Browsing by Author "Parkhomenko, Alexander"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- ItemEnoxaparin is superior to unfractionated heparin in patients with ST elevation myocardial infarction undergoing fibrinolysis regardless of the choice of lytic: an ExTRACT-TIMI 25 analysis(OXFORD UNIV PRESS, 2007) Giraldez, Roberto R.; Nicolau, Jose Carlos; Corbalan, Ramon; Gurfinkel, Enrique P.; Juarez, Ursulo; Lopez Sendon, Jose; Parkhomenko, Alexander; Molhoek, Peter; Mohanavelu, Satishkumar; Morrow, David A.; Antman, Elliott M.Aims We compared outcomes of ST-elevation myocardial infarction (STEMI) patients randomized to a strategy of either enoxaparin or unfractionated heparin (UFH) to support fibrinolysis. Methods and results In the Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment-Thrombolysis in Myocardial Infarction Study 25 (ExTRACT-TIMI 25) trial, 20 479 patients undergoing fibrinolysis for STEMI with a fibrin-specific agent (N = 16 283) or streptokinase (SK) IN = 4139) were randomized to enoxaparin throughout their hospitalization or UFH for at [east 48 h. The primary end point of death or nonfatal recurrent MI through 30 days occurred in 12.0% of patients in the UFH and 9.8% in the enoxaparin groups when treated with fibrin-specific lytics [odds ratio(adjusted) (ORadj) 0.78; 95% Cl 0.70-0.87; P < 0.001] and 11.8 vs. 10.2%, respectively, when treated with SK (ORadj 0.83; 95% CI 0.66-1.04; P = 0-10; P-interaction = 0.58). Major bleeding rates including intracranial hemorrhage within the fibrin specific cohort were 1.2 and 2.0% in the UFH and enoxaparin groups, respectively (P < 0.001) and 2.0% in UFH and 2.4% in enoxaparin patients in the SK cohort (P = 0.16). Interaction tests between antithrombin- and lytic-type were non-significant (P = 0.20). Death, nonfatal MI, or major bleeding was significantly reduced with enoxaparin in the fibrin-specific cohort (ORadj 0.82; 95% Cl 0.74-0.91; P < 0.001) and favoured enoxaparin in the SK cohort (ORadj 0.89; 95% Cl 0.72-1.10; P = 0.29; P-interaction = 0.53). Conclusion The benefits of an enoxaparin strategy over UFH were observed in both SK and fibrin -specific-treated STEMI patients. Therefore, an enoxaparin strategy is preferred over UFH to support fibrinolysis for STEMI regardless of lytic agent.
- ItemHistory of hypertension and eplerenone in patients with acute myocardial infarction complicated by heart failure(LIPPINCOTT WILLIAMS & WILKINS, 2008) Pitt, Bertram; Ahmed, Ali; Love, Thomas E.; Krum, Henry; Nicolau, Jose; Cardoso, Jose S.; Parkhomenko, Alexander; Aschermann, Michael; Corbalan, Ramon; Solomon, Henry; Shi, Harry; Zannad, FaiezIn the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study ( n = 6632), eplerenone- associated reduction in all- cause mortality was significantly greater in those with a history of hypertension ( Hx- HTN). There were 4007 patients with Hx- HTN ( eplerenone: n = 1983) and 2625 patients without Hx- HTN ( eplerenone: n = 1336). Propensity scores for eplerenone use, separately calculated for patients with and without Hx- HTN, were used to assemble matched cohorts of 1838 and 1176 pairs of patients. In patients with Hx- HTN, all- cause mortality occurred in 18% of patients treated with placebo ( rate, 1430/ 10 000 person- years) and 14% of patients treated with eplerenone ( rate, 1058/ 10 000 person- years) during 2350 and 2457 years of follow- up, respectively ( hazard ratio [ HR]: 0.71; 95% CI: 0.59 to 0.85; P < 0.0001). Composite end point of cardiovascular hospitalization or cardiovascular mortality occurred in 33% of placebo-treated patients ( 3029/ 10 000 person- years) and 28% of eplerenone- treated patients (2438/10 000 person- years) with Hx- HTN ( HR: 0.82; 95% CI: 0.72 to 0.94; P = 0.003). In patients without Hx- HTN, eplerenone reduced heart failure hospitalization ( HR: 73; 95% CI: 0.55 to 0.97; P = 0.028) but had no effect on mortality ( HR: 0.91; 95% CI: 0.72 to 1.15; P = 0.435) or on the composite end point ( HR: 0.91; 95% CI: 0.76 to 1.10; P = 0.331). Eplerenone should, therefore, be prescribed to all of the post - acute myocardial infarction patients with reduced left ventricular ejection fraction and heart failure regardless of Hx- HTN.
- ItemPrasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization(MASSACHUSETTS MEDICAL SOC, 2012) Roe, Matthew T.; Armstrong, Paul W.; Fox, Keith A. A.; White, Harvey D.; Prabhakaran, Dorairaj; Goodman, Shaun G.; Cornel, Jan H.; Bhatt, Deepak L.; Clemmensen, Peter; Martinez, Felipe; Ardissino, Diego; Nicolau, Jose C.; Boden, William E.; Gurbel, Paul A.; Ruzyllo, Witold; Dalby, Anthony J.; McGuire, Darren K.; Leiva Pons, Jose L.; Parkhomenko, Alexander; Gottlieb, Shmuel; Topacio, Gracita O.; Hamm, Christian; Pavlides, Gregory; Goudev, Assen R.; Oto, Ali; Tseng, Chuen Den; Merkely, Bela; Gasparovic, Vladimir; Corbalan, Ramon; Cinteza, Mircea; McLendon, R. Craig; Winters, Kenneth J.; Brown, Eileen B.; Lokhnygina, Yuliya; Aylward, Philip E.; Huber, Kurt; Hochman, Judith S.; Ohman, E. Magnus; TRILOGY ACS InvestigatorsBackground
- ItemTicagrelor for Prevention of Ischemic Events After Myocardial Infarction in Patients With Peripheral Artery Disease(2016) Bonaca, Marc P.; Bhatt, Deepak L.; Storey, Robert F.; Steg, Gabriel; Cohen, Marc; Kuder, Julia; Goodrich, Erica; Nicolau, José C.; Parkhomenko, Alexander; Corbalán Herreros, Ramón; López-Sendón, José; Dellborg, Mikael; Dalby, Anthony; Spinar, Jindrich; Aylward, Philip; Abola, María Teresa B.; Jensen, Eva C.; Held, Peter; Braunwald, Eugene; Sabatine, Marc S.