Skip Navigation



European Heart Journal Advance Access published online on October 7, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi590
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
26/22/2396    most recent
ehi590v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Sinnaeve, P. R.
Right arrow Articles by Granger, C. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sinnaeve, P. R.
Right arrow Articles by Granger, C. B.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received May 20, 2005
Revised September 15, 2005
Accepted September 22, 2005

Clinical research

Direct thrombin inhibitors in acute coronary syndromes: effect in patients undergoing early percutaneous coronary intervention

Peter R. Sinnaeve 1*, John Simes 2, Salim Yusuf 3, Jyotsna Garg 4, Shamir Mehta 3, John Eikelboom 5, John A. Bittl 6, Patrick Serruys 7, Eric J. Topol 8, and Christopher B. Granger 4

1 Duke Clinical Research Center, Durham, NC, USA; Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
2 NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
3 Department of Cardiology, Population Health Research Institute, McMaster University, Hamilton, Ont., Canada
4 Duke Clinical Research Center, Durham, NC, USA
5 Department of Medicine, McMaster University, Hamilton, Ont., Canada
6 Ocala Heart Institute, Munroe Regional Medical Center, Ocala, FL, USA
7 Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
8 Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, OH, USA

* To whom correspondence should be addressed.
Peter R. Sinnaeve, E-mail: peter.sinnaeve{at}uz.kuleuven.ac.be


  Abstract

Aims We evaluated the effect of direct thrombin inhibitors (DTIs) in patients undergoing early percutaneous coronary intervention (PCI), using the DTI Trialists' Collaboration database of 35 970 patients from 11 randomized trials of DTIs vs. heparin.

Methods and results We performed a Cox proportional hazards regression analysis with PCI as a time-dependent covariate to assess the independent impact of DTIs according to the performance of early PCI. PCI was performed in 7049 patients in the first 72 h after randomization. In trials in which PCI was not planned, DTIs were associated with a 10% relative risk reduction in death or myocardial infarction at 30 days (HR = 0.90, 95% CI: 0.84-0.97). This benefit was found to be greater in patients undergoing early PCI (HR = 0.66, 95% CI: 0.48-0.91) than those undergoing non-early PCI (HR = 0.94, 95% CI: 0.86-1.03). After adjustment for baseline characteristics and propensity to undergo PCI, the risk of death or myocardial infarction remained lower with DTI (HR = 0.62, 95% CI: 0.44-0.89).

Conclusion After adjustment for baseline differences and propensity to undergo early PCI, DTIs appeared to be more effective than heparin in reducing death or re-infarction among patients undergoing early PCI.

Keywords: Direct thrombin inhibitors; Percutaneous coronary intervention; Acute coronary syndromes.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
S. Bournazos, J. Rennie, S. P. Hart, K. A.A. Fox, and I. Dransfield
Monocyte Functional Responsiveness After PSGL-1-Mediated Platelet Adhesion Is Dependent on Platelet Activation Status
Arterioscler Thromb Vasc Biol, August 1, 2008; 28(8): 1491 - 1498.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. Schulman, R. J. Beyth, C. Kearon, and M. N. Levine
Hemorrhagic Complications of Anticoagulant and Thrombolytic Treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest, June 1, 2008; 133(6_suppl): 257S - 298S.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
E. Boersma
Direct thrombin inhibitors in acute coronary syndrome patients undergoing percutaneous coronary intervention: special effects in selected patients?
Eur. Heart J., November 2, 2005; 26(22): 2354 - 2355.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.