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dc.contributor.authorAmad, Hani
dc.contributor.authorYan, Andrew T.
dc.contributor.authorYan, Raymond T.
dc.contributor.authorHuynh, Thao
dc.contributor.authorGore, Joel M.
dc.contributor.authorMontalescot, Gilles
dc.contributor.authorDeYoung, J. Paul
dc.contributor.authorGallo, Richard
dc.contributor.authorRose, Barry
dc.contributor.authorSteg, Phillippe Gabriel
dc.contributor.authorGoodman, Shaun G.
dc.date2022-08-11T08:08:09.000
dc.date.accessioned2022-08-23T15:44:16Z
dc.date.available2022-08-23T15:44:16Z
dc.date.issued2012-01-25
dc.date.submitted2012-02-02
dc.identifier.citationCan J Cardiol. 2012 Jan;28(1):48-53. Epub 2011 Nov 23. <a href="http://dx.doi.org/10.1016/j.cjca.2011.09.003">Link to article on publisher's site</a>
dc.identifier.issn0828-282X (Linking)
dc.identifier.doi10.1016/j.cjca.2011.09.003
dc.identifier.pmid22112683
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27277
dc.description.abstractBACKGROUND: The role of acetylsalicylic acid (ASA [aspirin]) and warfarin in secondary prevention after acute coronary syndromes (ACS) is well established. However, there are sparse data comparing the presentation and outcomes of patients who present with ACS while on ASA and/or warfarin therapy and those on neither. METHODS: Using data from the Canadian Global Registry of Acute Coronary Events (GRACE), we stratified 14,090 ACS patients into 4 groups according to prior use of antithrombotic therapies and compared in-hospital management and outcomes. RESULTS: Among 14,090 ACS patients, 7411 (52.6%) were not on prior ASA or warfarin therapy, 5724 (40.6%) were on ASA only, 593 (4.2%) were on warfarin only, and 362 (2.6%) were on both ASA and warfarin. ACS patients taking ASA and/or warfarin were older with more comorbidities than the patients on neither drug. Patients receiving prior warfarin only or ASA and warfarin were less likely to receive guideline-recommended therapies. Patients who were taking prior warfarin only had higher unadjusted rates of death, death and/or reinfarction (re-MI), congestive heart failure (CHF), and major bleeding as compared with patients on no prior therapy. Furthermore, patients who were taking ASA and warfarin had higher unadjusted rates of death and/or re-MI and CHF than patients on prior ASA only. CONCLUSIONS: ACS patients on prior warfarin are a high-risk population, yet they receive less guideline-recommended therapies and have higher unadjusted adverse event rates during their index hospitalization. With the increasing use of oral anticoagulants, clinical trials are needed to guide the optimal management of these ACS patients. Inc. All rights reserved.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22112683&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.cjca.2011.09.003
dc.subjectAcute Coronary Syndrome
dc.subjectAspirin
dc.subjectWarfarin
dc.subjectTreatment Outcome
dc.subjectCardiovascular Diseases
dc.subjectHealth Services Research
dc.titleThe Association Between Prior Use of Aspirin and/or Warfarin and the In-hospital Management and Outcomes in Patients Presenting With Acute Coronary Syndromes: Insights From the Global Registry of Acute Coronary Events (GRACE)
dc.typeArticle
dc.source.journaltitleThe Canadian journal of cardiology
dc.source.volume28
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/94
dc.identifier.contextkey2490920
html.description.abstract<p>BACKGROUND: The role of acetylsalicylic acid (ASA [aspirin]) and warfarin in secondary prevention after acute coronary syndromes (ACS) is well established. However, there are sparse data comparing the presentation and outcomes of patients who present with ACS while on ASA and/or warfarin therapy and those on neither.</p> <p>METHODS: Using data from the Canadian Global Registry of Acute Coronary Events (GRACE), we stratified 14,090 ACS patients into 4 groups according to prior use of antithrombotic therapies and compared in-hospital management and outcomes.</p> <p>RESULTS: Among 14,090 ACS patients, 7411 (52.6%) were not on prior ASA or warfarin therapy, 5724 (40.6%) were on ASA only, 593 (4.2%) were on warfarin only, and 362 (2.6%) were on both ASA and warfarin. ACS patients taking ASA and/or warfarin were older with more comorbidities than the patients on neither drug. Patients receiving prior warfarin only or ASA and warfarin were less likely to receive guideline-recommended therapies. Patients who were taking prior warfarin only had higher unadjusted rates of death, death and/or reinfarction (re-MI), congestive heart failure (CHF), and major bleeding as compared with patients on no prior therapy. Furthermore, patients who were taking ASA and warfarin had higher unadjusted rates of death and/or re-MI and CHF than patients on prior ASA only.</p> <p>CONCLUSIONS: ACS patients on prior warfarin are a high-risk population, yet they receive less guideline-recommended therapies and have higher unadjusted adverse event rates during their index hospitalization. With the increasing use of oral anticoagulants, clinical trials are needed to guide the optimal management of these ACS patients. Inc. All rights reserved.</p>
dc.identifier.submissionpathcor_grace/94
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages48-53


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