Clinical outcomes following stent thrombosis occurring in-hospital versus out-of-hospital: results from the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial

Journal of the American College of Cardiology
George D DangasGregg W Stone

Abstract

The study sought to determine whether rapid access to medical care and reperfusion results in a better prognosis in patients with in-hospital compared with out-of-hospital stent thrombosis (ST) in patients with ST-segment elevation myocardial infarction (STEMI) in the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial. Whether the prognosis of in-hospital and out-of-hospital ST are similar is uncertain, with conflicting data reported from prior studies. A total of 3,602 STEMI patients undergoing primary percutaneous coronary intervention (PCI) were randomized to bivalirudin (n = 1,800) versus unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) (UFH+GPI; n = 1,802). Stents were implanted in 3,202 patients, 156 (4.9%) of whom developed Academic Research Consortium definite/probable ST during 3-year follow-up. We investigated the 1-year clinical outcomes after ST in 54 patients with in-hospital ST compared with 102 patients with out-of-hospital ST. One year after the ST event, patients with in-hospital compared with out-of-hospital ST had significantly greater mortality (27.8% vs. 10.8%, p < 0.01); most deaths in both groups occurred within 1 week of the...Continue Reading

References

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Citations

Feb 22, 2013·Thrombosis and Haemostasis·M A BrouwerF W A Verheugt
Nov 29, 2013·Thrombosis and Haemostasis·Victor L SerebruanyJames J DiNicolantonio
Mar 19, 2013·Journal of the American College of Cardiology·Simon R Dixon, Robert D Safian
Jul 3, 2013·Therapeutic Advances in Cardiovascular Disease·Ana Muñiz-LozanoDominick J Angiolillo
Jan 24, 2020·Cardiovascular Intervention and Therapeutics·Antonio MangieriAntonio Colombo
Feb 13, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·K Anette FiedlerAdnan Kastrati
Jun 24, 2020·Cardiovascular Drugs and Therapy·Jinying ZhouHongbing Yan
Jan 14, 2021·Cardiovascular Intervention and Therapeutics·Shoichi KuramitsuTakeshi Kimura
May 19, 2021·Circulation. Cardiovascular Quality and Outcomes·Jennifer ZhouDion Stub

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