PMID- 21311899
OWN - NLM
STAT- MEDLINE
DCOM- 20111013
LR  - 20211020
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 100
IP  - 7
DP  - 2011 Jul
TI  - Statin effect on thrombin inhibitor effectiveness during percutaneous coronary 
      intervention: a post-hoc analysis from the ISAR-REACT 3 trial.
PG  - 579-85
LID - 10.1007/s00392-011-0282-7 [doi]
AB  - OBJECTIVE: To determine whether statin therapy influences the efficacy of 
      thrombin inhibitor bivalirudin or unfractionated heparin (UFH) during PCI. 
      SETTING AND PATIENTS: The post-hoc analysis of the ISAR-REACT 3 Trial included 
      4,570 patients: 3,106 patients were on statin therapy and 1,464 patients were not 
      on statin therapy at the time of PCI procedure. MAIN OUTCOME MEASURES: The 
      primary outcome of this analysis was the 30-day composite of death, myocardial 
      infarction, target vessel revascularization (TVR) or major bleeding. RESULTS: The 
      primary outcome occurred in 7.9% patients (n = 246) in the statin group versus 
      9.8% (n = 143) in the non-statin group (P = 0.036). There was an interaction in 
      univariate (P = 0.028) and multivariable (P = 0.026) analysis between pre-PCI 
      statin therapy and the type of antithrombotic therapy regarding myocardial 
      infarction. In the statin group, bivalirudin significantly reduced the incidence 
      of major bleeding (2.6 vs. 4.3%, P = 0.013) with no significant difference in the 
      incidence of myocardial infarction (4.9 vs. 5.2%; P = 0.73) compared with UFH. In 
      the non-statin group, bivalirudin was inferior to UFH regarding the incidence of 
      myocardial infarction (7.1 vs. 4.1%, P = 0.013), yet major bleeding remained 
      lower among bivalirudin-treated patients (4.0 vs. 5.2%, P = 0.25). CONCLUSION: 
      This post-hoc analysis suggests the existence of an interaction between statin 
      therapy before PCI and antithrombotic therapy during PCI. Patients receiving 
      bivalirudin therapy at the time of PCI showed less periprocedural myocardial 
      infarction when on pre-PCI statin therapy which has to be investigated in further 
      studies.
FAU - Khattab, Ahmed A
AU  - Khattab AA
AD  - Herz-Kreislauf-Zentrum, Segeberger Kliniken GmbH, Bad Segeberg, Germany. 
      ahmed.khattab@insel.ch
FAU - Ndrepepa, Gjin
AU  - Ndrepepa G
FAU - Schulz, Stefanie
AU  - Schulz S
FAU - Neumann, Franz-Josef
AU  - Neumann FJ
FAU - Mehilli, Julinda
AU  - Mehilli J
FAU - Buttner, Heinz Joachim
AU  - Buttner HJ
FAU - Pache, Jurgen
AU  - Pache J
FAU - Seyfarth, Melchior
AU  - Seyfarth M
FAU - Dirschinger, Josef
AU  - Dirschinger J
FAU - Kastrati, Adnan
AU  - Kastrati A
FAU - Berger, Peter B
AU  - Berger PB
FAU - Schomig, Albert
AU  - Schomig A
FAU - Richardt, Gert
AU  - Richardt G
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20110211
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Antithrombins/adverse effects/therapeutic use
MH  - Coronary Artery Disease/mortality/*therapy
MH  - *Drug Interactions
MH  - Female
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hirudins/adverse effects/drug effects
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*pharmacology/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/adverse effects/drug effects/*therapeutic use
MH  - Recombinant Proteins/adverse effects/drug effects/therapeutic use
MH  - Treatment Outcome
EDAT- 2011/02/12 06:00
MHDA- 2011/10/14 06:00
CRDT- 2011/02/12 06:00
PHST- 2009/09/14 00:00 [received]
PHST- 2011/01/26 00:00 [accepted]
PHST- 2011/02/12 06:00 [entrez]
PHST- 2011/02/12 06:00 [pubmed]
PHST- 2011/10/14 06:00 [medline]
AID - 10.1007/s00392-011-0282-7 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2011 Jul;100(7):579-85. doi: 10.1007/s00392-011-0282-7. Epub 
      2011 Feb 11.