ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy

Arnoud Van't Hof; Francesco Giannini; Jurrien Ten Berg; Rudolf Tolsma; Peter Clemmensen; Debra Bernstein; Pierre Coste; Patrick Goldstein; Uwe Zeymer; Christian Hamm; Efthymios Deliargyris; Philippe G Steg

doi:10.1177/2048872615598633

ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy

Arnoud Van't Hof, Francesco Giannini, Jurrien Ten Berg, Rudolf Tolsma, Peter Clemmensen, Debra Bernstein, Pierre Coste, Patrick Goldstein, Uwe Zeymer, Christian Hamm, Efthymios Deliargyris, Philippe G Steg

4 Citationer (Scopus)

Abstract

BACKGROUND: Myocardial reperfusion after primary percutaneous coronary intervention (PCI) can be assessed by the extent of post-procedural ST-segment resolution. The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trial compared pre-hospital bivalirudin and pre-hospital heparin or enoxaparin with or without GPIIb/IIIa inhibitors (GPIs) in primary PCI. This nested substudy was performed in centres routinely using pre-hospital GPI in order to compare the impact of randomized treatments on ST-resolution after primary PCI.

METHODS: Residual cumulative ST-segment deviation on the single one hour post-procedure electrocardiogram (ECG) was assessed by an independent core laboratory and was the primary endpoint. It was calculated that 762 evaluable patients were needed to show non-inferiority (85% power, alpha 2.5%) between randomized treatments.

RESULTS: A total of 871 participated with electrocardiographic data available in 824 patients (95%). Residual ST-segment deviation one hour after PCI was 3.8±4.9 mm versus 3.9±5.2 mm for bivalirudin and heparin+GPI, respectively (p=0.0019 for non-inferiority). Overall, there were no differences between randomized treatments in any measures of ST-segment resolution either before or after the index procedure.

CONCLUSIONS: Pre-hospital treatment with bivalirudin is non-inferior to pre-hospital heparin + GPI with regard to residual ST-segment deviation or ST-segment resolution, reflecting comparable myocardial reperfusion with the two strategies.

Originalsprog	Engelsk
Tidsskrift	European heart journal. Acute cardiovascular care
Vol/bind	6
Udgave nummer	5
Sider (fra-til)	404-411
ISSN	2048-8726
DOI	https://doi.org/10.1177/2048872615598633
Status	Udgivet - 2017

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10.1177/2048872615598633

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Citationsformater

Van't Hof, A., Giannini, F., Ten Berg, J., Tolsma, R., Clemmensen, P., Bernstein, D., Coste, P., Goldstein, P., Zeymer, U., Hamm, C., Deliargyris, E., & Steg, P. G. (2017). ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy. European heart journal. Acute cardiovascular care, 6(5), 404-411. https://doi.org/10.1177/2048872615598633

ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy. / Van't Hof, Arnoud; Giannini, Francesco; Ten Berg, Jurrien et al.
I: European heart journal. Acute cardiovascular care, Bind 6, Nr. 5, 2017, s. 404-411.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Van't Hof, A, Giannini, F, Ten Berg, J, Tolsma, R, Clemmensen, P, Bernstein, D, Coste, P, Goldstein, P, Zeymer, U, Hamm, C, Deliargyris, E & Steg, PG 2017, 'ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy', European heart journal. Acute cardiovascular care, bind 6, nr. 5, s. 404-411. https://doi.org/10.1177/2048872615598633

Van't Hof A, Giannini F, Ten Berg J, Tolsma R, Clemmensen P, Bernstein D et al. ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy. European heart journal. Acute cardiovascular care. 2017;6(5):404-411. doi: 10.1177/2048872615598633

Van't Hof, Arnoud ; Giannini, Francesco ; Ten Berg, Jurrien et al. / ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention : The EUROMAX ST-segment resolution substudy. I: European heart journal. Acute cardiovascular care. 2017 ; Bind 6, Nr. 5. s. 404-411.

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title = "ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention: The EUROMAX ST-segment resolution substudy",

abstract = "BACKGROUND: Myocardial reperfusion after primary percutaneous coronary intervention (PCI) can be assessed by the extent of post-procedural ST-segment resolution. The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trial compared pre-hospital bivalirudin and pre-hospital heparin or enoxaparin with or without GPIIb/IIIa inhibitors (GPIs) in primary PCI. This nested substudy was performed in centres routinely using pre-hospital GPI in order to compare the impact of randomized treatments on ST-resolution after primary PCI.METHODS: Residual cumulative ST-segment deviation on the single one hour post-procedure electrocardiogram (ECG) was assessed by an independent core laboratory and was the primary endpoint. It was calculated that 762 evaluable patients were needed to show non-inferiority (85% power, alpha 2.5%) between randomized treatments.RESULTS: A total of 871 participated with electrocardiographic data available in 824 patients (95%). Residual ST-segment deviation one hour after PCI was 3.8±4.9 mm versus 3.9±5.2 mm for bivalirudin and heparin+GPI, respectively (p=0.0019 for non-inferiority). Overall, there were no differences between randomized treatments in any measures of ST-segment resolution either before or after the index procedure.CONCLUSIONS: Pre-hospital treatment with bivalirudin is non-inferior to pre-hospital heparin + GPI with regard to residual ST-segment deviation or ST-segment resolution, reflecting comparable myocardial reperfusion with the two strategies.",

author = "{Van't Hof}, Arnoud and Francesco Giannini and {Ten Berg}, Jurrien and Rudolf Tolsma and Peter Clemmensen and Debra Bernstein and Pierre Coste and Patrick Goldstein and Uwe Zeymer and Christian Hamm and Efthymios Deliargyris and Steg, {Philippe G}",

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year = "2017",

doi = "10.1177/2048872615598633",

language = "English",

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TY - JOUR

T1 - ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention

T2 - The EUROMAX ST-segment resolution substudy

AU - Van't Hof, Arnoud

AU - Giannini, Francesco

AU - Ten Berg, Jurrien

AU - Tolsma, Rudolf

AU - Clemmensen, Peter

AU - Bernstein, Debra

AU - Coste, Pierre

AU - Goldstein, Patrick

AU - Zeymer, Uwe

AU - Hamm, Christian

AU - Deliargyris, Efthymios

AU - Steg, Philippe G

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Myocardial reperfusion after primary percutaneous coronary intervention (PCI) can be assessed by the extent of post-procedural ST-segment resolution. The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trial compared pre-hospital bivalirudin and pre-hospital heparin or enoxaparin with or without GPIIb/IIIa inhibitors (GPIs) in primary PCI. This nested substudy was performed in centres routinely using pre-hospital GPI in order to compare the impact of randomized treatments on ST-resolution after primary PCI.METHODS: Residual cumulative ST-segment deviation on the single one hour post-procedure electrocardiogram (ECG) was assessed by an independent core laboratory and was the primary endpoint. It was calculated that 762 evaluable patients were needed to show non-inferiority (85% power, alpha 2.5%) between randomized treatments.RESULTS: A total of 871 participated with electrocardiographic data available in 824 patients (95%). Residual ST-segment deviation one hour after PCI was 3.8±4.9 mm versus 3.9±5.2 mm for bivalirudin and heparin+GPI, respectively (p=0.0019 for non-inferiority). Overall, there were no differences between randomized treatments in any measures of ST-segment resolution either before or after the index procedure.CONCLUSIONS: Pre-hospital treatment with bivalirudin is non-inferior to pre-hospital heparin + GPI with regard to residual ST-segment deviation or ST-segment resolution, reflecting comparable myocardial reperfusion with the two strategies.

AB - BACKGROUND: Myocardial reperfusion after primary percutaneous coronary intervention (PCI) can be assessed by the extent of post-procedural ST-segment resolution. The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trial compared pre-hospital bivalirudin and pre-hospital heparin or enoxaparin with or without GPIIb/IIIa inhibitors (GPIs) in primary PCI. This nested substudy was performed in centres routinely using pre-hospital GPI in order to compare the impact of randomized treatments on ST-resolution after primary PCI.METHODS: Residual cumulative ST-segment deviation on the single one hour post-procedure electrocardiogram (ECG) was assessed by an independent core laboratory and was the primary endpoint. It was calculated that 762 evaluable patients were needed to show non-inferiority (85% power, alpha 2.5%) between randomized treatments.RESULTS: A total of 871 participated with electrocardiographic data available in 824 patients (95%). Residual ST-segment deviation one hour after PCI was 3.8±4.9 mm versus 3.9±5.2 mm for bivalirudin and heparin+GPI, respectively (p=0.0019 for non-inferiority). Overall, there were no differences between randomized treatments in any measures of ST-segment resolution either before or after the index procedure.CONCLUSIONS: Pre-hospital treatment with bivalirudin is non-inferior to pre-hospital heparin + GPI with regard to residual ST-segment deviation or ST-segment resolution, reflecting comparable myocardial reperfusion with the two strategies.

U2 - 10.1177/2048872615598633

DO - 10.1177/2048872615598633

M3 - Journal article

C2 - 26250825

SN - 2048-8726

VL - 6

SP - 404

EP - 411

JO - European heart journal. Acute cardiovascular care

JF - European heart journal. Acute cardiovascular care

IS - 5

ER -