Bivalirudin in patients undergoing primary angioplasty for acute myocardial infarction (HORIZONS-AMI): 1-year results of a randomised controlled trial

Mehran, Roxana; Lansky, Alexandra J.; Witzenbichler, Bernhard; Guagliumi, Giulio; Peruga, Jan Z.; Brodie, Bruce R.; Dudek, Dariusz; Kornowski, Ran; Hartmann, Franz; Gersh, Bernard J.; Pocock, Stuart J.; Wong, S. Chiu; Nikolsky, Eugenia; Gambone, Louise; Vandertie, Lynn; Parise, Helen; Dangas, George; Stone, Gregg W.

doi:10.1016/s0140-6736(09)61484-7

Cited by 380 publications

(233 citation statements)

References 36 publications

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“…Bleeding complications carry an ominous prognostic implication in PCI patients [20,21]. The strong association between bleeding and unfavorable outcome is particularly relevant in acute coronary syndromes because of multiple factors, including premature DAPT discontinuation, need of transfusion, and background relationship between bleeding propensity and adverse overall cardiovascular risk profile [22][23][24][25]. In our study, the ongoing major bleeding risk during follow-up was substantially lower than that previously reported and was not significantly different among groups [26].…”

Section: Discussioncontrasting

confidence: 48%

One‐year clinical outcomes after sirolimus‐eluting coronary stent implantation in diabetics enrolled in the worldwide e‐SELECT registry

Bartorelli

Assenza

Abizaid

et al. 2015

Cathet Cardio Intervent

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BackgroundDiabetes mellitus has worse outcome after percutaneous coronary intervention.AimWe assessed stent thrombosis (ST), major adverse cardiac events (MACE), and major bleeding rates at 1 year after implantation of sirolimus‐eluting stents (SES) in patients with diabetes mellitus in a large multicenter registry.MethodsFrom May 2006 to April 2008, 15,147 unselected consecutive patients were enrolled at 320 centers in 56 countries in a prospective, observational registry after implantation of ≥ 1 SES. Source data were verified in 20% randomly chosen patients at > 100 sites. Adverse events were adjudicated by an independent Clinical Event Committee.ResultsComplete follow‐up at 1 year was obtained in 13,693 (92%) patients, 4,577 (30%) of whom were diabetics. Within diabetics, 1,238 (9%) were insulin‐treated diabetics (ITD). Diabetics were older (64 vs. 62 years, P < 0.001), with higher incidence of major coronary risk factors, co‐morbidities, and triple‐vessel coronary artery disease. Coronary lesions had smaller reference vessel diameter (2.88 ± 0.46 vs. 2.93 ± 0.45 mm, P < 0.001) and were more often heavily calcified (26.1% vs. 22.6%, P < 0.001). At 1 year, diabetics had higher MACE rate (6.8% vs. 3.9%, P < 0.001) driven by ITD (10.6% vs. 5.5%, P < 0.001). Finally, diabetics had significant increase in ST (1.7% vs. 0.7%, P < 0.001), principally owing to ITD (3.4% vs. 1.1%, P < 0.001). There was an overall low risk of major bleeding during follow‐up, without significant difference among subgroups.ConclusionsIn the e‐SELECT registry, diabetics represented 30% of patients undergoing SES implantation and had significantly more co‐morbidities and complex coronary lesions. Although 1‐year follow‐up documented good overall outcome in diabetics, higher ST and MACE rates were observed, mainly driven by ITD. © 2015 Wiley Periodicals, Inc.

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Section: Discussioncontrasting

confidence: 48%

One‐year clinical outcomes after sirolimus‐eluting coronary stent implantation in diabetics enrolled in the worldwide e‐SELECT registry

Bartorelli

Assenza

Abizaid

et al. 2015

Cathet Cardio Intervent

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“…While HORIZON-AMI and Bivalirudin Started during Emergency Transport for Primary PCI (EUROMAX) both showed better overall early and late outcomes in STEMI patients with bivalirudin compared to heparin with routine IIb/IIIa use, acute (<24 hours) stent thrombosis was incrementally 1% higher with bivalirudin (7)(8)(9).…”

mentioning

confidence: 99%

Risk guided use of the direct thrombin inhibitor bivalirudin: insights from recent trials and analyses

Hillegass

Bradford

2016

J. Thorac. Dis.

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“…Although the evidentiary landscape in support of antithrombotic treatment choices during PCI has been enriched by these trials, recent data from clinical trials and pooled analyses questioned the role of bivalirudin in the setting of planned and primary PCI [7][8][9][10][11][12].…”

mentioning

confidence: 99%

“…In the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial, the use of bivalirudin was associated with a significant reduction in bleeding, similar rates of major adverse cardiovascular events, and significantly lower mortality at 30 days, and 1, 2, and 3 years compared with patients treated with heparin plus glycoprotein IIb/IIIa inhibitors [10,12]. However, the incidence of acute stent thrombosis was significantly higher with bivalirudin than with glycoprotein IIb/IIIa inhibitors.…”

mentioning

confidence: 99%

Enhancing the Benefit of Bivalirudin in Percutaneous Coronary Intervention: Is High Risk of Bleeding the Key?

Angeli

Reboldi

2015

Am J Cardiovasc Drugs

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Bivalirudin in patients undergoing primary angioplasty for acute myocardial infarction (HORIZONS-AMI): 1-year results of a randomised controlled trial

Cited by 380 publications

References 36 publications

One‐year clinical outcomes after sirolimus‐eluting coronary stent implantation in diabetics enrolled in the worldwide e‐SELECT registry

One‐year clinical outcomes after sirolimus‐eluting coronary stent implantation in diabetics enrolled in the worldwide e‐SELECT registry

Risk guided use of the direct thrombin inhibitor bivalirudin: insights from recent trials and analyses

Enhancing the Benefit of Bivalirudin in Percutaneous Coronary Intervention: Is High Risk of Bleeding the Key?

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