Mortality benefit with prasugrel in the TRITON-TIMI 38 coronary artery bypass grafting cohort: risk-adjusted retrospective data analysis.

@article{Smith2012MortalityBW,
  title={Mortality benefit with prasugrel in the TRITON-TIMI 38 coronary artery bypass grafting cohort: risk-adjusted retrospective data analysis.},
  author={P Smith and Lawrence Tim Goodnough and Jerrold H Levy and Robert S Poston and Mary A Short and Govinda Weerakkody and Leroy A Lenarz},
  journal={Journal of the American College of Cardiology},
  year={2012},
  volume={60 5},
  pages={388-96}
}
OBJECTIVES The objective of this study was to characterize the bleeding, transfusion, and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting (CABG). BACKGROUND There is little evidence to guide clinical decision making regarding the use of prasugrel in patients who may need urgent or emergency CABG. Experience with performing CABG in the presence of clopidogrel has raised concern about perioperative bleeding… CONTINUE READING

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A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
Experience with performing CABG in the presence of clopidogrel has raised concern about perioperative bleeding complications that are unresolved .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Experience with performing CABG in the presence of clopidogrel has raised concern about perioperative bleeding complications that are unresolved .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
clopidogrelContraindicated with diseaseHemorrhage
A significantly higher mean 12-h chest tube blood loss ( 655 ± 580 ml vs. 503 ± 378 ml ; p = 0.050 ) was observed with prasugrel compared with clopidogrel , without significant differences in red blood cell transfusion ( 2.1 U vs. 1.7 U ; p = 0.442 ) or the total donor exposure ( 4.4 U vs. 3.0 U ; p = 0.463 ) .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
Experience with performing CABG in the presence of clopidogrel has raised concern about perioperative bleeding complications that are unresolved .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A significantly higher mean 12-h chest tube blood loss ( 655 ± 580 ml vs. 503 ± 378 ml ; p = 0.050 ) was observed with prasugrel compared with clopidogrel , without significant differences in red blood cell transfusion ( 2.1 U vs. 1.7 U ; p = 0.442 ) or the total donor exposure ( 4.4 U vs. 3.0 U ; p = 0.463 ) .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
All - cause mortality was significantly reduced with prasugrel ( 2.31% ) compared with 8.67% with clopidogrel ( adjusted odds ratio : 0.26 ; p = 0.025 ) .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
A subset of the TRITON - TIMI 38 study ( Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel - Thrombolysis In Myocardial Infarction 38 ) , in which patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel , underwent isolated CABG ( N = 346 ) .
Despite an increase in observed bleeding , platelet transfusion , and surgical re - exploration for bleeding , prasugrel was associated with a lower rate of death after CABG compared with clopidogrel .
The objective of this study was to characterize the bleeding , transfusion , and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting ( CABG ) .
A significantly higher mean 12-h chest tube blood loss ( 655 ± 580 ml vs. 503 ± 378 ml ; p = 0.050 ) was observed with prasugrel compared with clopidogrel , without significant differences in red blood cell transfusion ( 2.1 U vs. 1.7 U ; p = 0.442 ) or the total donor exposure ( 4.4 U vs. 3.0 U ; p = 0.463 ) .
All - cause mortality was significantly reduced with prasugrel ( 2.31% ) compared with 8.67% with clopidogrel ( adjusted odds ratio : 0.26 ; p = 0.025 ) .
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