The Clinical Outcomes of Percutaneous Coronary Intervention Performed Without Pre-Procedural Aspirin
Objectives The purpose of this study was to examine the incidence and outcomes of percutaneous coronary intervention (PCI) performed in patients who had not received pre-procedural aspirin. Background Aspirin is an essential component of peri-PCI pharmacotherapy. Previous studies suggest that pre-pr...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2013-12, Vol.62 (22), p.2083-2089 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Kenaan, Mohamad, MD Seth, Milan, MS Aronow, Herbert D., MD, MPH Wohns, David, MD Share, David, MD Gurm, Hitinder S., MD |
| description | Objectives The purpose of this study was to examine the incidence and outcomes of percutaneous coronary intervention (PCI) performed in patients who had not received pre-procedural aspirin. Background Aspirin is an essential component of peri-PCI pharmacotherapy. Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI. Methods We evaluated the incidence of PCIs performed without pre-procedural aspirin use among patients undergoing PCI from January 2010 through December 2011 at 44 hospitals in Michigan. Propensity-matched multivariate analysis was used to adjust for the nonrandom use of aspirin. Results Our study population comprised 65,175 patients, of whom 4,640 (7.1%) did not receive aspirin within 24 h before undergoing PCI. Aspirin nonreceivers were more likely to have had previous gastrointestinal bleeding or to present with cardiogenic shock or after cardiac arrest. In the propensity-matched analysis, absence of aspirin before PCI was associated with a higher rate of death (3.9% vs. 2.8%; odds ratio: 1.89 [95% confidence interval: 1.32 to 2.71], p |
| doi_str_mv | 10.1016/j.jacc.2013.08.1625 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1462761714</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S073510971305242X</els_id><sourcerecordid>1462761714</sourcerecordid><originalsourceid>FETCH-LOGICAL-c517t-5f3c7ccd28c102620c923b1e6643148e3bf5b30f630b8bae9e2292acac6d90f63</originalsourceid><addsrcrecordid>eNqFkk1r3DAQhkVpabbb_oJCMZRCL3b0YcvyoYWw9CMQyEJT2puQx2Mi1yttJDuQfx-Z3SaQS04C8cww87xDyHtGC0aZPB2KwQAUnDJRUFUwyasXZMWqSuWiauqXZEVrUeWMNvUJeRPjQCmVijWvyQkvacLKckW6q2vMNqN1FsyYXc4T-B3GzPfZFgPMk3Ho55htfPDOhLvs3E0YbtFN1rsF6X3YYZf9sdO1n6dsGzDfBg_YzSH1O4t7G6x7S171Zoz47viuye_v3642P_OLyx_nm7OLHCpWT3nVC6gBOq6AUS45hYaLlqGUpWClQtH2VStoLwVtVWuwQc4bbsCA7Jrle00-H_rug7-ZMU56ZyPgOB620KyUvJasZmVCPz5BBz8Hl6bTySBXSrBkb03EgYLgYwzY632wu-RBM6qXEPSglxD0EoKmSi8hpKoPx95zm-Q81Py3noBPR8DEpL0PxoGNj5yivGSCJ-7LgcMk7dZi0BEsumTXBoRJd94-M8jXJ_VwTPof3mF83FhHrqn-tdzLci5M0IqX_K-4B18wukA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1552883107</pqid></control><display><type>article</type><title>The Clinical Outcomes of Percutaneous Coronary Intervention Performed Without Pre-Procedural Aspirin</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Kenaan, Mohamad, MD ; Seth, Milan, MS ; Aronow, Herbert D., MD, MPH ; Wohns, David, MD ; Share, David, MD ; Gurm, Hitinder S., MD</creator><creatorcontrib>Kenaan, Mohamad, MD ; Seth, Milan, MS ; Aronow, Herbert D., MD, MPH ; Wohns, David, MD ; Share, David, MD ; Gurm, Hitinder S., MD ; Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)</creatorcontrib><description>Objectives The purpose of this study was to examine the incidence and outcomes of percutaneous coronary intervention (PCI) performed in patients who had not received pre-procedural aspirin. Background Aspirin is an essential component of peri-PCI pharmacotherapy. Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI. Methods We evaluated the incidence of PCIs performed without pre-procedural aspirin use among patients undergoing PCI from January 2010 through December 2011 at 44 hospitals in Michigan. Propensity-matched multivariate analysis was used to adjust for the nonrandom use of aspirin. Results Our study population comprised 65,175 patients, of whom 4,640 (7.1%) did not receive aspirin within 24 h before undergoing PCI. Aspirin nonreceivers were more likely to have had previous gastrointestinal bleeding or to present with cardiogenic shock or after cardiac arrest. In the propensity-matched analysis, absence of aspirin before PCI was associated with a higher rate of death (3.9% vs. 2.8%; odds ratio: 1.89 [95% confidence interval: 1.32 to 2.71], p < 0.001) and stroke (0.5% vs. 0.1%; odds ratio: 4.24 [95% confidence interval: 1.49 to 12.11], p = 0.007) with no difference in need for transfusions. This association was consistent across multiple pre-specified subgroups. Conclusions A significant number of patients do not receive aspirin before undergoing PCI. Lack of aspirin before PCI was associated with significantly increased in-hospital mortality and stroke. Our study results support the need for quality efforts focused on optimizing aspirin use before PCI.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2013.08.1625</identifier><identifier>PMID: 24055844</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage ; aspirin ; Aspirin - administration & dosage ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Clinical outcomes ; Coronary Artery Disease - therapy ; Coronary heart disease ; Coronary vessels ; death ; Diseases of the cardiovascular system ; Drug Utilization ; Female ; Heart ; Heart attacks ; Hospital Mortality ; Hospitals ; Humans ; in-hospital outcomes ; Incidence ; Internal Medicine ; Male ; Medical sciences ; Middle Aged ; Mortality ; PCI ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - standards ; Pharmacology. Drug treatments ; Propensity Score ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Registries ; Stroke - epidemiology ; Treatment Outcome</subject><ispartof>Journal of the American College of Cardiology, 2013-12, Vol.62 (22), p.2083-2089</ispartof><rights>American College of Cardiology Foundation</rights><rights>2013 American College of Cardiology Foundation</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 3, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c517t-5f3c7ccd28c102620c923b1e6643148e3bf5b30f630b8bae9e2292acac6d90f63</citedby><cites>FETCH-LOGICAL-c517t-5f3c7ccd28c102620c923b1e6643148e3bf5b30f630b8bae9e2292acac6d90f63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S073510971305242X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28024132$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24055844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kenaan, Mohamad, MD</creatorcontrib><creatorcontrib>Seth, Milan, MS</creatorcontrib><creatorcontrib>Aronow, Herbert D., MD, MPH</creatorcontrib><creatorcontrib>Wohns, David, MD</creatorcontrib><creatorcontrib>Share, David, MD</creatorcontrib><creatorcontrib>Gurm, Hitinder S., MD</creatorcontrib><creatorcontrib>Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)</creatorcontrib><title>The Clinical Outcomes of Percutaneous Coronary Intervention Performed Without Pre-Procedural Aspirin</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives The purpose of this study was to examine the incidence and outcomes of percutaneous coronary intervention (PCI) performed in patients who had not received pre-procedural aspirin. Background Aspirin is an essential component of peri-PCI pharmacotherapy. Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI. Methods We evaluated the incidence of PCIs performed without pre-procedural aspirin use among patients undergoing PCI from January 2010 through December 2011 at 44 hospitals in Michigan. Propensity-matched multivariate analysis was used to adjust for the nonrandom use of aspirin. Results Our study population comprised 65,175 patients, of whom 4,640 (7.1%) did not receive aspirin within 24 h before undergoing PCI. Aspirin nonreceivers were more likely to have had previous gastrointestinal bleeding or to present with cardiogenic shock or after cardiac arrest. In the propensity-matched analysis, absence of aspirin before PCI was associated with a higher rate of death (3.9% vs. 2.8%; odds ratio: 1.89 [95% confidence interval: 1.32 to 2.71], p < 0.001) and stroke (0.5% vs. 0.1%; odds ratio: 4.24 [95% confidence interval: 1.49 to 12.11], p = 0.007) with no difference in need for transfusions. This association was consistent across multiple pre-specified subgroups. Conclusions A significant number of patients do not receive aspirin before undergoing PCI. Lack of aspirin before PCI was associated with significantly increased in-hospital mortality and stroke. Our study results support the need for quality efforts focused on optimizing aspirin use before PCI.</description><subject>Aged</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - administration & dosage</subject><subject>aspirin</subject><subject>Aspirin - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Clinical outcomes</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>death</subject><subject>Diseases of the cardiovascular system</subject><subject>Drug Utilization</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>in-hospital outcomes</subject><subject>Incidence</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>PCI</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - standards</subject><subject>Pharmacology. Drug treatments</subject><subject>Propensity Score</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Registries</subject><subject>Stroke - epidemiology</subject><subject>Treatment Outcome</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk1r3DAQhkVpabbb_oJCMZRCL3b0YcvyoYWw9CMQyEJT2puQx2Mi1yttJDuQfx-Z3SaQS04C8cww87xDyHtGC0aZPB2KwQAUnDJRUFUwyasXZMWqSuWiauqXZEVrUeWMNvUJeRPjQCmVijWvyQkvacLKckW6q2vMNqN1FsyYXc4T-B3GzPfZFgPMk3Ho55htfPDOhLvs3E0YbtFN1rsF6X3YYZf9sdO1n6dsGzDfBg_YzSH1O4t7G6x7S171Zoz47viuye_v3642P_OLyx_nm7OLHCpWT3nVC6gBOq6AUS45hYaLlqGUpWClQtH2VStoLwVtVWuwQc4bbsCA7Jrle00-H_rug7-ZMU56ZyPgOB620KyUvJasZmVCPz5BBz8Hl6bTySBXSrBkb03EgYLgYwzY632wu-RBM6qXEPSglxD0EoKmSi8hpKoPx95zm-Q81Py3noBPR8DEpL0PxoGNj5yivGSCJ-7LgcMk7dZi0BEsumTXBoRJd94-M8jXJ_VwTPof3mF83FhHrqn-tdzLci5M0IqX_K-4B18wukA</recordid><startdate>20131203</startdate><enddate>20131203</enddate><creator>Kenaan, Mohamad, MD</creator><creator>Seth, Milan, MS</creator><creator>Aronow, Herbert D., MD, MPH</creator><creator>Wohns, David, MD</creator><creator>Share, David, MD</creator><creator>Gurm, Hitinder S., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20131203</creationdate><title>The Clinical Outcomes of Percutaneous Coronary Intervention Performed Without Pre-Procedural Aspirin</title><author>Kenaan, Mohamad, MD ; Seth, Milan, MS ; Aronow, Herbert D., MD, MPH ; Wohns, David, MD ; Share, David, MD ; Gurm, Hitinder S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c517t-5f3c7ccd28c102620c923b1e6643148e3bf5b30f630b8bae9e2292acac6d90f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - administration & dosage</topic><topic>aspirin</topic><topic>Aspirin - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Clinical outcomes</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>death</topic><topic>Diseases of the cardiovascular system</topic><topic>Drug Utilization</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>in-hospital outcomes</topic><topic>Incidence</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>PCI</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - standards</topic><topic>Pharmacology. Drug treatments</topic><topic>Propensity Score</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Registries</topic><topic>Stroke - epidemiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kenaan, Mohamad, MD</creatorcontrib><creatorcontrib>Seth, Milan, MS</creatorcontrib><creatorcontrib>Aronow, Herbert D., MD, MPH</creatorcontrib><creatorcontrib>Wohns, David, MD</creatorcontrib><creatorcontrib>Share, David, MD</creatorcontrib><creatorcontrib>Gurm, Hitinder S., MD</creatorcontrib><creatorcontrib>Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kenaan, Mohamad, MD</au><au>Seth, Milan, MS</au><au>Aronow, Herbert D., MD, MPH</au><au>Wohns, David, MD</au><au>Share, David, MD</au><au>Gurm, Hitinder S., MD</au><aucorp>Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Clinical Outcomes of Percutaneous Coronary Intervention Performed Without Pre-Procedural Aspirin</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2013-12-03</date><risdate>2013</risdate><volume>62</volume><issue>22</issue><spage>2083</spage><epage>2089</epage><pages>2083-2089</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives The purpose of this study was to examine the incidence and outcomes of percutaneous coronary intervention (PCI) performed in patients who had not received pre-procedural aspirin. Background Aspirin is an essential component of peri-PCI pharmacotherapy. Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI. Methods We evaluated the incidence of PCIs performed without pre-procedural aspirin use among patients undergoing PCI from January 2010 through December 2011 at 44 hospitals in Michigan. Propensity-matched multivariate analysis was used to adjust for the nonrandom use of aspirin. Results Our study population comprised 65,175 patients, of whom 4,640 (7.1%) did not receive aspirin within 24 h before undergoing PCI. Aspirin nonreceivers were more likely to have had previous gastrointestinal bleeding or to present with cardiogenic shock or after cardiac arrest. In the propensity-matched analysis, absence of aspirin before PCI was associated with a higher rate of death (3.9% vs. 2.8%; odds ratio: 1.89 [95% confidence interval: 1.32 to 2.71], p < 0.001) and stroke (0.5% vs. 0.1%; odds ratio: 4.24 [95% confidence interval: 1.49 to 12.11], p = 0.007) with no difference in need for transfusions. This association was consistent across multiple pre-specified subgroups. Conclusions A significant number of patients do not receive aspirin before undergoing PCI. Lack of aspirin before PCI was associated with significantly increased in-hospital mortality and stroke. Our study results support the need for quality efforts focused on optimizing aspirin use before PCI.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>24055844</pmid><doi>10.1016/j.jacc.2013.08.1625</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anti-Inflammatory Agents, Non-Steroidal - administration & dosage aspirin Aspirin - administration & dosage Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Cardiology Cardiology. Vascular system Cardiovascular Clinical outcomes Coronary Artery Disease - therapy Coronary heart disease Coronary vessels death Diseases of the cardiovascular system Drug Utilization Female Heart Heart attacks Hospital Mortality Hospitals Humans in-hospital outcomes Incidence Internal Medicine Male Medical sciences Middle Aged Mortality PCI Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - standards Pharmacology. Drug treatments Propensity Score Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Registries Stroke - epidemiology Treatment Outcome |
| title | The Clinical Outcomes of Percutaneous Coronary Intervention Performed Without Pre-Procedural Aspirin |
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