Document Detail


Bivalirudin: in patients with ST-segment elevation myocardial infarction.
MedLine Citation:
PMID:  20426499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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, <or=30 days, <or=1 year or <or=2 years.
Authors:
Monique P Curran
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drugs     Volume:  70     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-29     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  909-18     Citation Subset:  IM    
Affiliation:
Adis, Wolters Kluwer Business, Auckland, New Zealand. demail@adis.co.nz
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation / drug effects
Clinical Trials as Topic
Electrocardiography
Hirudins / adverse effects,  pharmacokinetics,  pharmacology
Humans
Myocardial Infarction / blood,  diagnosis,  drug therapy*,  metabolism
Peptide Fragments / adverse effects,  pharmacokinetics,  pharmacology,  therapeutic use*
Recombinant Proteins / adverse effects,  pharmacokinetics,  pharmacology,  therapeutic use
Thrombin / antagonists & inhibitors*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hirudins; 0/Peptide Fragments; 0/Recombinant Proteins; 128270-60-0/bivalirudin; EC 3.4.21.5/Thrombin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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