scholarly journals e0381 The Association between Lp-PLA2 activity and major cardiovascular events in acute coronary syndrome at the Chinese Community

Heart ◽  
2010 ◽  
Vol 96 (Suppl 3) ◽  
pp. A118-A118
Author(s):  
L. Ning ◽  
L. Shuijun ◽  
Y. Chen ◽  
G. Shuiming
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Pla2 Activity ◽  
Chinese Community ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events

5132Effect of PCSK9 inhibitors treatment on acute coronary syndrome and stroke incidence: a metanalysis of currently available clinical trials

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Cordero ◽  
L Facila ◽  
M Rodriguez-Manero ◽  
M Gomez-Martinez ◽  
V Bertomeu-Gonzalez ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Cochrane Collaboration ◽  
Significant Heterogeneity ◽  
Pcsk9 Inhibitors ◽  
Stroke Incidence ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events

Abstract Background Proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitors have demonstrated to induce large reductions in low-density lipoprotein cholesterol (LDLc) and major cardiovascular events but none of the studies was statistically powered to demonstrate reductions in specific endpoints rather than a combined end-point of major cardiovascular events. Methods We performed an intention-to-treat meta-analysis in line with recommendations from the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement using currently available studies involving PCSK9 inhibitors. The endpoint assessed were acute coronary syndrome (ACS) and stroke. Results We included 81,544 patients, 41,147 treated with a PSCK9 inhibitors: 17,179 with evolocumab; 13,718 with bococizumab and 10,250 with alirocumab (table 1). A total of 1,316 ACS were registered in the treatment group vs. 1,608 in controls, resulting in 18.0% reduction associated with PCSK9 treatment (figure 1). This result was reproduced exactly in the EBCT althougt a non-significant heterogeneity was detected (p=0.052). Metaregression analyses did not demonstrate the implication of the study (p=0.45), study drugs (p=0.26), age (p=0.89), hypertension (p=0.81) or diabetes (p=0.81) on such result. Results on stroke incidence are presented in figure 2. PCSK9 inhibitors treatment resulted in a 24% reduction of stroke when all studies were analyzed together; heterogeneity was statistically significant (p=0.021) but it was not observed in the EBCT analysis where PCSK9 inhibitors were associated with 24% stroke incidence reduction. Conclusions The meta-analysis of currently available studies demonstrates that PCSK9 inhibitors treatment reduces the incidence of ACS by 18% and stroke by 24%.

scholarly journals Combined glycoprotein IIb/IIIa inhibitor therapy with ticagrelor for patients with acute coronary syndrome

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246166
Author(s):  
Zhi-Jiang Xie ◽  
Shuan-Li Xin ◽  
Chao Chang ◽  
Hai-Jing Zhou ◽  
Xiu-Feng Zhao ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Ischemic Stroke ◽  
Combination Therapy ◽  
Cardiogenic Shock ◽  
Stent Thrombosis ◽  
Major Bleeding ◽  
Cardiovascular Events ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
All Cause Mortality

This study was to compare the efficacy and safety of combined glycoprotein IIb/IIIa inhibitor (GPI) and ticagrelor versus ticagrelor in patients with acute coronary syndrome (ACS). An observational study was conducted using the Improving Care for Cardiovascular Disease in China-ACS project. Totally, 13,264 patients with ACS and received combination therapy or ticagrelor therapy were analyzed. The primary outcome was the composite of major cardiovascular events (MACE: all-cause mortality, myocardial infarction [MI], stent thrombosis, cardiogenic shock, and ischemic stroke), and secondary outcomes included all-cause mortality, MI, stent thrombosis, cardiogenic shock, and ischemic stroke. The multivariable adjusted analysis indicated that combination therapy was associated with an increased risk of major cardiovascular events (MACE) (P = 0.001), any bleeding (P<0.001), and major bleeding (P = 0.005). Moreover, the multivariable adjusted for propensity score-matched (PSM) analysis suggested that combination therapy produced additional risk of MACE (P = 0.014), any bleeding (P<0.001), and major bleeding (P = 0.005). Moreover, PSM analysis suggested that combination therapy was associated with greater risk of stent thrombosis (P = 0.012) and intracranial bleeding (P = 0.020). Combined GPI and ticagrelor therapies did not have any beneficial effects on MACE, stent thrombosis, intracranial bleeding, any bleeding, or major bleeding.

scholarly journals P193 Echocardiographic prognosis score and stratification of the risk of major cardiovascular events after acute coronary syndrome

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F Menzou ◽  
N Laraba ◽  
M Ait Ali ◽  
M Krim
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Cardiovascular Event ◽  
Cardiovascular Events ◽  
Major Cardiovascular Event ◽  
Aggressive Approach ◽  
Clinical Prognosis ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
Echocardiographic Parameters

Abstract Introduction The stratification of the risk of a major cardiovascular event after an acute coronary syndrome by doppler echocardiography provides prognostic support to the different clinical models and allows a non-invasive evaluation of the risk, independent of comorbidities. The echo-score provides a better definition of the categories of high-risk and intermediate patients for whom a more aggressive approach improves outcomes. Purpose The aim of our study is to identify the echocardiographic parameters predictive of major cardiovascular events in the acute phase and after six months of follow-up of an acute coronary syndrome Methods To identify the echocardiographic parameters associated with major cardiovascular event, we recruited 302 patients in intensive care unit of cardiology for acute coronary syndrome consecutively on admission. Patients were assessed by clinical risk scores (GRACE, TIMI, CRUSADE) and resting echocardiography, Results We have 181 patients with major cardiovascular event. After studying the survival curves, univariate and multivariate analysis, acute coronary events echoscore (HR 1,95 ; p &lt; 0,0001), has four echocardiographic variables (VG-Simpson - biplane ejection fraction, VD-surface - Simpson shortening fraction, M-strain longitudinal total deformation and pulmonary ultrasonic comet). Its discrimination capacity (AUC= 0,85) greater than that of the scores clinical prognosis, (GRACE; AUC = 0,72, TIMI; AUC = 0,71, HR 1,33; p &lt; 0,0001) and (CRUSADE; AUC = 0,76; HR 1,03; p = 0,005) Conclusion The developed echocardiographic model could prove very useful in the decision-making process and optimization of the therapeutic strategy in some high-risk patients with acute coronary syndromes following an invasive strategy. It is appropriate for expert interpretation, yet relatively simple because it contains only four echocardiographic variables as predictors, (score 4 points for low risk with a probability of major cardiovascular event 3.4%, up to 16 points for risk high with a probability of 15.1%)

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