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Sökning: onr:"swepub:oai:DiVA.org:oru-69263" > Bivalirudin versus ...

Bivalirudin versus heparin monotherapy in non-ST-segment elevation myocardial infarction

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, Dept Cardiol, Lund, Sweden.,Department of Cardiology, Lund 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, Dept Cardiol, Lund, Sweden.,Department of Cardiology, Lund University, Sweden
Omerovic, Elmir (författare)
Department of Cardiology, Sahlgrenska University Hospital, Sweden,Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.
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Fröbert, Ole, 1964- (författare)
Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology, Örebro University, Sweden,Örebro Univ, Dept Cardiol, Örebro, Sweden.
Linder, Rikard (författare)
Karolinska Institutet,Department of Cardiology, Danderyd Hospital, Sweden,Danderyd Hosp, Dept Cardiol, Danderyd, Sweden.
Danielewicz, Mikael (författare)
PCI-Unit, Karlstad Hospital, Sweden,Karlstad Hosp, PCI Unit, Karlstad, Sweden.
Hamid, Mehmet (författare)
Department of Cardiology, Mälarsjukhuset, Sweden,Malarsjukhuset, Dept Cardiol, Eskilstuna, Sweden.
Venetsanos, Dimitrios (författare)
Department of Cardiology, Karolinska University Hospital, Sweden,Karolinska Univ Hosp, Dept Cardiol, Solna, Sweden.
Henareh, Loghman (författare)
Karolinska Institutet,Karolinska Univ Hosp, Dept Cardiol, Solna, Sweden.,Department of Cardiology, Karolinska University Hospital, Sweden
Pettersson, Björn (författare)
Umeå University,Umeå universitet,Kardiologi,Umeå Univ, Dept Cardiol, Umeå, Sweden.,Department of Cardiology, Umeå University, Sweden
Wagner, Henrik (författare)
Department of Cardiology, Helsingborg Lasarett, Sweden,Helsingborg Hospital,Helsingborg Lasarett, Dept Cardiol, Helsingborg, Sweden.
Grimfjärd, Per (författare)
Department of Internal Medicine, Västmanlands Sjukhus, Sweden,Vastmanlands Sjukhus, Dept Internal Med, Koping, Sweden.
Jensen, Jens (författare)
Karolinska Institutet,Capio St Gorans Hosp AB, Dept Cardiol, Stockholm, Sweden.,Department of Cardiology, Capio S:t Görans Hospital AB, Sweden
Hofmann, Robin (författare)
Karolinska Institutet,Soder Sjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Sweden
Ulvenstam, Anders (författare)
Umeå universitet,Avdelningen för medicin,Östersund Hosp, Dept Cardiol, Östersund, Sweden.,Department of Cardiology, Östersund Hospital, Sweden
Völz, Sebastian (författare)
Department of Cardiology, Sahlgrenska University Hospital, Sweden,Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.
Petursson, Petur (författare)
Department of Cardiology, Sahlgrenska University Hospital, Sweden,Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.,Department of Cardiology, Umeå University, Sweden
Östlund, Ollie (författare)
Uppsala universitet,Uppsala University,Institutionen för medicinska vetenskaper,Department of Medical Sciences, Uppsala University, Sweden
Sarno, Giovanna (författare)
Uppsala universitet,Uppsala University,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Department of Medical Sciences, Uppsala University, Sweden
Wallentin, Lars, 1943- (författare)
Uppsala universitet,Uppsala University,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Science for Life Laboratory, SciLifeLab,Department of Medical Sciences, Uppsala University, Sweden
Scherstén, Fredrik (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, Dept Cardiol, Lund, Sweden.,Department of Cardiology, Lund University, Sweden
Eriksson, Peter (författare)
Umeå University,Umeå universitet,Kardiologi,Umeå Univ, Dept Cardiol, Umeå, Sweden.
James, Stefan, 1964- (författare)
Uppsala universitet,Uppsala University,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Institutionen för kirurgiska vetenskaper,Klinisk fysiologi,Department of Medical Sciences, Uppsala University, Sweden
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 (creator_code:org_t)
2018-10-03
2019
Engelska.
Ingår i: European Heart Journal. - : Sage Publications. - 2048-8726 .- 2048-8734. ; 8:6, s. 492-501
Relaterad länk:
https://doi.org/10.1...
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https://academic.oup...
http://dx.doi.org/10...
https://urn.kb.se/re...
https://doi.org/10.1...
https://urn.kb.se/re...
http://kipublication...
https://lup.lub.lu.s...
https://urn.kb.se/re...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • BACKGROUND: The optimal anti-coagulation strategy for patients with non-ST-elevation myocardial infarction treated with percutaneous coronary intervention is unclear in contemporary clinical practice of radial access and potent P2Y12-inhibitors. The aim of this study was to investigate whether bivalirudin was superior to heparin monotherapy in patients with non-ST-elevation myocardial infarction without routine glycoprotein IIb/IIIa inhibitor use.METHODS: In a large pre-specified subgroup of the multicentre, prospective, randomised, registry-based, open-label clinical VALIDATE-SWEDEHEART trial we randomised patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention, treated with ticagrelor or prasugrel, to bivalirudin or heparin monotherapy with no planned use of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention. The primary endpoint was the rate of a composite of all-cause death, myocardial infarction or major bleeding within 180 days.RESULTS: A total of 3001 patients with non-ST-elevation myocardial infarction, were enrolled. The primary endpoint occurred in 12.1% (182 of 1503) and 12.5% (187 of 1498) of patients in the bivalirudin and heparin groups, respectively (hazard ratio of bivalirudin compared to heparin treatment 0.96, 95% confidence interval 0.78-1.18, p=0.69). The results were consistent in all major subgroups. All-cause death occurred in 2.0% versus 1.7% (hazard ratio 1.15, 0.68-1.94, p=0.61), myocardial infarction in 2.3% versus 2.5% (hazard ratio 0.91, 0.58-1.45, p=0.70), major bleeding in 8.9% versus 9.1% (hazard ratio 0.97, 0.77-1.24, p=0.82) and definite stent thrombosis in 0.3% versus 0.2% (hazard ratio 1.33, 0.30-5.93, p=0.82).CONCLUSION: Bivalirudin as compared to heparin during percutaneous coronary intervention for non-ST-elevation myocardial infarction did not reduce the composite of all-cause death, myocardial infarction or major bleeding in non-ST-elevation myocardial infarction patients receiving current recommended treatments with modern P2Y12-inhibitors and predominantly radial access.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Bivalirudin
heparin
non-ST-elevation myocardial infarction

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ref (ämneskategori)
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