Bivalirudin Versus Heparin Monotherapy in ST-Segment-Elevation Myocardial Infarction

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Bivalirudin Versus Heparin Monotherapy in ST-Segment-Elevation Myocardial Infarction

James, Stefan, 1964- (författare): Uppsala universitet,Uppsala University,Uppsala Univ, Sweden,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Institutionen för kirurgiska vetenskaper,Klinisk fysiologi,Department of Medical Sciences, Uppsala University, Sweden

Koul, Sasha (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Lund Univ, Sweden,Department of Cardiology, Clinical Sciences, Lund University, Sweden

Andersson, Jonas (författare): Umeå universitet,Umeå University,Umea Univ, Sweden,Avdelningen för medicin

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Angerås, Oskar (författare): Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden

Bhiladvala, Pallonji (författare): Lund University,Lunds universitet,Kardiologiska klinikens forskargrupp,Forskargrupper vid Lunds universitet,Cardiology Research Group,Lund University Research Groups,Lund Univ, Sweden,Department of Cardiology, Clinical Sciences, Lund University, Sweden

Calais, Fredrik, 1971- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiology, Faculty of Health, Örebro University, Sweden,Orebro Univ, Sweden

Danielewicz, Mikael (författare): PCI-Unit, Karlstad Hospital, Karlstad, Sweden,Karlstad Hosp, Sweden,PCI-Unit at Karlstad Hospital, Sweden

Fröbert, Ole, 1964- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology, Faculty of Health, Örebro University, Sweden,Orebro Univ, Sweden

Grimfjärd, Per (författare): Department of Internal Medicine, Västmanlands Sjukhus, Västerås, Sweden,Hacettepe University

Götberg, Matthias (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Univ, Sweden,Department of Cardiology, Clinical Sciences, Lund University, Sweden

Henareh, Loghman (författare): Karolinska Institutet,Department of Cardiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

Ioanes, Dan (författare): Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden

Jensen, Jens (författare): Karolinska Institutet,Department of Cardiology, Capio St Görans Hospital AB, Stockholm, Sweden

Linder, Rikard (författare): Karolinska Institutet,Department of Cardiology, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden

Lindroos, Pontus (författare): Department of Cardiology, Capio St Görans Hospital AB, Stockholm, Sweden,Capio St. Görans Sjukhus,Capio St Gorans Hosp AB, Sweden

Omerovic, Elmir (författare): Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden

Panayi, Georgios (författare): Linköping University,Region Östergötland, Kardiologiska kliniken US,Department of Cardiology, Linköping University, Sweden

Råmunddal, Truls (författare): Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden

Sarno, Giovanna (författare): Uppsala universitet,Uppsala University,Uppsala Univ, Sweden,Uppsala kliniska forskningscentrum (UCR),Kardiologi,kardiologi,Department of Medical Sciences, Uppsala University, Sweden

Ulvenstam, Anders (författare): Department of Cardiology, Östersund hospital, Sweden,Ostersund Hosp, Sweden

Völtz, Sebastian (författare): Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden

Wagner, Henrik (författare): Department of Cardiology, Helsingborg Lasarett, Sweden,Helsingborg Hospital

Wikström, Helena (författare): Department of Cardiology, Kristianstad Hospital, Sweden,Central Hospital Kristianstad,Kristianstad Hosp, Sweden

Östlund, Ollie (författare): Uppsala University,Uppsala Univ, Sweden,Uppsala Clinical Research Center, Uppsala University, Sweden

Erlinge, David (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Lund Univ, Sweden,Department of Cardiology, Clinical Sciences, Lund University, Sweden

Östlund, Olof Petter (författare): Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)

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Lippincott Williams & Wilkins, 2021
2021
Engelska.
Ingår i: Circulation. Cardiovascular Interventions. - : Lippincott Williams & Wilkins. - 1941-7640 .- 1941-7632. ; 14:12

Relaterad länk:: http://dx.doi.org/10...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; https://urn.kb.se/re...; https://urn.kb.se/re...; http://kipublication...; https://urn.kb.se/re...; visa färre...

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BACKGROUND: Bivalirudin was not superior to unfractionated heparin in patients with myocardial infarction (MI) treated with percutaneous coronary intervention and no planned use of GPI (glycoprotein IIb/IIIa inhibitors) in contemporary clinical practice of radial access and potent P2Y12-inhibitors in the VALIDATE-SWEDEHEART randomized clinical trial (Bivalirudin Versus Heparin in STEMI and NSTEMI Patients on Modern Antiplatelet Therapy-Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies Registry).METHODS: In this prespecified separately powered subgroup analysis, we included patients with ST-segment-elevation MI undergoing primary percutaneous coronary intervention with the primary composite end point of all-cause death, MI, or major bleeding event within 180 days.RESULTS: Among the 6006 patients enrolled in the trial, 3005 patients with ST-segment-elevation MI were randomized to receive bivalirudin or heparin. The mean age was 66.8 years. According to protocol recommendations, 87% were treated with potent oral P2Y12-inhibitors before start of angiography and radial access was used in 90%. GPI was used in 51 (3.4%) and 74 (4.9%) of patients randomized to receive bivalirudin and heparin, respectively. The primary end point occurred in 12.5% (187 of 1501) and 13.0% (196 of 1504; hazard ratio [HR], 0.95 [95% CI, 0.78-1.17], P=0.64) with consistent results in all major subgroups. All-cause death occurred in 3.9% versus 3.9% (HR, 1.00 [0.70-1.45], P=0.98), MI in 1.7% versus 2.2% (HR, 0.76 [0.45-1.28], P=0.30), major bleeding in 8.3% versus 8.0% (HR, 1.04 [0.81-1.33], P=0.78), and definite stent thrombosis in 0.5% versus 1.3% (HR, 0.42 [0.18-0.96], P=0.04).CONCLUSIONS: In patients with ST-segment-elevation MI undergoing primary percutaneous coronary intervention with radial access and receiving current recommended treatments with potent P2Y12-inhibitors rate of the composite of all-cause death, MI, or major bleeding was not lower in those randomized to receive bivalirudin as compared with heparin.REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02311231.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: Circulation. Car ...

Av lärosätet: Örebro universitet; Lunds universitet; Linköpings universitet; Uppsala universitet; Karolinska Institutet; Umeå universitet

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Bivalirudin Versus Heparin Monotherapy in ST-Segment-Elevation Myocardial Infarction

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