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Nascimento BR, de Sousa MR, Demarqui FN, et al. Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction: Systematic Review. ISRN Cardiol. 2014;2014:416253doi: 10.1155/2014/416253.
Nascimento, B. R., de Sousa, M. R., Demarqui, F. N., & Ribeiro, A. L. (2014). Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction: Systematic Review. ISRN cardiology, 2014416253. https://doi.org/10.1155/2014/416253
Nascimento, Bruno Ramos, et al. "Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction: Systematic Review." ISRN cardiology vol. 2014 (2014): 416253. doi: https://doi.org/10.1155/2014/416253
Nascimento BR, de Sousa MR, Demarqui FN, Ribeiro AL. Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction: Systematic Review. ISRN Cardiol. 2014 Feb 06;2014:416253. doi: 10.1155/2014/416253. eCollection 2014. PMID: 24653840; PMCID: PMC3933035.
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ISRN Cardiol. 2014 Feb 06;2014:416253. doi: 10.1155/2014/416253. eCollection 2014.

Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction: Systematic Review.

ISRN cardiology

Bruno Ramos Nascimento, Marcos Roberto de Sousa, Fábio Nogueira Demarqui, Antonio Luiz Pinho Ribeiro

Affiliations

  1. Serviço de Cardiologia e Cirurgia Cardiovascular, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, Campus Saúde, 30130-100 Belo Horizonte, MG, Brazil ; Serviço de Hemodinâmca do Hospital Universitário São José (INCOR Minas), Rua Aimorés 2896, Barro Preto, 30140-073 Belo Horizonte, MG, Brazil ; Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, Campus Saúde, 30130-100 Belo Horizonte, MG, Brazil.
  2. Serviço de Cardiologia e Cirurgia Cardiovascular, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, Campus Saúde, 30130-100 Belo Horizonte, MG, Brazil.
  3. Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6.627, Campus Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
  4. Serviço de Cardiologia e Cirurgia Cardiovascular, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, Campus Saúde, 30130-100 Belo Horizonte, MG, Brazil ; Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, Campus Saúde, 30130-100 Belo Horizonte, MG, Brazil.

PMID: 24653840 PMCID: PMC3933035 DOI: 10.1155/2014/416253

Abstract

Objectives. Assess the impact of associating thrombolytics, anticoagulants, antiplatelets, and primary angioplasty (PA) on death, reinfarction (AMI), and major bleeding (MB) in STEMI therapy. Methods. Medline search was performed to identify randomized trials comparing these classes in STEMI treatment, at least 500 patients, providing death, AMI, and MB rates. Similar arms were grouped. Correlation between number of drugs and PA and the outcomes was evaluated, as well as correlation between the year of the study and the outcomes. Results. Fifty-nine papers remained after exclusions. 404.556 patients were divided into 35 groups of arms. There was correlation between the number of drugs and rates of death (r = -0.466, P = 0.005) and MB (r = 0.403, P = 0.016), confirmed by multivariate regression. This model also showed that PA is associated with lower mortality and increased MB. Year and period of publication correlated with the outcomes: death (r = -0.380, P < 0.001), MB (r = 0.212, P = 0.014), and AMI (r = -0.231, P = 0.009). Conclusion. The increasing complexity of STEMI treatment has resulted in significant reduction in mortality along with increased rates of MB. Overall, however, the benefits of treatment outweigh the associated risks of MB.

References

  1. JAMA. 2011 Apr 27;305(16):1677-84 - PubMed
  2. Lancet. 1995 Aug 5;346(8971):329-36 - PubMed
  3. J Am Coll Cardiol. 1999 Dec;34(7):1954-62 - PubMed
  4. J Am Coll Cardiol. 1999 Oct;34(4):966-73 - PubMed
  5. Arch Intern Med. 2009 Oct 26;169(19):1756-61 - PubMed
  6. Circulation. 2008 Jan 15;117(2):296-329 - PubMed
  7. Lancet. 1993 Sep 25;342(8874):767-72 - PubMed
  8. Am Heart J. 2004 Nov;148(5):764-75 - PubMed
  9. BMJ. 1988 Nov 26;297(6660):1374-9 - PubMed
  10. Clin Cardiol. 2011 Feb;34(2):90-6 - PubMed
  11. Arch Intern Med. 2007 Oct 8;167(18):1930-6 - PubMed
  12. Arch Intern Med. 2007 Jan 8;167(1):68-73 - PubMed
  13. Lancet. 2009 Feb 28;373(9665):723-31 - PubMed
  14. Lancet. 2008 Aug 16;372(9638):537-46 - PubMed
  15. Lancet. 1989 Jul 22;2(8656):182-6 - PubMed
  16. N Engl J Med. 1989 Mar 9;320(10):618-27 - PubMed
  17. Lancet. 1988 Aug 13;2(8607):349-60 - PubMed
  18. G Ital Cardiol. 1994 Dec;24(12):1585-95 - PubMed
  19. JAMA. 2008 Apr 16;299(15):1788-99 - PubMed
  20. Lancet. 1986 Feb 22;1(8478):397-402 - PubMed
  21. Circulation. 2003 Sep 16;108(11):1316-23 - PubMed
  22. Lancet. 2006 Feb 18;367(9510):569-78 - PubMed
  23. Am Heart J. 2008 Jul;156(1):44-56 - PubMed
  24. N Engl J Med. 2009 Jun 25;360(26):2705-18 - PubMed
  25. N Engl J Med. 2006 Apr 6;354(14):1477-88 - PubMed
  26. Health Technol Assess. 2005 Jul;9(26):1-134, iii-iv - PubMed
  27. Circulation. 1995 Jun 1;91(11):2725-32 - PubMed
  28. Lancet. 1985 Sep 14;2(8455):578-82 - PubMed
  29. Lancet. 2001 Aug 25;358(9282):605-13 - PubMed
  30. JAMA. 1988 Oct 21;260(15):2259-63 - PubMed
  31. J Am Coll Cardiol. 2006 Feb 21;47(4):809-16 - PubMed
  32. Lancet. 1990 Jul 14;336(8707):65-71 - PubMed
  33. Circulation. 1996 Sep 1;94(5):911-21 - PubMed
  34. N Engl J Med. 2008 May 22;358(21):2218-30 - PubMed
  35. Ann Intern Med. 2009 Aug 18;151(4):W65-94 - PubMed
  36. N Engl J Med. 1986 Jun 5;314(23):1465-71 - PubMed
  37. Lancet. 1990 Jul 14;336(8707):71-5 - PubMed
  38. Circulation. 1991 May;83(5):1543-56 - PubMed
  39. Lancet. 1999 Aug 28;354(9180):716-22 - PubMed
  40. Lancet. 2008 Feb 16;371(9612):559-68 - PubMed
  41. Lancet. 2001 Dec 1;358(9296):1855-63 - PubMed
  42. N Engl J Med. 1993 Aug 5;329(6):383-9 - PubMed
  43. JAMA. 2005 Jan 26;293(4):427-35 - PubMed
  44. Circulation. 1990 May;81(5):1457-76 - PubMed
  45. Lancet. 1993 Sep 25;342(8874):759-66 - PubMed
  46. Am J Cardiol. 1991 Sep 1;68(6):585-92 - PubMed
  47. J Am Coll Cardiol. 2000 Mar 1;35(3):600-4 - PubMed
  48. J Clin Epidemiol. 1997 Jun;50(6):683-91 - PubMed
  49. N Engl J Med. 2009 Dec 10;361(24):2330-41 - PubMed
  50. N Engl J Med. 1993 Sep 2;329(10):673-82 - PubMed
  51. J Thromb Thrombolysis. 2010 Nov;30(4):434-40 - PubMed
  52. J Am Coll Cardiol. 1998 Mar 1;31(3):487-93 - PubMed
  53. Circulation. 1987 Jul;76(1):142-54 - PubMed
  54. Lancet. 2001 Jun 16;357(9272):1905-14 - PubMed
  55. N Engl J Med. 1997 Oct 16;337(16):1124-30 - PubMed
  56. Eur Heart J. 2002 Aug;23(16):1282-90 - PubMed
  57. Chest. 1989 May;95(5 Suppl):270S-275S - PubMed
  58. Eur Heart J. 2008 Dec;29(23):2909-45 - PubMed
  59. J Am Coll Cardiol. 2001 Dec;38(7):2114-30 - PubMed
  60. Lancet. 2002 Sep 14;360(9336):825-9 - PubMed
  61. Arq Bras Cardiol. 2009 Mar;92(3):229-38, 235-45 - PubMed
  62. N Engl J Med. 2005 Mar 24;352(12):1179-89 - PubMed
  63. Lancet. 1992 Mar 28;339(8796):753-70 - PubMed
  64. Circulation. 1994 Feb;89(2):588-95 - PubMed
  65. Br Heart J. 1992 Feb;67(2):122-8 - PubMed
  66. Am Heart J. 2005 Mar;149(3):402-7 - PubMed
  67. Lancet. 1990 Feb 24;335(8687):427-31 - PubMed
  68. N Engl J Med. 1997 Oct 16;337(16):1118-23 - PubMed
  69. Am Heart J. 1999 May;137(5):786-91 - PubMed
  70. J Am Coll Cardiol. 1999 Feb;33(2):576-82 - PubMed
  71. Circulation. 2009 Apr 14;119(14):1933-40 - PubMed
  72. Lancet. 2005 Nov 5;366(9497):1622-32 - PubMed
  73. N Engl J Med. 1983 Aug 18;309(7):396-403 - PubMed
  74. N Engl J Med. 1985 Nov 28;313(22):1369-75 - PubMed
  75. J Am Coll Cardiol. 1998 Jun;31(7):1493-8 - PubMed
  76. JAMA. 2006 Apr 5;295(13):1519-30 - PubMed
  77. Circulation. 2004 Aug 3;110(5):588-636 - PubMed
  78. N Engl J Med. 1988 Oct 27;319(17):1105-11 - PubMed
  79. Eur Heart J. 2000 Dec;21(24):2005-13 - PubMed
  80. Phys Ther. 2009 Sep;89(9):873-80 - PubMed
  81. J Clin Epidemiol. 2009 Oct;62(10):1006-12 - PubMed
  82. Circulation. 1998 Dec 22-29;98(25):2805-14 - PubMed
  83. Circulation. 1998 Aug 25;98(8):734-41 - PubMed
  84. Eur Heart J. 2004 May;25(10):837-46 - PubMed
  85. J Clin Epidemiol. 2010 Oct;63(10):1071-81 - PubMed

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