Is routine post-procedural anticoagulation warranted after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction? Insights from the HORIZONS-AMI trial
Research article published in European heart journal. Acute cardiovascular care (2015)
Abstract
AIM: Post-procedural anticoagulation (AC) for routine prophylaxis may be administered after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI), but the risks and benefits of this practice are uncertain. We therefore sought to assess the utility of routine post-procedural AC after primary PCI. METHODS AND RESULTS: Patients undergoing primary PCI in the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial were grouped according to whether they received post-PCI AC for routine prophylaxis. Outcomes were assessed using propensity-adjusted multivariable analysis. Among 2932 patients in whom primary PCI for STEMI was performed, 869 (29.6%) received post-PCI AC for routine prophylaxis (median duration four days) and 2063 (70.4%) received no post-PCI AC. Time from PCI to ambulation was similar in both groups (median 0.9 vs 1.0 days, p=0.40), although hospitalization was prolonged in patients receiving AC for routine prophylaxis (median 6.0 vs 4.0 days, p<0.0001). After propensity-adjustment, patients who received and did not receive AC for routine prophylaxis after PCI experienced similar rates of 30-day adverse ischemic and major bleeding events. Deep venous thrombosis or pulmonary emboli developed rarely (0.3%) within 30 days, and were not significantly reduced by use of post-PCI AC for routine prophylaxis. CONCLUSIONS: In this large-scale prospective study, use of post-procedural AC for routine prophylaxis was relatively common, and was not associated with improved clinical outcomes, although the duration of hospitalization was prolonged. These data suggest that post-PCI AC for routine prophylaxis may not provide benefit after successful primary PCI in patients in whom early ambulation is likely.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Is routine post-procedural anticoagulation warranted after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction? Insights from the HORIZONS-AMI trial.
Почему это важно для гирудотерапии
This study examined the utility of routine post-procedural anticoagulation for prophylaxis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction, using a propensity-adjusted multivariable comparison within the HORIZONS-AMI trial population. The authors report that routine post-procedural anticoagulation was not associated with improved clinical outcomes, including adverse ischemic events, major bleeding, or deep venous thrombosis/pulmonary embolism, while hospitalization duration was prolonged. The topic of systemic anticoagulation is pharmacologically adjacent to the leech secretome, but the study evaluates standard cardiovascular drug therapies rather than leech-derived substances. Therefore, this work has no direct relevance to hirudotherapy or the leech secretome.
Цитирование
Is routine post-procedural anticoagulation warranted after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction? Insights from the HORIZONS-AMI trial
Madhavan MV et al. · European heart journal. Acute cardiovascular care, 2015
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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