E N D
Impact of advanced age on the safety and effectiveness of bivalirudin in patients with acute myocardial infarction undergoing primary angioplasty: The HORIZONS AMI trialDariusz Dudek, Krzyszto Zmudka, Bernhard Witzenbichler, Giulio Guagliumi, Jan Z. Peruga, Bruce R. Brodie, Ran Kornowski, Franz Hartmann, Martin Mockel, Andrzej Ochala, Helen Parise, Roxana Mehran, Gregg W. Stone
Methods • A total of 3602 patients at 123 centers in 11 countries with AMI undergoing primary PCI were randomized tobivalirudin monotherapy or unfractionated heparin plus glycoprotein IIb/IIIa inhibitors. • Outcomes were analyzed according to age above or below the median of 60.2 years: • Bivalirudin (n=1800) • age ≤60.2 years (n=923) • age >60.2 years (n=877) • UFH+GPI (n=1802) • age ≤60.2 years (n=885) • age >60.2 years (n=917) Dudek et al ACC 2008
Outcomes, Age ≤ 60.2 years P=0.168 P=0.0012* P=0.354 P=0.109 *P<0.05 Dudek et al ACC 2008
Outcomes, Age > 60.2 years P=0.156 P=0.013* P=0.512 P=0.033* *P<0.05 Dudek et al ACC 2008
Conclusions • In patients with AMI undergoing primary PCI, bivalirudin monotherapy significantly reduces major bleeding and net adverse clinical events, effects which are independent of age. Dudek et al ACC 2008