PMID- 18755342
OWN - NLM
STAT- MEDLINE
DCOM- 20080919
LR  - 20161124
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 52
IP  - 10
DP  - 2008 Sep 2
TI  - Safety and efficacy of bivalirudin with and without glycoprotein IIb/IIIa 
      inhibitors in patients with acute coronary syndromes undergoing percutaneous 
      coronary intervention 1-year results from the ACUITY (Acute Catheterization and 
      Urgent Intervention Triage strategY) trial.
PG  - 807-14
LID - 10.1016/j.jacc.2008.05.036 [doi]
AB  - OBJECTIVES: This study was designed to determine the impact of bivalirudin on 
      1-year outcomes in acute coronary syndrome (ACS) patients undergoing percutaneous 
      coronary intervention (PCI). BACKGROUND: The ACUITY (Acute Catheterization and 
      Urgent Intervention Triage strategY) trial demonstrated that in moderate- and 
      high-risk ACS patients undergoing PCI, bivalirudin alone compared to 
      unfractionated heparin (UFH) or enoxaparin plus a glycoprotein (GP) IIb/IIIa 
      inhibitor resulted in less major bleeding and similar ischemic outcomes at 30 
      days. The impact of bivalirudin on 1-year outcomes in ACS patients undergoing PCI 
      is unknown. METHODS: In the ACUITY trial, 13,819 patients were enrolled, and 
      7,789 (56.4%) patients had PCI. Composite ischemia (death, myocardial infarction, 
      or unplanned revascularization) and mortality at 1 year were assessed. RESULTS: 
      Among patients undergoing PCI, 2,561, 2,609, and 2,619 were randomized to UFH or 
      enoxaparin plus a GP IIb/IIIa inhibitor, bivalirudin plus a GP IIb/IIIa 
      inhibitor, and bivalirudin monotherapy, respectively. At 1 year, there were no 
      differences in composite ischemia (17.8% vs. 19.4% vs. 19.2%, p = NS) or 
      mortality (3.2% vs. 3.3% vs. 3.1%, p = NS) among the 3 groups, respectively. 
      CONCLUSIONS: Bivalirudin compared with UFH or enoxaparin plus a GP IIb/IIIa 
      inhibitor results in similar rates of composite ischemia and mortality at 1 year 
      in moderate- and high-risk ACS patients undergoing PCI.
FAU - White, Harvey D
AU  - White HD
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. 
      HarveyW@adhb.govt.nz
FAU - Ohman, E Magnus
AU  - Ohman EM
FAU - Lincoff, A Michael
AU  - Lincoff AM
FAU - Bertrand, Michel E
AU  - Bertrand ME
FAU - Colombo, Antonio
AU  - Colombo A
FAU - McLaurin, Brent T
AU  - McLaurin BT
FAU - Cox, David A
AU  - Cox DA
FAU - Pocock, Stuart J
AU  - Pocock SJ
FAU - Ware, James A
AU  - Ware JA
FAU - Manoukian, Steven V
AU  - Manoukian SV
FAU - Lansky, Alexandra J
AU  - Lansky AJ
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Moses, Jeffrey W
AU  - Moses JW
FAU - Stone, Gregg W
AU  - Stone GW
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Acute Coronary Syndrome/*drug therapy/mortality/therapy
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Enoxaparin/adverse effects/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hirudins/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/adverse effects/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Recombinant Proteins/adverse effects/therapeutic use
MH  - Risk Factors
MH  - Time Factors
EDAT- 2008/08/30 09:00
MHDA- 2008/09/20 09:00
CRDT- 2008/08/30 09:00
PHST- 2007/12/12 00:00 [received]
PHST- 2008/05/21 00:00 [revised]
PHST- 2008/05/27 00:00 [accepted]
PHST- 2008/08/30 09:00 [pubmed]
PHST- 2008/09/20 09:00 [medline]
PHST- 2008/08/30 09:00 [entrez]
AID - S0735-1097(08)02050-0 [pii]
AID - 10.1016/j.jacc.2008.05.036 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2008 Sep 2;52(10):807-14. doi: 10.1016/j.jacc.2008.05.036.