Atherothrombotic Risk Stratification and the Efficacy and Safety of Vorapaxar in Patients with Stable Ischemic Heart Disease and Previous Myocardial Infarction

Erin A. Bohula, Marc P. Bonaca, Eugene Braunwald, Philip E. Aylward, Ramon Corbalan, Gaetano M. De Ferrari, Ping He, Basil S. Lewis, Piera A. Merlini, Sabina A. Murphy, Marc S. Sabatine, Benjamin M. Scirica, David A. Morrow

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with stable ischemic heart disease and previous myocardial infarction (MI) vary in their risk for recurrent cardiovascular events. Atherothrombotic risk assessment may be useful to identify high-risk patients who have the greatest potential to benefit from more intensive secondary preventive therapy such as treatment with vorapaxar. Methods: We identified independent clinical indicators of atherothrombotic risk among 8598 stable, placebo-treated patients with a previous MI followed up for 2.5 years (median) in TRA 2°P-TIMI 50 [Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-TIMI 50]. The efficacy and safety of vorapaxar (SCH 530348; MK-5348) were assessed by baseline risk among patients with previous MI without prior stroke or transient ischemic attack for whom there is a clinical indication for vorapaxar. End points were cardiovascular death, MI, or ischemic stroke and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) severe bleeding. Results: The 9 independent risk predictors were age, diabetes mellitus, hypertension, smoking, peripheral arterial disease, previous stroke, previous coronary bypass grafting, heart failure, and renal dysfunction. A simple integer-based scheme using these predictors showed a strong graded relationship with the rate of cardiovascular death/MI/ischemic stroke and the individual components (P for trend

Original languageEnglish
Pages (from-to)304-313
Number of pages10
JournalCirculation
Volume134
Issue number4
DOIs
Publication statusPublished - Jul 26 2016

Keywords

  • atherosclerosis
  • receptors, thrombin
  • risk assessment
  • secondary prevention

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Atherothrombotic Risk Stratification and the Efficacy and Safety of Vorapaxar in Patients with Stable Ischemic Heart Disease and Previous Myocardial Infarction'. Together they form a unique fingerprint.

Cite this