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  • Vorapaxar is a new oral protease-activated receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS: In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients who had acute coronary syndromes without ST-segment elevation. The primary end point was a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization. RESULTS: Follow-up in the trial was terminated early after a safety review. After a median follow-up of 502 days (interquartile range, 349 to 667), the primary end point occurred in 1031 of 6473 patients receiving vorapaxar versus 1102 of 6471 patients receiving placebo (Kaplan-Meier 2-year rate, 18.5010 vs. 19.9%; hazard ratio, 0.92; 95% confidence interval [CI], 0.85 to 1.01; P=0.07). A composite of death from cardiovascular causes, myocardial infarction, or stroke occurred in 822 patients in the vorapaxar group versus 910 in the placebo group (14.7% and 16.4%, respectively; hazard ratio, 0.89; 95% CI, 0.81 to 0.98; P=0.02). Rates of moderate and severe bleeding were 7.2% in the vorapaxar group and 5.2% in the placebo group (hazard ratio, 1.35; 95% CI, 1.16 to 1.58; P<0.001). Intracranial hemorrhage rates were 1.1% and 0.2%, respectively (hazard ratio, 3.39; 95% CI, 1.78 to 6.45; P<0.001). Rates of nonhemorrhagic adverse events were similar in the two groups. CONCLUSIONS: In patients with acute coronary syndromes, the addition of vorapaxar to standard therapy did not significantly reduce the primary composite end point but significantly increased the risk of major bleeding, including intracranial hemorrhage. (Funded by Merck; TRACER ClinicalTrials.gov number, NCT00527943.)
  • Vorapaxar is a new oral protease-activated receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS: In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients who had acute coronary syndromes without ST-segment elevation. The primary end point was a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization. RESULTS: Follow-up in the trial was terminated early after a safety review. After a median follow-up of 502 days (interquartile range, 349 to 667), the primary end point occurred in 1031 of 6473 patients receiving vorapaxar versus 1102 of 6471 patients receiving placebo (Kaplan-Meier 2-year rate, 18.5010 vs. 19.9%; hazard ratio, 0.92; 95% confidence interval [CI], 0.85 to 1.01; P=0.07). A composite of death from cardiovascular causes, myocardial infarction, or stroke occurred in 822 patients in the vorapaxar group versus 910 in the placebo group (14.7% and 16.4%, respectively; hazard ratio, 0.89; 95% CI, 0.81 to 0.98; P=0.02). Rates of moderate and severe bleeding were 7.2% in the vorapaxar group and 5.2% in the placebo group (hazard ratio, 1.35; 95% CI, 1.16 to 1.58; P<0.001). Intracranial hemorrhage rates were 1.1% and 0.2%, respectively (hazard ratio, 3.39; 95% CI, 1.78 to 6.45; P<0.001). Rates of nonhemorrhagic adverse events were similar in the two groups. CONCLUSIONS: In patients with acute coronary syndromes, the addition of vorapaxar to standard therapy did not significantly reduce the primary composite end point but significantly increased the risk of major bleeding, including intracranial hemorrhage. (Funded by Merck; TRACER ClinicalTrials.gov number, NCT00527943.) (en)
Title
  • Thrombin-receptor antagonist vorapaxar in acute coronary syndromes
  • Thrombin-receptor antagonist vorapaxar in acute coronary syndromes (en)
skos:prefLabel
  • Thrombin-receptor antagonist vorapaxar in acute coronary syndromes
  • Thrombin-receptor antagonist vorapaxar in acute coronary syndromes (en)
skos:notation
  • RIV/00023001:_____/12:00057975!RIV13-MZ0-00023001
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • N
http://linked.open...iv/cisloPeriodika
  • 1
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
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http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 175232
http://linked.open...ai/riv/idVysledku
  • RIV/00023001:_____/12:00057975
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • ST-segment elevation, glycoprotein IIB/IIIA inhibitors, placebo-controlled trial, dougle-blind, antiplatelet therapy (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [25190967BA64]
http://linked.open...i/riv/nazevZdroje
  • New England journal of medicine
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 366
http://linked.open...iv/tvurceVysledku
  • Cornel, J. H
  • Diaz, R.
  • Harrington, R. A.
  • Huber, K.
  • Ogawa, H.
  • Ruzyllo, W.
  • Wallentin, L.
  • Van de Werf, F.
  • Lewis, BS
  • Kettner, Jiří
  • Armstrong, PW
  • Aylward, PE
  • Hudson, MP
  • Mahaffey, KW
  • Widimsky, P.
  • Huang, Z.
  • Leonardi, S.
  • Lokhnygina, Y.
  • White, H. D
  • Ambrosio, G.
  • Bode, C.
  • Carlos, JC
  • Cequier, A.
  • Chen, E.
  • Erkan, A.
  • Held, C.
  • Jennings, LHK
  • Jiang, LX
  • Jukema, JW
  • Kilian, A. M.
  • Lincoff, A. M.
  • Moliterno, DJ
  • Montalescot, G.
  • Nicolau, JC
  • Pei, J. L.
  • Pfisterer, M.
  • Rorick, TL
  • Sinnaeve, PR
  • Storey, RF
  • Strony, J.
  • Tricoci, P.
  • Valgimigli, M.
  • Whellan, DJ
http://linked.open...ain/vavai/riv/wos
  • 000299968800004
issn
  • 0028-4793
number of pages
http://bibframe.org/vocab/doi
  • 10.1056/NEJMoa1109719
is http://linked.open...avai/riv/vysledek of
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