Acute coronary syndromes incidence

Eptifibatide, tirofiban, and abciximab can all decrease the incidence of cardiac events associated with acute coronary syndromes direct comparisons are needed to establish which, if any, issuperior for angioplasty, until more data become available, abciximab appears to be the drug of choice... 

Matsuo T Tomaru T Kario K, et al. Incidence of heparin-PF4 complex antibody formation and heparin-induced thrombocytopenia in acute coronary syndrome. Thromb Res 2005 ... 

Despite the success of the DESs, the incidence of atherosclerosis and accompanying acute coronary syndromes remain... 

Secondary prevention. In a meta-analysis of randomised, controlled studies in patients following myocardial infarction or acute coronary syndrome, intensive warfarin (INR greater than 2) plus aspirin 80 to 325 mg daily was associated with 2.5-fold increased risk of major bleeding, when compared with aspirin alone, although the actual incidence was low (1.5% versus 0.6%). This analysis excluded studies of coronary stenting, see (b) above. In another similar meta-analysis, combined use of aspirin and warfarin (INR 2 to 3) was associated with a 2.3 odds ratio of a major bleed, when compared with aspirin alone.The number needed to treat to cause one major bleed was 100. This compared with a number needed to treat to avoid one major adverse event (death, myocardial infarction or stroke) of 33. 

Although the manufacturers of abciximab recommend concurrent therapy with heparin, they also report that there is an increase in the incidence of bleeding. In one study in patients with acute coronary syndrome without early revascularisation, the concurrent use of low-molecular-weight heparin was considered to be one of the factors that increased the risk of bleeding events with abciximab ... 

Cardiovascular Heart failure (New York Heart Association classes II-IV) has been observed in patients receiving trastuzumab, alone or in combination with paclitaxel or docetaxel, particularly after chemotherapy containing an anthracycline (doxorubicin or epirubicin) [303, 304, 305, 306. It can be moderate or severe and can be fatal. The results of many randomized trials have shown that the degree of cardiotoxicity is generally acceptable the incidence of cardiac damage caused by trastuzumab was 0.4-4.1% [307 ]. Older age, lower left ventricular ejection fraction, and antihypertensive medications are associated with an increased risk of cardiac dysfunction in patients receiving trastuzumab [308 "]. The cardiac dysfunction associated with trastuzumab is usually reversible on withdrawal and standard medical therapy [309 ]. In one case, trastuzumab-associated cardiomyopathy presented with complete left bundle-branch block mimicking acute coronary syndrome [310" ]. 

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