A5057167171- Acute Myocardial Infarction Research
- Antiplatelet Therapy and Cardiovascular Diseases
- Coronary Interventions and Diagnostics
- Atrial Fibrillation Management and Outcomes
- Cardiac Imaging and Diagnostics
- Venous Thromboembolism Diagnosis and Management
- Vascular Procedures and Complications
- Lipoproteins and Cardiovascular Health
- Peripheral Artery Disease Management
- Cardiac Valve Diseases and Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Heart Failure Treatment and Management
- Cardiovascular Function and Risk Factors
- Diabetes Treatment and Management
- Health Systems, Economic Evaluations, Quality of Life
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Central Venous Catheters and Hemodialysis
- Cardiac Arrhythmias and Treatments
- Cardiac electrophysiology and arrhythmias
- Blood Pressure and Hypertension Studies
- Acute Ischemic Stroke Management
- Cardiovascular Disease and Adiposity
- Cerebrovascular and Carotid Artery Diseases
- Heparin-Induced Thrombocytopenia and Thrombosis
- Healthcare cost, quality, practices
Hamilton Health Sciences
2016-2025
Population Health Research Institute
2016-2025
McMaster University
2016-2025
Universidad Autónoma de Madrid
2024
Radboud University Medical Center
2024
Christ Hospital
2015-2024
Health Net
2024
Radboud University Nijmegen
2024
Sorbonne Université
2024
St Mary's Hospital
2024
The use of multiple antithrombotic drugs and aggressive invasive strategies has increased the risk major bleeding in acute coronary syndrome (ACS) patients. It is not known to what extent determines clinical outcome.Using Cox proportional-hazards modeling, we examined association between death or ischemic events 34,146 patients with ACS enrolled Organization Assess Ischemic Syndromes Clopidogrel Unstable Angina Prevent Recurrent Events studies. Patients were older, more often had diabetes a...
ContextDespite many therapeutic advances, mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) remains high. The role of additional antithrombotic agents is unclear, especially among not receiving reperfusion therapy.ObjectiveTo evaluate the effect fondaparinux, a factor Xa inhibitor, when initiated early and given for up to 8 days vs usual care (placebo those whom unfractionated heparin [UFH] indicated [stratum 1] or 48 hours followed by placebo 2])...
Earlier trials have shown that a routine invasive strategy improves outcomes in patients with acute coronary syndromes without ST-segment elevation. However, the optimal timing of such intervention remains uncertain.We randomly assigned 3031 to undergo either early (coronary angiography < or = 24 hours after randomization) delayed > 36 randomization). The primary outcome was composite death, myocardial infarction, stroke at 6 months. A prespecified secondary refractory ischemia...
Monotherapy with a P2Y12 inhibitor after minimum period of dual antiplatelet therapy is an emerging approach to reduce the risk bleeding percutaneous coronary intervention (PCI).
Background— Antiplatelet therapy and antithrombin have been demonstrated to reduce the risk of cardiac events in patients presenting with acute coronary syndrome, yet all effective therapies also increase bleeding. Methods Results— In Clopidogrel Unstable angina prevent Recurrent ischemic Events (CURE) trial, 12 562 were randomized clopidogrel or placebo addition aspirin, primary outcome was cardiovascular (CV) death, myocardial infarction (MI), stroke. The benefits consistent among those...
In patients with ST-segment elevation myocardial infarction (STEMI), percutaneous coronary intervention (PCI) of the culprit lesion reduces risk cardiovascular death or infarction. Whether PCI nonculprit lesions further such events is unclear.
Clopidogrel and aspirin are widely used for patients with acute coronary syndromes those undergoing percutaneous intervention (PCI). However, evidence-based guidelines dosing have not been established either agent.We randomly assigned, in a 2-by-2 factorial design, 25,086 an syndrome who were referred invasive strategy to double-dose clopidogrel (a 600-mg loading dose on day 1, followed by 150 mg daily 6 days 75 thereafter) or standard-dose 300-mg higher-dose (300 325 daily) lower-dose (75...
Background— We studied the benefits and risks of adding clopidogrel to different doses aspirin in treatment patients with acute coronary syndrome (ACS). Methods Results— In Clopidogrel Unstable angina prevent Recurrent Events (CURE) trial, 12 562 ACS using aspirin, 75 325 mg daily, were randomized or placebo for up 1 year. this analysis, divided into following 3 dose groups: ≤100 mg, 101 through 199 ≥200 mg. The combined incidence cardiovascular death, myocardial infarction, stroke was...
ContextGlucose-insulin-potassium (GIK) infusion is a widely applicable, low-cost therapy that has been postulated to improve mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Given the potential global importance of GIK infusion, large, adequately powered randomized trial required determine effect on STEMI.ObjectiveTo high-dose STEMI.Design, Setting, and ParticipantsRandomized controlled conducted 470 centers worldwide among 20 201 STEMI who presented...
Patients with a myocardial infarction ST-segment elevation who present to hospitals that do not have the capability of performing percutaneous coronary intervention (PCI) often cannot undergo timely primary PCI and therefore receive fibrinolysis. The role optimal timing routine after fibrinolysis been established.We randomly assigned 1059 high-risk patients had were receiving fibrinolytic therapy at centers did either standard treatment (including rescue PCI, if required, or delayed...
It has been suggested that clopidogrel may be less effective in reducing the rate of cardiovascular events among persons who are carriers loss-of-function CYP2C19 alleles associated with reduced conversion to its active metabolite.We genotyped patients from two large, randomized trials showed clopidogrel, as compared placebo, (the primary efficacy outcome) acute coronary syndromes and atrial fibrillation. Patients were for three single-nucleotide polymorphisms (*2, *3, *17) define major...
Severe tricuspid regurgitation is a debilitating condition that associated with substantial morbidity and often poor quality of life. Decreasing may reduce symptoms improve clinical outcomes in patients this disease.We conducted prospective randomized trial percutaneous transcatheter edge-to-edge repair (TEER) for severe regurgitation. Patients symptomatic were enrolled at 65 centers the United States, Canada, Europe randomly assigned 1:1 ratio to receive either TEER or medical therapy...
Patients with stable coronary artery disease and diabetes mellitus who have not had a myocardial infarction or stroke are at high risk for cardiovascular events. Whether adding ticagrelor to aspirin improves outcomes in this population is unclear.
Background— Drug eluting stents with durable polymers may be associated hypersensitivity, delayed healing, and incomplete endothelialization, which contribute to late/very late stent thrombosis the need for prolonged dual antiplatelet therapy. Bioabsorbable facilitate thus enhancing clinical safety. The SYNERGY is a thin-strut, platinum chromium metal alloy platform an ultrathin bioabsorbable Poly(D,L-lactide-co-glycolide) abluminal everolimus-eluting polymer. We performed multicenter,...
Long-term continuous electrocardiographic monitoring shows a substantial prevalence of asymptomatic, subclinical atrial fibrillation (SCAF) in patients with pacemakers and cryptogenic stroke. Whether SCAF is also common other without these conditions unknown.We implanted subcutaneous monitors (St. Jude CONFIRM-AF) ≥65 years age attending cardiovascular or neurology outpatient clinics if they had no history but any the following: CHA2DS2-VASc score ≥2, sleep apnea, body mass index >30 kg/m2....