Pooled Analysis of Bivalirudin During Primary Percutaneous Coronary Intervention

An analysis of HORIZONS-AMI and EUROMAX patients supports the original studies' findings — and limitations.

The recent HEAT-PPCI trial (NEJM JW Cardiol Aug 18 2014) has called into question the benefits of bivalirudin in primary percutaneous intervention (PCI) that were previously demonstrated in the HORIZONS-AMI (NEJM JW Cardiol May 21 2008) and EUROMAX (NEJM JW Cardiol Nov 6 2013) trials. To gain insight into these conflicting results, investigators performed a pooled patient-level analysis of the data in the latter two trials, which allowed greater power to analyze endpoints. For this analysis, partially funded by the manufacturer of bivalirudin, researchers assessed outcomes in 5800 patients randomized to bivalirudin or heparin (with or without glycoprotein IIb/IIIa inhibition [GPI] in both treatment arms) along with primary PCI. Important di…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)