What is the optimal antithrombotic strategy in primary percutaneous coronary intervention?

Current Opinion in Cardiology
Ziad SergieGregg W Stone

Abstract

Major bleeding in the setting of acute coronary syndromes and percutaneous coronary intervention has been associated with increased short-term and long-term risk for adverse cardiac events and mortality. Recent studies on antithrombotic agents in this setting have highlighted their differential impact on ischemic and hemorrhagic complications. To measure bleeding events consistently, an updated standardized definition has been developed by the Bleeding Academic Research Consortium (BARC) representatives. Additionally, the antithrombin agent bivalirudin has emerged as a frontrunner in the invasive management of acute coronary syndromes because of fewer bleeding complications, lower long-term mortality, and similar efficacy compared with heparin plus a glycoprotein IIb/IIIa inhibitor. The mortality benefit with bivalirudin is most likely correlated with reductions in major bleeding, including in-hospital, access-site, and nonaccess site bleeding, and despite the use of preprocedural unfractionated heparin. The BARC definition is an improved version of prior bleeding classifications, and will likely play a significant role in comparing different anticoagulation strategies in future clinical trials and registry analyses. Bivalirudi...Continue Reading

References

May 24, 2008·The New England Journal of Medicine·Gregg W StoneUNKNOWN HORIZONS-AMI Trial Investigators
May 30, 2009·Journal of the American College of Cardiology·Brendan J DoyleDavid R Holmes
Sep 1, 2009·The New England Journal of Medicine·Lars WallentinMona Thorsén
Jun 2, 2010·Journal of the American College of Cardiology·Roxana MehranGregg W Stone
Nov 27, 2010·Expert Review of Cardiovascular Therapy·David A Van De CarE Magnus Ohman
Jan 14, 2011·Expert Opinion on Pharmacotherapy·Cheuk-Kit Wong, Harvey D White
Apr 13, 2011·Circulation·George D DangasUNKNOWN Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) Trial Investigators
Apr 23, 2011·JACC. Cardiovascular Interventions·Young-Hak KimSeung-Jung Park
Jun 4, 2011·Journal of the American College of Cardiology·George D DangasUNKNOWN HORIZONS-AMI Trial Investigators
Nov 15, 2011·The New England Journal of Medicine·Pierluigi TricociUNKNOWN TRACER Investigators
Nov 15, 2011·The New England Journal of Medicine·Adnan KastratiUNKNOWN ISAR-REACT 4 Trial Investigators
Dec 6, 2011·Lancet·Girish DwivediAun Yeong Chong
Dec 20, 2011·Circulation·Véronique L RogerUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jan 27, 2012·The New England Journal of Medicine·Jarett D BerryDonald M Lloyd-Jones
Feb 22, 2012·Circulation·Sunil V Rao, Roxana Mehran

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