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Acute coronary syndrome in very elderly patients —a real-world experience
AbstractVery elderly population constitutes an increasingly larger proportion of patients admitted for acute coronary syndromes (ACS). Notably, age represents both a proxy of frailty and an exclusion criterion in clinical randomized trials, which probably contributes to lack of data and undertreatment of real-world elderly patients. The aim of the study is to describe patterns of treatment and outcome of very elderly patients with ACS. All consecutive patients aged  ≥ 80 years old (yo) admitted between January 2017 and December 2019 with ACS were included. The primary endpoint was in-hospital occurrence of major adv...
Source: Heart and Vessels - July 15, 2023 Category: Cardiology Source Type: research

Comparison of effects of triple antithrombotic therapy and dual antiplatelet therapy on long-term outcomes of acute myocardial infarction
This study aimed to compare the long-term outcome of triple antithrombotic therapy (TAT) with that of dual antiplatelet therapy (DAPT) after AMI. This was a nationwide, propensity score-matched, case –control study of 186,112 first AMI patients, of whom 2,825 received TAT comprising aspirin, clopidogrel, and warfarin. Propensity score matching in a ratio of 1:4 by age, sex, comorbidities, and treatment was adopted, Finally, 2,813 AMI patients and 11,252 matched controls that were administered TAT and DAPT (aspirin and clopidogrel), respectively, were included in our analysis. The 12-year overall survival rate did not dif...
Source: Heart and Vessels - October 8, 2020 Category: Cardiology Source Type: research

Cilostazol-based triple versus potent P2Y12 inhibitor-based dual antiplatelet therapy in patients with acute myocardial infarction undergoing percutaneous coronary intervention
AbstractAlthough potent P2Y12 inhibitor-based dual antiplatelet therapy (DAPT) has replaced clopidogrel-based therapy as the standard treatment in patients with acute myocardial infarction (AMI), there is a concern about the risk of bleeding in East Asian patients. We compared the efficacy and safety of cilostazol-based triple antiplatelet therapy (TAT) with potent P2Y12 inhibitor-based DAPT in Korean patients. A total of 4152 AMI patients who underwent percutaneous coronary intervention (PCI) in the Korea Acute Myocardial Infarction Registry were analyzed retrospectively. Patients were divided into two groups: the TAT gro...
Source: Heart and Vessels - April 7, 2020 Category: Cardiology Source Type: research

Multicenter research of bleeding risk between prasugrel and clopidogrel in Japanese patients with coronary artery disease undergoing percutaneous coronary intervention
AbstractAlthough it has been reported that prasugrel achieves stronger antiplatelet effect and fewer cardiovascular events compared to clopidogrel in Japanese patients, there are limited data comparing the safety between the 2 dose regimens. Data from 1031 consecutive patients with coronary artery disease undergoing PCI at 5 institutions from May 2014 to April 2016, who received aspirin plus either clopidogrel (619 patients) or prasugrel (412 patients), were retrospectively analyzed. The choice of  clopidogrel or prasugrel was left to the operator's discretion. Adverse events were defined as a composite of bleeding, hepat...
Source: Heart and Vessels - April 2, 2019 Category: Cardiology Source Type: research

Antiplatelet therapy in Takotsubo cardiomyopathy: does it improve cardiovascular outcomes during index event?
Abstract Plasma catecholamines may play an important role in Takotsubo cardiomyopathy (TCM) pathophysiology. Patients with disproportionately high catecholamine responses to stressful events are prone to worse clinical outcomes. Catecholamines stimulate platelet activation and, therefore, may determine the clinical presentation and outcomes of TCM. We conducted a retrospective, descriptive study TCM patients admitted between 2003 and 2013 to Einstein Medical Center, Philadelphia, PA, USA and Danbury Hospital, Danbury, CT, USA. A total of 206 patients met Modified Mayo TCM criteria. Using a multiple logistic model,...
Source: Heart and Vessels - August 13, 2015 Category: Cardiology Source Type: research

Comparison of new adenosine diphosphate receptor antagonists with clopidogrel in patients with coronary artery disease: a meta-analysis
Abstract Recent data suggest the superiority of new adenosine diphosphate (ADP) receptor antagonists compared with clopidogrel in acute coronary syndrome patients. We aimed to assess the risks and benefits of new ADP receptor antagonists in patients with coronary artery disease (CAD). Relevant studies published through February 28, 2014 were searched and identified in the MEDLINE, EMBASE, and Cochrane databases. Summary estimates were obtained using a random-effects model. All nine published randomized controlled studies comparing new ADP receptor antagonists with clopidogrel in CAD were included. The database con...
Source: Heart and Vessels - November 6, 2014 Category: Cardiology Source Type: research