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15. 11.8. 11.7. 10.1. 10. 5. 0. ACUITY: Death, MI, revascularization for ischemia, or major bleeding by 30 days. %. Heparin + GPI IIb/IIIa. Bivalirudin + GPI IIb/IIIa. Bivalirudin alone. p = 0.015 for superiority of bivalrudin alone vs. hep+GPI
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15 11.8 11.7 10.1 10 5 0 ACUITY: Death, MI, revascularizationfor ischemia, or major bleeding by 30 days % Heparin + GPI IIb/IIIa Bivalirudin + GPI IIb/IIIa Bivalirudin alone p = 0.015 for superiority of bivalrudin alone vs. hep+GPI p < 0.001 for non-inferiority of hep+GPI vs. bival+GPI Stone GW, et al. N Engl J Med 2006;355:2203-16.
Primary Endpoint Measures (ITT) — 30 DaysUFH/Enoxaparin + GPI vs. Bivalirudin Alone GPI = glycoprotein IIb/IIIa inhibitor; ITT = intention to treat; UFH = unfractionated heparin. Presented at ACC.07 and Stone GW et al. N Engl J Med 2006;355:2203-16.
Kaplan-Meier Curves for Mortalityin Patients With or Without Major Bleeding Manoukian S et al. J Am Coll Cardiol 2007;49:1362-8.
ACUITY Trial Treatment Strategy UFH = unfractionated heparin; GPI = glycoprotein IIb/IIIa inhibitor; PCI = percutaneous coronary intervention; CABG = coronary artery bypass graft. Stone GW et al. N Engl J Med 2006;355:2203-16.
1-Year ACUITY Trial ResultsPCI Cohort ACS = acute coronary syndrome; GP = glycoprotein; LOS = length of stay; PCI = percutaneous coronary intervention.
1-Year ACUITY Trial Conclusion These results suggest bivalirudin monotherapy should be the preferred adjunctive antithrombotic strategy in moderate- and high-risk acute coronary syndrome patients undergoing percutaneous coronary intervention and add to the evidence on the relationship between early bleeding and long-term outcome.