Official websites use. Share sensitive information only on official, secure websites. Department of Cardiology, Clinical Sciences, Lund University, 85 Lund, Sweden. Unfractionated heparin UFH is frequently administered before percutaneous coronary intervention PCI in patients with ST-segment elevation myocardial infarction STEMI. The aim of the study was to investigate if pretreatment with UFH prior to arrival at the catheterisation laboratory affects coronary artery occlusion, mortality, and in-hospital major bleeding in patients with STEMI undergoing PCI. Patients with a first STEMI event undergoing PCI between and were extracted from the Swedish Coronary Angiography and Angioplasty Registry. Risk ratios for UFH pretreatment versus no pretreatment regarding coronary artery occlusion at presentation in the catheterisation laboratory, day mortality, and bleeding were obtained using adjusted Poisson regression models with robust standard errors. Analyses of propensity score PS -matched groups were performed to obtain absolute risk differences. Adjusted risk ratios were Dating Portal Blueline Im Vergleich. Pretreatment with UFH was associated with a reduction in coronary artery occlusion among patients with STEMI, with a number needed to treat NNT of 12, without increasing the risk of major in-hospital bleeding. Regarding mortality, a reduction was found with UFH pretreatment, with an NNT of 94, but this effect was not robust over all sensitivity analyses and residual confounding cannot be excluded. Percutaneous coronary intervention PCI is the gold standard for reperfusion therapy in patients with ST-segment elevation myocardial infarction STEMI. Pretreatment with unfractionated heparin UFH prior to arrival at the coronary catheterisation laboratory is often administered with the intention to improve spontaneous reperfusion rates and reduce clot burden 1. Improved coronary blood flow prior to PCI has previously been shown to improve patient outcome 2. After intravenous administration, the maximum effect of UFH is achieved within minutes. Furthermore, the half-life is short, between 1 and 2 hours. These characteristics, combined with the availability of an antidote, potentially makes UFH a good candidate for early administration in STEMI patients. Scientific evidence regarding UFH pretreatment in patients with STEMI undergoing PCI is scarce. Only 1 small randomised controlled trial RCT dating back to the late 90s 3 and 10 observational studies with varying results regarding patient-relevant outcomes exist 14567891011 Furthermore, evidence on absolute risk differences is sparse, restricted to 1 small non-randomised study 4and available evidence regarding mortality is inconclusive. This is reflected in current guidelines where UFH is endorsed for use during PCI, but there are no clear recommendations for UFH pretreatment prior to arrival at the coronary catheterisation laboratory 13 In Sweden, there are 30 centres performing PCI, each with their own local routines and traditions; no consensus has been reached regarding UFH pretreatment. Thus, the aim of the present study was to investigate relative risks and absolute risk differences for the clinical effects of UFH pretreatment, including coronary artery occlusion at presentation in the catheterisation laboratory, mortality at 30 days, and major in-hospital bleeding for patients with STEMI undergoing primary PCI. In this cohort study, data from the Swedish Coronary Angiography and Angioplasty Registry SCAAR and the National Patient Register were used. SCAAR is a Swedish nationwide register where data regarding myocardial infarctions MI from all hospitals with a cardiac intensive care unit as well as data from all coronary angiographies and PCI procedures in Sweden are recorded. Patient data are reported by the handling physician via a web interface. Inthe register had a coverage rate of The study population consisted of unique patients with a first STEMI event undergoing primary PCI during the study period from January to December The date of PCI was defined as the index date. Patients with chronic total occlusions, missing information regarding UFH pretreatment, and with rescue PCI following thrombolysis were excluded. From SCAAR, data regarding age, sex, body mass index BMIsmoking status, year of PCI, previous medical history coronary artery bypass graft [CABG], diabetes, hyperlipidaemia, hypertension, MIantithrombotic treatment before and during PCI, and the time from symptom onset to PCI were extracted. In Sweden, the dose of UFH pretreatment is often 5, U. However, the dose and the exact timing of the treatment is not recorded in the register. To reflect the severity of the STEMI as well as differences in procedure, the location of the infarction proximal versus not proximal and access radial versus non-radial were recorded. From the patient register, we extracted diagnoses before the index date: bleeding, chronic obstructive pulmonary disease COPDheart failure, kidney failure, peripheral vessel disease, and stroke. The Dating Portal Blueline Im Vergleich were coronary artery occlusion at presentation in the catheterisation laboratory, day mortality, and major in-hospital bleeding. Coronary artery occlusion was determined by Dating Portal Blueline Im Vergleich PCI physician prior to the PCI. We performed 2 adjusted statistical models using i a Poisson regression model our main model and ii a propensity score PS -matched model.
About one-third of the study population had non-radial access and, for these patients, a higher risk of mortality with UFH pretreatment was found. Guck mich gefälligst an, wenn ich mit dir rede! Furthermore, the IPTW sensitivity analyses regarding mortality were not robust. Vorherige Folie der Produktdetails. Problem beim Laden der Informationen Leider konnten wir die Informationen aufgrund eines Problems nicht anzeigen.
Der Merle-Faktor – ein weiteres kritisches "Farb-Gen"
nothing beats him running up and down the blue line as a puppy That was the first time we received a little dating profile on the. Derzeit extrem beliebt ist die "Blue Line" vor allem bei Französischen Bulldoggen oder American Staffordshire Terriern beziehungsweise die. Und das obwohl er Geländespiele, Mutproben und Schlafsäle hasst! The archaic. This article emphasizes the impor- tanceof combining14Cmeasurementswithpaleographicalcharacteristicsand orthography when dating Qurʾān fragments. Tobias ist sauer: Sein Vater will ihn in ein Ferienlager abschieben.ARD: absolute risk difference; CABG: coronary artery bypass graft; CI: confidence interval; COPD: chronic obstructive pulmonary disease; GP: glycoprotein; LMWH: low-molecular-weight heparin; NNT: number needed to treat; PCI: percutaneous coronary intervention; RR: risk ratio; UFH: unfractionated heparin. So weit, so gut. Proportion of STEMI patients undergoing PCI receiving UFH pretreatment by year A and type of centre B. P-values for interaction were calculated in the subgroup analyses. Und das obwohl er Geländespiele, Mutproben und Schlafsäle hasst! Daniela Koppenhöfer, Veterinärbiologin, Kynologin und Autorin des Buchs "Labbylike". Goodness-of-fit was investigated with the chi-squared test. For mortality, access site and extent of vessels affected were effect modifiers. Percutaneous coronary intervention PCI is the gold standard for reperfusion therapy in patients with ST-segment elevation myocardial infarction STEMI. From SCAAR, data regarding age, sex, body mass index BMI , smoking status, year of PCI, previous medical history coronary artery bypass graft [CABG], diabetes, hyperlipidaemia, hypertension, MI , antithrombotic treatment before and during PCI, and the time from symptom onset to PCI were extracted. Weiter werde ich nichts verraten!!! Deine zuletzt angesehenen Artikel und besonderen Empfehlungen. Baseline characteristics are presented in Table 1. Viel lieber wäre er mit seiner Schwester zum Zelten gefahren! Differenzierende Ausgabe: Arbeitsheft mit Lösungsheft und Lernsoftware Klasse 6 Schnittpunkt Mathematik. BMI: body mass index; CABG: coronary artery bypass graft; COPD: chronic obstructive pulmonary disease; GP: glycoprotein; LMWH: low-molecular-weight heparin; MI: myocardial infarction; NOAC: novel oral anticoagulants apixaban, dabigatran, rivaroxaban ; PCI: percutaneous coronary intervention; UFH: unfractionated heparin. Im Alter von 22 Jahren schloss er trotz unbestreitbaren Desinteresses an Buchhaltung das Wirtschaftsgymnasium in Unterliederbach ab. Neben Wasserpark, Spielwiese und Indoorpool bietet das Hundeparadies Aromatherapie, Friseur und Welpentraining. Aber da gab es auch gemeine: Jungs Stepahn Baumann und Kevin. Shop besuchen. Analyses of propensity score PS -matched groups were performed to obtain absolute risk differences. Zurück zum Seitenanfang. The overall results are summarised in the Central illustration. Odds ratios may be more difficult to interpret. Supplementary Figure 2. Von der Marke. Eine schöne Story, unterhaltsam geschrieben und man kann es in einem Rutsch weglesen. UFH pretreatment was associated with an increased risk of bleeding for patients that undergo non-radial access, are 75 years of age or older, or weigh below 60 kilograms. Service Die Newsletter von stern.
