PMID- 27753600
OWN - NLM
STAT- MEDLINE
DCOM- 20170726
LR  - 20181202
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 12
IP  - 9
DP  - 2016 Oct 20
TI  - Impact of time to treatment on the effects of bivalirudin vs. glycoprotein 
      IIb/IIIa inhibitors and heparin in patients undergoing primary percutaneous 
      coronary intervention: insights from the HORIZONS-AMI trial.
PG  - 1144-1153
LID - EIJV12I9A186 [pii]
LID - 10.4244/EIJV12I9A186 [doi]
AB  - AIMS: In the HORIZONS-AMI trial, bivalirudin compared to unfractionated heparin 
      (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) improved net clinical outcomes 
      in patients undergoing primary percutaneous coronary intervention (PCI) at the 
      cost of an increased rate of acute stent thrombosis. We sought to examine whether 
      these effects are dependent on time to treatment. METHODS AND RESULTS: The 
      interaction between anticoagulation regimen and symptom onset to first balloon 
      inflation time (SBT) on the 30-day and three-year rates of major adverse cardiac 
      events (MACE) was examined in 3,199 randomised patients according to SBT </=3 hours 
      versus >3 hours. Among patients with an SBT </=3 hours, bivalirudin resulted in 
      higher 30-day rates of MACE compared to UFH plus a GPI. Non-significant 
      differences were observed in patients with an SBT >3 hours. Similar results were 
      found for MACE at three years and stent thrombosis and reinfarction at 30 days 
      and three years. By multivariable analysis, bivalirudin was an independent 
      predictor of MACE at 30 days and three years in patients with an SBT </=3 hours, 
      but not in patients with SBT >3 hours. CONCLUSIONS: Bivalirudin compared to UFH 
      plus a GPI is associated with an increased rate of stent thrombosis and MACE in 
      patients with short SBTs, but not in those with longer SBTs.
FAU - Schoos, Mikkel M
AU  - Schoos MM
AD  - Mount Sinai Medical Center, New York, NY, USA.
FAU - De Luca, Giuseppe
AU  - De Luca G
FAU - Dangas, George D
AU  - Dangas GD
FAU - Clemmensen, Peter
AU  - Clemmensen P
FAU - Ayele, Girma Minalu
AU  - Ayele GM
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
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
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  - Aged
MH  - Anticoagulants/therapeutic use
MH  - Antithrombins/*therapeutic use
MH  - Cause of Death
MH  - Drug Therapy, Combination
MH  - Female
MH  - Graft Occlusion, Vascular/epidemiology
MH  - Heparin/*therapeutic use
MH  - Hirudins
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Myocardial Infarction/epidemiology
MH  - Myocardial Revascularization/statistics & numerical data
MH  - Peptide Fragments/*therapeutic use
MH  - Percutaneous Coronary Intervention/*methods
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Postoperative Complications/epidemiology
MH  - Recombinant Proteins/therapeutic use
MH  - Recurrence
MH  - ST Elevation Myocardial Infarction/*therapy
MH  - Stroke/epidemiology
MH  - Thrombosis/epidemiology
MH  - Time-to-Treatment/*statistics & numerical data
MH  - Treatment Outcome
EDAT- 2016/10/19 06:00
MHDA- 2017/07/27 06:00
CRDT- 2016/10/19 06:00
PHST- 2016/10/19 06:00 [pubmed]
PHST- 2017/07/27 06:00 [medline]
PHST- 2016/10/19 06:00 [entrez]
AID - EIJV12I9A186 [pii]
AID - 10.4244/EIJV12I9A186 [doi]
PST - ppublish
SO  - EuroIntervention. 2016 Oct 20;12(9):1144-1153. doi: 10.4244/EIJV12I9A186.