BACKGROUND: Perioperative antiplatelet agents potentially increase @entity548 after non-ST-segment elevation (NSTE) @entity1187 ( @entity1187 ). The @entity8781 antagonist vorapaxar reduced cardiovascular events and was associated with increased @entity548 versus placebo in NSTE @entity1187 , but its efficacy and safety in noncardiac surgery (NCS) remain unknown. We aimed to evaluate @entity63 , @entity548 , and long-term outcomes of vorapaxar in NCS after NSTE @entity1187 . METHODS AND RESULTS: In the TRACER trial, 2202 (17.0%) @entity1 underwent major or minor NCS after NSTE @entity1187 over 1.5 years (median); continuing study treatment perioperatively was recommended. The primary @entity63 end point for this analysis was @entity65 , @entity583 , stent @entity715 , or urgent revascularization within 30 days of NCS. Safety outcomes included 30-day NCS @entity548 and GUSTO moderate/severe @entity548 . Overall, 1171 vorapaxar and 1031 placebo @entity1 underwent NCS. Preoperative @entity117 and @entity1747 use was 96.8% versus 97.7% (P=0.235) and 89.1% versus 86.1% (P=0.036) for vorapaxar versus placebo, respectively. Within 30 days of NCS, no differences were observed in the primary @entity63 end point between vorapaxar and placebo groups (3.4% versus 3.9%; adjusted odds ratio 0.81, 95% CI 0.50 to 1.33, P=0.41). Similarly, no differences in NCS @entity548 (3.9% versus 3.4%; adjusted odds ratio 1.41, 95% CI 0.87 to 2.31, P=0.17) or GUSTO moderate/severe @entity548 (4.2% versus 3.7%; adjusted odds ratio 1.15, 95% CI, 0.72 to 1.83, P=0.55) were observed. In a 30-day landmarked analysis, NCS @entity1 had a higher long-term risk of the @entity63 end point (adjusted hazard ratio 1.62, 95% CI 1.33 to 1.97, P<0.001) and GUSTO moderate/severe @entity548 (adjusted hazard ratio 5.63, 95% CI 3.98 to 7.97, P<0.001) versus @entity1 who did not undergo NCS, independent of study treatment. CONCLUSION: NCS after NSTE @entity1187 is common and associated with more @entity63 outcomes and @entity548 . Vorapaxar after NSTE @entity1187 was not associated with increased perioperative @entity63 or @entity548 events in @entity1 undergoing NCS.

Efficacy and Safety of Vorapaxar in Non-ST-Segment Elevation Acute Coronary Syndrome XXXX Undergoing Noncardiac Surgery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['ACS', 'acute coronary syndromes'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity1747 :: ('MESH:C446540', 'Chemical') :: ['thienopyridine'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity8781 :: ('2149', 'Gene') :: ['protease-activated receptor 1'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular death']
@entity1 :: (9606,Species) :: ['Patients']
