Trace element levels in coronary artery disease

G. Subrahmanyam, E. Ravi Kumar, Mahaboob V. Shaik
2015 Indian Heart Journal  
of trace elements are correlated with the risk factors and ischemic heart disease. Based on the above study we suggest that further detailed studies can be done to consider fortification of food with trace elements to reduce the risk of Ischemic Heart Disease. Study to assess improvement in therapeutic outcomes by platelet inhibition with prasugrel Amit Madaan Flat No. 402 Anand Towers, Sarvodya Nagar 117/k/13, Kanpur 208005, Uttar Pradesh, India Background: Despite the established short term
more » ... lished short term and long term benefits of DAPT with aspirin and clopidogrel, many patients continue to have recurrent atherothrombotic events. Prasugrel is thought to inhibit ADP induced platelet aggregation more rapidly, consistently and to a greater extent than do standard and higher doses of clopidogrel. We aimed to test whether prasugrel prevents clinical ischemic events better than clopidogrel and also compared the safety (bleeding events) among the two. Methods: A total of 136 patients were studied with a primary diagnosis of ACS (NSTEMI or STEMI) who underwent PCI. Patients were assigned into clopidogrel (600 mg LD/150 mg MD (1 month) and 75 mg (8 months)) or prasugrel receiving group (60 mg LD/ 10 mg MD). Primary end points studied were CV Death and ACS; Stent thrombosis and Bleeding events (GUSTO Bleeding criteria). Results: Incidence of CV Death and ACS was 11.7% and 8.8% in clopidogrel and prasugrel group respectively ( p < 0.05); while that of Stent thrombosis was 4.4% and 2.9% ( p < 0.05). When studied in diabetic subgroup, incidence of CV Death and ACS was 16.7% and 8.3% ( p < 0.05). Bleeding events in the two groups were similar, with severe or life threatening (0%), moderate (2.9%) and mild (5.8%) ( p > 0.05). Conclusions: Our results support the hypothesis that the greater inhibition of ADP induced platelet aggregation by prasugrel (a potent P2Y12 inhibitor) is more effective at preventing ischemic events (including stent thrombosis) than is the inhibition conferred by a high dose clopidogrel regimen, with similar risks of bleeding. The results were in favor of prasugrel when studied in context of diabetic subgroup as well.
doi:10.1016/j.ihj.2015.10.335 fatcat:6xlnuw4nhbejxk2376qanakbyy