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6 results on '"Schoos, Mikkel"'

4. Polypill Strategy in Secondary Cardiovascular Prevention

Author

Castellano, Jose M, Pocock, Stuart J, Bhatt, Deepak L, Quesada, Antonio J, Owen, Ruth, Fernandez-Ortiz, Antonio, Sanchez, Pedro L, Marin Ortuño, Francisco, Vazquez Rodriguez, Jose M, Domingo-Fernández, Alexandra, Lozano, Iñigo, Roncaglioni, Maria C, Baviera, Marta, Foresta, Andreana, Ojeda-Fernandez, Luisa, Colivicchi, Furio, Di Fusco, Stefania A, Doehner, Wolfram, Meyer, Antje, Schiele, François, Ecarnot, Fiona, Linhart, Aleš, Lubanda, Jean-Claude, Barczi, Gyorgy, Merkely, Bela, Ponikowski, Piotr, Kasprzak, Marta, Fernandez Alvira, Juan M, Andres, Vicente, Bueno, Hector, Collier, Timothy, Van de Werf, Frans, Perel, Pablo, Rodriguez-Manero, Moises, Alonso Garcia, Angeles, Proietti, Marco, Schoos, Mikkel M, Simon, Tabassome, Fernandez Ferro, Jose, Lopez, Nicolas, Beghi, Ettore, Bejot, Yannick, Vivas, David, Cordero, Alberto, Ibañez, Borja, Fuster, Valentin, and SECURE Investigators

Subjects
Aspirin, Ramipril, Cardiovascular Diseases, Atorvastatin, Myocardial Infarction, Secondary Prevention, Humans, Angiotensin-Converting Enzyme Inhibitors, General Medicine, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Platelet Aggregation Inhibitors, Ischemic Stroke
Abstract

BACKGROUND: A polypill that includes key medications associated with improved outcomes (aspirin, angiotensin-converting-enzyme [ACE] inhibitor, and statin) has been proposed as a simple approach to the secondary prevention of cardiovascular death and complications after myocardial infarction. METHODS: In this phase 3, randomized, controlled clinical trial, we assigned patients with myocardial infarction within the previous 6 months to a polypill-based strategy or usual care. The polypill treatment consisted of aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and atorvastatin (20 or 40 mg). The primary composite outcome was cardiovascular death, nonfatal type 1 myocardial infarction, nonfatal ischemic stroke, or urgent revascularization. The key secondary end point was a composite of cardiovascular death, nonfatal type 1 myocardial infarction, or nonfatal ischemic stroke. RESULTS: A total of 2499 patients underwent randomization and were followed for a median of 36 months. A primary-outcome event occurred in 118 of 1237 patients (9.5%) in the polypill group and in 156 of 1229 (12.7%) in the usual-care group (hazard ratio, 0.76; 95% confidence interval [CI], 0.60 to 0.96; P = 0.02). A key secondary-outcome event occurred in 101 patients (8.2%) in the polypill group and in 144 (11.7%) in the usual-care group (hazard ratio, 0.70; 95% CI, 0.54 to 0.90; P = 0.005). The results were consistent across prespecified subgroups. Medication adherence as reported by the patients was higher in the polypill group than in the usual-care group. Adverse events were similar between groups. CONCLUSIONS: Treatment with a polypill containing aspirin, ramipril, and atorvastatin within 6 months after myocardial infarction resulted in a significantly lower risk of major adverse cardiovascular events than usual care. (Funded by the European Union Horizon 2020; SECURE ClinicalTrials.gov number, NCT02596126; EudraCT number, 2015-002868-17.).

Published
2022

5. Clinical outcome following late reperfusion with percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Author

Nepper-Christensen, Lars, Lønborg, Jacob, Høfsten, Dan Eik, Sadjadieh, Golnaz, Schoos, Mikkel Malby, Pedersen, Frants, Jørgensen, Erik, Kelbæk, Henning, Haahr-Pedersen, Sune, Flensted Lassen, Jens, Køber, Lars, Holmvang, Lene, and Engstrøm, Thomas

Abstract

Background: Up to 40% of patients with ST-segment elevation myocardial infarction (STEMI) present later than 12 hours after symptom onset. However, data on clinical outcomes in STEMI patients treated with primary percutaneous coronary intervention 12 or more hours after symptom onset are non-existent. We evaluated the association between primary percutaneous coronary intervention performed later than 12 hours after symptom onset and clinical outcomes in a large all-comer contemporary STEMI cohort.Methods: All STEMI patients treated with primary percutaneous coronary intervention in eastern Denmark from November 2009 to November 2016 were included and stratified by timing of the percutaneous coronary intervention. The combined clinical endpoint of all-cause mortality and hospitalisation for heart failure was identified from nationwide Danish registries.Results: We included 6674 patients: 6108 (92%) were treated less than 12 hours and 566 (8%) were treated 12 or more hours after symptom onset. During a median follow-up period of 3.8 (interquartile range 2.3–5.6) years, 30-day, one-year and long-term cumulative rates of the combined endpoint were 11%, 17% and 25% in patients treated 12 or fewer hours and 21%, 29% and 37% in patients treated more than 12 hours (P<0.001 for all) after symptom onset. Late presentation was independently associated with an increased risk of an adverse clinical outcome (hazard ratio 1.42, 95% confidence interval 1.22–1.66; P<0.001).Conclusions: Increasing duration from symptom onset to primary percutaneous coronary intervention was associated with an increased risk of an adverse clinical outcome in patients with STEMI, especially when the delay exceeded 12 hours.

Published
2024
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6. Polypill Strategy in Secondary Cardiovascular Prevention.

Author

Castellano JM, Pocock SJ, Bhatt DL, Quesada AJ, Owen R, Fernandez-Ortiz A, Sanchez PL, Marin Ortuño F, Vazquez Rodriguez JM, Domingo-Fernández A, Lozano I, Roncaglioni MC, Baviera M, Foresta A, Ojeda-Fernandez L, Colivicchi F, Di Fusco SA, Doehner W, Meyer A, Schiele F, Ecarnot F, Linhart A, Lubanda JC, Barczi G, Merkely B, Ponikowski P, Kasprzak M, Fernandez Alvira JM, Andres V, Bueno H, Collier T, Van de Werf F, Perel P, Rodriguez-Manero M, Alonso Garcia A, Proietti M, Schoos MM, Simon T, Fernandez Ferro J, Lopez N, Beghi E, Bejot Y, Vivas D, Cordero A, Ibañez B, and Fuster V

Subjects
Aspirin adverse effects, Aspirin therapeutic use, Atorvastatin adverse effects, Atorvastatin therapeutic use, Humans, Ischemic Stroke prevention & control, Myocardial Infarction complications, Myocardial Infarction prevention & control, Myocardial Infarction therapy, Ramipril adverse effects, Ramipril therapeutic use, Secondary Prevention methods, Angiotensin-Converting Enzyme Inhibitors adverse effects, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Cardiovascular Diseases etiology, Cardiovascular Diseases mortality, Cardiovascular Diseases prevention & control, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Platelet Aggregation Inhibitors adverse effects, Platelet Aggregation Inhibitors therapeutic use
Abstract

Background: A polypill that includes key medications associated with improved outcomes (aspirin, angiotensin-converting-enzyme [ACE] inhibitor, and statin) has been proposed as a simple approach to the secondary prevention of cardiovascular death and complications after myocardial infarction., Methods: In this phase 3, randomized, controlled clinical trial, we assigned patients with myocardial infarction within the previous 6 months to a polypill-based strategy or usual care. The polypill treatment consisted of aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and atorvastatin (20 or 40 mg). The primary composite outcome was cardiovascular death, nonfatal type 1 myocardial infarction, nonfatal ischemic stroke, or urgent revascularization. The key secondary end point was a composite of cardiovascular death, nonfatal type 1 myocardial infarction, or nonfatal ischemic stroke., Results: A total of 2499 patients underwent randomization and were followed for a median of 36 months. A primary-outcome event occurred in 118 of 1237 patients (9.5%) in the polypill group and in 156 of 1229 (12.7%) in the usual-care group (hazard ratio, 0.76; 95% confidence interval [CI], 0.60 to 0.96; P = 0.02). A key secondary-outcome event occurred in 101 patients (8.2%) in the polypill group and in 144 (11.7%) in the usual-care group (hazard ratio, 0.70; 95% CI, 0.54 to 0.90; P = 0.005). The results were consistent across prespecified subgroups. Medication adherence as reported by the patients was higher in the polypill group than in the usual-care group. Adverse events were similar between groups., Conclusions: Treatment with a polypill containing aspirin, ramipril, and atorvastatin within 6 months after myocardial infarction resulted in a significantly lower risk of major adverse cardiovascular events than usual care. (Funded by the European Union Horizon 2020; SECURE ClinicalTrials.gov number, NCT02596126; EudraCT number, 2015-002868-17.)., (Copyright © 2022 Massachusetts Medical Society.)

Published
2022
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