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HORIZONS AMI trial - Summary & Results
HORIZONS AMI trial - Summary & Results
HORIZONS AMI trial - Summary & Results
HORIZONS AMI trial - Summary & Results
HORIZONS AMI trial - Summary & Results
HORIZONS AMI trial - Summary & Results
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HORIZONS AMI trial - Summary & Results

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http://www.theheart.org/web_slides/1136417.do …

http://www.theheart.org/web_slides/1136417.do

A study on harmonizing outcomes with revascularization and stents in acute myocardial Infarction (HORIZONS AMI) with 3600 patients with STEMI and symptom onset of less than 12 hours undergoing primary PCI

Published in: Health & Medicine, Technology
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  • 1. HORIZONS AMI (Harmonizing Outcomeswith Revascularization and Stents inAcute Myocardial Infarction)
  • 2. HORIZONS AMI (Harmonizing Outcomes withRevascularization and Stents in Acute Myocardial Infarction)GW Stone (Columbia University Medical Center Cardiovascular Research Foundation, NY)TCT 2007 Meeting• Population: 3600 patients with STEMI and symptom onset of less than 12 hours undergoing primary PCI• Treatment: Patients randomized to UFH plus a GP IIb/IIIa inhibitor or to bivalirudin monotherapy stopped at the end of the procedure, plus provisional GP IIb/IIIa inhibitors for large thrombus or refractory no-flow• Primary outcomes: Major bleeding and net adverse clinical events* (NACE) within 30 days UFH=unfractionated heparin *Combination of major bleeding or major adverse CV events, including death, reinfarction, target vessel revascularization for ischemia, and stroke
  • 3. HORIZONS AMI: Results• 24% reduction in NACE and 40% reduction in major bleeding at 30 daysMajor outcomes at 30 days End point UFH–GP IIb/IIIa inhibitors Bivalirudin p, noninferiority p, superiority (%) (%) NACE 12.1 9.2 <0.0001 0.006 Major bleeding 8.3 4.9 <0.0001 <0.0001 MACE 5.5 5.4 — NS MACE=major adverse CV events (defined as all-cause death, reinfarction, ischemic target vessel revascularization, or stroke)
  • 4. HORIZONS AMI: Results• There was a significant reduction in cardiac death at 30 daysDeath at 30 daysEnd point UFH–GP IIb/IIIa inhibitors Bivalirudin p (%) (%)All death 3.1 2.1 0.058Cardiac death 2.9 1.8 0.035
  • 5. HORIZONS AMI: Commentary*"Its going to be hard to find anyone who will have anything critical to say aboutthis. . . When theres a reduction in cardiac mortality, that kind of trumps everythingelse." - Dr Deepak Bhatt"Overall, the results appear to look quite favorable for bivalirudin. . . . It isreasonable to ask whether bivalirudin alone would provide superior outcomescompared with heparin alone during contemporary management of STEMI withprimary PCI. This has important implications for clinical practice.." - Dr Sanjay Kaul *All comments from HORIZONS AMI: Bivalirudin reduces bleeding, adverse clinical events in STEMI (http://www.theheart.org/article/821109.do)
  • 6. Become a member of http://www.theheart.org Become a fan on Facebook: http://www.facebook.com/theheartorg Follow us on Twitter: http://www.twitter.com/theheartorgtheheart.org is the leading online source of independent cardiology news.We are the top provider of news and opinions for over 100 000 physicians.

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