Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial  

Oleh:

Stone, Gregg W. ; White, Harvey D. ; Ohman, E. Magnus ; Bertrand, Michel E ; Lincoff, A. Michael ; McLaurin, Brent T. ; Cox, David A. ; Pocock, Stuart J. ; Ware, James H. ; Feit, Frederick ; Colombo, Antonio ; Manoukian, Steven V. ; Lansky, Alexandra J. ; Mehran, Roxana ; Moses, Jeffrey W.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Lancet (keterangan: ada di Proquest) vol. 369 no. 9565 (Mar. 2007), page 907.

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Perpustakaan FK Nomor Panggil: L01.K.2007.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Summary Background The aim of this study was to assess anticoagulation with the direct thrombin inhibitor bivalimdin during Lancet 2007; 369: 907-19 percutaneous coronary intervention in individuals with moderate and high-risk acute coronary syndromes. See Comment page 881 Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA (Prof G W Stone MD, AJ Lansky MD, R Mehran MD, J W Moses MD); Auckland City Hospital, Auckland, New Zealand (Prof H D White MD); Duke University Medical Center, Durham, NC, USA (Prof E M Ohman MD); Hopital Cardiologique, Lille, France (Prof ME Bertrand MD); Cleveland Clinic, Cleveland, OH, USA (Prof AM Lincoff MD); AnMed Health, Anderson, SC, USA (B T Mclaurin MD); Mid Carolina Cardiology, Charlotte, NC, USA (D A Cox MD); London School of Hygiene and Tropical Medicine, London, UK (ProfS J Pocock Ph D); Harvard University, Boston, MA, USA (Prof) H Ware PhD); New York University School of Medicine, New York, NY (F Feit MD); Ospedale San Raphael, Milan, Italy (A Colombo MD); and Emory University School of Medicine, Atlanta, GA, USA (5 V Manoukian MD) Correspondence to: Prof Gregg W Stone, Columbia Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial Gregg W Stone, Harvey D White, E Magnus Ohman, Michel E Bertrand, A Michael Lincoff. Brent T McLaurin, David A Cox, Stuart) Pocock, James H Ware, Frederick Fe;t, Antonio Colombo, Steven V Manoukian, Alexandra) Lansky, Roxana Mehran, Jeffrey W Moses, for the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial investigators Methods 13819 individuals in the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial were prospectively randomly assigned to receive heparin (unfractionated or enoxaparin) plus glycoprotein lIb/IlIa inhibitors, bivalirudin plus glycoprotein lIb/IlIa inhibitors, or bivalimdin alone. Of these individuals, 7789 underwent percutaneous coronary intervention after angiography. The effect of the three regimens on the primary 30-day endpoints of composite ischaemia (death, myocardial infarction, or unplanned revascularisation for ischaemia), major bleeding, and net clinical outcomes (composite ischaemia or major bleeding) was assessed in this subgroup. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, with the number NCTOO093158. Findings Of the individuals who underwent percutaneous coronary intervention, 2561 received heparin plus glycoprotein lIb/IlIa inhibitors, 2609 received bivalimdin plus glycoprotein lIb/IlIa inhibitors, and 2619 received bivalimdin alone. 26 (0, 3%) individuals dropped out or were lost to follow-up. There was no significant difference in the proportion of individuals with composite ischaemia, major bleeding, or net clinical outcomes at 30 days between those who received bivalirudin plus glycoprotein lIb/IlIa inhibitors and those who received heparin plus glycoprotein lIb/IlIa inhibitors (composite ischaemia: 243 [9%] patients vs 210 [8%] patients, p=O .16; major bleeding: 196 [8%] patients vs 174 [7%] patients, p=O. 32; net clinical outcomes: 389 [15%] patients vs 341 [13%] patients, p=O. 1). Rates of composite ischaemia were much the same in those who received bivalimdin alone and those who received heparin plus glycoprotein lIb/IlIa inhibitors (230 [9%] patients vs 210 [8%] patients, p=0.45); however, there were significantly fewer individuals who experienced major bleeding among those who received bivalimdin alone than among those who received heparin plus glycoprotein lIb/IlIa inhibitors (92 [4%] patients vs 174 [7%] patients, p

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