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351. SHORTER HOSPITAL STAYS AND OUTCOMES AFTER NON-ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Author

Rymer, Jennifer, primary, Tempelhof, Michael, additional, Clare, Robert, additional, Pieper, Karen, additional, Lopes, Renato, additional, Granger, Christopher, additional, Van De Werf, Frans, additional, Moliterno, David, additional, Harrington, Robert, additional, White, Harvey, additional, Armstrong, Paul, additional, Califf, Robert, additional, Mahaffey, Kenneth, additional, and Newby, L. Kristin, additional

Published
2014
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353. Vorapaxar, a platelet thrombin-receptor antagonist, in medically managed patients with non-ST-segment elevation acute coronary syndrome: results from the TRACER trial

Author

Held, Claes, primary, Tricoci, Pierluigi, additional, Huang, Zhen, additional, Van de Werf, Frans, additional, White, Harvey D, additional, Armstrong, Paul W, additional, Ambrosio, Giuseppe, additional, Aylward, Philip E, additional, Moliterno, David J, additional, Wallentin, Lars, additional, Chen, Edmond, additional, Erkan, Aycan, additional, Jiang, Lixin, additional, Strony, John, additional, Harrington, Robert A, additional, and Mahaffey, Kenneth W, additional

Published
2014
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354. Association of Aspirin Dose and Vorapaxar Safety and Efficacy in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome (from the TRACER Trial)

Author

Mahaffey, Kenneth W., primary, Huang, Zhen, additional, Wallentin, Lars, additional, Storey, Robert F., additional, Jennings, Lisa K., additional, Tricoci, Pierluigi, additional, White, Harvey D., additional, Armstrong, Paul W., additional, Aylward, Philip E., additional, Moliterno, David J., additional, Van de Werf, Frans, additional, Chen, Edmond, additional, Leonardi, Sergio, additional, Rorick, Tyrus, additional, Held, Claes, additional, Strony, John, additional, and Harrington, Robert A., additional

Published
2014
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355. Vorapaxar in Acute Coronary Syndrome Patients Undergoing Coronary Artery Bypass Graft Surgery

Author

Whellan, David J., primary, Tricoci, Pierluigi, additional, Chen, Edmond, additional, Huang, Zhen, additional, Leibowitz, David, additional, Vranckx, Pascal, additional, Marhefka, Gregary D., additional, Held, Claes, additional, Nicolau, Jose C., additional, Storey, Robert F., additional, Ruzyllo, Witold, additional, Huber, Kurt, additional, Sinnaeve, Peter, additional, Weiss, A. Teddy, additional, Dery, Jean-Pierre, additional, Moliterno, David J., additional, Van de Werf, Frans, additional, Aylward, Philip E., additional, White, Harvey D., additional, Armstrong, Paul W., additional, Wallentin, Lars, additional, Strony, John, additional, Harrington, Robert A., additional, and Mahaffey, Kenneth W., additional

Published
2014
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357. Effects of vorapaxar on platelet reactivity and biomarker expression in non-ST-elevation acute coronary syndromes

Author

Smyth, Susan S., primary, Moliterno, David J., primary, Rorick, Tyrus L., primary, Moccetti, Tiziano, primary, Valgimigli, Marco, primary, Dery, Jean Pierre, primary, Cornel, Jan H., primary, Thomas, Gregory S., primary, Huber, Kurt, primary, Harrington, Robert A., primary, Hord, Edward, primary, Judge, Heather M., primary, Chen, Edmond, primary, Strony, John, primary, Mahaffey, Kenneth W., primary, Tricoci, Pierluigi, primary, Becker, Richard C., primary, Storey, Robert F., additional, Kotha, Jayaprakash, additional, and Jennings, Lisa K., additional

Published
2014
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358. Prognostic relevance of baseline pro- and anti-inflammatory markers in STEMI : An APEX AMI substudy

Author

van Diepen, Sean, Newby, L. Kristin, Lopes, Renato D., Stebbins, Amanda, Hasselblad, Vic, James, Stefan, Roe, Matthew T., Ezekowitz, Justin A., Moliterno, David J., Neumann, Franz-Josef, Reist, Craig, Mahaffey, Kenneth W., Hochman, Judith S., Hamm, Christian W., Armstrong, Paul W., Granger, Christopher B., Theroux, Pierre, van Diepen, Sean, Newby, L. Kristin, Lopes, Renato D., Stebbins, Amanda, Hasselblad, Vic, James, Stefan, Roe, Matthew T., Ezekowitz, Justin A., Moliterno, David J., Neumann, Franz-Josef, Reist, Craig, Mahaffey, Kenneth W., Hochman, Judith S., Hamm, Christian W., Armstrong, Paul W., Granger, Christopher B., and Theroux, Pierre

Abstract

Background: Plaque rupture, acute ischemia, and necrosis in acute coronary syndromes are accompanied by concurrent pro-and anti-inflammatory cascades. Whether STEMI clinical prediction models can be improved with the addition of baseline inflammatory biomarkers remains unknown. Methods: In an APEX-AMI trial substudy, 772 patients had a panel of 9 inflammatory serum biomarkers, high sensitivity C reactive protein (hsCRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) measured at baseline after randomization. Baseline biomarkers were incorporated into a clinical prediction model for a composite of 90-day death, shock, or heart failure. Incremental prognostic value was assessed using Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI). Results: Individually, several biomarkers were independent predictors of clinical outcome: hsCRP (hazard ratio [HR] 1.12; 95% confidence interval [CI], 1.03-1.21; p=0.007, per doubling), NT-proBNP (HR 1.14; 95% CI, 1.06-1.23; p<0.001, per doubling), interleukin (IL)-6 (HR 1.26; 95% CI, 1.12-1.41; p<0.001, per doubling), and inducible protein-10 (IP-10) (HR 0.86; 95% CI, 0.76-0.98; p<0.025, per doubling). The addition of baseline NT-proBNP (NRI 8.6%, p=0.028; IDI 0.030, p<0.001) and IL-6 (NRI 8.8%, p=0.012; IDI 0.036, p<0.001) improved the clinical risk prediction model and the addition of hsCRP (NRI 6.5%, p=0.069; IDI 0.018, p=0.004) yielded minimal improvement. After incorporating NT-proBNP into the model, the remaining biomarkers added little additional predictive value. Conclusions: Multiple inflammatory biomarkers independently predicted 90-day death, shock or heart failure; however, they added little value to a clinical prediction model that included NT-proBNP. Future studies of inflammatory biomarkers in STEMI should report incremental value in a prediction model that includes NT-proBNP.

Published
2013
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359. Effect of vorapaxar on myocardial infarction in the thrombin receptor antagonist for clinical event reduction in acute coronary syndrome (TRA·CER) trial

Author

Leonardi, Sergio, Tricoci, Pierluigi, White, Harvey D, Armstrong, Paul W, Huang, Zhen, Wallentin, Lars, Aylward, Philip E, Moliterno, David J, Van de Werf, Frans, Chen, Edmond, Providencia, Luis, Nordrehaug, Jan E, Held, Claes, Strony, John, Rorick, Tyrus L, Harrington, Robert A, Mahaffey, Kenneth W, Leonardi, Sergio, Tricoci, Pierluigi, White, Harvey D, Armstrong, Paul W, Huang, Zhen, Wallentin, Lars, Aylward, Philip E, Moliterno, David J, Van de Werf, Frans, Chen, Edmond, Providencia, Luis, Nordrehaug, Jan E, Held, Claes, Strony, John, Rorick, Tyrus L, Harrington, Robert A, and Mahaffey, Kenneth W

Abstract

Aims The TRA·CER trial compared vorapaxar, a novel platelet protease-activated receptor (PAR)-1 antagonist, with placebo in 12 944 patients with high-risk non–ST-segment elevation acute coronary syndromes (NSTE ACS). In this analysis, we explored the effect of vorapaxar on myocardial infarction (MI). Methods and results A blinded, independent central endpoint adjudication committee prospectively defined and classified MI according to the universal MI definition, including peak cardiac marker value (creatine kinase-MB [CK-MB] and/or troponin). Because the trial failed to meet its primary endpoint, these analyses are considered exploratory. During a median follow-up of 502 days, 1580 MIs occurred in 1319 patients. The majority (n = 1025, 64.9%) were type 1 (spontaneous) MI, followed by type 4a [percutaneous coronary intervention (PCI)-related] MI (n = 352; 22.3%). Compared with placebo, vorapaxar reduced the hazard of a first MI of any type by 12% [hazard ratio (HR), 0.88; 95% confidence interval (CI), 0.79–0.98; P = 0.021] and the hazard of total number of MIs (first and subsequent) by 14% (HR, 0.86; 95% CI, 0.77–0.97; P = 0.014), an effect that was sustained over time. Vorapaxar reduced type 1 MI by 17% (HR, 0.83; 95% CI, 0.73–0.95; P = 0.007). Type 4a MIs were not significantly reduced by vorapaxar (HR, 0.90; 95% CI, 0.73–1.12; P = 0.35). Vorapaxar effect was consistent across MI sizes defined by peak cardiac marker elevations and across key clinical subgroups; however, in patients not treated with thienopyridine at baseline (HR, 0.65; 95% CI, 0.46–0.92) compared with patients who received thienopyridine (HR, 0.91; 95% CI, 0.81–1.02), there was a trend towards a higher effect (Pint = 0.077). Conclusion The PAR-1 antagonist vorapaxar was associated with a reduction of MI, including total number of infarctions. This reduction was sustained over time and was mostly evident in type 1 MI, the most common type of MI observed.

Published
2013
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360. Vorapaxar in Non-ST-Segment Elevation Acute Coronary Syndrome Patients With Peripheral Artery Disease : Results From TRACER

Author

Jones, Schuyler, Tricoci, Pierluigi, Huang, Zhen, Moliterno, David J., Harrington, Robert A., Sinnaeve, Peter, Strony, John, Van de Werf, Frans, White, Harvey D., Held, Claes, Armstrong, Paul W., Aylward, Philip E., Chen, Edmond, Patel, Manesh R., Mahaffey, Kenneth W., Jones, Schuyler, Tricoci, Pierluigi, Huang, Zhen, Moliterno, David J., Harrington, Robert A., Sinnaeve, Peter, Strony, John, Van de Werf, Frans, White, Harvey D., Held, Claes, Armstrong, Paul W., Aylward, Philip E., Chen, Edmond, Patel, Manesh R., and Mahaffey, Kenneth W.

Published
2013

361. CYP2C19 Polymorphism and PON-1 Activity in NSTE ACS : Vorapaxar Effect in Relation to Clopidogrel Metabolism in the TRACER Trial

Author

Tricoci, Pierluigi, Chen, Edmond, Neely, Megan L., Warner, Amelia, Wong, Peggy H., Sinnaeve, Peter, Wallentin, Lars, Jennings, Lisa K., Storey, Robert F., Aylward, Phillip E., White, Harvey D., Van de Werf, Frans, Armstrong, Paul W., Held, Claes, Valgimigli, Marco, Harrington, Robert A., Strony, John, Mahaffey, Kenneth W., Moliterno, David J., Tricoci, Pierluigi, Chen, Edmond, Neely, Megan L., Warner, Amelia, Wong, Peggy H., Sinnaeve, Peter, Wallentin, Lars, Jennings, Lisa K., Storey, Robert F., Aylward, Phillip E., White, Harvey D., Van de Werf, Frans, Armstrong, Paul W., Held, Claes, Valgimigli, Marco, Harrington, Robert A., Strony, John, Mahaffey, Kenneth W., and Moliterno, David J.

Published
2013

362. Efficacy and Safety of Vorapaxar in Elderly Patients With Non-ST-Segment Elevation Acute Coronary Syndrome : Insights From the TRACER Trial

Author

Armaganijan, Luciana, Lopes, Renato, Huang, Zhen, Tricoci, Pierluigi, Held, Claes, Van de Werf, Frans, Armstrong, Paul W., Aylward, Philip E., White, Harvey D., Moliterno, David J., Wallentin, Lars, Chen, Edmond, Harrington, Robert A., Strony, John, Mahaffey, Kenneth W., Armaganijan, Luciana, Lopes, Renato, Huang, Zhen, Tricoci, Pierluigi, Held, Claes, Van de Werf, Frans, Armstrong, Paul W., Aylward, Philip E., White, Harvey D., Moliterno, David J., Wallentin, Lars, Chen, Edmond, Harrington, Robert A., Strony, John, and Mahaffey, Kenneth W.

Published
2013

363. Arterial Access Site and Outcomes in Patients Undergoing Percutaneous Coronary Intervention With and Without Vorapaxar

Author

Dery, Jean-Pierre P., Mahaffey, Kenneth, Tricoci, Pierluigi, White, Harvey, Podder, Mohua, Moliterno, David, Harrington, Robert, Chen, Edmond, Strony, John, Van de Werf, Frans, Ziada, Khaled M., Held, Claes, Aylward, Philip, Armstrong, Paul W., Rao, Sunil, Dery, Jean-Pierre P., Mahaffey, Kenneth, Tricoci, Pierluigi, White, Harvey, Podder, Mohua, Moliterno, David, Harrington, Robert, Chen, Edmond, Strony, John, Van de Werf, Frans, Ziada, Khaled M., Held, Claes, Aylward, Philip, Armstrong, Paul W., and Rao, Sunil

Published
2013

364. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study

Author

Mehran, Roxana, primary, Baber, Usman, additional, Steg, Philippe Gabriel, additional, Ariti, Cono, additional, Weisz, Giora, additional, Witzenbichler, Bernhard, additional, Henry, Timothy D, additional, Kini, Annapoorna S, additional, Stuckey, Thomas, additional, Cohen, David J, additional, Berger, Peter B, additional, Iakovou, Ioannis, additional, Dangas, George, additional, Waksman, Ron, additional, Antoniucci, David, additional, Sartori, Samantha, additional, Krucoff, Mitchell W, additional, Hermiller, James B, additional, Shawl, Fayaz, additional, Gibson, C Michael, additional, Chieffo, Alaide, additional, Alu, Maria, additional, Moliterno, David J, additional, Colombo, Antonio, additional, and Pocock, Stuart, additional

Published
2013
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365. Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction : insights from the APEX-AMI trial

Author

van Diepen, Sean, Roe, Matthew T., Lopes, Renato D., Stebbins, Amanda, James, Stefan, Newby, L. Kristin, Moliterno, David J., Neumann, Franz-Josef, Ezekowitz, Justin A., Mahaffey, Kenneth W., Hochman, Judith S., Hamm, Christian W., Armstrong, Paul W., Theroux, Pierre, Granger, Christopher B., van Diepen, Sean, Roe, Matthew T., Lopes, Renato D., Stebbins, Amanda, James, Stefan, Newby, L. Kristin, Moliterno, David J., Neumann, Franz-Josef, Ezekowitz, Justin A., Mahaffey, Kenneth W., Hochman, Judith S., Hamm, Christian W., Armstrong, Paul W., Theroux, Pierre, and Granger, Christopher B.

Abstract

Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory mediators in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) is not well described. Of 5,745 STEMI patients treated with primary PCI in the APEX-AMI trial, we evaluated the relationship between baseline NT-proBNP levels and baseline levels of inflammatory markers and markers of myonecrosis in a subset of 772 who were enrolled in a biomarker substudy. Spearman correlations (r (s)) were calculated between baseline NT-proBNP levels and a panel of ten systemic inflammatory biomarkers. Interleukin (IL)-6, a pro-inflammatory cytokine, was significantly positively correlated with NT-proBNP (r (s) = 0.317, P < 0.001). In a sensitivity analysis excluding all heart failure patients, the correlation between baseline IL-6 and NT-proBNP remained significant (n = 651, r (s) = 0.296, P < 0.001). A positive association was also observed with high sensitivity C-reactive protein (r (s) = 0.377, P < 0.001) and there was a weak negative correlation with the anti-inflammatory cytokine IL-10 (r (s) = -0.109, P = 0.003). No other significant correlations were observed among the other testes inflammatory cytokines and chemokines. In STEMI patients undergoing primary PCI, the pro-inflammatory cytokine IL-6 was modestly correlated with baseline NT-proBNP levels. This relationship remained significant in patients without heart failure. This finding is consistent with pre-clinical and clinical research suggesting that systemic inflammation may influence NT-proBNP expression independently of myocardial stretch.

Published
2012
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366. Thrombin-receptor antagonist vorapaxar in acute coronary syndromes.

Author

UCL - (SLuc) Service de pathologie cardiovasculaire, Tricoci, Pierluigi, Huang, Zhen, Held, Claes, Moliterno, David J, Armstrong, Paul W, Van de Werf, Frans, White, Harvey D, Aylward, Philip E, Wallentin, Lars, Chen, Edmond, Lokhnygina, Yuliya, Pei, Jinglan, Leonardi, Sergio, Rorick, Tyrus L, Kilian, Ann M, Jennings, Lisa H K, Ambrosio, Giuseppe, Bode, Christoph, Cequier, Angel, Cornel, Jan H, Diaz, Rafael, Erkan, Aycan, Huber, Kurt, Hudson, Michael P, Jiang, Lixin, Jukema, J Wouter, Lewis, Basil S, Lincoff, A Michael, Montalescot, Gilles, Nicolau, José Carlos, Ogawa, Hisao, Pfisterer, Matthias, Prieto, Juan Carlos, Ruzyllo, Witold, Sinnaeve, Peter R, Storey, Robert F, Valgimigli, Marco, Whellan, David J, Widimsky, Petr, Strony, John, Harrington, Robert A, Mahaffey, Kenneth W, Hanet, Claude, UCL - (SLuc) Service de pathologie cardiovasculaire, Tricoci, Pierluigi, Huang, Zhen, Held, Claes, Moliterno, David J, Armstrong, Paul W, Van de Werf, Frans, White, Harvey D, Aylward, Philip E, Wallentin, Lars, Chen, Edmond, Lokhnygina, Yuliya, Pei, Jinglan, Leonardi, Sergio, Rorick, Tyrus L, Kilian, Ann M, Jennings, Lisa H K, Ambrosio, Giuseppe, Bode, Christoph, Cequier, Angel, Cornel, Jan H, Diaz, Rafael, Erkan, Aycan, Huber, Kurt, Hudson, Michael P, Jiang, Lixin, Jukema, J Wouter, Lewis, Basil S, Lincoff, A Michael, Montalescot, Gilles, Nicolau, José Carlos, Ogawa, Hisao, Pfisterer, Matthias, Prieto, Juan Carlos, Ruzyllo, Witold, Sinnaeve, Peter R, Storey, Robert F, Valgimigli, Marco, Whellan, David J, Widimsky, Petr, Strony, John, Harrington, Robert A, Mahaffey, Kenneth W, and Hanet, Claude

Abstract

In patients with acute coronary syndromes, the addition of vorapaxar to standard therapy did not significantly reduce the primary composite end point but significantly increased the risk of major bleeding, including intracranial hemorrhage. (Funded by Merck; TRACER ClinicalTrials.gov number, NCT00527943.).

Published
2012

369. The Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRA.CER) trial : study design and rationale

Author

Harrington, Robert A., Van de Werf, Frans, Armstrong, Paul W., Aylward, Phil, Veltri, Enrico, Mahaffey, Kenneth W., Moliterno, David J., Strony, John, Wallentin, Lars, White, Harvey D., Diaz, Rafael, Huber, Kurt, Nicolau, Jose Carlos, Carlos Prieto, Juan, Isaza, Daniel, Widimsky, Petr, Grande, Peer, Nieminen, Markku, Montalescot, Gilles, Bode, Christoph, Wong, Lawrence, Ofner, Peter, Lewis, Basil S., Ambrosio, Giuseppe, Valgimigli, Marco, Ogawa, Hisao, Yamaguchi, Jun-ichi, Jukema, J. Wouter, Cornel, Jan H., Nordrehaug, Jan Erik, Ruzyllo, Witold, Providencia, Luis, Tan, Huay-Cheem, Dalby, Anthony, Seung-Jung, Park, Betriu, Amadeo, Cequier, Angel, Held, Claes, Pfisterer, Mathias, Ming-Fong, Chen, Timurkaynak, Timur, Storey, Robert F., Chen, Edmond, Hudson, Michael P., Lincoff, A. Michael, Morrow, David A., Tricoci, Pierluigi, Whellan, David, Harrington, Robert A., Van de Werf, Frans, Armstrong, Paul W., Aylward, Phil, Veltri, Enrico, Mahaffey, Kenneth W., Moliterno, David J., Strony, John, Wallentin, Lars, White, Harvey D., Diaz, Rafael, Huber, Kurt, Nicolau, Jose Carlos, Carlos Prieto, Juan, Isaza, Daniel, Widimsky, Petr, Grande, Peer, Nieminen, Markku, Montalescot, Gilles, Bode, Christoph, Wong, Lawrence, Ofner, Peter, Lewis, Basil S., Ambrosio, Giuseppe, Valgimigli, Marco, Ogawa, Hisao, Yamaguchi, Jun-ichi, Jukema, J. Wouter, Cornel, Jan H., Nordrehaug, Jan Erik, Ruzyllo, Witold, Providencia, Luis, Tan, Huay-Cheem, Dalby, Anthony, Seung-Jung, Park, Betriu, Amadeo, Cequier, Angel, Held, Claes, Pfisterer, Mathias, Ming-Fong, Chen, Timurkaynak, Timur, Storey, Robert F., Chen, Edmond, Hudson, Michael P., Lincoff, A. Michael, Morrow, David A., Tricoci, Pierluigi, and Whellan, David

Abstract

Background The protease-activated receptor 1 (PAR-1), the main platelet receptor for thrombin, represents a novel target for treatment of arterial thrombosis, and SCH 530348 is an orally active, selective, competitive PAR-1 antagonist. We designed TRA.CER to evaluate the efficacy and safety of SCH 530348 compared with placebo in addition to standard of care in patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) and high-risk features. Trial design TRA.CER is a prospective, randomized, double-blind, multicenter, phase III trial with an original estimated sample size of 10,000 subjects. Our primary objective is to demonstrate that SCH 530348 in addition to standard of care will reduce the incidence of the composite of cardiovascular death, myocardial infarction (MI), stroke, recurrent ischemia with rehospitalization, and urgent coronary revascularization compared with standard of care alone. Our key secondary objective is to determine whether SCH 530348 will reduce the composite of cardiovascular death, MI, or stroke compared with standard of care alone. Secondary objectives related to safety are the composite of moderate and severe GUSTO bleeding and clinically significant TIMI bleeding. The trial will continue until a predetermined minimum number of centrally adjudicated primary and key secondary end point events have occurred and all subjects have participated in the study for at least I year. The TRA.CER trial is part of the large phase III SCH 530348 development program that includes a concomitant evaluation in secondary prevention. Conclusion TRA.CER will define efficacy and safety of the novel platelet PAR-1 inhibitor SCH 530348 in the treatment of high-risk patients with NSTE ACS in the setting of current treatment strategies.

Published
2009
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370. Prognostic relevance of baseline pro- and anti-inflammatory markers in STEMI: An APEX AMI substudy

Author

van Diepen, Sean, primary, Newby, L. Kristin, additional, Lopes, Renato D., additional, Stebbins, Amanda, additional, Hasselblad, Vic, additional, James, Stefan, additional, Roe, Matthew T., additional, Ezekowitz, Justin A., additional, Moliterno, David J., additional, Neumann, Franz-Josef, additional, Reist, Craig, additional, Mahaffey, Kenneth W., additional, Hochman, Judith S., additional, Hamm, Christian W., additional, Armstrong, Paul W., additional, Granger, Christopher B., additional, and Theroux, Pierre, additional

Published
2013
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372. Trends in clinical trials of non-ST-segment elevation acute coronary syndromes over 15 years

Author

Chan, Mark Y., primary, Sun, Jie-Lena, additional, Newby, L. Kristin, additional, Lokhnygina, Yuliya, additional, White, Harvey D., additional, Moliterno, David J., additional, Théroux, Pierre, additional, Ohman, E. Magnus, additional, Simoons, Maarten L., additional, Mahaffey, Kenneth W., additional, Pieper, Karen S., additional, Giugliano, Robert P., additional, Armstrong, Paul W., additional, Califf, Robert M., additional, Van de Werf, Frans, additional, and Harrington, Robert A., additional

Published
2013
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375. EFFECTS OF GLYCOPROTEIN IIB/IIIA INHIBITORS IN COMBINATION WITH VORAPAXAR, A PLATELET THROMBIN-RECEPTOR ANTAGONIST, AMONG PATIENTS WITH NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROMES: INSIGHTS FROM THE TRACER TRIAL

Author

Cornel, J.H., primary, Tricoci, Pierluigi, additional, Horton, john, additional, Moliterno, David, additional, Wallentin, Lars, additional, Armstrong, Paul, additional, Aylward, Philip, additional, Huang, Zhen, additional, Lokhnygina, Yuliya, additional, Chen, Edmond, additional, Leonardi, Sergio, additional, Van de Werf, Frans, additional, White, Harvey, additional, Held, Claes, additional, Strony, John, additional, Mahaffey, Kenneth, additional, and Harrington, Robert, additional

Published
2013
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376. FREQUENCY AND IMPACT OF SINGLE VERSUS DUAL ANTIPLATELET CESSATION ON ADVERSE CARDIAC EVENTS: RESULTS FROM THE PARIS REGISTRY

Author

Gukathasan, Nilusha, primary, Weisz, Giora, additional, Witzenbichler, Bernhard, additional, Kini, Annapoorna, additional, Henry, Timothy, additional, Sartori, Samantha, additional, Baber, Usman, additional, Cohen, David, additional, Chieffo, Alaide, additional, Hermiller, James, additional, Stuckey, Thomas, additional, Shawl, Fayaz, additional, Moliterno, David, additional, Antoniucci, David, additional, Berger, Peter, additional, Waksman, Ron, additional, Colombo, Antonio, additional, and Mehran, Roxana, additional

Published
2013
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377. INCIDENCE AND PREDICTORS OF SUDDEN CARDIAC DEATH AFTER HOSPITALIZATION FOR NON-ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: AN ANALYSIS FROM THE TRACER TRIAL

Author

Hess, Paul L., primary, Tricoci, Pierluigi, additional, Horton, John, additional, Lokhnygina, Yuliya, additional, Al-Khatib, Sana M., additional, Piccini, Jonathan, additional, Harrington, Robert, additional, Armstrong, Paul, additional, Aylward, Philip, additional, Moliterno, David, additional, Van de Werf, Frans, additional, Wallentin, Lars, additional, White, Harvey, additional, Held, Claes, additional, and Mahaffey, Kenneth, additional

Published
2013
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378. PREDICTORS OF DUAL ANTIPLATELET THERAPY NON-ADHERENCE AFTER PCI: ONE-YEAR INSIGHTS FROM THE PARIS REGISTRY

Author

Kherada, Nisharahmed, primary, Sartori, Samantha, additional, Vadde, Raj, additional, Bharathi, Pushpam, additional, Cohen, David, additional, Moliterno, David, additional, Steg, Philippe, additional, Henry, Timothy, additional, Weisz, Giora, additional, Witzenbichler, Bernhard, additional, Colombo, Antonio, additional, and Mehran, Roxana, additional

Published
2013
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379. Documento de consenso de expertos. Tercera definición universal del infarto de miocardio

Author

Thygesen, Kristian, primary, Alpert, Joseph S., additional, Jaffe, Allan S., additional, Simoons, Maarten L., additional, Chaitman, Bernard R., additional, White, Harvey D., additional, Thygesen, Kristian, additional, Katus, Hugo A., additional, Apple, Fred S., additional, Lindahl, Bertil, additional, Morrow, David A., additional, Clemmensen, Peter M., additional, Johanson, Per, additional, Hod, Hanoch, additional, Underwood, Richard, additional, Bax, Jeroen J., additional, Bonow, Robert O., additional, Pinto, Fausto, additional, Gibbons, Raymond J., additional, Fox, Keith A., additional, Atar, Dan, additional, Newby, L. Kristin, additional, Galvani, Marcello, additional, Hamm, Christian W., additional, Uretsky, Barry F., additional, Steg, P. Gabriel, additional, Wijns, William, additional, Bassand, Jean-Pierre, additional, Menasché, Phillippe, additional, Ravkilde, Jan, additional, Ohman, E. Magnus, additional, Antman, Elliott M., additional, Wallentin, Lars C., additional, Armstrong, Paul W., additional, Januzzi, James L., additional, Nieminen, Markku S., additional, Gheorghiade, Mihai, additional, Filippatos, Gerasimos, additional, Luepker, Russell V., additional, Fortmann, Stephen P., additional, Rosamond, Wayne D., additional, Levy, Dan, additional, Wood, David, additional, Smith, Sidney C., additional, Hu, Dayi, additional, López-Sendón, José Luis, additional, Robertson, Rose Marie, additional, Weaver, Douglas, additional, Tendera, Michal, additional, Bove, Alfred A., additional, Parkhomenko, Alexander N., additional, Vasilieva, Elena J., additional, Mendis, Shanti, additional, Baumgartner, Helmut, additional, Ceconi, Claudio, additional, Dean, Veronica, additional, Deaton, Christi, additional, Fagard, Robert, additional, Funck-Brentano, Christian, additional, Hasdai, David, additional, Hoes, Arno, additional, Kirchhof, Paulus, additional, Knuuti, Juhani, additional, Kolh, Philippe, additional, McDonagh, Theresa, additional, Moulin, Cyril, additional, Popescu, Bogdan A., additional, Reiner, Željko, additional, Sechtem, Udo, additional, Sirnes, Per Anton, additional, Torbicki, Adam, additional, Vahanian, Alec, additional, Windecker, Stephan, additional, Morais, Joao, additional, Aguiar, Carlos, additional, Almahmeed, Wael, additional, Arnar, David O., additional, Barili, Fabio, additional, Bloch, Kenneth D., additional, Bolger, Ann F., additional, Bøtker, Hans Erik, additional, Bozkurt, Biykem, additional, Bugiardini, Raffaele, additional, Cannon, Christopher, additional, de Lemos, James, additional, Eberli, Franz R., additional, Escobar, Edgardo, additional, Hlatky, Mark, additional, James, Stefan, additional, Kern, Karl B., additional, Moliterno, David J., additional, Mueller, Christian, additional, Neskovic, Aleksandar N., additional, Pieske, Burkert Mathias, additional, Schulman, Steven P., additional, Storey, Robert F., additional, Taubert, Kathryn A., additional, Vranckx, Pascal, additional, and Wagner, Daniel R., additional

Published
2013
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380. Effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST segment elevation acute coronary syndromes : benefit and harm in different age subgroups

Author

Hernández, Adrián V., Westerhout, Cynthia M., Steyerberg, Ewout W., Ioannidis, John P. A., Bueno, Héctor, White, Harvey, Theroux, Pierre, Moliterno, David J., Armstrong, Paul W., Califf, Robert M., Wallentin, Lars C., Simoons, Maarten L., Boersma, Eric, Hernández, Adrián V., Westerhout, Cynthia M., Steyerberg, Ewout W., Ioannidis, John P. A., Bueno, Héctor, White, Harvey, Theroux, Pierre, Moliterno, David J., Armstrong, Paul W., Califf, Robert M., Wallentin, Lars C., Simoons, Maarten L., and Boersma, Eric

Abstract

OBJECTIVE: To investigate whether the beneficial and harmful effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST elevation acute coronary syndromes (NSTE-ACS) depend on age. METHODS: A meta-analysis of six trials of platelet glycoprotein IIb/IIIa receptor blockers in patients with NSTE-ACS (PRISM, PRISM-PLUS, PARAGON-A, PURSUIT, PARAGON-B, GUSTO IV-ACS; n = 31 402) was performed. We applied multivariable logistic regression analyses to evaluate the drug effects on death or non-fatal myocardial infarction at 30 days, and on major bleeding, by age subgroups (<60, 60-69, 70-79, > or =80 years). We quantified the reduction of death or myocardial infarction as the number needed to treat (NNT), and the increase of major bleeding as the number needed to harm (NNH). RESULTS: Subgroups had 11 155 (35%), 9727 (31%), 8468 (27%) and 2049 (7%) patients, respectively. The relative benefit of platelet glycoprotein IIb/IIIa receptor blockers did not differ significantly (p = 0.5) between age subgroups (OR (95% CI) for death or myocardial infarction: 0.86 (0.74 to 0.99), 0.90 (0.80 to 1.02), 0.97 (0.86 to 1.10), 0.90 (0.73 to 1.16); overall 0.91 (0.86 to 0.99). ORs for major bleeding were 1.9 (1.3 to 2.8), 1.9 (1.4 to 2.7), 1.6 (1.2 to 2.1) and 2.5 (1.5-4.1). Overall NNT was 105, and overall NNH was 90. The oldest patients had larger absolute increases in major bleeding, but also had the largest absolute reductions of death or myocardial infarction. Patients > or =80 years had half of the NNT and a third of the NNH of patients <60 years. CONCLUSIONS: In patients with NSTE-ACS, the relative reduction of death or non-fatal myocardial infarction with platelet glycoprotein IIb/IIIa receptor blockers was independent of patient age. Larger absolute outcome reductions were seen in older patients, but with a higher risk of major bleeding. Close monitoring of these patients is warranted.

Published
2007
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386. ACCF 2012 Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations

Author

Newby, L. Kristin, primary, Jesse, Robert L., additional, Babb, Joseph D., additional, Christenson, Robert H., additional, De Fer, Thomas M., additional, Diamond, George A., additional, Fesmire, Francis M., additional, Geraci, Stephen A., additional, Gersh, Bernard J., additional, Larsen, Greg C., additional, Kaul, Sanjay, additional, McKay, Charles R., additional, Philippides, George J., additional, Weintraub, William S., additional, Harrington, Robert A., additional, Bhatt, Deepak L., additional, Anderson, Jeffrey L., additional, Bates, Eric R., additional, Bridges, Charles R., additional, Eisenberg, Mark J., additional, Ferrari, Victor A., additional, Fisher, John D., additional, Garcia, Mario J., additional, Gardner, Timothy J., additional, Gentile, Federico, additional, Gilson, Michael F., additional, Hernandez, Adrian F., additional, Hlatky, Mark A., additional, Jacobs, Alice K., additional, Linderbaum, Jane A., additional, Moliterno, David J., additional, Mukherjee, Debabrata, additional, Rosenson, Robert S., additional, Stein, James H., additional, Weitz, Howard H., additional, and Wesley, Deborah J., additional

Published
2012
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387. Abstract 9964: Vorapaxar, a Platelet Thrombin-Receptor Antagonist, in Medically Managed Patients with Non-ST-Segment Elevation Acute Coronary Syndrome: Results from the TRACER Trial

Author

Held, Claes, primary, Tricoci, Pierluigi, additional, Huang, Zhen, additional, Van de Werf, Frans, additional, White, Harvey, additional, Armstrong, Paul, additional, Ambrosio, Giuseppe, additional, Aylward, Philip, additional, Moliterno, David, additional, Wallentin, Lars, additional, Chen, Edmond, additional, Erkan, Aycan, additional, Jiang, Lixin, additional, Strony, John, additional, Harrington, Robert, additional, and Mahaffey, Kenneth, additional

Published
2012
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388. Abstract 19049: Net Clinical Benefit of Vorapaxar in NSTE ACS: Role of Ischemic and Bleeding Risk Stratification

Author

Tricoci, Pierluigi, primary, Huang, Zhen, additional, Van de Werf, Frans, additional, White, Harvey, additional, Moliterno, David, additional, Lewis, Basil, additional, Held, Claes, additional, Bode, Christoph, additional, Ogawa, Hisao, additional, Lokhnygina, Yuliya, additional, Aylward, Philip, additional, Wallentin, Lars, additional, Harrington, Robert, additional, Mahaffey, Kenneth, additional, and Armstrong, Paul, additional

Published
2012
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389. Abstract 18805: Vorapaxar, A Platelet Thrombin-Receptor Antagonist, in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Results from the TRACER Trial

Author

Valgimigli, Marco, primary, Tricoci, Pierluigi, additional, Huang, Zhen, additional, Aylward, Philip, additional, Armstrong, Paul, additional, White, Harvey, additional, Widimsky, Petr, additional, Harrington, Robert, additional, Cequier, Angel, additional, Ziada, Khaled, additional, Chen, Ming-Fong, additional, Chen, Edmond, additional, Lokhnygina, Yuliya, additional, Wallentin, Lars, additional, Strony, John, additional, Mahaffey, Kenneth, additional, and Moliterno, David, additional

Published
2012
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390. Abstract 18402: Impact of the Use of Different Bleeding Scales on the Rate of 6-Month Bleeding After PCI: Results from the PARIS Registry

Author

Vlachojannis, Georgios, primary, Weisz, Giora, additional, Witzenbichler, Bernhard, additional, Henry, Timothy D, additional, Kini, Annapoorna S, additional, Stuckey, Thomas, additional, Cohen, David J, additional, Berger, Peter B, additional, Colombo, Antonio, additional, Iakovou, Ioannis, additional, Steg, Philippe Gabriel, additional, Moliterno, David J, additional, Atoniucci, David, additional, Waksman, Ron, additional, Krucoff, Mitchell, additional, Vadde, Raj, additional, Elias, Elliot, additional, Yu, Jennifer, additional, Khalili, Leila, additional, Sartori, Samantha, additional, Baber, Usman, additional, and Mehran, Roxana, additional

Published
2012
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391. Abstract 18502: Bleeding Post PCI: Predictors of “ANY” Bleeds: Six Month Results from the PARIS (Patterns of Non-Adherence to Antiplatelet Regimens in Stented Patients) Registry

Author

Yu, Jennifer, primary, Weisz, Giora, additional, Witzenbichler, Bernhard, additional, Henry, Timothy D, additional, Kini, Annapoorna S, additional, Stuckey, Thomas, additional, Cohen, David J, additional, Berger, Peter B, additional, Colombo, Antonio, additional, Shawl, Fayaz, additional, Steg, Philippe Gabriel, additional, Moliterno, David, additional, Hermiller, James, additional, Xistris, Sylvia, additional, Kakoulides, Socrates, additional, Cashy, Catherine, additional, Kulina, Robert, additional, Krucoff, Mitchell, additional, Vlachojannis, Georgios, additional, Sartori, Samantha, additional, and mehran, Roxana, additional

Published
2012
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394. Clinical Application of Procedural Platelet Monitoring during Percutaneous Coronary Intervention among Patients at Increased Bleeding Risk

Author

Department of Cardiology, University of Michigan, Ann Arbor, Michigan; Clinic Foundation, Cleveland, Ohio, Department of Cardiology, University of Michigan, Ann Arbor, Michigan, Ann Arbor, Mukherjee, Debabrata, Chew, Derek P., Robbins, Mark, Yadav, Jay S., Raymond, Russell E., Moliterno, David J., Department of Cardiology, University of Michigan, Ann Arbor, Michigan; Clinic Foundation, Cleveland, Ohio, Department of Cardiology, University of Michigan, Ann Arbor, Michigan, Ann Arbor, Mukherjee, Debabrata, Chew, Derek P., Robbins, Mark, Yadav, Jay S., Raymond, Russell E., and Moliterno, David J.

Abstract

The goal of platelet function testing in the catheterization laboratory is to provide information about the platelet contributions to the risk of thrombotic or hemorrhagic events and optimization of anti-platelet therapy for percutaneous interventions. We present several illustrative cases in which platelet monitoring with the Rapid Platelet Function Assay (RPFA TM, Accumetrics) was used to guide dosing of a glycoprotein (GP) IIb/IIIa inhibitor for coronary and peripheral intervention among patients at increased bleeding risk.

Published
2006

396. 2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

Author

Bashore, Thomas M., primary, Balter, Stephen, additional, Barac, Ana, additional, Byrne, John G., additional, Cavendish, Jeffrey J., additional, Chambers, Charles E., additional, Hermiller, James Bernard, additional, Kinlay, Scott, additional, Landzberg, Joel S., additional, Laskey, Warren K., additional, McKay, Charles R., additional, Miller, Julie M., additional, Moliterno, David J., additional, Moore, John W.M., additional, Oliver-McNeil, Sandra M., additional, Popma, Jeffrey J., additional, and Tommaso, Carl L., additional

Published
2012
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397. 2012 American college of cardiology foundation/society for cardiovascular angiography and interventions expert consensus document on cardiac catheterization laboratory standards update: American college of cardiology foundation task force on expert consen

Author

Bashore, Thomas M., primary, Balter, Stephen, additional, Barac, Ana, additional, Byrne, John G., additional, Cavendish, Jeffrey J., additional, Chambers, Charles E., additional, Hermiller, James Bernard, additional, Kinlay, Scott, additional, Landzberg, Joel S., additional, Laskey, Warren K., additional, McKay, Charles R., additional, Miller, Julie M., additional, Moliterno, David J., additional, Moore, John W.M., additional, Oliver-McNeil, Sandra M., additional, Popma, Jeffrey J., additional, Tommaso, and Carl L., additional, Harrington, Robert A., additional, Bates, Eric R., additional, Bhatt, Deepak L., additional, Bridges, Charles R., additional, Eisenberg, Mark J., additional, Ferrari, Victor A., additional, Fisher, John D., additional, Gardner, Timothy, additional, Gentile, Federico, additional, Gilson, Michael F., additional, Hlatky, Mark A., additional, Jacobs, Alice K., additional, Kaul, Sanjay, additional, Mukherjee, Debabrata, additional, Rosenson, Robert S., additional, Weitz, Howard H., additional, and Wesley, Deborah J., additional

Published
2012
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399. Abstract 84: Impact of Education on Dual Antiplatelet Therapy Adherence

Author

Sergie, Ziad, primary, Baber, Usman, additional, Sartori, Samantha, additional, Cohen, David J, additional, Bharathi, Pushpam, additional, Alu, Maria, additional, Clark, Avery, additional, Gibson, C. Michael, additional, Chieffo, Alaide, additional, Krucoff, Mitchell W, additional, Moliterno, David J., additional, Steg, Philippe Gabriel, additional, Weisz, Giora, additional, Witzenbichler, Bernard, additional, Colombo, Antonio, additional, and Mehran, Roxana, additional

Published
2012
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400. REDUCTION OF MYOCARDIAL INFARCTION WITH VORAPAXAR: RESULTS FROM THE TRA&middot;CER TRIAL

Author

Leonardi, Sergio, primary, Tricoci, Pierluigi, additional, White, Harvey, additional, Armstrong, Paul, additional, Huang, Zhen, additional, Wallentin, Lars, additional, Aylward, Philip, additional, Moliterno, David, additional, Van de Werf, Frans, additional, Chen, Edmond, additional, Providencia, Luis, additional, Nordrehaug, Jan Erik, additional, Held, Claes, additional, Strony, John, additional, Rorick, Tyrus, additional, Harrington, Robert, additional, and Mahaffey, Kenneth, additional

Published
2012
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