Use of prasugrel and clinical outcomes in African-American patients treated with percutaneous coronary intervention for acute coronary syndromes
Autor: | Brian A. Baker, Samir Kapadia, Bimmer E. Claessen, Sameer Bansilal, Zhen Ge, Timothy Henry, Stuart J. Pocock, Roxana Mehran, Usman Baber, Sunil V. Rao, Craig Strauss, Stuart Keller, William S. Weintraub, Samantha Sartori, Kanhaiya L. Poddar, Clayton Snyder, Annapoorna Kini, Melissa Aquino, Birgit Vogel, Sandra Weiss, Catalin Toma, Brent Muhlestein, Mark B. Effron, Michela Faggioni, Anthony C. DeFranco, Jaya Chandrasekhar |
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Rok vydání: | 2019 |
Předmět: |
Male
Time Factors Prasugrel medicine.medical_treatment Comorbidity 030204 cardiovascular system & hematology 0302 clinical medicine Risk Factors Cause of Death Prevalence Prospective Studies Registries 030212 general & internal medicine Myocardial infarction Stroke education.field_of_study Incidence Age Factors General Medicine Middle Aged Clopidogrel Race Factors Treatment Outcome Female Cardiology and Cardiovascular Medicine medicine.drug medicine.medical_specialty Acute coronary syndrome Population Hemorrhage Risk Assessment 03 medical and health sciences Percutaneous Coronary Intervention Sex Factors Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Acute Coronary Syndrome Healthcare Disparities education Aged business.industry Percutaneous coronary intervention Health Status Disparities medicine.disease United States Black or African American Conventional PCI business Prasugrel Hydrochloride Platelet Aggregation Inhibitors Kidney disease |
Zdroj: | Catheterization and Cardiovascular Interventions. 94:53-60 |
ISSN: | 1522-1946 |
Popis: | OBJECTIVE: To investigate the use of prasugrel after percutaneous coronary intervention (PCI) in African American (AA) patients presenting with acute coronary syndrome (ACS). BACKGROUND: AA patients are at higher risk for adverse cardiovascular outcomes after PCI and may derive greater benefit from the use of potent antiplatelet therapy. METHODS: Using the multicenter PROMETHEUS observational registry of ACS patients treated with PCI, we grouped patients by self-reported AA or other races. Clinical outcomes at 90-day and 1-year included non-fatal myocardial infarction (MI), major adverse cardiac events (composite of death, MI, stroke, or unplanned revascularization) and major bleeding. RESULTS: The study population included 2,125 (11%) AA and 17,707 (89%) non-AA patients. AA patients were younger, more often female (46% vs. 30%) with a higher prevalence of diabetes mellitus, chronic kidney disease, and prior coronary intervention than non-AA patients. Although AA patients more often presented with troponin (+) ACS, prasugrel use was much less common in AA vs. non-AA (11.9% vs. 21.4%, respectively, P = 0.001). In addition, the use of prasugrel increased with the severity of presentation in non-AA but not in AA patients. Multivariable logistic regression showed AA race was an independent predictor of reduced use of prasugrel (0.42 [0.37-0.49], P |
Databáze: | OpenAIRE |
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