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http://hdl.handle.net/1942/26234
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DC Field | Value | Language |
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dc.contributor.author | Gargiulo, Giuseppe | - |
dc.contributor.author | Carrara, Greta | - |
dc.contributor.author | Frigoli, Enrico | - |
dc.contributor.author | VRANCKX, Pascal | - |
dc.contributor.author | Leonardi, Sergio | - |
dc.contributor.author | Ciociano, Nestor | - |
dc.contributor.author | Campo, Gianluca | - |
dc.contributor.author | Varbella, Ferdinando | - |
dc.contributor.author | Calabro, Paolo | - |
dc.contributor.author | Garducci, Stefano | - |
dc.contributor.author | Iannone, Alessandro | - |
dc.contributor.author | Briguori, Carlo | - |
dc.contributor.author | Ando, Giuseppe | - |
dc.contributor.author | Crimi, Gabriele | - |
dc.contributor.author | Limbruno, Ugo | - |
dc.contributor.author | Garbo, Roberto | - |
dc.contributor.author | Sganzerla, Paolo | - |
dc.contributor.author | Russo, Filippo | - |
dc.contributor.author | Lupi, Alessandro | - |
dc.contributor.author | Cortese, Bernardo | - |
dc.contributor.author | Ausiello, Arturo | - |
dc.contributor.author | Ierna, Salvatore | - |
dc.contributor.author | Esposito, Giovanni | - |
dc.contributor.author | Zavalloni, Dennis | - |
dc.contributor.author | Santarelli, Andrea | - |
dc.contributor.author | Sardella, Gennaro | - |
dc.contributor.author | Tresoldi, Simone | - |
dc.contributor.author | de Cesare, Nicoletta | - |
dc.contributor.author | Sciahbasi, Alessandro | - |
dc.contributor.author | Zingarelli, Antonio | - |
dc.contributor.author | Tosi, Paolo | - |
dc.contributor.author | van't Hof, Arnoud | - |
dc.contributor.author | Omerovic, Elmir | - |
dc.contributor.author | Brugaletta, Salvatore | - |
dc.contributor.author | Windecker, Stephan | - |
dc.contributor.author | Valgimigli, Marco | - |
dc.date.accessioned | 2018-06-29T07:38:17Z | - |
dc.date.available | 2018-06-29T07:38:17Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 71(11), p. 1231-1242 | - |
dc.identifier.issn | 0735-1097 | - |
dc.identifier.uri | http://hdl.handle.net/1942/26234 | - |
dc.description.abstract | BACKGROUND Contrasting evidence exists on the comparative efficacy and safety of bivalirudin and unfractionated heparin (UFH) in relation to the planned use of glycoprotein IIb/IIIa inhibitors (GPIs). OBJECTIVES This study assessed the efficacy and safety of bivalirudin compared with UFH with or without GPIs in patients with acute coronary syndrome (ACS) who underwent invasive management. METHODS In the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX) program, 7,213 patients were randomly assigned to receive either bivalirudin or UFH with or without GPIs at discretion of the operator. The 30-day coprimary outcomes were major adverse cardiovascular events (MACEs) (a composite of death, myocardial infarction, or stroke), and net adverse clinical events (NACEs) (a composite of MACEs or major bleeding). RESULTS Among 3,603 patients assigned to receive UFH, 781 (21.7%) underwent planned treatment with GPI before coronary intervention. Bailout use of GPIs was similar between the bivalirudin and UFH groups (4.5% and 5.4%) (p = 0.11). At 30 days, the 2 coprimary endpoints of MACEs and NACEs, as well as individual endpoints of mortality, myocardial infarction, stent thrombosis or stroke did not differ among the 3 groups after adjustment. Compared with the UFH and UFH+GPI groups, bivalirudin reduced bleeding, mainly the most severe bleeds, including fatal and nonaccess site-related events, as well as transfusion rates and the need for surgical access site repair. These findings were not influenced by the administered intraprocedural dose of UFH and were confirmed at multiple sensitivity analyses, including the randomly allocated access site. CONCLUSIONS In patients with ACS, the rates of MACEs and NACEs were not significantly lower with bivalirudin than with UFH, irrespective of planned GPI use. However, bivalirudin significantly reduced bleeding complications, mainly those not related to access site, irrespective of planned use of GPIs. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX [MATRIX]; NCT01433627) (c) 2018 by the American College of Cardiology Foundation. | - |
dc.description.sponsorship | The trial was sponsored by the Societa Italiana di Cardiologia Invasiva (GISE, a non-profit organization), which received grant support from The Medicines Company and TERUMO. This substudy did not receive any direct or indirect funding. Dr. Gargiulo has received research grant support from the Cardiopath PhD program. Dr. Vranckx has received speaking or consulting fees from Bayer Health Care and Daiichi-Sankyo. Dr. Leonardi has received grants and personal fees from AstraZeneca; and personal fees from Chiesi, Daiichi-Sankyo, and The Medicines Company. Dr. Varbella has received speaking or consulting fees from Boeringher Ingelheim, Daiichi-Sankyo, Bayer, Pfizer, AstraZeneca, OrbusNeich, Biosensors, AbbottVascular, Amgen, and Bristol-Myers Squibb; and has received grants from Medtronic, Boston Scientific, Abbott, St. Jude, Biosensors, CID Alvimedica, and Abbott Vascular. Dr. Ando has received nonfinancial support from Terumo during the study; personal fees from Daiichi-Sankyo, Pfizer, and AstraZeneca; and personal fees and nonfinancial support from Bayer. Dr. Cortese has received research grants from AB Medica, Abbott, St. Jude Medical, and Stentys; and personal fees from Abbott, AstraZeneca, Daiichi-Sankyo, and Eli Lilly and Stentys. Dr Sciahbasi has served as advisory board member for Bayer HealthCare. Dr van't Hof has received speaker fees from The Medicines Company; has received unrestricted grants from Medtronic and AstraZeneca; and has served as Executive Board member of the EUROMAX trial. Dr. Omervoic has been a member of the advisory board for Boston Scientific; and has received a research grant from AstraZeneca. Dr. Windecker has received research grants from Abbott, Amgen, Bracco, Boston Scientific, Biotronick, St. Jude, and Terumo. Dr. Valgimigli has received grants from The Medicines Company, Terumo, and AstraZeneca; and has received personal fees from Terumo, St. Jude Vascular, and Abbott Vascular. | - |
dc.language.iso | en | - |
dc.rights | (C) 2018 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION | - |
dc.subject.other | acute coronary syndrome; bivalirudin; GP IIb/IIIa inhibitor; heparin; MATRIX | - |
dc.title | Bivalirudin or Heparin in Patients Undergoing Invasive Management of Acute Coronary Syndromes | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 1242 | - |
dc.identifier.issue | 11 | - |
dc.identifier.spage | 1231 | - |
dc.identifier.volume | 71 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Valgimigli, M (reprint author), Bern Univ Hosp, Dept Cardiol, Freiburgstr 4, CH-3010 Bern, Switzerland, marco.valgimigli@insel.ch | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1016/j.jacc.2018.01.033 | - |
dc.identifier.isi | 000427463400007 | - |
item.validation | ecoom 2019 | - |
item.fulltext | With Fulltext | - |
item.accessRights | Restricted Access | - |
item.fullcitation | Gargiulo, Giuseppe; Carrara, Greta; Frigoli, Enrico; VRANCKX, Pascal; Leonardi, Sergio; Ciociano, Nestor; Campo, Gianluca; Varbella, Ferdinando; Calabro, Paolo; Garducci, Stefano; Iannone, Alessandro; Briguori, Carlo; Ando, Giuseppe; Crimi, Gabriele; Limbruno, Ugo; Garbo, Roberto; Sganzerla, Paolo; Russo, Filippo; Lupi, Alessandro; Cortese, Bernardo; Ausiello, Arturo; Ierna, Salvatore; Esposito, Giovanni; Zavalloni, Dennis; Santarelli, Andrea; Sardella, Gennaro; Tresoldi, Simone; de Cesare, Nicoletta; Sciahbasi, Alessandro; Zingarelli, Antonio; Tosi, Paolo; van't Hof, Arnoud; Omerovic, Elmir; Brugaletta, Salvatore; Windecker, Stephan & Valgimigli, Marco (2018) Bivalirudin or Heparin in Patients Undergoing Invasive Management of Acute Coronary Syndromes. In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 71(11), p. 1231-1242. | - |
item.contributor | Gargiulo, Giuseppe | - |
item.contributor | Carrara, Greta | - |
item.contributor | Frigoli, Enrico | - |
item.contributor | VRANCKX, Pascal | - |
item.contributor | Leonardi, Sergio | - |
item.contributor | Ciociano, Nestor | - |
item.contributor | Campo, Gianluca | - |
item.contributor | Varbella, Ferdinando | - |
item.contributor | Calabro, Paolo | - |
item.contributor | Garducci, Stefano | - |
item.contributor | Iannone, Alessandro | - |
item.contributor | Briguori, Carlo | - |
item.contributor | Ando, Giuseppe | - |
item.contributor | Crimi, Gabriele | - |
item.contributor | Limbruno, Ugo | - |
item.contributor | Garbo, Roberto | - |
item.contributor | Sganzerla, Paolo | - |
item.contributor | Russo, Filippo | - |
item.contributor | Lupi, Alessandro | - |
item.contributor | Cortese, Bernardo | - |
item.contributor | Ausiello, Arturo | - |
item.contributor | Ierna, Salvatore | - |
item.contributor | Esposito, Giovanni | - |
item.contributor | Zavalloni, Dennis | - |
item.contributor | Santarelli, Andrea | - |
item.contributor | Sardella, Gennaro | - |
item.contributor | Tresoldi, Simone | - |
item.contributor | de Cesare, Nicoletta | - |
item.contributor | Sciahbasi, Alessandro | - |
item.contributor | Zingarelli, Antonio | - |
item.contributor | Tosi, Paolo | - |
item.contributor | van't Hof, Arnoud | - |
item.contributor | Omerovic, Elmir | - |
item.contributor | Brugaletta, Salvatore | - |
item.contributor | Windecker, Stephan | - |
item.contributor | Valgimigli, Marco | - |
crisitem.journal.issn | 0735-1097 | - |
crisitem.journal.eissn | 1558-3597 | - |
Appears in Collections: | Research publications |
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