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- Title
Bivalirudin: In Patients with ST-Segment Elevation Myocardial Infarction.
- Authors
Curran, Monique P.
- Abstract
Bivalirudin is a synthetic 20 amino acid polypeptide that directly inhibits both fibrin-bound and soluble thrombin. In the randomized, open-label, multicentre HORIZONS-AMI trial in patients with ST-segment elevation myocardial infarction (STEMI) who were undergoing primary percutaneous coronary intervention (PCI), compared with unfractionated heparin (UFH) plus a glycoprotein (GP) IIb/IIIa inhibitor, bivalirudin was associated with a significantly lower 30-day rate of net adverse clinical events that was largely due to the significantly lower 30-day rate of non-coronary-artery bypass grafting major bleeding. There was no significant between-group difference in the 30-day rate of major adverse cardiovascular events. These 30-day clinical outcomes were maintained at the 1- and 2-year follow-up. Bivalirudin, compared with UFH plus a GP IIb/IIIa inhibitor, was associated with lower short-(30-day) and long- (1- and 2-year) term overall and cardiac mortality rates. Although there was an increased risk of acute stent thrombosis within 24 hours in recipients of bivalirudin compared with UFH plus a GP IIb/IIIa inhibitor, there was no significant between-group difference between 24 hours and 30 days, ⩽30 days, ⩽1 year or ⩽2 years.
- Subjects
MYOCARDIAL infarction; CARDIOVASCULAR system; CARDIAC arrest prevention; MORTALITY; AMINO acids
- Publication
Drugs, 2010, Vol 70, Issue 7, p909
- ISSN
0012-6667
- Publication type
Article
- DOI
10.2165/11205120-000000000-00000