PMID- 21864816
OWN - NLM
STAT- MEDLINE
DCOM- 20111229
LR  - 20161125
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 108
IP  - 10
DP  - 2011 Nov 15
TI  - Impact of smoking on outcomes of patients with ST-segment elevation myocardial 
      infarction (from the HORIZONS-AMI Trial).
PG  - 1387-94
LID - 10.1016/j.amjcard.2011.06.063 [doi]
AB  - We assessed the impact of smoking on outcomes in patients with ST-segment 
      elevation myocardial infarction treated with primary percutaneous coronary 
      intervention using alternative antithrombotic regimens and stent types. In the 
      HORIZONS-AMI trial 3,602 patients were randomly assigned to unfractionated 
      heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) or bivalirudin alone 
      and paclitaxel-eluting stents or bare-metal stents. Compared to nonsmokers, 
      smokers had significantly lower rates of mortality and major bleeding at 30 days 
      and at 1 year; however, the differences were no longer significant after 
      covariate adjustment. Smoking was associated with increased rates of 
      definite/probable stent thrombosis (ST) at 1 year (adjusted RR 1.99, 95% 
      confidence interval 1.28 to 3.10) mainly because of a higher rate of late ST 
      after paclitaxel-eluting stent implantation (1.9% vs 0.4%, p = 0.0006). In 
      smokers bivalirudin monotherapy compared to UFH plus a GPI was associated with 
      lower mortality at 30 days (0.5% vs 2.2%, p = 0.002) and at 1 year (1.8% vs 4.0%, 
      p = 0.008). No decrease in mortality was seen with bivalirudin in nonsmokers. 
      Major bleeding was significantly decreased with bivalirudin regardless of smoking 
      status (smokers 3.7% vs 8.9%, p <0.0001; nonsmokers 6.5% vs 9.6%, p = 0.01). In 
      conclusion, in patients with ST-segment elevation myocardial infarction treated 
      with primary percutaneous coronary intervention, smoking is an independent 
      predictor of definite/probable ST at 1 year. Bivalirudin monotherapy compared to 
      UFH plus a GPI decreased major bleeding regardless of smoking status but may have 
      different effects on individual components of ischemic events.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Goto, Kenji
AU  - Goto K
AD  - Columbia University Medical Center and Cardiovascular Research Foundation, New 
      York, New York, USA.
FAU - Nikolsky, Eugenia
AU  - Nikolsky E
FAU - Lansky, Alexandra J
AU  - Lansky AJ
FAU - Dangas, George
AU  - Dangas G
FAU - Witzenbichler, Bernhard
AU  - Witzenbichler B
FAU - Parise, Helen
AU  - Parise H
FAU - Guagliumi, Giulio
AU  - Guagliumi G
FAU - Kornowski, Ran
AU  - Kornowski R
FAU - Claessen, Bimmer E
AU  - Claessen BE
FAU - Fahy, Martin
AU  - Fahy M
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Stone, Gregg W
AU  - Stone GW
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20110823
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Pyridines)
RN  - 0 (Recombinant Proteins)
RN  - 0 (thienopyridine)
RN  - 9005-49-6 (Heparin)
RN  - P88XT4IS4D (Paclitaxel)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary
MH  - Antithrombins/therapeutic use
MH  - Coronary Angiography
MH  - Coronary Restenosis/epidemiology
MH  - Coronary Thrombosis/*epidemiology
MH  - Drug Therapy, Combination
MH  - Drug Utilization
MH  - Female
MH  - Hemorrhage/epidemiology
MH  - Heparin/therapeutic use
MH  - Hirudins
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/*mortality/*therapy
MH  - Paclitaxel/administration & dosage
MH  - Peptide Fragments/therapeutic use
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Pyridines/therapeutic use
MH  - Recombinant Proteins/therapeutic use
MH  - Smoking/adverse effects/*epidemiology
MH  - Stents/*adverse effects
EDAT- 2011/08/26 06:00
MHDA- 2011/12/30 06:00
CRDT- 2011/08/26 06:00
PHST- 2011/05/24 00:00 [received]
PHST- 2011/06/30 00:00 [revised]
PHST- 2011/06/30 00:00 [accepted]
PHST- 2011/08/26 06:00 [entrez]
PHST- 2011/08/26 06:00 [pubmed]
PHST- 2011/12/30 06:00 [medline]
AID - S0002-9149(11)02267-3 [pii]
AID - 10.1016/j.amjcard.2011.06.063 [doi]
PST - ppublish
SO  - Am J Cardiol. 2011 Nov 15;108(10):1387-94. doi: 10.1016/j.amjcard.2011.06.063. 
      Epub 2011 Aug 23.