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  • James, Stefan,1964-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 (author)

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

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • Lippincott Williams & Wilkins,2021
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-95948
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-95948URI
  • https://doi.org/10.1161/CIRCINTERVENTIONS.120.008969DOI
  • https://lup.lub.lu.se/record/fd90a3d9-1aa3-4d69-b16d-143e93dd93c1URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-182938URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-464027URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:148699819URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-191746URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Swedish Heart and Lung FoundationSwedish Heart-Lung Foundation; Swedish Research CouncilSwedish Research CouncilEuropean Commission; AstraZenecaAstraZeneca; Medicines Company; Swedish Foundation for Strategic Research (TOTAL-AMI project [Tailoring of Treatment in All Comers With Acute Myocardial Infarction])
  • 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.

Subject headings and genre

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  • Koul, SashaLund 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(Swepub:lu)med-sku (author)
  • Andersson, JonasUmeå universitet,Umeå University,Umea Univ, Sweden,Avdelningen för medicin(Swepub:umu)joan0102 (author)
  • Angerås, OskarDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden (author)
  • Bhiladvala, PallonjiLund 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(Swepub:lu)medf-pbh (author)
  • Calais, Fredrik,1971-Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiology, Faculty of Health, Örebro University, Sweden,Orebro Univ, Sweden(Swepub:oru)fcs (author)
  • Danielewicz, MikaelPCI-Unit, Karlstad Hospital, Karlstad, Sweden,Karlstad Hosp, Sweden,PCI-Unit at Karlstad Hospital, Sweden (author)
  • Fröbert, Ole,1964-Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology, Faculty of Health, Örebro University, Sweden,Orebro Univ, Sweden(Swepub:oru)oft (author)
  • Grimfjärd, PerDepartment of Internal Medicine, Västmanlands Sjukhus, Västerås, Sweden,Hacettepe University (author)
  • Götberg, MatthiasLund 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(Swepub:lu)kard-mgo (author)
  • Henareh, LoghmanKarolinska Institutet,Department of Cardiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden (author)
  • Ioanes, DanDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden (author)
  • Jensen, JensKarolinska Institutet,Department of Cardiology, Capio St Görans Hospital AB, Stockholm, Sweden (author)
  • Linder, RikardKarolinska Institutet,Department of Cardiology, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden (author)
  • Lindroos, PontusDepartment of Cardiology, Capio St Görans Hospital AB, Stockholm, Sweden,Capio St. Görans Sjukhus,Capio St Gorans Hosp AB, Sweden (author)
  • Omerovic, ElmirDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden (author)
  • Panayi, GeorgiosLinköping University,Region Östergötland, Kardiologiska kliniken US,Department of Cardiology, Linköping University, Sweden(Swepub:liu)n/a (author)
  • Råmunddal, TrulsDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden (author)
  • Sarno, GiovannaUppsala universitet,Uppsala University,Uppsala Univ, Sweden,Uppsala kliniska forskningscentrum (UCR),Kardiologi,kardiologi,Department of Medical Sciences, Uppsala University, Sweden(Swepub:uu)giosa853 (author)
  • Ulvenstam, AndersDepartment of Cardiology, Östersund hospital, Sweden,Ostersund Hosp, Sweden (author)
  • Völtz, SebastianDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Sweden (author)
  • Wagner, HenrikDepartment of Cardiology, Helsingborg Lasarett, Sweden,Helsingborg Hospital(Swepub:lu)med-hkw (author)
  • Wikström, HelenaDepartment of Cardiology, Kristianstad Hospital, Sweden,Central Hospital Kristianstad,Kristianstad Hosp, Sweden (author)
  • Östlund, OllieUppsala University,Uppsala Univ, Sweden,Uppsala Clinical Research Center, Uppsala University, Sweden (author)
  • Erlinge, DavidLund 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(Swepub:lu)kard-der (author)
  • Östlund, Olof PetterUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)oos27600 (author)
  • Uppsala UniversityUppsala Univ, Sweden (creator_code:org_t)

Related titles

  • In:Circulation. Cardiovascular Interventions: Lippincott Williams & Wilkins14:121941-76401941-7632

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