Matches in SemOpenAlex for { <https://semopenalex.org/work/W89861054> ?p ?o ?g. }
Showing items 1 to 70 of
70
with 100 items per page.
- W89861054 abstract "Although few concrete data exist about the optimal timing and dose of clopidogrel pretreatment, the ACC/AHA & ESC guidelines endorse pretreatment with 300 – 600 mg of clopidogrel at least 2– 6 hours before PCI as Class IA (ACS) and Class IC (elective PCI) recommendation. To evaluate the current evidence base in support for clopidogrel pretreat-ment. Five trials examining the impact of clopidogrel pretreatment in stable and unstable CAD were evaluated: PCI-CURE, PCI-CLARITY, CREDO, PRAGUE-8, ARMYDA-5. Because of substantial clinical heterogeneity in trial design and population, concomitant therapies (glycoprotein 2b/3a inhibitors, thrombolysis, etc), loading dose, pretreatment duration and analysis plan between PCI-CURE, PCI-CLARITY and the rest, a formal meta-analysis was confined only to CREDO, PRAGUE-8, ARMYDA-5. The key data are summarized in the Table . Clopidogrel pretreatment was associated with significant reduction in ischemic outcomes without a significant increase in major bleeding in two out of the 5 trials (PCI-CURE and PCI-CLARITY). Both these trials utilized nonrandomized subgroup comparisons with pretreatment duration longer than that typically encountered in clinical practice (<48h). A meta-analysis of the 3 trials demonstrated a nonsignificant 23% odds reduction in efficacy (P=0.1) and a nonsignificant 29% odds increase in major bleeding (P=0.24). No significant heterogeneity was observed for pooled efficacy (P=0.79) or bleeding (P=0.77) outcomes. Pretreatment hypothesis is currently not validated in rigorous prospective assessments, thereby calling into question the Class I recommendation (benefit >>>risk) endorsed by the guidelines. Clearly, further clinical data regarding dose, time course of pretreatment and associated benefit are warranted to provide unequivocal support. Until then, it is prudent to rule out surgical CAD before pretreatment to avoid bleeding risk. Trials Assessing Clopidogrel Pretreatment" @default.
- W89861054 created "2016-06-24" @default.
- W89861054 creator A5003094687 @default.
- W89861054 creator A5028360644 @default.
- W89861054 creator A5031087237 @default.
- W89861054 creator A5074163264 @default.
- W89861054 creator A5082113071 @default.
- W89861054 creator A5088392571 @default.
- W89861054 date "2008-10-28" @default.
- W89861054 modified "2023-09-26" @default.
- W89861054 title "Abstract 4450: Does the Evidence Support Guideline Recommendations for Clopidogrel Pretreatment?" @default.
- W89861054 doi "https://doi.org/10.1161/circ.118.suppl_18.s_891" @default.
- W89861054 hasPublicationYear "2008" @default.
- W89861054 type Work @default.
- W89861054 sameAs 89861054 @default.
- W89861054 citedByCount "0" @default.
- W89861054 crossrefType "journal-article" @default.
- W89861054 hasAuthorship W89861054A5003094687 @default.
- W89861054 hasAuthorship W89861054A5028360644 @default.
- W89861054 hasAuthorship W89861054A5031087237 @default.
- W89861054 hasAuthorship W89861054A5074163264 @default.
- W89861054 hasAuthorship W89861054A5082113071 @default.
- W89861054 hasAuthorship W89861054A5088392571 @default.
- W89861054 hasConcept C126322002 @default.
- W89861054 hasConcept C141071460 @default.
- W89861054 hasConcept C142724271 @default.
- W89861054 hasConcept C156957248 @default.
- W89861054 hasConcept C168563851 @default.
- W89861054 hasConcept C2777628954 @default.
- W89861054 hasConcept C2777849778 @default.
- W89861054 hasConcept C2779581417 @default.
- W89861054 hasConcept C2780182762 @default.
- W89861054 hasConcept C2908647359 @default.
- W89861054 hasConcept C45393284 @default.
- W89861054 hasConcept C500558357 @default.
- W89861054 hasConcept C71924100 @default.
- W89861054 hasConcept C99454951 @default.
- W89861054 hasConceptScore W89861054C126322002 @default.
- W89861054 hasConceptScore W89861054C141071460 @default.
- W89861054 hasConceptScore W89861054C142724271 @default.
- W89861054 hasConceptScore W89861054C156957248 @default.
- W89861054 hasConceptScore W89861054C168563851 @default.
- W89861054 hasConceptScore W89861054C2777628954 @default.
- W89861054 hasConceptScore W89861054C2777849778 @default.
- W89861054 hasConceptScore W89861054C2779581417 @default.
- W89861054 hasConceptScore W89861054C2780182762 @default.
- W89861054 hasConceptScore W89861054C2908647359 @default.
- W89861054 hasConceptScore W89861054C45393284 @default.
- W89861054 hasConceptScore W89861054C500558357 @default.
- W89861054 hasConceptScore W89861054C71924100 @default.
- W89861054 hasConceptScore W89861054C99454951 @default.
- W89861054 hasIssue "suppl_18" @default.
- W89861054 hasLocation W898610541 @default.
- W89861054 hasOpenAccess W89861054 @default.
- W89861054 hasPrimaryLocation W898610541 @default.
- W89861054 hasRelatedWork W2019045182 @default.
- W89861054 hasRelatedWork W2170949977 @default.
- W89861054 hasRelatedWork W2333943037 @default.
- W89861054 hasRelatedWork W2358185051 @default.
- W89861054 hasRelatedWork W2363315954 @default.
- W89861054 hasRelatedWork W2377201884 @default.
- W89861054 hasRelatedWork W2763747986 @default.
- W89861054 hasRelatedWork W45326695 @default.
- W89861054 hasRelatedWork W979863887 @default.
- W89861054 hasRelatedWork W2527719101 @default.
- W89861054 hasVolume "118" @default.
- W89861054 isParatext "false" @default.
- W89861054 isRetracted "false" @default.
- W89861054 magId "89861054" @default.
- W89861054 workType "article" @default.