Back to Search
Start Over
Association of Parenteral Anticoagulation Therapy With Outcomes in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Without Invasive Therapy: Findings from the Improving Care for Cardiovascular Disease in China (CCC) project
- Source :
- Clinical pharmacology and therapeutics. 110(4)
- Publication Year :
- 2021
-
Abstract
- Our previous study showed that parenteral anticoagulation therapy (PACT) in the context of aggressive antiplatelet therapy failed to improve clinical outcomes in patients undergoing percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome (NSTE-ACS). However, the role of PACT in patients managed medically remains unknown. This observational cohort study enrolled patients with NSTE-ACS receiving medical therapy from November 2014 to June 2017 in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project. Eligible patients were included in the PACT group and non-PACT group. The primary outcomes were in-hospital all-cause mortality and major bleeding. The secondary outcome included minor bleeding. Among 23,726 patients, 8,845 eligible patients who received medical therapy were enrolled. After adjusting the potential confounders, PACT was not associated with a lower risk of in-hospital all-cause mortality (adjusted odds ratio (OR), 1.25; 95% confidence interval (CI), 0.92-1.71; P = 0.151). Additionally, PACT did not increase the incidence of major bleeding or minor bleeding (major bleeding: adjusted OR, 1.04; 95% CI, 0.80-1.35; P = 0.763; minor bleeding: adjusted OR, 1.27; 95% CI, 0.91-1.75; P = 0.156). The propensity score analysis confirmed the primary analyses. In patients with NSTE-ACS receiving antiplatelet therapy, PACT was not associated with a lower risk of in-hospital all-cause mortality or a higher bleeding risk in patients with NSTE-ACS receiving non-invasive therapies and concurrent antiplatelet strategies. Randomized clinical trials are warranted to reevaluate the safety and efficacy of PACT in all patients with NSTE-ACS who receive noninvasive therapies and current antithrombotic strategies.
- Subjects :
- Male
medicine.medical_specialty
Acute coronary syndrome
China
medicine.medical_treatment
Myocardial Infarction
Hemorrhage
Pact
Lower risk
law.invention
Injections
Randomized controlled trial
law
Recurrence
Internal medicine
medicine
Humans
Pharmacology (medical)
Infusions, Parenteral
Angina, Unstable
Hospital Mortality
Acute Coronary Syndrome
Non-ST Elevated Myocardial Infarction
Aged
Ischemic Stroke
Pharmacology
Aged, 80 and over
business.industry
Heparin
Dual Anti-Platelet Therapy
Percutaneous coronary intervention
Anticoagulants
Odds ratio
Heparin, Low-Molecular-Weight
Middle Aged
medicine.disease
Fondaparinux
Propensity score matching
Female
business
Cohort study
Subjects
Details
- ISSN :
- 15326535
- Volume :
- 110
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Clinical pharmacology and therapeutics
- Accession number :
- edsair.doi.dedup.....056d30549b9b2982f22c369a9f3ba6a0