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    Impact of aspirin on presentation and hospital outcomes in patients with acute coronary syndromes (The Global Registry of Acute Coronary Events [GRACE])

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    Authors
    Spencer, Frederick A.
    Santopinto, Jose J.
    Gore, Joel M.
    Goldberg, Robert J.
    Fox, Keith A. A.
    Moscucci, Mauro
    White, Kami
    Gurfinkel, Enrique P.
    UMass Chan Affiliations
    Center for Outcomes Research, Department of Surgery
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2002-11-09
    Keywords
    Aged
    Argentina
    Aspirin
    Australia
    Brazil
    Canada
    Europe
    Female
    Hospital Mortality
    Hospitalization
    Humans
    Male
    Medical Records
    Middle Aged
    Multivariate Analysis
    Myocardial Infarction
    control
    New Zealand
    Odds Ratio
    *Outcome Assessment (Health Care)
    Platelet Aggregation Inhibitors
    Registries
    Retrospective Studies
    Severity of Illness Index
    United States
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/S0002-9149(02)02769-8
    Abstract
    The long-term use of aspirin (ASA) reduces the risk of subsequent acute coronary syndromes in patients with coronary artery disease (CAD). It is less clear whether ASA therapy benefits patients who develop an acute coronary syndrome despite its use. Baseline characteristics, type of acute coronary syndrome, and in-hospital events were compared on the basis of previous use of ASA in 11,388 patients with and without a history of CAD presenting to 94 multinational hospitals. A total of 73.0% of patients with a history of CAD (n = 4,974) were previously on long-term ASA therapy compared with 19.4% of patients without a history of CAD (n = 6,414). After multivariate regression analysis controlling for various potentially confounding factors, patients with a history of CAD who were previously taking ASA were significantly less likely to present with ST-segment elevation myocardial infarction (MI) (adjusted odds ratio [OR] 0.52, 95% confidence intervals [CI] 0.44 to 0.61) or die during hospitalization (OR 0.69, 95% CI 0.50 to 0.95) in comparison to patients who were not taking ASA. Patients without a history of CAD and who were previously taking ASA also had a lower risk of developing ST-segment elevation MI (OR 0.35, 95% CI 0.30 to 0.40) and a trend toward a decreased hospital death rate (OR 0.77, 95% CI 0.55 to 1.07). These results demonstrate that patients with a history of CAD who present with an acute coronary syndrome despite prior ASA use have less severe clinical presentation, fewer hospital complications, and lower in-hospital death rates than patients not previously taking ASA.
    Source
    Am J Cardiol. 2002 Nov 15;90(10):1056-61.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47159
    PubMed ID
    12423703
    Related Resources
    Link to Article in PubMed
    Collections
    Population and Quantitative Health Sciences Publications

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