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Kaski JC, Lluch N, Lopez-Sendon JL, Gorog DA, Antorrena-Miranda I, Avanzas P, Herrero Puente P, Sionis A, González-Juanatey JR, Íñiguez A, Cordero A, Ako E, Fernández-Avilés F, Atienza F, Recio-Mayoral A, Wu AHB, Crea F, Storey R, Badimon L, Cubedo J. Changes in circulating ApoJ-Glyc levels in patients with suspected acute coronary syndrome: The EDICA trial. Int J Cardiol 2023; 391:131291. [PMID: 37619880 DOI: 10.1016/j.ijcard.2023.131291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/08/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Myocardial ischemia induces intracellular accumulation of non-glycosylated apolipoprotein J that results in a reduction of circulating glycosylated ApoJ (ApoJ-Glyc). The latter has been suggested to be a marker of transient myocardial ischemia. OBJECTIVE This proof-of-concept clinical study aimed to assess whether changes in circulating ApoJ-Glyc could detect myocardial ischemia in patients attending the emergency department (ED) with chest pain suggestive of acute coronary syndrome (ACS). METHODS In suspected ACS patients, EDICA (Early Detection of Myocardial Ischemia in Suspected Acute Coronary Syndromes by ApoJ-Glyc a Novel Pathologically based Ischemia Biomarker), a multicentre, international, cohort study assessed changes in 2 glycosylated variants of ApoJ-Glyc, (ApoJ-GlycA2 and ApoJ-GlycA6), in serum samples obtained at ED admission (0 h), and 1 h and 3 h thereafter, blinded to the clinical diagnosis (i.e. STEMI, NSTEMI, unstable angina, non-ischemic). RESULTS 404 patients were recruited; 291 were given a clinical diagnosis of "non-ischemic" chest pain and 113 were considered to have had an ischemic event. ApoJ-GlycA6 was lower on admission in ischemic compared with "non-ischemic" patients (66 [46-90] vs. 73 [56-95] μg/ml; P = 0.04). 74% of unstable angina patients (all with undetectable hs-Tn), had ischemic changes in ApoJ-Glyc at 0 h and 89% at 1 h. Initially low ApoJ-Glyc levels in 62 patients requiring coronary revascularization increased significantly after successful percutaneous intervention. CONCLUSIONS Circulating ApoJ-Glyc concentrations decrease early in ED patients with myocardial ischemia compared with "non-ischemic" patients, even in the absence of troponin elevations. ApoJ-Glyc may be a useful marker of myocardial ischemia in the ED setting.
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Affiliation(s)
- Juan Carlos Kaski
- Molecular and Clinical Sciences Research Institute, St George's, University of London, London, United Kingdom; GlyCardial Diagnostics, S.L., Barcelona, Spain
| | - Nuria Lluch
- GlyCardial Diagnostics, S.L., Barcelona, Spain
| | | | - Diana A Gorog
- Postgraduate Medical School, University of Hertfordshire, Hertfordshire, United Kingdom; Faculty of Medicine, National Heart and Lung Institute, Imperial College, London
| | | | - Pablo Avanzas
- Interventional Cardiology Unit, Hospital Universitario Central de Asturias, Department of Medicine, University of Oviedo, Oviedo, Spain Sanitaria del Principado de Asturias, Spain
| | - Pablo Herrero Puente
- Emergency Department, University Central Hospital of Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Alessandro Sionis
- Cardiology Department Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | | | - Andrés Íñiguez
- Department of Cardiology, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Alberto Cordero
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
| | - Emmanuel Ako
- Chelsea & Westminster Hospital, London, United Kingdom
| | - Francisco Fernández-Avilés
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Ciber Cardiovascular (CiberCV), Madrid, Spain
| | - Felipe Atienza
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Ciber Cardiovascular (CiberCV), Madrid, Spain
| | | | - Alan H B Wu
- Clinical Chemistry and Toxicology Laboratories, San Francisco General Hospital and Dept. Lab. Medicine, University of California, San Francisco, USA
| | - Filippo Crea
- Università Cattolica del Sacro Cuore, and Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Robert Storey
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Lina Badimon
- GlyCardial Diagnostics, S.L., Barcelona, Spain; Cardiovascular-Program-ICCC, IR-Hospital Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; Cardiovascular Research, Universitat Autònoma de Barcelona, Barcelona, Spain
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2
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Patel S, Morrow D, Bonaca M, Palazzolo M, Jarolim P, Steg PG, Bhatt D, Storey R, Cohen M, Braunwald E, Sabatine M, O'Donoghue M. Lipoprotein(a), cardiovascular events, and benefit of P2Y12 inhibition: insights from the PEGASUS-TIMI 54 trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lp(a) plays a causal role in atherogenesis and may exert pro-thrombotic effects by inhibiting fibrinolysis owing to its structural homology with plasminogen. Patients with higher Lp(a) concentrations may derive greater benefit from anti-thrombotic therapy.
Purpose
We assessed whether patients with higher Lp(a) derive greater risk reduction from P2Y12 inhibition with ticagrelor vs. placebo on a background of aspirin therapy.
Methods
Lp(a) concentration was measured (Randox) in a prospective nested cohort of 8,967 pts enrolled in PEGASUS-TIMI 54, a randomized trial of ticagrelor vs. placebo in patients 1–3 years post MI (median follow-up: 2.7 y). Lp(a) was dichotomized at 200 nmol/L as an established threshold of risk. The prespecified MACE endpoint was CV death, MI or stroke, with KM rates reported at 3y. Cox proportional hazards were used to assess the relationship between Lp(a), MACE and treatment benefit. Models were adjusted for relevant baseline characteristics including apolipoprotein B.
Results
The median Lp(a) was 29 (25th-75th percentile: 12–137) nmol/L. A total of 1,053 pts (11.7%) had a high Lp(a) (≥200 nmol/L). In the pooled trial population, high Lp(a) concentration was associated with a 29% higher risk of MACE (9.1% vs 7.6%; adjusted hazard ratio [adj HR] 1.29, 95% confidence interval [CI] 1.02–1.62; p=0.03), including a 37% higher risk of MI (6.9% vs. 5.3%; adj HR 1.37, 95% CI 1.05–1.79; p=0.02). The hazard ratios for MACE with ticagrelor vs. placebo were 0.73 (95% CI 0.48–1.11) for patients with higher Lp(a) and 0.88 (95% CI 0.74–1.05) for patients with lower Lp(a) (p-interaction=0.41; Figure 1). The absolute risk reductions were 2.4% and 1.2%, respectively.
Conclusion
Lp(a) above 200 nmol/L identifies patients with prior MI at increased risk of MACE who may derive greater absolute risk reduction from treatment with ticagrelor. These exploratory observations provide insights for therapeutics that are evaluating the clinical benefit of Lp(a) reduction.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): The PEGASUS-TIMI 54 trial was funded by AstraZeneca
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Affiliation(s)
- S Patel
- Brigham and Women's Hospital , Boston , United States of America
| | - D Morrow
- Brigham and Women's Hospital , Boston , United States of America
| | - M Bonaca
- University of Colorado , Denver , United States of America
| | - M Palazzolo
- Brigham and Women's Hospital , Boston , United States of America
| | - P Jarolim
- Brigham and Women's Hospital , Boston , United States of America
| | - P G Steg
- University Paris Diderot , Paris , France
| | - D Bhatt
- Brigham and Women's Hospital , Boston , United States of America
| | - R Storey
- University of Sheffield , Sheffield , United Kingdom
| | - M Cohen
- Newark Beth Israel Medical Center , Newark , United States of America
| | - E Braunwald
- Brigham and Women's Hospital , Boston , United States of America
| | - M Sabatine
- Brigham and Women's Hospital , Boston , United States of America
| | - M O'Donoghue
- Brigham and Women's Hospital , Boston , United States of America
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Oqab Z, Kunadian V, Wood D, Rao S, Mehran R, Pinilla N, Storey R, Boone R, Sibbald M, Valettas N, Moreno R, Steg PG, Cairns J, Mehta S. TCT-36 Complete Revascularization Versus Culprit Lesion–Only PCI in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease: A Subgroup Analysis of the COMPLETE Trial. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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4
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Ono M, Onuma Y, Kawashima H, Hara H, Gao C, Wang R, O’Leary N, Garg S, Juni P, Hamm C, Valgimigli M, Windecker S, Vranckx P, Deliargyris E, Bhatt D, Storey R, Serruys P. TCT-201 Impact of Proton Pump Inhibitors on Efficacy of Antiplatelet Strategies With Ticagrelor or Aspirin After Percutaneous Coronary Intervention. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zimarino M, Angiolillo DJ, Dangas G, Capodanno D, Barbato E, Hahn JY, Rossini R, Sibbing D, Burzotta F, Louvard Y, Shehab A, Renda G, Kimura T, Gwon HC, Chen SL, Costa R, Koo BK, Storey R, Valgimigli M, Mehran R, Stankovic G, Storey RF, Valgimigli M, Mehran R, Stankovic G. Antithrombotic therapy after percutaneous coronary intervention of bifurcation lesions. EUROINTERVENTION 2021; 17:59-66. [PMID: 32928716 PMCID: PMC9725001 DOI: 10.4244/eij-d-20-00885] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Coronary bifurcations exhibit localised turbulent flow and an enhanced propensity for atherothrombosis, platelet deposition and plaque rupture. Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with an increased risk of thrombotic events. Such risk is modulated by anatomical complexity, intraprocedural factors and pharmacological therapy. There is no consensus on the appropriate PCI strategy or the optimal regimen and duration of antithrombotic treatment in order to decrease the risk of ischaemic and bleeding complications in the setting of coronary bifurcation. A uniform therapeutic approach meets a clinical need. The present initiative, promoted by the European Bifurcation Club (EBC), involves opinion leaders from Europe, America, and Asia with the aim of analysing the currently available evidence. Although mainly derived from small dedicated studies, substudies of large trials or from authors' opinions, an algorithm for the optimal management of patients undergoing bifurcation PCI, developed on the basis of clinical presentation, bleeding risk, and intraprocedural strategy, is proposed here.
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Affiliation(s)
- Marco Zimarino
- Institute of Cardiology, “G. d'Annunzio” University – Chieti, c/o Ospedale SS. Annunziata, Via dei Vestini, 66013 Chieti, Italy
| | - Dominick J. Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - George Dangas
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Davide Capodanno
- Cardio-Thoracic-Vascular Department, Centro Alte Specialità e Trapianti, Catania, and Azienda Ospedaliero Universitario “Vittorio Emanuele-Policlinico”, University of Catania, Catania, Italy
| | - Emanuele Barbato
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Joo-Yong Hahn
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | - Dirk Sibbing
- Privatklinik Lauterbacher Mühle am Ostersee, Iffeldorf, and Department of Cardiology, Ludwig-Maximilians-University (LMU) München, Munich, Germany
| | - Francesco Burzotta
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Yves Louvard
- Ramsay Générale de Santé - Institut cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France
| | - Abdulla Shehab
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Giulia Renda
- Institute of Cardiology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hyeon-Cheol Gwon
- Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Shao-Liang Chen
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ricardo Costa
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Robert Storey
- Cardiovascular Research Unit, Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | | | - Roxana Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Goran Stankovic
- Department of Cardiology, Clinical Center of Serbia, and Medical faculty, University of Belgrade, Belgrade, Serbia
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Storey R, Alexander J, Wojdyla D, Mehran R, Vora A, Goodman S, Aronson R, Windecker S, Granger C, Lopes R. Choice of P2Y12 inhibitor and clinical outcomes in the AUGUSTUS study: support for an individualised approach. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
AUGUSTUS randomized patients with atrial fibrillation and ACS and/or PCI to apixaban or VKA and aspirin or placebo for 6 months on background P2Y12 inhibitor.
Purpose
To characterise the clinical outcomes in patients receiving clopidogrel or ticagrelor.
Methods
Patients enrolled in AUGUSTUS (n=4614) were grouped by P2Y12 inhibitor at randomization. Baseline characteristics were compared among groups. Rates of ISTH major or CRNM bleeding, definite/probable stent thrombosis (ST), stroke, MI, and death or ischaemic event were quantified and treatment groups were compared according to treatment with clopidogrel or ticagrelor.
Results
At randomization, patients were treated with clopidogrel (n=4165), ticagrelor (n=280), prasugrel (n=51) or no P2Y12 inhibitor (n=118). Median ages were 71, 69, 66 and 72 years (P<0.001). Ticagrelor and prasugrel were more commonly used in PCI-managed ACS (53% and 55%) whilst clopidogrel or no P2Y12 inhibitor was more common in medically-managed ACS (25% and 36%); elective PCI was the index event in 37–41% for each group. Irrespective of P2Y12 inhibitor used, bleeding risk was lower with apixaban vs. VKA and higher with aspirin vs. placebo (Table). ST rate was lowest but major/CRNM bleeding rate highest with ticagrelor + aspirin vs ticagrelor without aspirin or clopidogrel with or without aspirin.
Conclusions
Apixaban is safer than VKA regardless of P2Y12 inhibitor used. Dropping aspirin reduces bleeding but is associated with numerically higher ST rates regardless of P2Y12 inhibitor used. These data support current recommendations for preferential use of NOAC vs. VKA and individualised choice of P2Y12 inhibitor and timing of aspirin cessation after PCI according to the patient's risks of bleeding and stent thrombosis.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Bristol-Myers Squibb/Pfizer
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Affiliation(s)
- R Storey
- University of Sheffield, Cardiovascular Research Unit, Sheffield, United Kingdom
| | - J.H Alexander
- Duke Clinical Research Institute, Durham, United States of America
| | - D.M Wojdyla
- Duke Clinical Research Institute, Durham, United States of America
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, Zena and Michael A. Weiner Cardiovascular Institute and Cardiovascular Research Foundation, New York, United States of America
| | - A.N Vora
- UPMC Pinnacle, Harrisburg, United States of America
| | - S.G Goodman
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - R Aronson
- Bristol-Myers Squibb, Lawrenceville, United States of America
| | - S Windecker
- Bern University Hospital, Inselspital, Bern, Switzerland
| | - C.B Granger
- Duke Clinical Research Institute, Durham, United States of America
| | - R.D Lopes
- Duke Clinical Research Institute, Durham, United States of America
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Marston N, Melloni G, Gurmu Y, Lee C, Kamanu F, Roselli C, Bonaca MP, Cavallari I, Giugliano R, Scirica BM, Bhatt D, Steg PG, Cohen M, Storey R, Pedersen T, Keech AC, Raz I, Mosenzon O, Braunwald E, Lubitz S, Ellinor PT, Sabatine M, Ruff CT. PERFORMANCE OF A NOVEL GENETIC RISK SCORE TO IDENTIFY RISK OF VENOUS THROMBOEMBOLISM IN PATIENTS WITH CARDIOMETABOLIC DISEASE. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32821-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Hijazi Z, Alexander JH, Li Z, Wojdyla D, Mehran R, Granger CB, Bahit MC, Windecker S, Berwanger O, Halvorsen S, Sinnaeve P, Storey R, Lopes R. APIXABAN VERSUS WARFARIN AND ASPIRIN VERSUS PLACEBO ACCORDING TO RENAL FUNCTION AFTER ACUTE CORONARY SYNDROME OR PCI IN ATRIAL FIBRILLATION: INSIGHTS FROM THE AUGUSTUS TRIAL. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)30925-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Tomaniak M, Chichareon P, Modolo R, Plante S, Brunel P, Beygui F, Van Geuns RJ, Storey R, Hamm C, Steg PG, Vranckx P, Windecker S, Onuma Y, Valgimigli M, Serruys PW. P6411Dyspnea in ticagrelor treated patients in the all-comer randomized GLOBAL LEADERS study and its association with clinical outcomes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Dyspnea represents a drug adverse effect reported with a higher frequency for ticagrelor, as compared with other P2Y12 antagonists. The impact of dyspnea on clinical outcomes has not been yet evaluated in the context of aspirin-free therapies after percutaneous coronary intervention (PCI).
Purpose
The study aimed to evaluate the incidence of dyspnea and its associations with demographic characteristics and clinical outcomes in patients undergoing PCI treated with ticagrelor either as monotherapy or as a part of a dual antiplatelet therapy (DAPT) in the GLOBAL LEADERS cohort.
Methods
This is a sub-analysis of the randomized all-comer GLOBAL LEADERS study (n=15991), comparing the experimental strategy of ticagrelor monotherapy following one-month DAPT after PCI with the reference strategy of 12-month DAPT followed by 12-month aspirin monotherapy. The incidence of dyspnea reported as adverse event (AE) and its relation to demographic characteristics and 2-year clinical outcomes was evaluated (intention-to-treat analysis). Multivariable Cox proportional hazards models were performed, including randomized treatment and incidence of first dyspnea event as a time-dependent covariate. The primary endpoint was a composite of 2-year all-cause mortality or centrally adjudicated, new Q-wave myocardial infarction (MI). Patient-oriented clinical endpoints (POCE) comprised all-cause death, any stroke, MI or revascularization, whereas net adverse clinical events (NACE) included POCE and Bleeding Academic Research Consortium (BARC)-defined bleeding type 3 or 5.
Results
Overall, dyspnea was reported as an AE in 2101 patients (13.2%) up to two years of follow-up, with a higher frequency in the experimental arm (16.4%) as compared with the reference group (11.1%) (hazard ratio [HR]1.70, 95% confidence interval [CI] 1.56–1.86, p=0.001).
Predictors of dyspnea AE up to 2 years by multivariate analyses were: chronic obstructive pulmonary disease (HR1.71, 95% CI 1.56–1.87, p=0.001), female gender (HR1.31, 95% CI 1.18–1.44, p=0.001), hypertension (HR1.31, 95% CI 1.19–1.44, p=0.001, prior coronary artery bypass grafting (HR1.30, 95% CI 1.10–1.54, p=0.003), left ventricle ejection fraction below 40% (HR1.22, 95% CI 1.04–1.42, p=0.012), presentation with acute coronary syndrome (HR1.19, 95% CI 1.09–1.29, p=0.001) and body mass index (≥27kg/m2) (HR1.17, 95% CI 1.08–1.28, p=0.001).
In patients who reported dyspnea AE, the two-year rates of the efficacy and safety endpoints in the experimental and reference arm were: for the primary endpoint 3.4% vs. 4.3% (p adjusted=0.807), for POCE 15.8% vs. 17.6% (p adjusted=0.218), for NACE 17.2% vs. 19.6% (p adjusted=0.082), for BARC 3 or 5 type bleeding 17.2% vs. 19.6% (p adjusted=0.082), respectively.
Conclusions
The occurrence of dyspnea AE up to two years after PCI appeared not to affect the safety of the experimental treatment strategy of 23-month ticagrelor monotherapy following one-month DAPT after PCI.
Acknowledgement/Funding
Study founded by European Cardiovascular Research Institute, which received unrestricted grants from Biosensors Int., AstraZeneca, Medicines Company.
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Affiliation(s)
- M Tomaniak
- Erasmus Medical Centre, Rotterdam, Medical University of Warsaw, Warsaw, Poland
| | - P Chichareon
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - S Plante
- Southlake Regional Health Centre, Newmarket, Canada
| | - P Brunel
- Clinique de Fontaine, Paris, France
| | | | - R.-J Van Geuns
- Erasmus Medical Centre, Rotterdam, Radboud UMC, Nijmegen, Netherlands (The)
| | - R Storey
- University of Sheffield, Sheffield, United Kingdom
| | - C Hamm
- University of Giessen, Giessen, Germany
| | - P G Steg
- FACT (French Alliance for Cardiovascular Trials), Université Paris Diderot, Hôpital Bichat, Paris, France
| | - P Vranckx
- Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
| | - S Windecker
- Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, ThoraxCenter, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - P W Serruys
- NHLI, Imperial College London, London, United Kingdom
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Tomaniak M, Chichareon P, Onuma Y, Deliargyris E, Takahashi K, Kogame N, Modolo R, Chang CC, Rademaker-Havinga T, Storey R, Dangas G, Bhatt D, Angiolillo D, Hamm C, Valgimigli M, Windecker S, Steg PG, Vranckx P, Serruys P. TCT-404 Benefit and Risks of Aspirin on Top of Ticagrelor in Acute Coronary Syndromes: Insights From the Randomized GLOBAL LEADERS Trial. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Geisler T, Muenzer P, Alnaggar N, Geue S, Tegtmeyer R, Rath D, Droppa M, Seizer P, Heitmeier S, Heemskerk JW, Jennings L, Storey R, Angiolillo D, Rocca B, Spronk H, Cate HT, Gawaz M, Borst O. INHIBITORY MECHANISMS OF VERY LOW DOSE RIVAROXABAN IN NON-ST-ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31939-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Oldroyd K, Wilcox R, Storey R. Open Multicentre Study of the P
2T
Receptor Antagonist AR-C69931MX Assessing Safety, Tolerability and Activity in Patients with Acute Coronary Syndromes. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1615596] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryPlatelet aggregation is the central process in the pathophysiology of acute coronary syndromes. ADP contributes to thrombosis by activating platelets, and AR-C69931MX is a specific antagonist of this process acting at the P
2T
receptor. At 5 hospitals, 39 patients with unstable angina or non-Q wave myocardial infarction, who were receiving aspirin and heparin, were administered intravenous AR-C69931MX with stepped dose increments over 3 h to a plateau of either 2 μg/kg/min for 21 h (Part 1; n = 12) or up to 69 h (Part 2; n = 13) or 4 μg/kg/min for up to 69 h (Part 3: n = 14). Safety parameters, platelet aggregation (PA) induced by ADP 3 μmol/L (impedance aggregometry), bleeding time (BT) and plasma concentrations of AR-C69931XX were assessed. AR-C69931MX was well tolerated. 33 patients completed the study. There were no deaths at 30 days and no serious adverse events attributed to AR-C69931MX. Trivial bleeding (56%) was common. At 24 h, mean inhibition of PA was 96.0 ± 8.6, 94.9 ± 14.4 and 98.7 ± 2.1% and BT was 9.5 ± 8.4, 14.0 ± 9.7 and 16.0 ± 11.1 min for Parts 1, 2 and 3 respectively. At 1 h post-infusion, mean inhibition of PA was 36.2 ± 39.2, 20.7 ± 25.9 and 40.7 ± 36.7% respectively. 90% patients had a plasma half-life for AR-C69931XX of 9 min. In conclusion, AR-C69931MX is a potent, short-acting platelet ADP receptor antagonist suitable for further studies as an antithrombotic agent.
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Storey R, May J, Heptinstall S, Wilcox R. A Whole Blood Assay of Inhibition of Platelet Aggregation by Glycoprotein IIb/IIIa Antagonists: Comparison with other Aggregation Methodologies. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryWe have used a whole blood single-platelet counting assay (WBSPC) that is sensitive to microaggregation for monitoring GPIIb/IIIa antagonists and have compared this with other methodologies. In vitro effects of the GPIIb/IIIa antagonist fradafiban on ADP-induced platelet aggregation were determined using WBSPC and PRP turbidimetry, comparing citrate and hirudin anticoagulation. Fradafiban was a more potent inhibitor of aggregation assessed by PRP turbidimetry compared to WBSPC. Citrate showed only a trend towards enhancing fradafiban potency (p = 0.087). Citrated blood from 8 patients with unstable angina, randomised to receive oral lefradafiban (the oral prodrug of fradafiban) or placebo, was studied before and during treatment using WBSPC, PRP turbidimetry, impedance aggregometry and Rapid Platelet Function Assay (RPFA, Accumetrics). RPFA, PRP turbidimetry and WBSPC measurements correlated well. Impedance aggregometry responses were oversensitive to GPIIb/IIIa blockade. WBSPC was most discriminating at high levels of inhibition and offered a rapid means of monitoring GPIIb/IIIa antagonist effect within the therapeutic range of inhibition.
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Judge H, Wilcox R, Heptinstall S, Storey R. Inhibition of ADP-induced P-selectin Expression and Platelet-Leukocyte Conjugate Formation by Clopidogrel and the P2Y12 Receptor Antagonist AR-C69931MX but not Aspirin. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613242] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryPlatelet-leukocyte interactions are recognised to have pro-inflammatory effects, which may be important in the pathophysiology of ischaemic heart disease. Clopidogrel and the novel intravenous antithrombotic agent AR-C69931MX act at the level of the platelet P2Y12 receptor, which is known to amplify platelet activation, aggregation and other responses induced by numerous platelet agonists. We studied the effects of clopidogrel and aspirin on ADP-induced platelet-leukocyte conjugate formation and P-selectin expression in healthy volunteers. The effects of clopidogrel and AR-C69931MX administered to patients with ischaemic heart disease were also assessed. AR-C69931MX and aspirin were also studied in vitro. Clopidogrel and AR-C69931MX suppressed ADP-induced platelet aggregation, P-selectin expression and platelet-leukocyte conjugate formation whereas aspirin had no inhibitory effect. These effects of clopidogrel and AR-C69931MX may confer therapeutic benefits in the management of acute coronary syndromes.
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Daly R, Mehra S, Dhutia A, Howgego K, Ecob R, Judge H, Morton A, Storey R, Sumaya W. Hirudin anticoagulation allows more rapid determination of P2Y12 inhibition by the VerifyNow P2Y12 assay. Thromb Haemost 2017; 109:550-5. [DOI: 10.1160/th12-10-0718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 12/07/2012] [Indexed: 11/05/2022]
Abstract
SummaryVerifyNow (VN) P2Y12 is a point-of-care assay used to assess response to P2Y12 inhibitors. Sodium citrate (citrate) is the standard anticoagulant used for this assay but requires a pre-incubation period. Hirudin is an alternative anticoagulant for platelet function studies that maintains physiological divalent cation levels. We investigated whether hirudin anticoagulation might allow more rapid testing of P2Y12 inhibition at the time of percutaneous coronary intervention (PCI). Blood was collected from the arterial sheath of aspirin-treated patients undergoing elective, urgent or emergency coronary angiography ± PCI and aliquots were anticoagulated with either citrate or hirudin. For each anticoagulant, VN P2Y12 was performed both immediately and after 20 minutes. A total of 98 patients were included in this study following pre-treatment with clopidogrel (n = 88), prasugrel (n = 6) or no P2Y12 inhibitor (n = 4). PRU with hirudin immediately (PRU_H_Imm) and PRU with citrate 20 minutes post sampling (PRU_C_20) were very strongly correlated (R = 0.95) though PRU_H_Imm tended to be lower than PRU_C_20 so that optimal correlation was estimated by the equation PRU_H_Imm = 0.95 x PRU_C_20 (p < 0.001). Bland-Altman plots showed good agreement between PRU_H_Imm and (0.95 x PRU_C_20). Platelet reactivity was more stable over the studied time course with hirudin as compared to citrate. We therefore conclude that VN P2Y12 with hirudin anticoagulation can be performed more rapidly and results are strongly correlated with delayed citrate measurements. Further studies are warranted to assess the utility of this method for improving clinical outcomes in patients undergoing PCI.
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Buckland R, Sugidachi A, Jakubowski J, Storey R, Judge H. Relationship between degree of P2Y12 receptor blockade and inhibition of P2Y12-mediated platelet function. Thromb Haemost 2017; 103:1210-7. [DOI: 10.1160/th09-11-0770] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 01/29/2010] [Indexed: 11/05/2022]
Abstract
SummaryThe thienopyridine P2Y12 receptor antagonists clopidogrel and prasugrel prevent arterial thrombosis and are routinely used following percutaneous coronary intervention. However, the optimal level of P2Y12 blockade to effectively inhibit platelet function is unknown. These studies utilised the active metabolite of prasugrel (R-138727) to achieve a range of P2Y12 blockade in vitro and assessed several aspects of platelet function. Blood from healthy volunteers was incubated with R-138727 (0–10 μM). P2Y12 receptor number was assessed using a 33P-2MeSADP binding assay. Platelet aggregation (PA) was measured by optical aggregometry with ADP 2–20 μM. VASP phosphorylation, annexin V binding, microparticle formation and P-selectin expression were assessed by flow cytometry. Increasing numbers of unblocked receptors were required for a sustained aggregation response with decreasing concentrations of ADP. A P2Y12 receptor blockade of 60–80% resulted in strong inhibition of final PA response, P-selectin expression, microparticle formation and vasodilator-stimulated phosphoprotein (VASP). PA induced by ADP 2 μM and P-selectin expression were particularly sensitive to low levels of receptor blockade whereas the VASP phosphorylation assay was relatively insensitive, requiring 60% receptor blockade to achieve substantial inhibition. Different assays varied in their ability to discriminate particular ranges of P2Y12 blockade and 80% or greater P2Y12 receptor blockade is required for consistently strong inhibition of several aspects of platelet function. These data guide the interpretation of results from different assays used to monitor the effects of P2Y12 receptor antagonists.
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Runkel M, Gordon A, Farkas N, Storey R. Representation Following Negative Appendicectomy. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lip GYH, Collet JP, Caterina RD, Fauchier L, Lane DA, Larsen TB, Marin F, Morais J, Narasimhan C, Olshansky B, Pierard L, Potpara T, Sarrafzadegan N, Sliwa K, Varela G, Vilahur G, Weiss T, Boriani G, Rocca B, Gorenek B, Savelieva I, Sticherling C, Kudaiberdieva G, Chao TF, Violi F, Nair M, Zimerman L, Piccini J, Storey R, Halvorsen S, Gorog D, Rubboli A, Chin A, Scott-Millar R. Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Europace 2017; 19:1757-1758. [DOI: 10.1093/europace/eux240] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 01/08/2023] Open
Affiliation(s)
- Gregory Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark (Chair, representing EHRA)
| | - Jean Philippe Collet
- Sorbonne Université Paris 6, ACTION Study Group, Institut De Cardiologie, Groupe Hôpital Pitié-Salpetrière (APHP), INSERM UMRS 1166, Paris, France
| | | | - Laurent Fauchier
- Centre Hospitalier Universitaire Trousseau et Faculté de Medicinde, Université François Rabelais, Tours, France
| | - Deirdre A Lane
- Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom; and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Torben B Larsen
- Thrombosis Research Unit,Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | | | - Joao Morais
- Department of Cardiology, Leiria Hospital Centre, Leiria, Portugal
| | | | | | - Luc Pierard
- Department of Cardiology, University Hospital Sart-Tilman, Liege, Belgium
| | - Tatjana Potpara
- School of Medicine, Belgrade University; Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center (WHO Collaborating Center), Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran and School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, South Africa; and Mary McKillop Institute, ACU, Melbourne, Australia
| | - Gonzalo Varela
- Servicio de Electrofisiología, Centro Cardiovascular Casa de Galicia, Hidalgos, Uruguay
| | - Gemma Vilahur
- Cardiovascular Science Institute - ICCC, IIB-Sant Pau, CiberCV, Hospital de Sant Pau, Barcelona, Spain
| | - Thomas Weiss
- Medical Department For Cardiology and Intensive Care, Wilhelminenhospital, and Medical Faculty Sigmund Freud University, Vienna, Austria
| | - Giuseppe Boriani
- Cardiology Department, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Bianca Rocca
- Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy (Co-Chair, representing ESC Working Group on Thrombosis)
| | - Bulent Gorenek
- Eskisehir Osmangazi University, Eskisehir, Turkey (Reviewer Coordinator)
| | - Irina Savelieva
- Molecular and Clinical Sciences Institute, St George's University of London, London, UK
| | | | | | - Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (APHRS reviewer)
| | | | - Mohan Nair
- Department of Cardiology, Max Super Specialty Hospital, New Delhi, India
| | - Leandro Zimerman
- Hospital de Cl쭩cas de Porto Alegre, Federal University of Rio Grande do Sul, Brasil (SOLAECE reviewer)
| | - Jonathan Piccini
- Duke University Medical Center, Duke Clinical Research Institute, Durham, USA (HRS reviewer)
| | - Robert Storey
- Department of Cardiovascular Sciences, University of Sheffield, Sheffield, UK
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway
| | - Diana Gorog
- National Heart and Lung Institute, Imperial College, London, and Postgraduate Medicine, University of Hertfordshire, Hertfordshire, UK
| | - Andrea Rubboli
- Ospedale Maggiore, Division of Cardiology, Bologna, Italy (Working Group of Thrombosis reviewer)
| | - Ashley Chin
- Electrophysiology and Pacing, Groote Schuur Hospital, University of Cape Town, South Africa (CASSA reviewer)
| | - Robert Scott-Millar
- Department of Medicine, Division of Cardiology, University of Cape Town, South Africa (SAHeart reviewer)
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Collet JP, Roffi M, Byrne RA, Costa F, Valgimigli M, Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A, Jüni P, Kastrati A, Kolh P, Mauri L, Montalescot G, Neumann FJ, Petricevic M, Roffi M, Steg PG, Windecker S, Zamorano JL, Badimon L, Vranckx P, Agewall S, De Luca L, Desmet W, James S, Lettino M, McFadden EP, Storey R, Ten Berg JM, Aboyans V, Jofresa AB, Biščević A, Calabrò P, Constantinides S, Damrina E, Diakite M, Dzudovic B, Ruiz VG, Yáñez IK, Lacalzada-Almeida J, Leite L, Maskon O, Myat LL, Ricottini E, Saporito F, Wong PSC, Yamaji K, Zeitouni M. Case-based implementation of the 2017 ESC Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease. Eur Heart J 2017; 39:e1-e33. [DOI: 10.1093/eurheartj/ehx503] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Weng Ow K, Thomas M, Parker W, Judge H, Storey R. 72 Offset of ticagrelor prior to coronary artery bypass graft surgery (cabg) surgery. Heart 2017. [DOI: 10.1136/heartjnl-2017-311726.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Fabris E, van’t Hof A, Hamm C, Lapostolle F, Lassen J, Goodman S, ten Berg J, Bolognese L, Cequier A, Chettibi M, Hammett C, Huber K, Janzon M, Merkely B, Storey R, Zeymer U, Cantor W, Rousseau H, Vicaut E, Montalescot G. Impact of presentation and transfer delays on complete ST-segment resolution before primary percutaneous coronary intervention: insights from the ATLANTIC trial. EUROINTERVENTION 2017; 13:69-77. [DOI: 10.4244/eij-d-16-00965] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- Rachel Orme
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Heather Judge
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Robert Storey
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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Gosling R, Yazdani M, Parviz Y, Hall I, Grech E, Gunn J, Storey R, Iqbal J. COMPARISON OF P2Y12 INHIBITORS FOR MORTALITY AND STENT THROMBOSIS IN PATIENTS WITH ACUTE CORONARY SYNDROMES: SINGLE CENTRE STUDY OF 10,793 CONSECUTIVE ‘REAL-WORLD’ PATIENTS. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Bonaca MP, Bhatt DL, Oude Ophuis T, Steg PG, Storey R, Cohen M, Kuder J, Im K, Magnani G, Budaj A, Theroux P, Hamm C, Špinar J, Kiss RG, Dalby AJ, Medina FA, Kontny F, Aylward PE, Jensen EC, Held P, Braunwald E, Sabatine MS. Long-term Tolerability of Ticagrelor for the Secondary Prevention of Major Adverse Cardiovascular Events. JAMA Cardiol 2016; 1:425-32. [DOI: 10.1001/jamacardio.2016.1017] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Marc P. Bonaca
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Deepak L. Bhatt
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Ton Oude Ophuis
- Department of Cardiology, CWZ Hospital, Nijmegen, the Netherlands
| | - P. Gabriel Steg
- Département Hospitalo Universitaire FIRE, AP-HP, Hôpital Bichat, Paris, France4Université Paris–Diderot, Sorbonne Paris Cité, Paris, France
| | - Robert Storey
- Department of Cardiovascular Science, University of Sheffield, Sheffield, England
| | - Marc Cohen
- Cardiovascular Division, Newark Beth Israel Medical Center, Rutgers–New Jersey Medical School, Newark, New Jersey
| | - Julia Kuder
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Kyungah Im
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Giulia Magnani
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Andrzej Budaj
- Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland
| | - Pierre Theroux
- Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
| | - Christian Hamm
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany10University of Giessen, Giessen, Hesse, Germany
| | - Jindrich Špinar
- Internal Cardiology Department, University Hospital and Medical Faculty, Brno, Czech Republic
| | - Robert G. Kiss
- Department of Cardiology, Military Hospital, Budapest, Hungary
| | - Anthony J. Dalby
- South African Cardiology Clinical Trials Group, Milpark Hospital, Johannesburg, South Africa
| | - Felix A. Medina
- Departamento de Clínicas Médicas, Hospital Nacional Cayetano Heredia, San Martin de Porres, Lima, Peru
| | - Frederic Kontny
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Philip E. Aylward
- South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Eva C. Jensen
- AstraZeneca Research and Development, Mölndal, Sweden
| | - Peter Held
- AstraZeneca Research and Development, Mölndal, Sweden
| | - Eugene Braunwald
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Marc S. Sabatine
- TIMI Study Group, Brigham and Women’s Hospital Heart and Vascular Center, Boston, Massachusetts18Deputy Editor, JAMA Cardiology
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Horne A, Gunn J, Iqbal J, Morgan K, Hall I, West J, Grech E, Barmby D, Wheeldon N, Storey R, Richardson J. 27 Impact of Culprit Versus Non-Culprit Angiography Strategy on Primary PCI Door to Balloon Times. Heart 2016. [DOI: 10.1136/heartjnl-2016-309890.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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27
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Lapan RT, Marcotte AM, Storey R, Carbone P, Loehr-Lapan S, Guerin D, Thomas T, Cuffee-Grey D, Coburn A, Pfeiffer T, Wilson L, Mahoney S. Infusing Career Development to Strengthen Middle School English Language Arts Curricula. The Career Development Quarterly 2016. [DOI: 10.1002/cdq.12046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Richard T. Lapan
- Department of Student Development; University of Massachusetts Amherst
| | | | - Robert Storey
- Department of Student Development; University of Massachusetts Amherst
| | | | | | - Donna Guerin
- 21st Century Learning Partners; Agawam Massachusetts
| | - Teisha Thomas
- Springfield Renaissance School; Springfield Massachusetts
| | | | - Aria Coburn
- Springfield Renaissance School; Springfield Massachusetts
| | | | - Latoya Wilson
- Springfield Renaissance School; Springfield Massachusetts
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Bonaca MP, Bhatt D, Storey R, Steg P, Cohen M, Kuder J, Im K, Held P, Jensen E, Braunwald E, Sabatine M. EFFICACY AND SAFETY OF TICAGRELOR AS LONG-TERM SECONDARY PREVENTION IN PATIENTS WITH PRIOR MYOCARDIAL INFARCTION AND PERIPHERAL ARTERY DISEASE. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32267-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Åkerblom A, James S, Bertilsson M, Himmelmann A, Huhn M, Pieper K, Husted S, Storey R, Becker R, Wallentin L. SERUM URIC ACID IS ASSOCIATED WITH CARDIOVASCULAR OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROMES: RESULTS FROM THE PLATELET INHIBITION AND PATIENT OUTCOMES (PLATO) TRIAL. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30557-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bansilal S, Bonaca M, Cornel J, Storey R, Bhatt D, Steg P, Im K, Held P, Jensen E, Braunwald E, Sabatine M, Ophuis TO. EFFICACY AND SAFETY OF TICAGRELOR FOR LONG-TERM SECONDARY PREVENTION OF ATHEROTHROMBOTIC EVENTS IN PATIENTS WITH PRIOR MI AND MULTIVESSEL CORONARY DISEASE: INSIGHTS FROM THE PEGASUS-TIMI 54 TRIAL. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32147-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lindholm D, Lindbäck J, James S, Becker R, Cornel J, Himmelmann A, Giannitsis E, Harrington R, Held C, Husted S, Katus H, Mahaffey K, Steg PG, Storey R, Siegbahn A, Varenhorst C, Wallentin L. PREDICTION OF MAJOR BLEEDING IN REVASCULARIZED PATIENTS WITH ACUTE CORONARY SYNDROMES: DEVELOPMENT OF A NOVEL BIOMARKER-BASED CLINICAL PREDICTION MODEL. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Storey R. Social Assistance or a Worker’s Right: Workmen’s Compensation and the Struggle of Injured Workers in Ontario, 1970–1985. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/19187033.2006.11675102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Thomas M, Ajjan R, Phoenix F, Outteridge S, Dockrell D, Sabroe I, Storey R. 203 Ticagrelor and Clopidogrel Attenuate the Prothrombotic State induced by Bacterial Endotoxaemia. Heart 2015. [DOI: 10.1136/heartjnl-2015-308066.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Andell P, James S, Cannon C, Cyr D, Himmelmann A, Husted S, Keltai M, Koul S, Santoso A, Steg P, Storey R, Wallentin L, Erlinge D. TICAGRELOR VERSUS CLOPIDOGREL IN PATIENTS WITH ACUTE CORONARY SYNDROMES AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: AN ANALYSIS FROM THE PLATELET INHIBITION AND PATIENT OUTCOMES (PLATO) TRIAL. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wallentin L, Michelsen AE, Aukrust P, Becker R, Bertilsson M, Budaj A, Cornel J, Himmelmann A, Husted S, Siegbahn A, Storey R, Kontny F, Ueland T. ACTIVATED LEUKOCYTE CELL ADHESION MOLECULE (ALCAM) AND OUTCOMES IN ACUTE CORONARY SYNDROMES: A PLATO BIOMARKER SUBSTUDY. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60231-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saraf K, Morris PD, Morris P, Garg P, Sheridan P, Storey R. Non-vitamin K antagonist oral anticoagulants (NOACs): clinical evidence and therapeutic considerations. Postgrad Med J 2014; 90:520-8. [PMID: 25085900 DOI: 10.1136/postgradmedj-2014-132605] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Warfarin, a vitamin K antagonist, is the most widely used oral anticoagulant in the world. It is cheap and effective, but its use is limited in many patients by unpredictable levels of anticoagulation, which increases the risk of thromboembolic or haemorrhagic complications. It also requires regular blood monitoring and dose adjustment. New classes of drugs, non-vitamin K antagonist oral anticoagulants (NOACs), are now supported as alternatives to warfarin. Three NOACs are licensed: dabigatran, a direct thrombin inhibitor, and rivaroxaban and apixaban, antagonists of factor Xa. NOACs do not require routine blood monitoring or dose adjustment. They have a rapid onset and offset of action and fewer food and drug interactions. Current indications include treatment and prophylaxis of venous thromboembolism and prevention of cardioembolic disease in non-valvular atrial fibrillation. Effective antidotes are lacking and some caution must be used in severe renal impairment, but favourable trial evidence has led to their widespread adoption. Research is ongoing, and an increase in their use and indications is expected in the coming years.
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Affiliation(s)
- Karan Saraf
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK
| | | | - Paul Morris
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK Department of Cardiovascular Science, University of Sheffield, Medical School, Sheffield, UK
| | - Pankaj Garg
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK
| | - Paul Sheridan
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK Department of Cardiovascular Science, University of Sheffield, Medical School, Sheffield, UK
| | - Robert Storey
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK Department of Cardiovascular Science, University of Sheffield, Medical School, Sheffield, UK
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Affiliation(s)
- Robert Storey
- Community Services Institute, Inc.; 1695 Main St, Ste 400 Springfield MA 01103 USA
| | - Mark Gapen
- Community Services Institute, Inc.; 1695 Main St, Ste 400 Springfield MA 01103 USA
| | - James S. Sacco
- Community Services Institute, Boston and Springfield; 77 Reed Street Agawam MA 01001 USA
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Sousa-Uva M, Storey R, Huber K, Falk V, Leite-Moreira AF, Amour J, Al-Attar N, Ascione R, Taggart D, Collet JP. Expert position paper on the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery. Eur Heart J 2014; 35:1510-4. [PMID: 24748565 PMCID: PMC4057644 DOI: 10.1093/eurheartj/ehu158] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Miguel Sousa-Uva
- Department of Cardiac Surgery, Hospital Cruz Vermelha, Lisbon, Portugal Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research Center, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Robert Storey
- Department of Cardiovascular Science, University of Sheffield, Sheffield, UK
| | - Kurt Huber
- 3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminenhospital, Vienna, Austria
| | - Volkmar Falk
- Cardivascular Surgery Address University Hospital Zurich, Zurich, Switzeland
| | - Adelino F Leite-Moreira
- Department of Cardiothoracic Surgery, Hospital São João, Porto, Portugal Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research Center, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Julien Amour
- Institut de Cardiologie, UMRS 1166, Pitié-Salpêtrière Hospital (AP-HP), Université, Pierre et Marie Curie, 47-83 Bvd de l'Hôpital, Paris 75013, France
| | - Nawwar Al-Attar
- Cardiac Surgery and Transplantation, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, UK
| | - Raimondo Ascione
- Cardiac Surgery & Translational Research, Bristol Royal Infirmary, UK
| | - David Taggart
- Cardiovascular Surgery, University of Oxford, Oxford, UK
| | - Jean-Philippe Collet
- Institut de Cardiologie, UMRS 1166, Pitié-Salpêtrière Hospital (AP-HP), Université, Pierre et Marie Curie, 47-83 Bvd de l'Hôpital, Paris 75013, France
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Bui A, Cannon C, Steg P, Storey R, Husted S, Ren F, James S, Michelson E, Himmelmann A, Wallentin L, Scirica B. RISK OF CARDIOVASCULAR DEATH AND NON-SUSTAINED VENTRICULAR TACHYCARDIA DETECTED 30-DAYS AFTER ACUTE CORONARY SYNDROME IN THE PLATO (PLATELET INHIBITION AND PATIENT OUTCOMES) TRIAL. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Varenhorst C, Eriksson N, Johansson Å, Barratt B, Åkerblom A, Hagström E, Syvänen AC, Becker R, James S, Katus H, Husted S, Steg G, Siegbahn A, Voora D, Storey R, Wallentin L. TICAGRELOR PLASMA LEVELS BUT NOT CLINICAL OUTCOMES ARE ASSOCIATED WITH TRANSPORTER AND METABOLISM ENZYME GENETIC POLYMORPHISMS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60025-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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West L, Francis S, Storey R. YIA6: VESSEL WALL, BUT NOT PLATELET, P2Y12 CONTRIBUTES TO EARLY ATHEROGENESIS. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lim M, Hussain Z, Howe A, Storey R, Petty D, Haselden J, Sebag-Montefiore D, Alexander D. The oncological outcome after right hemicolectomy and accuracy of CT scan as a preoperative tool for staging in right sided colonic cancers. Colorectal Dis 2013; 15:536-43. [PMID: 23067005 DOI: 10.1111/codi.12061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Accepted: 06/13/2012] [Indexed: 02/08/2023]
Abstract
AIM Neoadjuvant chemotherapy may have a role in the management of colonic carcinoma but clinical trials are required to determine whether this approach is superior to the standard policy of radical surgery, high-quality histopathology and selective postoperative chemotherapy. The selection of appropriate patients for such trials will depend on accurate locoregional staging of disease by preoperative CT scanning. We studied the outcome after radical right hemicolectomy and assessed the accuracy of preoperative CT scans in the prediction of postoperative pathology. METHOD A retrospective analysis of right hemicolectomies performed with curative intent for colon cancer under the care of a single colorectal surgeon (D.J.A.) was performed. Preoperative CT-proven Dukes D patients were excluded. Patient demographics, postoperative histology, use of adjuvant chemotherapy and survival data were collected. Kaplan-Meier curves were constructed and log-rank testing was performed to compare cancer-specific survival. Fifty patients had their preoperative CT scan images reviewed by two radiologists both blinded to the results of the postoperative histology. The accuracy of preoperative CT for T and N staging was studied. A P-value of < 0.05 was significant. RESULTS There were 136 patients (79 women). Median age was 76 (interquartile ratio 67-82) years. Median period of follow-up was 72 (interquartile ratio 39-92) months. There were 56 deaths (39 medical, 16 oncological and 1 postoperative). There were three groups of patients: node negative (n = 84), node positive with postoperative adjuvant chemotherapy (n = 30) and node positive without chemotherapy (n = 22). Five-year cancer-specific survival for node negative disease was 84% and was poorer for node positive patients who received adjuvant chemotherapy when compared with those who did not (62 vs 72%, P-value = 0.046 on log-rank testing). Sensitivity, specificity, positive and negative predictive value of CT scan for tumour (T) stage were 90, 33, 86 and 43% respectively, while that for nodal (N) stage was 83, 38, 57 and 69%, respectively. CONCLUSION CT scan has limited accuracy in predicting those patients with advanced locoregional disease who might benefit from neoadjuvant treatment. When this finding is combined with relatively high cancer-specific survival with surgery alone the impact of adjuvant chemotherapy on survival after radical surgery for right colon carcinoma may be marginal.
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Affiliation(s)
- M Lim
- Department of General Surgery, York District Hospital, York, UK
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Lindholm D, Varenhorst C, Cannon C, Harrington R, Himmelmann A, Maya J, Husted S, Katus H, Steg P, Storey R, Wallentin L, James SK. TICAGRELOR VERSUS CLOPIDOGREL IN PATIENTS WITH NON-ST-ELEVATION ACUTE CORONARY SYNDROME: RESULTS FROM THE PLATO TRIAL. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)60002-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bushakra JM, Krieger C, Deng D, Stephens MJ, Allan AC, Storey R, Symonds VV, Stevenson D, McGhie T, Chagné D, Buck EJ, Gardiner SE. QTL involved in the modification of cyanidin compounds in black and red raspberry fruit. Theor Appl Genet 2013; 126:847-65. [PMID: 23224381 DOI: 10.1007/s00122-012-2022-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/15/2012] [Indexed: 05/24/2023]
Abstract
Fruit from Rubus species are highly valued for their flavor and nutritive qualities. Anthocyanin content contributes to these qualities, and although many studies have been conducted to identify and quantify the major anthocyanin compounds from various Rubus species, the genetic control of the accumulation of these complex traits in Rubus is not yet well understood. The identification of the regions of the genome involved in the production of anthocyanins is an important first step in identifying the genes underlying their expression. In this study, ultra and high-performance liquid chromatography (UHPLC and HPLC) and two newly developed Rubus linkage maps were used to conduct QTL analyses to explore the presence of associations between concentrations of five anthocyanins in fruit and genotype. In total, 27 QTL were identified on the Rubus linkage maps, four of which are associated with molecular markers designed from transcription factors and three of which are associated with molecular markers designed from anthocyanin biosynthetic pathway candidate genes. The results of this study suggest that, while QTL for anthocyanin accumulation have been identified on six of seven Rubus linkage groups (RLG), the QTL on RLG2 and RLG7 may be very important for genetic control of cyanidin modification in Rubus.
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Affiliation(s)
- J M Bushakra
- The New Zealand Institute for Plant & Food Research Limited (PFR), Batchelar Road, Private Bag 11600, Palmerston North, 4442, New Zealand.
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Bansilal S, Wiviott S, Becker R, Harrington R, Himmelmann A, Neely B, Husted S, Storey R, Steg P, Katus H, James S, Wallentin L, Cannon C. THE EFFICACY AND SAFETY OF TICAGRELOR AS COMPARED TO CLOPIDOGREL, WITH AND WITHOUT A GLYCOPROTEIN IIB/IIIA INHIBITOR IN PATIENTS WITH ACUTE CORONARY SYNDROMES UNDERGOING PERCUTANEOUS INTERVENTION: A PLATO (STUDY OF PLATELET INHIBITION AND PATIENT OUTCOMES) ANALYSIS. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61858-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Anderson Y, Wynter L, Moller K, Storey R, Sigurdsson K, Law R, Horo L, Hofman P. Whanau Pakari: A multidisciplinary intervention programme for child and adolescent weight issues in Taranaki – Results of the first intake's baseline assessments. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wallentin L, James S, Storey R, Barratt B, Horrow J, Husted S, Katus H, Steg P, Becker R. GREATER EFFICACY OF TICAGRELOR COMPARED TO CLOPIDOGREL IN ACUTE CORONARY SYNDROME IS NOT DRIVEN BY OUTCOMES IN POOR METABOLIZERS OF CLOPIDOGREL. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60501-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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