Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Dr. Robert M Califf,
Dr. Roxana Mehran,
Presenter report:Mehran, Roxana (United States of America)Webcast
To determine the impact of major bleeding and/or major adverse cardiac events, a multivariable Cox model was developed with 5 significant baseline predictor variables of mortality within 30 days of presentation with STEMI in patients enrolled in HORIZONS AMI Trial.
The main event endpoints from the trial (including the components of MACE and major bleeding) were then added to the model as time updated covariates. Within 30 days of randomization, there were 93 deaths; 26 following a major bleed (non CABG-related) in 238 patients, 10 deaths following a reinfarction in 65 patients, 9 following 82 ischemic TVRs, and 3 following 22 strokes. In the fully adjusted models, time updated reinfarction (HR [95% CI]= 9.75 [2.72,34.91]) and non-CABG major bleeding (HR [95% CI]= 4.66 [2.84,7.63]) were significantly associated with mortality, yielding 9.0 and 20.3 attributable deaths respectively. Ischemic TVR (HR [95% CI]= 1.11 [0.29,4.21]) and stroke (HR [95% CI]= 2.64 [0.71,9.75]) were not significantly associated with mortality within the first 30 days.
After accounting for baseline predictors, both reinfarction and major bleeding have a significant impact on mortality in the first 30 days after presenting with STEMI. While the hazard ratio for reinfarction is nominally higher, there are more deaths attributable to major bleeding as compared with a reinfarction within the first 30 days in this population. As most drugs which reduce ischemia also increase bleeding, the offsetting impact of adverse ischemic and hemorrhagic events must be carefully examined in future trials.
Discussant: Califf, Robert M (United States of America
Clinical Trial Update I
This congress report accompanies a presentation given at the ESC Congress 2008. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
© 2017 European Society of Cardiology. All rights reserved