Pre-existing treatment with aspirin or statins influences clinical presentation, infarct size and inflammation in patients with de novo acute coronary syndromes.

Détails

ID Serval
serval:BIB_DF322647F023
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Pre-existing treatment with aspirin or statins influences clinical presentation, infarct size and inflammation in patients with de novo acute coronary syndromes.
Périodique
International journal of cardiology
Auteur(s)
Weidmann L., Obeid S., Mach F., Shahin M., Yousif N., Denegri A., Muller O., Räber L., Matter C.M., Lüscher T.F.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Statut éditorial
Publié
Date de publication
15/01/2019
Peer-reviewed
Oui
Volume
275
Pages
171-178
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
Influence of pre-existing treatment with aspirin and/or statins prior to a first acute coronary syndrome (ACS) on clinical presentation, infarct size and inflammation markers. We analyzed patients from the Swiss Program University Medicine ACS-cohort (SPUM-ACS; ClinicalTrials.govnumber:NCT01075867).
1639 patients were categorized into 4 groups: (1) patients without either drug (n = 1181); (2) patients only on aspirin (n = 157); (3) patients only on statins (n = 133) and (4) patients on both drugs (n = 168). Clinical features, electrocardiogram (ECG), creatinine kinase (CK, U/l), high-sensitivity troponin T (hsTNT, μg/l), N-terminal brain natriuretic peptide (NT-proBNP, ng/l), leucocytes (Lc, G/l), neutrophils (Nc, G/l), C-reactive protein (CRP, mg/l) and angiographic features were documented at baseline.
Incidences of ST-elevation myocardial infarction (STEMI) were 64% in group 1, 45% in group 2, 52% in group 3 and 40% in group 4 (p < 0.0001). Those with both drugs had significantly lower CK (median 145 U/l, interquartile range (IQR) 89-297), hsTNT (median 0.13 μg/l, IQR 0.03-0.52) and higher left ventricular ejection fraction values (LVEF) (mean 55 ± 12%) compared to untreated patients (median CK 273 U/l, IQR 128-638; median hsTNT 0.26 μg/l, IQR 0.08-0.85; mean LVEF 51 ± 11%) (p < 0.0001, p = 0.001, p = 0.028, respectively). Co-medicated groups matched for high risk factors presented less frequently as STEMIs (p < 0.0001), had significantly smaller infarcts determined by CK and hsTNT (both p < 0.0001) and lower CRP levels (p = 0.01) compared to patients without pre-existing treatment with either drug.
Pre-existing treatment with aspirin and/or statins and particularly with their combination changes the clinical presentation, infarct size, inflammation markers and LVEF in patients suffering their first ACS.
Mots-clé
Acute Coronary Syndrome/complications, Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/drug therapy, Aged, Aspirin/therapeutic use, Biomarkers/blood, C-Reactive Protein/metabolism, Coronary Angiography, Electrocardiography, Female, Follow-Up Studies, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Inflammation/diagnosis, Inflammation/drug therapy, Inflammation/etiology, Male, Middle Aged, Myocardial Infarction/diagnosis, Myocardial Infarction/drug therapy, Myocardial Infarction/etiology, Natriuretic Peptide, Brain, Peptide Fragments, Platelet Aggregation Inhibitors/therapeutic use, Prognosis, Prospective Studies, Stroke Volume/physiology, Troponin T/blood, Ventricular Function, Left/physiology, ACS, Aspirin, Biomarkers, ECG, Inflammation, Statins
Pubmed
Web of science
Création de la notice
05/11/2018 10:26
Dernière modification de la notice
20/08/2019 17:03
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