View in EDS

Heparin plus a glycoprotein IIb/IIIa inhibitor versus bivalirudin monotherapy and paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction (HORIZONS-AMI): final 3-year results from a multicentre, randomised controlled trial.

Saved in:
Bibliographic Details
Title: Heparin plus a glycoprotein IIb/IIIa inhibitor versus bivalirudin monotherapy and paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction (HORIZONS-AMI): final 3-year results from a multicentre, randomised controlled trial.
Authors: Stone GW (AUTHOR), Witzenbichler B (AUTHOR), Guagliumi G (AUTHOR), Peruga JZ (AUTHOR), Brodie BR (AUTHOR), Dudek D (AUTHOR), Kornowski R (AUTHOR), Hartmann F (AUTHOR), Gersh BJ (AUTHOR), Pocock SJ (AUTHOR), Dangas G (AUTHOR), Wong SC (AUTHOR), Fahy M (AUTHOR), Parise H (AUTHOR), Mehran R (AUTHOR), HORIZONS-AMI Trial Investigators (CORPORATE AUTHOR), Stone, Gregg W (AUTHOR), Witzenbichler, Bernhard (AUTHOR), Guagliumi, Giulio (AUTHOR), Peruga, Jan Z (AUTHOR)
Source: Lancet. 6/25/2011, Vol. 377 Issue 9784, p2193-2204. 12p.
Abstract: Background: Primary results of the HORIZONS-AMI trial have been previously reported. In this final report, we aimed to assess 3-year outcomes.Methods: HORIZONS-AMI was a prospective, open-label, randomised trial undertaken at 123 institutions in 11 countries. Patients aged 18 years or older were eligible for enrolment if they had ST-segment elevation myocardial infarction (STEMI), presented within 12 h after onset of symptoms, and were undergoing primary percutaneous coronary intervention. By use of a computerised interactive voice response system, we randomly allocated patients 1:1 to receive bivalirudin or heparin plus a glycoprotein IIb/IIIa inhibitor (GPI; pharmacological randomisation; stratified by previous and expected drug use and study site) and, if eligible, randomly allocated 3:1 to receive a paclitaxel-eluting stent or a bare metal stent (stent randomisation; stratified by pharmacological group assignment, diabetes mellitus status, lesion length, and study site). We produced Kaplan-Meier estimates of major adverse cardiovascular events at 3 years by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00433966.Findings: Compared with 1802 patients allocated to receive heparin plus a GPI, 1800 patients allocated to bivalirudin monotherapy had lower rates of all-cause mortality (5·9%vs 7·7%, difference -1·9% [-3·5 to -0·2], HR 0·75 [0·58-0·97]; p=0·03), cardiac mortality (2·9%vs 5·1%, -2·2% [-3·5 to -0·9], 0·56 [0·40-0·80]; p=0·001), reinfarction (6·2%vs 8·2%, -1·9% [-3·7 to -0·2], 0·76 [0·59-0·99]; p=0·04), and major bleeding not related to bypass graft surgery (6·9%vs 10·5%, -3·6% [-5·5 to -1·7], 0·64 [0·51-0·80]; p=0·0001) at 3 years, with no significant differences in ischaemia-driven target vessel revascularisation, stent thrombosis, or composite adverse events. Compared with 749 patients who received a bare-metal stent, 2257 patients who received a paclitaxel-eluting stent had lower rates of ischaemia-driven target lesion revascularisation (9·4%vs 15·1%, -5·7% [-8·6 to -2·7], 0·60 [0·48-0·76]; p<0·0001) after 3 years, with no significant differences in the rates of death, reinfarction, stroke or stent thrombosis. Stent thrombosis was high (≥4·5%) in both groups.Interpretation: The effectiveness and safety of bivalirudin monotherapy and paclitaxel-eluting stenting are sustained at 3 years for patients with STEMI undergoing primary percutaneous coronary intervention.Funding: Boston Scientific and The Medicines Company. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 108233654
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Heparin plus a glycoprotein IIb/IIIa inhibitor versus bivalirudin monotherapy and paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction (HORIZONS-AMI): final 3-year results from a multicentre, randomised controlled trial.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stone+GW%22&quot;&gt;Stone GW&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Witzenbichler+B%22&quot;&gt;Witzenbichler B&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Guagliumi+G%22&quot;&gt;Guagliumi G&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Peruga+JZ%22&quot;&gt;Peruga JZ&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Brodie+BR%22&quot;&gt;Brodie BR&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dudek+D%22&quot;&gt;Dudek D&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kornowski+R%22&quot;&gt;Kornowski R&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hartmann+F%22&quot;&gt;Hartmann F&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gersh+BJ%22&quot;&gt;Gersh BJ&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pocock+SJ%22&quot;&gt;Pocock SJ&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dangas+G%22&quot;&gt;Dangas G&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wong+SC%22&quot;&gt;Wong SC&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fahy+M%22&quot;&gt;Fahy M&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Parise+H%22&quot;&gt;Parise H&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mehran+R%22&quot;&gt;Mehran R&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22HORIZONS-AMI+Trial+Investigators%22&quot;&gt;HORIZONS-AMI Trial Investigators&lt;/searchLink&gt; (CORPORATE AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stone%2C+Gregg+W%22&quot;&gt;Stone, Gregg W&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Witzenbichler%2C+Bernhard%22&quot;&gt;Witzenbichler, Bernhard&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Guagliumi%2C+Giulio%22&quot;&gt;Guagliumi, Giulio&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Peruga%2C+Jan+Z%22&quot;&gt;Peruga, Jan Z&lt;/searchLink&gt; (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Lancet%22&quot;&gt;Lancet&lt;/searchLink&gt;. 6/25/2011, Vol. 377 Issue 9784, p2193-2204. 12p.
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: &lt;bold&gt;Background: &lt;/bold&gt;Primary results of the HORIZONS-AMI trial have been previously reported. In this final report, we aimed to assess 3-year outcomes.&lt;bold&gt;Methods: &lt;/bold&gt;HORIZONS-AMI was a prospective, open-label, randomised trial undertaken at 123 institutions in 11 countries. Patients aged 18 years or older were eligible for enrolment if they had ST-segment elevation myocardial infarction (STEMI), presented within 12 h after onset of symptoms, and were undergoing primary percutaneous coronary intervention. By use of a computerised interactive voice response system, we randomly allocated patients 1:1 to receive bivalirudin or heparin plus a glycoprotein IIb/IIIa inhibitor (GPI; pharmacological randomisation; stratified by previous and expected drug use and study site) and, if eligible, randomly allocated 3:1 to receive a paclitaxel-eluting stent or a bare metal stent (stent randomisation; stratified by pharmacological group assignment, diabetes mellitus status, lesion length, and study site). We produced Kaplan-Meier estimates of major adverse cardiovascular events at 3 years by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00433966.&lt;bold&gt;Findings: &lt;/bold&gt;Compared with 1802 patients allocated to receive heparin plus a GPI, 1800 patients allocated to bivalirudin monotherapy had lower rates of all-cause mortality (5&#183;9%vs 7&#183;7%, difference -1&#183;9% [-3&#183;5 to -0&#183;2], HR 0&#183;75 [0&#183;58-0&#183;97]; p=0&#183;03), cardiac mortality (2&#183;9%vs 5&#183;1%, -2&#183;2% [-3&#183;5 to -0&#183;9], 0&#183;56 [0&#183;40-0&#183;80]; p=0&#183;001), reinfarction (6&#183;2%vs 8&#183;2%, -1&#183;9% [-3&#183;7 to -0&#183;2], 0&#183;76 [0&#183;59-0&#183;99]; p=0&#183;04), and major bleeding not related to bypass graft surgery (6&#183;9%vs 10&#183;5%, -3&#183;6% [-5&#183;5 to -1&#183;7], 0&#183;64 [0&#183;51-0&#183;80]; p=0&#183;0001) at 3 years, with no significant differences in ischaemia-driven target vessel revascularisation, stent thrombosis, or composite adverse events. Compared with 749 patients who received a bare-metal stent, 2257 patients who received a paclitaxel-eluting stent had lower rates of ischaemia-driven target lesion revascularisation (9&#183;4%vs 15&#183;1%, -5&#183;7% [-8&#183;6 to -2&#183;7], 0&#183;60 [0&#183;48-0&#183;76]; p&lt;0&#183;0001) after 3 years, with no significant differences in the rates of death, reinfarction, stroke or stent thrombosis. Stent thrombosis was high (≥4&#183;5%) in both groups.&lt;bold&gt;Interpretation: &lt;/bold&gt;The effectiveness and safety of bivalirudin monotherapy and paclitaxel-eluting stenting are sustained at 3 years for patients with STEMI undergoing primary percutaneous coronary intervention.&lt;bold&gt;Funding: &lt;/bold&gt;Boston Scientific and The Medicines Company. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=108233654
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/S0140-6736(11)60764-2
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 2193
    Titles:
      – TitleFull: Heparin plus a glycoprotein IIb/IIIa inhibitor versus bivalirudin monotherapy and paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction (HORIZONS-AMI): final 3-year results from a multicentre, randomised controlled trial.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Stone GW
      – PersonEntity:
          Name:
            NameFull: Witzenbichler B
      – PersonEntity:
          Name:
            NameFull: Guagliumi G
      – PersonEntity:
          Name:
            NameFull: Peruga JZ
      – PersonEntity:
          Name:
            NameFull: Brodie BR
      – PersonEntity:
          Name:
            NameFull: Dudek D
      – PersonEntity:
          Name:
            NameFull: Kornowski R
      – PersonEntity:
          Name:
            NameFull: Hartmann F
      – PersonEntity:
          Name:
            NameFull: Gersh BJ
      – PersonEntity:
          Name:
            NameFull: Pocock SJ
      – PersonEntity:
          Name:
            NameFull: Dangas G
      – PersonEntity:
          Name:
            NameFull: Wong SC
      – PersonEntity:
          Name:
            NameFull: Fahy M
      – PersonEntity:
          Name:
            NameFull: Parise H
      – PersonEntity:
          Name:
            NameFull: Mehran R
      – PersonEntity:
          Name:
            NameFull: HORIZONS-AMI Trial Investigators
      – PersonEntity:
          Name:
            NameFull: Stone, Gregg W
      – PersonEntity:
          Name:
            NameFull: Witzenbichler, Bernhard
      – PersonEntity:
          Name:
            NameFull: Guagliumi, Giulio
      – PersonEntity:
          Name:
            NameFull: Peruga, Jan Z
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 25
              M: 06
              Text: 6/25/2011
              Type: published
              Y: 2011
          Identifiers:
            – Type: issn-print
              Value: 01406736
          Numbering:
            – Type: volume
              Value: 377
            – Type: issue
              Value: 9784
          Titles:
            – TitleFull: Lancet
              Type: main
ResultId 1