PMID- 19702677
OWN - NLM
STAT- MEDLINE
DCOM- 20100106
LR  - 20161125
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 22
IP  - 5
DP  - 2009 Oct
TI  - Outcomes of patients with coronary artery perforation complicating percutaneous 
      coronary intervention and correlations with the type of adjunctive antithrombotic 
      therapy: pooled analysis from REPLACE-2, ACUITY, and HORIZONS-AMI trials.
PG  - 453-9
LID - 10.1111/j.1540-8183.2009.00494.x [doi]
AB  - BACKGROUND: The lack of a specific counteragent to bivalirudin may complicate the 
      management of patients with coronary artery (CA) perforation during percutaneous 
      coronary intervention (PCI). AIM: Assess outcomes of patients with CA perforation 
      from three PCI trials comparing intravenous bivalirudin with provisional 
      glycoprotein (GP) IIb/IIIa inhibition versus unfractionated heparin (UFH) plus GP 
      IIb/IIIa. METHODS: A pooled analysis of patients treated with PCI in three 
      randomized trials including REPLACE-2, ACUITY, and HORIZONS-AMI. RESULTS: Among a 
      total of 12,921 patients, CA perforation occurred in 35 patients (0.27%). By 
      multivariable analysis, baseline creatinine clearance was the only independent 
      predictor of CA perforation (per 10 mL/min decrease, odds ratio [95% confidence 
      interval]= 1.28 [1.11, 1.47], P = 0.0007). At 30 days, patients with versus 
      without CA perforation had significantly (all P values < or =0.001) higher rates 
      of 30-day mortality (11.4% vs. 1.0%), myocardial infarction (MI) [Q wave: 22.9% 
      vs. 5.7%; non-Q wave: 17.1% vs. 4.9%], target vessel revascularization (TVR) 
      [20.1% vs. 1.8%], and composite end-point of death/MI/TVR (31.4% vs. 7.8%). 
      Patients assigned to bivalirudin versus UFH plus a GP IIb/IIIa inhibitor had 
      nonsignificantly lower rates of death (0% vs. 18.8%, P = 0.08), similar rates of 
      MI (26.7% vs. 25.0%, P = 0.92), significantly lower rates of TVR (6.7% vs. 37.5%, 
      P = 0.04), and similar rates of the composite end-point of death/MI/TVR (35.5% 
      vs. 26.7%, P = 0.54). CONCLUSION: In three PCI trials, treatment of patients 
      experiencing CA perforation with adjunctive antithrombotic therapy of bivalirudin 
      monotherapy was not associated with worse outcomes compared to treatment with UFH 
      plus GP IIb/IIIa inhibitors.
FAU - Doll, Jacob A
AU  - Doll JA
AD  - Columbia University Medical Center and the Cardiovascular Research Foundation, 
      New York, USA.
FAU - Nikolsky, Eugenia
AU  - Nikolsky E
FAU - Stone, Gregg W
AU  - Stone GW
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Lincoff, A Michael
AU  - Lincoff AM
FAU - Caixeta, Adriano
AU  - Caixeta A
FAU - McLaurin, Brent
AU  - McLaurin B
FAU - Cristea, Ecaterina
AU  - Cristea E
FAU - Fahy, Martin
AU  - Fahy M
FAU - Kesanakurthy, Vijaya
AU  - Kesanakurthy V
FAU - Lansky, Alexandra J
AU  - Lansky AJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20090820
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
RN  - 0 (Anticoagulants)
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
CIN - J Interv Cardiol. 2010 Apr;23(2):203. PMID: 20236210
MH  - Aged
MH  - Anticoagulants/administration & dosage
MH  - Chemotherapy, Adjuvant
MH  - Coronary Vessels/*injuries
MH  - Drug Therapy, Combination
MH  - Female
MH  - Fibrinolytic Agents/*administration & dosage
MH  - Heparin/administration & dosage
MH  - Hirudins/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*surgery
MH  - Myocardial Revascularization/*adverse effects/methods/mortality
MH  - Peptide Fragments/*administration & dosage
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Recombinant Proteins/administration & dosage
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Wounds, Penetrating/*etiology/*therapy
EDAT- 2009/08/26 09:00
MHDA- 2010/01/07 06:00
CRDT- 2009/08/26 09:00
PHST- 2009/08/26 09:00 [entrez]
PHST- 2009/08/26 09:00 [pubmed]
PHST- 2010/01/07 06:00 [medline]
AID - JOIC494 [pii]
AID - 10.1111/j.1540-8183.2009.00494.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2009 Oct;22(5):453-9. doi: 10.1111/j.1540-8183.2009.00494.x. 
      Epub 2009 Aug 20.