an European perspective on management strategies to minimize the rate, extent, and consequences of bleeding. Finally, the research implications of bleeding (measuring and reporting bleeding in trials, the importance of bleeding as an outcome measure, and bleeding as a subject for future research) are also discussed.

Published
2011

118. The future of clinical trials in secondary prevention after acute coronary syndromes

Author

Bueno, H., Armstrong, P.W., Buxton, M.J., Danchin, N., Lubsen, J., Roland, E., Verheugt, F.W.A., Zalewski, A., Jackson, N., Komajda, M., Steg, P.G., Bueno, H., Armstrong, P.W., Buxton, M.J., Danchin, N., Lubsen, J., Roland, E., Verheugt, F.W.A., Zalewski, A., Jackson, N., Komajda, M., and Steg, P.G.

Abstract

Contains fulltext : 97431.pdf (publisher's version ) (Closed access)

Published
2011

119. Incidence, prognostic impact, and influence of antithrombotic therapy on access and nonaccess site bleeding in percutaneous coronary intervention

Author

Verheugt, F.W.A., Steinhubl, S.R., Hamon, M., Darius, H., Steg, P.G., Valgimigli, M., Marso, S.P., Rao, S.V., Gershlick, A.H., Lincoff, A.M., Mehran, R., Stone, G.W., Verheugt, F.W.A., Steinhubl, S.R., Hamon, M., Darius, H., Steg, P.G., Valgimigli, M., Marso, S.P., Rao, S.V., Gershlick, A.H., Lincoff, A.M., Mehran, R., and Stone, G.W.

Abstract

Item does not contain fulltext, OBJECTIVES: The aim of this study was to evaluate the relative frequency of access and nonaccess site bleeding, the association of these events with 1-year mortality, and the impact of randomized antithrombotic therapy. BACKGROUND: Post-percutaneous coronary intervention (PCI) bleeding has been strongly associated with subsequent mortality. The extent to which access versus nonaccess site bleeding contributes to this poor prognosis and the role of antithrombotic therapies remains poorly understood. METHODS: The incidence and impact of Thrombolysis In Myocardial Infarction (TIMI) major/minor 30-day bleeding and randomized antithrombotic therapy were examined in a combined dataset from the REPLACE-2 (Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events), Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY), and HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trials in 17,393 PCI patients. RESULTS: The TIMI major/minor bleeding occurred in 5.3% of patients, 61.4% of which (3.3%) were nonaccess site bleeds. After multivariable adjustment, TIMI bleeding was associated with an increased risk of 1-year mortality (hazard ratio [HR]: 3.17, 95% confidence interval [CI]: 2.51 to 4.00, p < 0.0001). The HR of a nonaccess site bleed was approximately 2-fold that of an access site bleed: HR: 3.94, 95% CI: 3.07 to 5.15, p < 0.0001 versus HR: 1.82, 95% CI: 1.17 to 2.83, p = 0.008, respectively. Randomization to bivalirudin versus heparin + a glycoprotein IIb/IIIa inhibitor resulted in 38% and 43% relative reductions in TIMI major/minor and TIMI major bleeding, respectively (p < 0.0001 for both), with significant reductions in both access and nonaccess site bleeding. CONCLUSIONS: Nonaccess site bleeding after PCI is common, representing approximately two-thirds of all TIMI bleeding events, and is associated with a 4-fold increase in 1-year mortality. Use of bivalirudin rather than heparin + a g

Published
2011

120. Meeting report ESC Forum on Drug Eluting Stents, European Heart House, Nice, 27-28 September 2007

Author

Daemen, J. (Joost), Simoons, M.L. (Maarten), Wijns, W. (William), Bagust, A. (Adrian), Bos, G. (Gert), Bowen, J.M. (James), Braunwald, E. (Eugene), Camenzind, E. (Edoardo), Chevalier, B. (Bernard), DiMario, C. (Carlo), Fajadet, J. (Jean), Gitt, A.K. (Anselm), Guagliumi, G. (Giulio), Hillege, H.L. (Hans), James, S.K. (Stefan), Jüni, P. (Peter), Kastrati, A. (Adnan), Kloth, S. (Sabine), Kristensen, S.D. (Steen), Krucoff, M. (Mitchell), Legrand, V.M.G. (Victor), Pfisterer, M.E. (Matthias), Rothman, M. (Martin), Serruys, P.W.J.C. (Patrick), Silber, S. (Sigmund), Steg, P.G. (Philippe Gabriel), Tariah, I. (Ibrahim), Wallentin, L.C. (Lars), Windecker, S.W. (Stephan), Daemen, J. (Joost), Simoons, M.L. (Maarten), Wijns, W. (William), Bagust, A. (Adrian), Bos, G. (Gert), Bowen, J.M. (James), Braunwald, E. (Eugene), Camenzind, E. (Edoardo), Chevalier, B. (Bernard), DiMario, C. (Carlo), Fajadet, J. (Jean), Gitt, A.K. (Anselm), Guagliumi, G. (Giulio), Hillege, H.L. (Hans), James, S.K. (Stefan), Jüni, P. (Peter), Kastrati, A. (Adnan), Kloth, S. (Sabine), Kristensen, S.D. (Steen), Krucoff, M. (Mitchell), Legrand, V.M.G. (Victor), Pfisterer, M.E. (Matthias), Rothman, M. (Martin), Serruys, P.W.J.C. (Patrick), Silber, S. (Sigmund), Steg, P.G. (Philippe Gabriel), Tariah, I. (Ibrahim), Wallentin, L.C. (Lars), and Windecker, S.W. (Stephan)

Published
2009
Full Text
View/download PDF

123. 758 High Use of Guideline-Recommended Therapies in Canadian Outpatients with Stable Coronary Artery Disease: Insights From the Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease (CLARIFY) Registry

Author

Gandhi, S., primary, Dorian, P., additional, Tardif, J.C., additional, Steg, P.G., additional, Huynh, T., additional, Wong, G.C., additional, Love, M.P., additional, Jervis, K., additional, and Goodman, S.G., additional

Published
2012
Full Text
View/download PDF

124. 340 How Do Canadian Patients With Stable Coronary Artery Disease Compare to the Rest of the World? A Description of Secondary Prevention Targets in the Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease (Clarify) Registry

Author

Gandhi, S., primary, Dorian, P., additional, Tardif, J.C., additional, Steg, P.G., additional, Huynh, T., additional, Wong, G.C., additional, Love, M.P., additional, Jervis, K., additional, and Goodman, S.G., additional

Published
2012
Full Text
View/download PDF

126. Expert consensus document on the use of antiplatelet agents. The task force on the use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the European society of cardiology.

Author

Patrono, C., Bachmann, F., Baigent, C., Bode, C., Caterina, R. de, Charbonnier, B., Fitzgerald, D., Hirsh, J., Husted, S., Kvasnicka, J., Montalescot, G., Garcia Rodriguez, L.A., Verheugt, F.W.A., Vermylen, J., Wallentin, L., Priori, S.G., Alonso Garcia, M.A., Blanc, J.J., Budaj, A., Cowie, M., Dean, V., Deckers, J.A., Fernandez Bugos, E., Lekakis, J., Lindahl, B., Mazzotta, G., Steg, P.G., Teixeira, F., Wilcox, R., Patrono, C., Bachmann, F., Baigent, C., Bode, C., Caterina, R. de, Charbonnier, B., Fitzgerald, D., Hirsh, J., Husted, S., Kvasnicka, J., Montalescot, G., Garcia Rodriguez, L.A., Verheugt, F.W.A., Vermylen, J., Wallentin, L., Priori, S.G., Alonso Garcia, M.A., Blanc, J.J., Budaj, A., Cowie, M., Dean, V., Deckers, J.A., Fernandez Bugos, E., Lekakis, J., Lindahl, B., Mazzotta, G., Steg, P.G., Teixeira, F., and Wilcox, R.

Abstract

Contains fulltext : 58492.pdf (publisher's version ) (Closed access)

Published
2004

134. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events

Author

Bhatt, D.L., primary, Fox, K.A., additional, Hacke, W., additional, Berger, P.B., additional, Black, H.R., additional, Boden, W.E., additional, Cacoub, P., additional, Cohen, E.A., additional, Creager, M.A., additional, Easton, J.D., additional, Flather, M.D., additional, Haffner, S.M., additional, Hamm, C.W., additional, Hankey, G.J., additional, Johnston, S.C., additional, Mak, K.H., additional, Mas, J.L., additional, Montalescot, G., additional, Pearson, T.A., additional, Steg, P.G., additional, Steinhubl, S.R., additional, Weber, M.A., additional, Brennan, D.M., additional, Fabry-Ribaudo, L., additional, Booth, J., additional, and Topol, E.J., additional

Published
2006
Full Text
View/download PDF

140. Assessment of coronary angiograms prior to and after treatment with abciximab, and the outcome of angioplasty in refractory unstable angina patients. Angiographic results from the CAPTURE trial.

Author

Brand, M.J.B.M. (Marcel) van den, Laarman, G-J. (GertJan), Steg, P.G. (Philippe Gabriel), Scheerder, I.K. (Ivan) de, Heyndrickx, G.R. (Guy), Beatt, K.J. (Kevin), Kootstra, J.G. (Jille), Simoons, M.L. (Maarten), Brand, M.J.B.M. (Marcel) van den, Laarman, G-J. (GertJan), Steg, P.G. (Philippe Gabriel), Scheerder, I.K. (Ivan) de, Heyndrickx, G.R. (Guy), Beatt, K.J. (Kevin), Kootstra, J.G. (Jille), and Simoons, M.L. (Maarten)

Abstract

BACKGROUND: The CAPTURE study (c 7E3 A nti P latelet T herapy in U nstable Re fractory angina) was designed to assess outcome in patients with refractory angina undergoing angioplasty, receiving either abciximab or placebo. METHODS: One thousand two hundred and sixty-five patients with refractory unstable angina, defined as recurrent myocardial ischaemia despite medical treatment including heparin and nitrates were enrolled. After angiography, patients received an infusion of abciximab or placebo over 18-24 h preceding angioplasty, continuing until 1 h after the procedure. In 1197 patients undergoing angioplasty the angiographic committee centrally reviewed the baseline as well as the procedural angiograms. Coronary flow and lesion characteristics were assessed in the baseline angiogram as well as before intervention. Angiographic outcome, reason for failure as well as complications were assessed after angioplasty. RESULTS: At 30 days follow-up, patients receiving abciximab (n=595) compared with placebo (

Published
1999
Full Text
View/download PDF

145. Vectorcardiographic monitoring to assess early vessel patency after reperfusion therapy for acute myocardial infarction

Author

Dellborg, M., Steg, P.G. (Philippe Gabriel), Simoons, M.L. (Maarten), Dietz, R., Sen, S. (Semi), Lotze, U. (Ulrich), Himbert, D., Svensson, A.M., Swedberg, K. (Karl), Brand, M.J.B.M. (Marcel) van den, Wieken, L.R. (Ron) van der, Hauck, S., Dellborg, M., Steg, P.G. (Philippe Gabriel), Simoons, M.L. (Maarten), Dietz, R., Sen, S. (Semi), Lotze, U. (Ulrich), Himbert, D., Svensson, A.M., Swedberg, K. (Karl), Brand, M.J.B.M. (Marcel) van den, Wieken, L.R. (Ron) van der, and Hauck, S.

Abstract

Reperfusion therapy has lowered mortality in patients suffering from acute myocardial infarction. Failure to reperfuse is associated with an increased short- and long-term mortality. In a prospective study we used dynamic vectorcardiography to monitor 96 patients with acute myocardial infarction treated with reperfusion therapy to non-invasively assess coronary patency. The results from continuous monitoring were compared to those obtained from angiography. By using trend-analysis of QRS vector difference and ST vector magnitude, we were able to correctly identify 58 of the 70 patients (83%) with a reperfused infarct-related artery, and 19 of the 26 patients (73%) with a persistently occluded artery demonstrated at an early angiogram (diagnostic accuracy 80%). In patients with high-grade collateral flow to the infarct-related area, the results of the vectorcardiographic monitoring and of angiography showed the largest disagreement, whereas the accuracy of vectorcardiographic monitoring was high: 88% among patients without collaterals. The present results suggest that QRS complex and ST segment vectorcardiographic monitoring is a useful tool for assessing early coronary artery patency, and that dynamic vectorcardiography may help in identifying candidates for emergency coronary angiography.

Published
1995

Catalog

Books, media, physical & digital resources
See catalog results