Impact of sex on comparative outcomes of bivalirudin versus unfractionated heparin in patients with acute coronary syndromes undergoing invasive management: a pre-specified analysis of the MATRIX trial

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Giuseppe GargiuloMarco Valgimigli

Abstract

Our aim was to assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in males and females with acute coronary syndrome (ACS) undergoing invasive management. In the MATRIX programme, 7,213 patients were randomised to bivalirudin or UFH. Patients in the bivalirudin group were subsequently randomly assigned to receive or not a post-PCI bivalirudin infusion. The 30-day co-primary outcomes were major adverse cardiovascular events (MACE), defined as death, myocardial infarction, or stroke, and net adverse clinical events (NACE), defined as MACE or major bleeding. The primary outcome for the comparison of a post-PCI bivalirudin infusion with no post-PCI infusion was a composite of urgent target vessel revascularisation (TVR), definite stent thrombosis (ST), or NACE. The rate of MACE was not significantly lower with bivalirudin than with heparin in male (rate ratio [RR] 0.90, 95% confidence interval [CI]: 0.75-1.07; p=0.22) and female patients (RR 1.06, 95% CI: 0.80-1.40; p=0.67) without significant interaction (pint=0.31), nor was the rate of NACE (males: RR 0.85, 95% CI: 0.72-1.01; p=0.07; females: RR 0.98, 95% CI: 0.76-1.28; p=0.91; pint=0.38). Post-PCI bivalirudin infusion, as ...Continue Reading

References

Dec 19, 2007·Circulation·Wayne RosamondUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Sep 2, 2015·The New England Journal of Medicine·Marco ValgimigliUNKNOWN MATRIX Investigators
Jan 15, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Zhenyang LiangYaling Han
Jun 20, 2016·JACC. Cardiovascular Interventions·Marco Valgimigli, Giuseppe Gargiulo
Aug 29, 2017·The New England Journal of Medicine·David ErlingeStefan James
Mar 17, 2018·Journal of the American College of Cardiology·Giuseppe GargiuloMarco Valgimigli

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Citations

Jun 1, 2021·Interventional Cardiology Clinics·Chirag Bavishi, J Dawn Abbott

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