PMID- 20127904
OWN - NLM
STAT- MEDLINE
DCOM- 20110607
LR  - 20211020
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 33
IP  - 3
DP  - 2010 Mar
TI  - Influence of clinical trial participation on subsequent antithrombin use.
PG  - E49-55
LID - 10.1002/clc.20581 [doi]
AB  - BACKGROUND: Results from the Superior Yield of the New Strategy of Enoxaparin, 
      Revascularization, and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial showed 
      that the low-molecular-weight heparin (LMWH) enoxaparin was non-inferior compared 
      with unfractionated heparin (UFH) in patients with non-ST-elevation acute 
      coronary syndromes (NSTE-ACS) managed invasively. HYPOTHESIS: We explored the 
      influence of SYNERGY trial site participation on subsequent patterns of heparin 
      use for NSTE-ACS patients treated in routine practice. METHODS: We examined 
      temporal patterns of LMWH use compared with UFH use among 122 764 patients with 
      NSTE-ACS enrolled in the Can Rapid Risk Stratification of Unstable Angina 
      Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA 
      Guidelines (CRUSADE) quality improvement initiative between January 1, 2002 and 
      June 30, 2006, to determine whether site participation in SYNERGY influenced the 
      type of heparin used before and after publication of the SYNERGY results in July 
      2004. RESULTS: A total of 118 out of 388 (30%) U.S. hospitals participating in 
      CRUSADE simultaneously participated in SYNERGY. SYNERGY sites in the CRUSADE 
      registry were more likely to have a teaching affiliation and have more hospital 
      beds than non-SYNERGY centers in the registry. There was no difference in the 
      proportion of patients treated with LMWH at SYNERGY and non-SYNERGY sites prior 
      to July 2004 compared with after July 2004. However, at SYNERGY sites, there was 
      a slight decrease in the proportion of patients treated with both UFH and LMWH 
      within 24 hours of presentation. CONCLUSIONS: The results of the SYNERGY trial 
      did not appear to influence temporal patterns of LMWH use at sites in the CRUSADE 
      registry. Furthermore, site participation in the SYNERGY trial did not alter 
      patterns of LMWH use for NSTE-ACS after publication of the trial results in July 
      2004.
CI  - Copyright (c) 2009 Wiley Periodicals, Inc.
FAU - Shah, Bimal R
AU  - Shah BR
AD  - Duke Clinical Research Institute, Duke University Medical Center, 2400 Pratt 
      Street, Durham, NC 27705, USA. bimal.shah@duke.edu
FAU - Peterson, Eric D
AU  - Peterson ED
FAU - Chen, Anita Y
AU  - Chen AY
FAU - Mahaffey, Kenneth W
AU  - Mahaffey KW
FAU - DeLong, Elizabeth R
AU  - DeLong ER
FAU - Ohman, E Magnus
AU  - Ohman EM
FAU - Pollack, Charles V Jr
AU  - Pollack CV Jr
FAU - Gibler, W Brian
AU  - Gibler WB
FAU - Roe, Matthew T
AU  - Roe MT
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Anticoagulants)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Antithrombins)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Hypolipidemic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Antihypertensive Agents/therapeutic use
MH  - Antithrombins/*therapeutic use
MH  - *Clinical Trials as Topic
MH  - Cohort Studies
MH  - Female
MH  - Health Knowledge, Attitudes, Practice
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Hypolipidemic Agents/therapeutic use
MH  - Male
MH  - *Medication Adherence
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Registries/statistics & numerical data
MH  - *Research Subjects
MH  - Time Factors
PMC - PMC6653075
EDAT- 2010/02/04 06:00
MHDA- 2011/06/08 06:00
PMCR- 2010/02/02
CRDT- 2010/02/04 06:00
PHST- 2010/02/04 06:00 [entrez]
PHST- 2010/02/04 06:00 [pubmed]
PHST- 2011/06/08 06:00 [medline]
PHST- 2010/02/02 00:00 [pmc-release]
AID - CLC20581 [pii]
AID - 10.1002/clc.20581 [doi]
PST - ppublish
SO  - Clin Cardiol. 2010 Mar;33(3):E49-55. doi: 10.1002/clc.20581.