Guideline-Based Medications for Older Adults Discharged after Percutaneous Coronary Intervention in a Suburban City of Japan: A Cohort Study Using Claims Data.

Guideline-Based Medications for Older Adults Discharged after Percutaneous Coronary Intervention in a Suburban City of Japan: A Cohort Study Using Claims Data. Tohoku J Exp Med. 2020;252(2):143-152 Authors: Shimada K, Hamada S, Sawano M, Yamamoto H, Yoshie S, Iijima K, Miyata H Abstract Secondary prevention with medications is essential for the better prognosis of patients who have experienced cardiovascular events. We aimed to evaluate the use of guideline-based medications for secondary prevention in older adults in the community settings after discharge following percutaneous coronary intervention (PCI). A retrospective cohort study was conducted using anonymized claims data of older beneficiaries in a suburban city of Japan between April 2012 and March 2015. The prescriptions of antiplatelets, statins, angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARB), and β-blockers were evaluated for 3 months before and after the month in which the participants underwent PCI. Multivariable logistic regression analysis was conducted to evaluate the associations of age ("pre-old" group [63-72 years] vs. "old" group [≥ 73 years]) and sex with the prescriptions, adjusting for whether a participant was followed-up by the PCI-performing hospital. Of 815 participants, 59.6% constituted the old group and 70.9% were men. The prescription rates for antiplatelets, statins, ACEi/ARB, and β-blockers after dis...
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research

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In conclusion, PPAR-α G209A and A208G were associated with lower platelet reactivity in patients undergoing elective PCI who were treated with clopidogrel and statin/fibrate co-medication. Further research is necessary to confirm these findings.
Source: Genes - Category: Genetics & Stem Cells Authors: Tags: Article Source Type: research
AbstractLittle is known about the impact of a high-dose statin on cardiovascular outcomes after ST-elevation acute myocardial infarction (STEMI) in real-world Japanese patients. Between July 2011 and June 2017, 1110 consecutive STEMI patients underwent primary percutaneous coronary intervention at our hospital and were discharged. A high-dose statin was administered in 117 patients (10.5%) and non-high-dose statin was administered in 947 patients (85.3%). The low-density lipoprotein cholesterol level was significantly higher in the high-dose statin group at admission (129.8  ± 44.9 vs. 110.4 &pl...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Abstract BACKGROUND: Whether Vitamin D deficiency represents an independent predictor of mortality and major cardiovascular events or rather the mirror of a more advanced clinical condition with increased comorbidities is still debated. We aimed at assessing the impact of vitamin D levels on the long-term outcomes among patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention. METHODS: Consecutive patients from a single centre were included. Vitamin D levels were measured at admission by chemiluminescence immunoassay kit LIAISON® Vitamin D assay (Diasorin Inc). Severe defi...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
AbstractBackgroundUnlike neighboring countries, the Netherlands does not have a national acute coronary syndrome (ACS) registry to evaluate quality of care.ObjectiveWe conducted a pilot registry in two hospitals to assess the prescription of guideline-recommended therapies in Dutch patients with ACS.MethodsWe included all consecutive patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) (n = 1309) admitted to two Dutch percutaneous coronary intervention centers between March 2015 and February 2016. We collected follow-up medication use and reasons for discontinuation at discharge and 1, ...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
CONCLUSION: Treatment completion might be improved. Among patients who completed the treatment, implementation was high. The factors associated with completion could help to identify patients who might benefit from interventions that aim to optimize treatment completion. PMID: 32722910 [PubMed - in process]
Source: Journal of Population Therapeutics and Clinical Pharmacology - Category: Drugs & Pharmacology Tags: J Popul Ther Clin Pharmacol Source Type: research
Conclusion: The DM patients had high-risk plaque composition features like a higher necrotic core, which is a marker of plaque vulnerability. Thus, aggressive medical therapy targeting vascular inflammation using high-dose statins would help in the stabilization of unstable plaque morphology and the reduction of major cardiovascular events.Cardiology
Source: Cardiology - Category: Cardiology Source Type: research
ConclusionsThe in-hospital high-dose intensive statins are not associated with the lower risk of in-hospital or 30-day all-cause death among ASCVD patients undergoing PCI. Given the robust beneficial effect of high-dose intensive statins with in-hospital dialysis, an individualized high-dose intensive statin therapy can be rational in specified populations.
Source: European Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Source Type: research
AbstractThe pivotal studies that led to the recommendations for emergent reperfusion therapy for ST-elevation myocardial infarction (STEMI) were conducted for the most part over 25  years ago. At that time, contemporary standard treatments including aspirin, statin, and even anticoagulation were not commonly used. The 2013 American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines and the 2017 European Society of Cardiology guidelines give a class I recommendation (with the level of evidence A) for primary percutaneous coronary intervention (pPCI) in patients with STEMI and ischemic s...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
Authors: Tang B, Xiao S Abstract Objective: To analyze the risk factors for upper gastrointestinal bleeding (UGIB) in patients with ST-segment elevation myocardial infarction (STEMI) during double antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). Methods: A total of 388 patients treated from January 2015 to September 2017 due to STEMI were selected. Thirty-two cases of UGIB occurring during DAPT after PCI were included as a UGIB group, and another 356 cases without UGIB were set as a control group. Age, gender, body mass index, smoking, drinking, history of previous diseases (hypertens...
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
In this study, we have evaluated the detailed therapeutic effect of statin plus ezetimibe intensive therapy. METHOD: For STEMI patients with non-IRA disease undergoing primary percutaneous coronary intervention (PCI), 183 control STEMI patients without non-IRA disease undergoing primary PCI, and 200 STEMI patients with non-IRA disease undergoing primary PCI were introduced into this study. 200 STEMI patients with non-IRA disease undergoing primary PCI were divided into Normal group, Intensive group, Normal &Combined group, and Intensive &Combined group. The baseline information for each participant was recorde...
Source: Current Pharmaceutical Biotechnology - Category: Biotechnology Authors: Tags: Curr Pharm Biotechnol Source Type: research
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