The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.
Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial
Open accessAbstract
AIMS: Dual antiplatelet therapy reduces non-fatal ischaemic events after acute coronary syndrome (ACS) but increases bleeding to a similar extent. We sought to determine the prognostic impact of myocardial infarction (MI) vs. bleeding during an extended follow-up period to gain insight into the trade-off between efficacy and safety among patients after ACS. METHODS AND RESULTS: In 12 944 patients with non-ST-segment elevation ACS from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial, we investigated the relative impact of MI and bleeding occurring >30 days post-ACS and subsequent all-cause mortality. Bleeding was graded according to Bleeding Academic Research Consortium (BARC) criteria. MI was associated with a five-fold increase in mortality. BARC type 2 and 3, but not type 1, bleeding had a significant impact on mortality. MI was associated with a greater risk of mortality compared with BARC 2 [relative risk (RR) 3.5; 95% confidence interval (CI) 2.08-4.77; P < 0.001] and BARC 3a bleeding (RR 2.23; 95% CI 1.36-3.64; P = 0.001), and a risk similar to BARC 3b bleeding (RR 1.37; 95% CI 0.81-2.30; P = 0.242). Risk of death after MI was significantly lower than after BARC 3c bleeding (RR 0.22; 95% CI 0.13-0.36; P < 0.001). MI and bleeding had similar time-associations with mortality, which remained significant for several months, still being higher early after the event. CONCLUSION: In patients treated with antiplatelet therapy after ACS, both MI and bleeding significantly impacted mortality with similar time-dependency. Although BARC 2 and 3a bleeding were less prognostic for death than MI, the risk of mortality was equivalent between BARC 3b bleeding and MI, and was higher following BARC 3c bleeding.
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Citations
Cites
Ticagrelor versus clopidogrel in patients with acute coronary syndromes
Wallentin, L., Becker, R. C., Budaj, A., Cannon, C. P., Emanuelsson, H., Held, C., Horrow, J., Husted, S., James, S., Katus, H., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0904327 · Cited by 7,117
Self-citationPrasugrel versus clopidogrel in patients with acute coronary syndromes
Wiviott, S. D., Braunwald, E., McCabe, C. H., Montalescot, G., Ruzyllo, W., Gottlieb, S., Neumann, F.-J., Ardissino, D., De Servi, S., Murphy, S. A., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa0706482 · Cited by 6,790
(2001) · New England Journal of Medicine · doi:10.1056/nejmoa010746 · Cited by 6,470
Third Universal Definition of Myocardial Infarction
Thygesen, K., Alpert, J. S., Jaffe, A. S., Simoons, M. L., Chaitman, B. R., & White, H. D. (2012) · Circulation · doi:10.1161/cir.0b013e31826e1058 · Cited by 2,985
Self-citationLong-term use of ticagrelor in patients with prior myocardial infarction
Bonaca, M. P., Bhatt, D. L., Cohen, M., Steg, P. G., Storey, R. F., Jensen, E. C., Magnani, G., Bansilal, S., Fish, M. P., Im, K., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1500857 · Cited by 1,999 · cited 3×
“In light of recent clinical trial data with DAPT regimens beyond 1 year showing further reduction of ischaemic events at the price of a similar increase in bleeding, the number of patients who may qualify for longer-term DAPT is going to increase.(14,15) Therefore, it is critical to understand the prognostic implicati…”
Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents
Mauri, L., Kereiakes, D. J., Yeh, R. W., Driscoll-Shempp, P., Cutlip, D. E., Steg, P. G., Normand, S.-L. T., Braunwald, E., Wiviott, S. D., Cohen, D. J., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1409312 · Cited by 1,928
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2023 ESC Guidelines for the management of acute coronary syndromes
Byrne, R. A., Rossello, X., Coughlan, J. J., Barbato, E., Berry, C., Chieffo, A., Claeys, M. J., Dan, G.-A., Dweck, M. R., Galbraith, M., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad191 · Cited by 5,333
Collet, J.-P., Thiele, H., Barbato, E., Barthélémy, O., Bauersachs, J., Bhatt, D. L., Dendale, P., Dorobantu, M., Edvardsen, T., Folliguet, T., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa575 · Cited by 5,037
Self-citation2024 ESC Guidelines for the management of chronic coronary syndromes
Vrints, C., Andreotti, F., Koskinas, K. C., Rossello, X., Adamo, M., Ainslie, J., Banning, A. P., Budaj, A., Buechel, R. R., Chiariello, G. A., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae177 · Cited by 2,774
Ticagrelor with or without Aspirin in High-Risk Patients after PCI
Mehran, R., Baber, U., Sharma, S. K., Cohen, D. J., Angiolillo, D. J., Briguori, C., Cha, J. Y., Collier, T., Dangas, G., Dudek, D., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1908419 · Cited by 1,039
Self-citationRao, S. V., O’Donoghue, M. L., Ruel, M., Rab, T., Tamis-Holland, J. E., Alexander, J. H., Baber, U., Baker, H., Cohen, M. G., Cruz-Ruiz, M., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001309 · Cited by 625
Metadata
- Authors
- Valgimigli, M., Costa, F., Lokhnygina, Y., Clare, R. M., Wallentin, L., Moliterno, D. J., Armstrong, P. W., White, H. D., Held, C., Aylward, P. E., Van de Werf, F., Harrington, R. A., Mahaffey, K. W., & Tricoci, P.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-11-13
- Volume
- 38
- Issue
- 11
- Pages
- ehw525
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2556925459
- Cited by
- 330
- References
- 6
- FWCI
- 15.44
- Type
- journal article
- Language
- en
- Open access
- bronze
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- CoChat. (2026). Citation check: Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial. https://app.cochat.ai/papers/10.1093/eurheartj/ehw525
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- Valgimigli, M., Costa, F., Lokhnygina, Y., Clare, R. M., Wallentin, L., Moliterno, D. J., Armstrong, P. W., White, H. D., Held, C., Aylward, P. E., Van de Werf, F., Harrington, R. A., Mahaffey, K. W., & Tricoci, P. (2016). Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial. European Heart Journal. https://doi.org/10.1093/eurheartj/ehw525
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
