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Sex-related respons...
Sex-related response to bivalirudin and unfractionated heparin in patients with acute myocardial infarction undergoing percutaneous coronary intervention : A subgroup analysis of the VALIDATE-SWEDEHEART trial
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- Venetsanos, Dimitrios (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Sederholm Lawesson, Sofia, 1973- (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Fröbert, Ole, 1964- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology, Örebro University, Sweden,Orebro Univ, Dept Cardiol, Orebro, Sweden
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- Omerovic, E. (author)
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden
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- Henareh, L. (author)
- Karolinska Institutet,Karolinska Inst, Dept Med, Solna, Sweden,Department of Medicine, Karolinska Institute, Sweden
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- Robertsson, L. (author)
- Karolinska Institutet,Sodra Alvsborgs Sjukhus, Dept Cardiol, Boras, Sweden,Danderyd Hosp, Dept Cardiol, Danderyd, Sweden,Department of Cardiology, Södra Älvsborgs Sjukhus, Sweden,Department of Cardiology, Danderyd Hospital, Sweden
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- Linder, R. (author)
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
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- Götberg, M. (author)
- Department of Cardiology, Skåne University Hospital, Sweden,Skane Univ Hosp, Dept Cardiol, Lund, Sweden
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- James, Stefan, 1964- (author)
- Uppsala universitet,Kardiologi,Department of Medical Sciences, Uppsala University, Sweden
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- Alfredsson, Joakim, 1962- (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Erlinge, D. (author)
- Department of Cardiology, Skåne University Hospital, Sweden,Skane Univ Hosp, Dept Cardiol, Lund, Sweden
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- Swahn, Eva (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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(creator_code:org_t)
- 2018-10-23
- 2019
- English.
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In: European Heart Journal. - : Sage Publications. - 2048-8726 .- 2048-8734. ; 8:6, s. 502-509
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Abstract
Subject headings
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- AIMS: Our aim was to study the impact of sex on anticoagulant treatment outcomes during percutaneous coronary intervention in acute myocardial infarction patients.METHODS: This study was a prespecified analysis of the Bivalirudin versus Heparin in ST-Segment and Non ST-Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated according to Recommended Therapies Registry Trial (VALIDATE-SWEDEHEART) trial, in which patients with myocardial infarction were randomised to bivalirudin or unfractionated heparin during percutaneous coronary intervention. The primary outcome was the composite of death, myocardial infarction or major bleeding at 180 days.RESULTS: There was a lower risk of the primary outcome in women assigned to bivalirudin than to unfractionated heparin (13.6% vs 17.1%, hazard ratio 0.78, 95% confidence interval (0.60-1.00)) with no significant difference in men (11.8% vs 11.2%, hazard ratio 1.06 (0.89-1.26), p for interaction 0.05). The observed difference was primarily due to lower risk of major bleeding (Bleeding Academic Research Consortium definition 2, 3 or 5) associated with bivalirudin in women (8.9% vs 11.8%, hazard ratio 0.74 (0.54-1.01)) but not in men (8.5% vs 7.3%, hazard ratio 1.16 (0.94-1.43) in men, p for interaction 0.02). Conversely, no significant difference in the risk of Bleeding Academic Research Consortium 3 or 5 bleeding, associated with bivalirudin, was found in women 4.5% vs 5.4% (hazard ratio 0.84 (0.54-1.31)) or men 2.9% vs 2.1% (hazard ratio 1.36 (0.93-1.99)). Bleeding Academic Research Consortium 2 bleeding occurred significantly less often in women assigned to bivalirudin than to unfractionated heparin. The risk of death or myocardial infarction did not significantly differ between randomised treatments in men or women.CONCLUSION: In women, bivalirudin was associated with a lower risk of adverse outcomes, compared to unfractionated heparin, primarily due to a significant reduction in Bleeding Academic Research Consortium 2 bleeds.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Gender
- bivalirudin
- heparin
- myocardial infarction
- percutaneous coronary intervention
- sex
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Venetsanos, Dimi ...
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Sederholm Lawess ...
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Fröbert, Ole, 19 ...
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Omerovic, E.
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Henareh, L.
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Robertsson, L.
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Linder, R.
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Götberg, M.
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James, Stefan, 1 ...
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Alfredsson, Joak ...
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Erlinge, D.
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Swahn, Eva
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Heart J ...
- By the university
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Örebro University
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Karolinska Institutet
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Uppsala University
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Linköping University