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dc.contributor.authorBanihashemi, Behnam
dc.contributor.authorGoodman, Shaun G.
dc.contributor.authorYan, Raymond T.
dc.contributor.authorWelsh, Robert C.
dc.contributor.authorMeta, Shamir R.
dc.contributor.authorMontalescot, Gilles
dc.contributor.authorKornder, Jan
dc.contributor.authorWong, Graham C.
dc.contributor.authorGyenes, Gabor
dc.contributor.authorSteg, Phillippe Gabriel
dc.contributor.authorYan, Andrew T.
dc.contributor.authorGlobal Registry of Acute Coronary Events (GRACE/GRACE2) Investigators
dc.date2022-08-11T08:08:09.000
dc.date.accessioned2022-08-23T15:44:21Z
dc.date.available2022-08-23T15:44:21Z
dc.date.issued2009-12-05
dc.date.submitted2011-10-20
dc.identifier.citationAm Heart J. 2009 Dec;158(6):917-24. <a href="http://dx.doi.org/10.1016/j.ahj.2009.09.016">Link to article on publisher's site</a>
dc.identifier.issn0002-8703 (Linking)
dc.identifier.doi10.1016/j.ahj.2009.09.016
dc.identifier.pmid19958857
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27296
dc.description.abstractBACKGROUND: There are limited contemporary data on the early use of clopidogrel or glycoprotein (Gp) IIb/IIIa inhibitors, alone versus combination therapies, in non-ST-elevation acute coronary syndrome (NSTE-ACS). METHODS: This study included 5,806 Canadian NSTE-ACS patients with elevated cardiac biomarker and/or ST deviation on presentation in the prospective GRACE between 2003-2007. We stratified the study population according to the management strategy (non-invasive vs invasive) and into low-(GRACE risk score or=141). RESULTS: Overall, 3,893 patients (67.1%) received early ( CONCLUSIONS: In this contemporary NSTE-ACS population, both clopidogrel and GpIIb/IIIa inhibitors were targeted toward patients treated with an invasive strategy but paradoxically toward the lower-risk group. In particular, clopidogrel appeared to be underused among conservatively managed patients despite its proven efficacy, whereas GpIIb/IIIa inhibitors were administered to only a minority of the high-risk patients with elevated cardiac biomarkers. Our findings emphasize the ongoing need to promote the optimal use of evidence-based antiplatelet therapies among high-risk patients with NSTE-ACS.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=19958857&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.ahj.2009.09.016
dc.subjectAcute Coronary Syndrome; Aged; Canada; Drug Utilization; Female; Guideline Adherence; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Platelet Glycoprotein GPIIb-IIIa Complex; Prospective Studies; Registries; Retrospective Studies; Ticlopidine
dc.subjectHealth Services Research
dc.titleUnderutilization of clopidogrel and glycoprotein IIb/IIIa inhibitors in non-ST-elevation acute coronary syndrome patients: the Canadian global registry of acute coronary events (GRACE) experience
dc.typeJournal Article
dc.source.journaltitleAmerican heart journal
dc.source.volume158
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace2/9
dc.identifier.contextkey2305122
html.description.abstract<p><h4>BACKGROUND:</h4></p> <p>There are limited contemporary data on the early use of clopidogrel or glycoprotein (Gp) IIb/IIIa inhibitors, alone versus combination therapies, in non-ST-elevation acute coronary syndrome (NSTE-ACS). <h4>METHODS:</h4></p> <p>This study included 5,806 Canadian NSTE-ACS patients with elevated cardiac biomarker and/or ST deviation on presentation in the prospective GRACE between 2003-2007. We stratified the study population according to the management strategy (non-invasive vs invasive) and into low-(GRACE risk score or=141). <h4>RESULTS:</h4></p> <p>Overall, 3,893 patients (67.1%) received early ( <h4>CONCLUSIONS:</h4></p> <p>In this contemporary NSTE-ACS population, both clopidogrel and GpIIb/IIIa inhibitors were targeted toward patients treated with an invasive strategy but paradoxically toward the lower-risk group. In particular, clopidogrel appeared to be underused among conservatively managed patients despite its proven efficacy, whereas GpIIb/IIIa inhibitors were administered to only a minority of the high-risk patients with elevated cardiac biomarkers. Our findings emphasize the ongoing need to promote the optimal use of evidence-based antiplatelet therapies among high-risk patients with NSTE-ACS.</p>
dc.identifier.submissionpathcor_grace2/9
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages917-24


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