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Verfasst von:Cornel, Jan Hein [VerfasserIn]   i
 Katus, Hugo [VerfasserIn]   i
Titel:Prior smoking status, clinical outcomes, and the comparison of ticagrelor with clopidogrel in acute coronary syndromes - insights from the PLATelet inhibition and patient Outcomes (PLATO) trial
Verf.angabe:Jan H. Cornel, Richard C. Becker, Shaun G. Goodman, Steen Husted, Hugo Katus, Anwar Santoso, Gabriel Steg, Robert F. Storey, Marius Vintila, Jie L. Sun, Jay Horrow, Lars Wallentin, Robert Harrington, and Stefan James
E-Jahr:2012
Jahr:September 2012
Umfang:10 S.
Teil:volume:164
 year:2012
 number:3
 pages:334-342.e1
 extent:10
Fussnoten:Available online 26 July 2012 ; Gesehen am 08.10.2018
Titel Quelle:Enthalten in: American heart journal
Ort Quelle:Amsterdam [u.a.] : Elsevier, 1925
Jahr Quelle:2012
Band/Heft Quelle:164(2012), 3, Seite 334-342.e1
ISSN Quelle:1097-6744
Abstract:Background: Habitual smoking has been associated with increased platelet reactivity, increased risk of thrombotic complications and greater efficacy of clopidogrel therapy over placebo. In the PLATO trial, ticagrelor compared to clopidogrel in patients with acute coronary syndromes (ACS) reduced the primary composite end point of vascular death, myocardial infarction and stroke, without increasing overall rates of major bleeding. We evaluated the results in relation to smoking habits. Methods: Interactions between habitual smokers (n = 6678) and in ex/nonsmokers (n = 11,932) and the effects of randomized treatments on ischemic and bleeding outcomes were evaluated by Cox regression analyses.Results: Habitual smokers had an overall lower risk profile and more often ST-elevation ACS. After adjustment for baseline imbalances, habitual smoking was associated with a higher incidence of definite stent thrombosis (adjusted HR, 1.44 [95% CI, 1.07-1.94]); there were no significant associations with other ischemic or bleeding end points. The effects of ticagrelor compared to clopidogrel were consistent for all outcomes regardless of smoking status. Thus, there was a similar reduction in the primary composite end point for habitual smokers (adjusted HR, 0.83 [95% CI, 0.68-1.00]) and ex/nonsmokers (adjusted HR, 0.89 [95% CI, 0.79-1.00]) (interaction P = .50), and in definite stent thrombosis for habitual smokers (adjusted HR, 0.59 [0.39-0.91]) and ex/nonsmokers (adjusted HR, 0.69 [95% CI, 0.45-1.07]) (interaction P = .61). Conclusions: In patients hospitalized with ACS, habitual smoking is associated with a greater risk of subsequent stent thrombosis. The reduction of vascular death, myocardial infarction, stroke, and stent thrombosis by ticagrelor compared to clopidogrel is consistent regardless of smoking habits.
DOI:doi:10.1016/j.ahj.2012.06.005
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: http://dx.doi.org/10.1016/j.ahj.2012.06.005
 Volltext: http://www.sciencedirect.com/science/article/pii/S0002870312003833
 DOI: https://doi.org/10.1016/j.ahj.2012.06.005
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1581616813
Verknüpfungen:→ Zeitschrift

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