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Anticoagulation plus double antiplatelet in acute myocardial

Renato D Lopes, Li Li, Christopher B Granger, Tracy Y Wang, JoAnne M Foody, Marjorie Funk, Eric D Peterson, Karen P Alexander
BACKGROUND: Atrial fibrillation guidelines recommend long-term use of warfarin according to a patient's predicted risk of stroke. After acute myocardial infarction, however, combining warfarin and antiplatelet medications poses challenges. METHODS: By using data from more than 69,255 patients with acute myocardial infarction who were enrolled in the National Cardiovascular Data Registry's Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines at 309 hospitals from July 1, 2008, to September 30, 2009, we describe the characteristics and outcomes of the population with myocardial infarction with atrial fibrillation diagnosed within 2 weeks before index myocardial infarction admission (7...
September 2012: American Journal of Medicine
C Michael Gibson, Jessica L Mega, Paul Burton, Shinya Goto, Freek Verheugt, Christoph Bode, Alexei Plotnikov, Xiang Sun, Nancy Cook-Bruns, Eugene Braunwald
BACKGROUND: Although therapy with aspirin or aspirin plus a thienopyridine reduces the incidence of long-term adverse cardiovascular events among patients with acute coronary syndrome (ACS), there remains a significant residual risk of cardiovascular death, recurrent myocardial infarction (MI), and stroke. In a phase 2 trial ( NCT00402597) in which the addition of the factor Xa inhibitor rivaroxaban was compared with placebo, among ACS patients receiving either aspirin alone or dual-antiplatelet therapy with aspirin and a thienopyridine, the end point of death, MI, or stroke compared with placebo was reduced (87/2331 [3...
May 2011: American Heart Journal
John H Alexander, Richard C Becker, Deepak L Bhatt, Frank Cools, Filippo Crea, Mikael Dellborg, Keith A A Fox, Shaun G Goodman, Robert A Harrington, Kurt Huber, Steen Husted, Basil S Lewis, Jose Lopez-Sendon, Puneet Mohan, Gilles Montalescot, Mikhail Ruda, Witold Ruzyllo, Freek Verheugt, Lars Wallentin
BACKGROUND: After an acute coronary syndrome, patients remain at risk of recurrent events. Apixaban, an oral direct factor Xa inhibitor, is a novel anticoagulant that may reduce these events but also poses a risk of bleeding. METHODS AND RESULTS: Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) was a phase 2, double-blind, placebo-controlled, dose-ranging study. Patients (n=1715) with recent ST-elevation or non-ST-elevation acute coronary syndrome were randomized to 6 months of placebo (n=611) or 1 of 4 doses of apixaban: 2...
June 9, 2009: Circulation
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