Impact of combined pharmacologic treatment with clopidogrel and a statin on outcomes of patients with non-ST-segment elevation acute coronary syndromes: perspectives from a large multinational registry
Authors
Lim, Michael J.Spencer, Frederick A.
Gore, Joel M.
Dabbous, Omar H.
Agnelli, Giancarlo
Kline-Rogers, Eva M.
Dibenedetto, Donna
Eagle, Kim A.
Mehta, Rajendra H.
UMass Chan Affiliations
Department of Medicine, Division of Cardiolovascular MedicineCenter for Outcomes Research
Document Type
Journal ArticlePublication Date
2005-06-18Keywords
AdolescentAdult
Aged
Angina, Unstable
Aspirin
Drug Therapy, Combination
Female
Hospitalization
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction
Myocardial Revascularization
Platelet Aggregation Inhibitors
Stroke
Ticlopidine
Treatment Outcome
Health Services Research
Metadata
Show full item recordAbstract
AIMS: To evaluate clinical outcomes associated with the combined use of clopidogrel and statins vs. clopidogrel alone on a background of aspirin therapy in patients with the spectrum of acute coronary syndromes (ACS). METHODS AND RESULTS: Utilizing data from the Global Registry of Acute Coronary Events, we studied 15 693 patients admitted with non-ST-segment elevation myocardial infarction (MI) or unstable angina, dividing them according to discharge medications: aspirin alone (group I); aspirin + clopidogrel (group II); aspirin + statin (group III); aspirin + clopidogrel + statin (group IV). Among the groups of patients in whom clopidogrel was used (groups II and IV), group II patients were older, more likely to have prior MI, but less likely to have a history of prior revascularization. In-hospital cardiac catheterization and revascularization rates were similar between groups II and IV. Importantly, Kaplan-Meier analysis showed that the 6 month mortality rate was lower in group IV (log-rank test 22.8, P<0.0001). The hazard ratio for the 6 month mortality rate was adjusted using the Cox proportional hazard model for confounding variables and for propensity score, and the 6 month mortality rate for patients in group IV remained lower compared with those in group II [0.59 (0.41-0.86), P<0.0001]. CONCLUSION: Our data suggest that the combination of clopidogrel with a statin has synergistic effects on the clinical outcomes of patients with non-ST-segment elevation ACS.Source
Eur Heart J. 2005 Jun;26(11):1063-9. Epub 2005 Feb 16. Link to article on publisher's siteDOI
10.1093/eurheartj/ehi139Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27250PubMed ID
15716281Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1093/eurheartj/ehi139