Alien Registration- Dorler, John J. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/31292/thumbnail.jp

Alien Registration- Dorler, John J. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/31292/thumbnail.jp

Diabetic patients with acute coronary syndromes in contemporary European registries: characteristics and outcomes

In acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at high risk of recurrent cardiovascular events and premature death. We described patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in 10 contemporary European registries. In the 10 registries there were 28,899 with and 97,505 without without DM. In the DM population, the proportion of patients with ST-Segment Elevation Myocardial Infarction (STEMI) ranged from 22.1% to 100.0% (other patients had non-ST-Segment Elevation Myocardial Infarction (NSTEMI-ACS) or unstable angina). All-cause mortality in the registries ranged from 1.4% to 9.4% in-hospital; 2.8% to 7.9% at 30 days post-discharge; 5.1% to 10.7% at 180 days post-discharge; and 3.3% to 10.5% at 1 year post-discharge. Major bleeding events were reported in up to 3.8% of patients while in hospital (8 registries); up to 1.3% at 30 days (data from two registries only), and 2.0% at 1 year (one registry only). Registries differed substantially in terms of study setting, site, patient selection, definition and schedule of endpoints, and use of various P2Y12 inhibitors. Pooled risk ratios comparing cohorts with DM vs. no DM were in-hospital significantly higher in DM for all-cause death (1.66; 95% CI 1.42-1.94), for cardiovascular death (2.33; 1.78 - 3.03), and for major bleeding (1.35; 1.21-1.52)

Alien Registration- Dorler, John J. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/31292/thumbnail.jp

Comparison of P2Y12 receptor inhibitors in patients with ST-elevation myocardial infarction in clinical practice: a propensity score analysis of five contemporary European registries

INTRODUCTION Among acute coronary syndromes (ACS), ST-segment elevation myocardial infarction (STEMI) has the most severe early clinical course. Recent randomized clinical trials have demonstrated that novel antithrombotic therapies improve in-hospital outcomes in STEMI patients. We aimed to describe the effectiveness and safety of P2Y12 receptor inhibitors in clinical practice in patients with STEMI based on data from contemporary European ACS registries. METHODS AND RESULTS Five registries from the PIRAEUS initiative (AAPCI/ADPAT, ALKK-PIC, AMIS Plus, Belgium STEMI, EYESHOT) provided data for the assessment of P2Y12 receptor inhibitor-based dual antiplatelet therapy. Registries were heterogeneous in terms of setting, patient characteristics and treatment selection. Matched pair analysis and propensity score matching were used to assess all-cause in-hospital death rates based on data from 25'250 patients (8'577 patients on prasugrel, 5'995 on ticagrelor, and 10'678 on clopidogrel). The odds ratio for death of any cause when compared to clopidogrel were 0.72 (CI 0.62 - 0.84, p < 0.001) in favor of the new P2Y12 receptor inhibitors (prasugrel and ticagrelor combined). In the comparison between prasugrel and ticagrelor, there were no relevant differences (OR 0.97; CI 0.77 -1.23, p = 0.81). Event rates of cardiovascular death and stroke were also substantially lower for the new P2Y12 receptor inhibitors. The differences between clopidogrel and prasugrel or ticagrelor on major bleeding were numerically in the same order as for death of any cause, but were not statistically significant. No differences in ischemic and bleeding outcomes were observed between prasugrel and ticagrelor. CONCLUSION This analysis suggests that the prasugrel or ticagrelor compared to clopidogrel have favorable outcomes in clinical practice while not being inferior in terms of safety

An ordinal prediction model of the diagnosis of non-obstructive coronary artery and multi-vessel disease in the CARDIIGAN cohort

Development and application of statistical models for medical scientific researchAnalysis and support of clinical decision makin