| Ethnic variation in adverse cardiovascular outcomes and bleeding complications in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) study. | |
| | |
MedLine Citation:
|
PMID: 19332192 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Atherothrombosis is a common condition affecting individuals worldwide. Its impact on different ethnic groups receiving evidence-based therapy is unclear. We aimed to determine if ethnicity is an independent predictor for cardiovascular events and bleeding complications in a contemporary clinical trial on antiplatelet therapy. METHODS: This was a prospective observational study of 15,603 patients enrolled in the CHARISMA trial followed up every 6 months for a median of 28 months. The primary efficacy end point was the first occurrence of cardiovascular death, myocardial infarction, or stroke. The primary safety end point was bleeding. RESULTS: The cohort comprised 12,502 (80.1%) white, 486 (3.1%) black, 775 (5.0%) Asian, and 1,613 (10.3%) Hispanic patients. There was no difference in the occurrence of the primary composite end point among the 4 ethnic groups. Compared with Asians, cardiovascular and all-cause mortality occurred more frequently among black (adjusted hazard 2.19 and 2.04) and Hispanic (adjusted hazard, 1.83 and 1.69) patients. Although the occurrence of severe bleeding was similarly low among the 4 ethnic groups, Asian (adjusted hazard, 2.21) and black (adjusted hazard, 3.06) patients were more likely to have moderate bleeding complications than Hispanic patients. CONCLUSION: In this trial of individuals at risk of vascular events, ethnicity was not a significant, independent predictor of the primary composite cardiovascular event. However, ethnicity was a significant, independent predictor of the secondary outcomes, cardiovascular and all-cause mortality (blacks and Hispanics), and moderate bleeding complications (blacks and Asians). |
| | |
Authors:
|
Koon-Hou Mak; Deepak L Bhatt; Mingyuan Shao; Graeme J Hankey; J Donald Easton; Keith A A Fox; Eric J Topol |
Publication Detail:
|
Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial Date: 2008-11-06 |
Journal Detail:
|
Title: American heart journal Volume: 157 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-03-31 Completed Date: 2009-04-21 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
|
Languages: eng Pagination: 658-65 Citation Subset: AIM; IM |
Affiliation:
|
Gleneagles Medical Centre, Singapore, Singapore. makheart@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Atherosclerosis / drug therapy*, ethnology Cause of Death / trends Double-Blind Method Ethnic Groups* Female Follow-Up Studies Hemorrhage / ethnology*, etiology Humans Incidence Male Middle Aged Myocardial Ischemia / ethnology*, etiology Platelet Aggregation Inhibitors / adverse effects*, therapeutic use Prognosis Prospective Studies Risk Factors Stroke / ethnology*, etiology Ticlopidine / adverse effects, analogs & derivatives*, therapeutic use Time Factors United States |
| Chemical | |
Reg. No./Substance:
|
0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Evaluation and management of thrombocytopenia and suspected heparin-induced thrombocytopenia in hosp...
Next Document: Impact of stress testing before percutaneous coronary intervention or medical management on outcomes...