PMID- 29769167
OWN - NLM
STAT- MEDLINE
DCOM- 20190730
LR  - 20190730
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 15
IP  - 3
DP  - 2019 Jun 12
TI  - Impact of sex on comparative outcomes of bivalirudin versus unfractionated 
      heparin in patients with acute coronary syndromes undergoing invasive management: 
      a pre-specified analysis of the MATRIX trial.
PG  - e269-e278
LID - EIJ-D-18-00247 [pii]
LID - 10.4244/EIJ-D-18-00247 [doi]
AB  - AIMS: Our aim was to assess whether bivalirudin compared with unfractionated 
      heparin (UFH) is associated with consistent outcomes in males and females with 
      acute coronary syndrome (ACS) undergoing invasive management. METHODS AND 
      RESULTS: In the MATRIX programme, 7,213 patients were randomised to bivalirudin 
      or UFH. Patients in the bivalirudin group were subsequently randomly assigned to 
      receive or not a post-PCI bivalirudin infusion. The 30-day co-primary outcomes 
      were major adverse cardiovascular events (MACE), defined as death, myocardial 
      infarction, or stroke, and net adverse clinical events (NACE), defined as MACE or 
      major bleeding. The primary outcome for the comparison of a post-PCI bivalirudin 
      infusion with no post-PCI infusion was a composite of urgent target vessel 
      revascularisation (TVR), definite stent thrombosis (ST), or NACE. The rate of 
      MACE was not significantly lower with bivalirudin than with heparin in male (rate 
      ratio [RR] 0.90, 95% confidence interval [CI]: 0.75-1.07; p=0.22) and female 
      patients (RR 1.06, 95% CI: 0.80-1.40; p=0.67) without significant interaction 
      (pint=0.31), nor was the rate of NACE (males: RR 0.85, 95% CI: 0.72-1.01; p=0.07; 
      females: RR 0.98, 95% CI: 0.76-1.28; p=0.91; pint=0.38). Post-PCI bivalirudin 
      infusion, as compared with no infusion, did not significantly decrease the rate 
      of urgent TVR, definite ST, or NACE (males: RR 0.84, 95% CI: 0.66-1.07; p=0.15; 
      females: RR 1.06, 95% CI: 0.74-1.53; p=0.74; pint=0.28). CONCLUSIONS: In ACS 
      patients, the rates of MACE and NACE were not significantly lower with 
      bivalirudin than with UFH in both sexes. The rate of the composite of urgent TVR, 
      definite ST, or NACE was not significantly lower with a post-PCI bivalirudin 
      infusion than with no post-PCI infusion in both sexes.
FAU - Gargiulo, Giuseppe
AU  - Gargiulo G
AD  - Department of Cardiology, Bern University Hospital, Bern, Switzerland and 
      Department of Advanced Biomedical Sciences, Federico II University of Naples, 
      Naples, Italy.
FAU - da Costa, Bruno R
AU  - da Costa BR
FAU - Frigoli, Enrico
AU  - Frigoli E
FAU - Palmieri, Cataldo
AU  - Palmieri C
FAU - Nazzaro, Marco Stefano
AU  - Nazzaro MS
FAU - Falcone, Camillo
AU  - Falcone C
FAU - Liso, Armando
AU  - Liso A
FAU - Vigna, Carlo
AU  - Vigna C
FAU - Abate, Fabio
AU  - Abate F
FAU - Comeglio, Marco
AU  - Comeglio M
FAU - Diletti, Roberto
AU  - Diletti R
FAU - Gabrielli, Gabriele
AU  - Gabrielli G
FAU - Di Lorenzo, Emilio
AU  - Di Lorenzo E
FAU - Mazzarotto, Pietro
AU  - Mazzarotto P
FAU - Zimarino, Marco
AU  - Zimarino M
FAU - Moretti, Claudio
AU  - Moretti C
FAU - Colombo, Antonio
AU  - Colombo A
FAU - Penzo, Carlo
AU  - Penzo C
FAU - Pasquetto, Giampaolo
AU  - Pasquetto G
FAU - Brugaletta, Salvatore
AU  - Brugaletta S
FAU - Ferrari, Fabio
AU  - Ferrari F
FAU - Casu, Gavino
AU  - Casu G
FAU - Guiducci, Vincenzo
AU  - Guiducci V
FAU - Dellavalle, Antonio
AU  - Dellavalle A
FAU - Liistro, Francesco
AU  - Liistro F
FAU - Mauro, Ciro
AU  - Mauro C
FAU - Van't Hof, Arnoud W J
AU  - Van't Hof AWJ
FAU - Omerovic, Elmir
AU  - Omerovic E
FAU - Curello, Salvatore
AU  - Curello S
FAU - de la Torre Hernandez, Jose Maria
AU  - de la Torre Hernandez JM
FAU - De Servi, Stefano
AU  - De Servi S
FAU - Belloni, Flavia
AU  - Belloni F
FAU - Windecker, Stephan
AU  - Windecker S
FAU - Valgimigli, Marco
AU  - Valgimigli M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20190612
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 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
MH  - *Acute Coronary Syndrome/therapy
MH  - Anticoagulants
MH  - Antithrombins
MH  - Female
MH  - Heparin/*therapeutic use
MH  - Hirudins
MH  - Humans
MH  - Male
MH  - Peptide Fragments/*therapeutic use
MH  - *Percutaneous Coronary Intervention
MH  - Recombinant Proteins/therapeutic use
MH  - Treatment Outcome
EDAT- 2018/05/18 06:00
MHDA- 2019/07/31 06:00
CRDT- 2018/05/18 06:00
PHST- 2018/05/18 06:00 [pubmed]
PHST- 2019/07/31 06:00 [medline]
PHST- 2018/05/18 06:00 [entrez]
AID - EIJ-D-18-00247 [pii]
AID - 10.4244/EIJ-D-18-00247 [doi]
PST - epublish
SO  - EuroIntervention. 2019 Jun 12;15(3):e269-e278. doi: 10.4244/EIJ-D-18-00247.