Bivalirudin for primary percutaneous coronary intervention in acute myocardial infarction: the HORIZONS-AMI trial
Review published in Expert Rev Cardiovasc Ther (2012)
Abstract
The combination of unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPIs) has been a frequently used anti-thrombotic treatment strategy for acute coronary syndrome patients, including those with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. However, the ischemic benefit of the UFH plus GPI combination came at the expense of high rates of bleeding complications and thrombocytopenia, both of which have been independently associated with increased mortality. By contrast, bivalirudin monotherapy compared with the combination of UFH plus GPI resulted in improved net clinical outcomes, based on similar ischemic protection with significant reductions in bleeding complications in randomized trials including patients with stable angina, those with unstable angina and those with non-ST-segment elevation myocardial infarction. More recently, the HORIZONS-AMI randomized, open-label, multicenter trial has compared the efficacy and safety of bivalirudin alone versus UFH plus a GPI in 3602 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Clinical results derived from this large study, including the final 3-year follow-up data, will be reviewed in the present clinical trial report.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
The combination of unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPIs) has been a frequently used anti-thrombotic treatment strategy for acute coronary syndrome patients, including those with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
Por qué esto importa para la hirudoterapia
Este artículo de revisión describe el ensayo aleatorizado, abierto y multicéntrico HORIZONS-AMI, que comparó la monoterapia con bivalirudina frente a heparina no fraccionada más un inhibidor de la glucoproteína IIb/IIIa en 3.602 pacientes con IAMCEST sometidos a ICP primaria, señalando que se revisarán los resultados finales del seguimiento a 3 años. El resumen indica que la monoterapia con bivalirudina mostró mejores resultados clínicos netos con reducciones significativas del sangrado en comparación con heparina más GPI en ensayos aleatorizados previos de pacientes con síndrome coronario estable y agudo. El resumen no menciona sanguijuelas, hirudina, hirudoterapia ni ninguna conexión derivada de sanguijuela, por lo que la relevancia del artículo para el ámbito de ASH no queda establecida.
Citación
Bivalirudin for primary percutaneous coronary intervention in acute myocardial infarction: the HORIZONS-AMI trial.
Capranzano P et al. · Expert Rev Cardiovasc Ther, 2012
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026