TY - JOUR
T1 - Effect of clopidogrel pretreatment on ischemic complications of percutaneous coronary intervention among bivalirudin-treated patients (from the EVENT registry)
AU - Amin, Amit P.
AU - Kennedy, Kevin F.
AU - Pencina, Michael
AU - Berger, Peter
AU - Piana, Robert N.
AU - Lopez, John
AU - Kleiman, Neal
AU - Cohen, David J.
N1 - Funding Information:
Dr. Berger has served as a consultant to AstraZeneca, Wilmington, Delaware, Boehringer Ingelheim, Ridgefield, Connecticut, Eli Lilly, Indianapolis, Indiana/Daichi Sankyo, Parsippany, New Jersey, Medicure, Somerset, New Jersey, and Ortho McNeil, Titusville, New Jersey (each for less than $10,000) and has received research funding for Geisinger Clinic, Danville, Pennsylvania for studies for which he is the Principle Investigator from Thrombovision, Houston, Texas, Helena, Collierville, Tennessee, Accumetrics, San Diego, California, AstraZeneca, Wilmington, Delaware, Haemoscope, Niles, Illinois, the Medicines Company, Parsippany, New Jersey, and Corgenix/Aspirinworks, Broomfield, Colorado (all for more than $10,000). He owns equity in Lumen,Inc., Weston, Massachusetts (a company that is has an embolic protection device and aspiration catheter [greater than $10,000]). Dr. Lopez has served as a consultant for Philips, Andover, Massachusetts and Angioslide, Minneapolis, Minnesota. Dr. Kleiman has received research grants from Sanofi-Aventis , Bridgewater, New Jersey and serves on the advisory board for Eli Lilly, Indianapolis, Indiana. Dr. Cohen has received research grant support from Boston Scientific , Natick, Massachusetts, Eli Lilly , Indianapolis, Indiana/ Daichi Sankyo , Parsippany, New Jersey, Accumetrix , San Diego, California, BMS , New York, New York/ Sanofi , Bridgewater, New Jersey, Merck/Schering-Plough , Whitehouse Station, New Jersey, and Edwards Lifesciences , Irvine, California and has received consulting fees from Cordis, Bridgewater, New Jersey and Medtronic, Minneapolis, Minnesota and speaking honoraria from Eli Lilly, Indianapolis, Indiana and the Medicines Company, Parsippany, New Jersey.
Funding Information:
Funding for EVENT and its analysis was provided by grants from Millennium Pharmaceuticals and Schering Plough, Inc . Dr. Amin was funded, in part, by an award from the American Heart Association Pharmaceutical Round Table, Dallas, Texas and David and Stevie Spina, Wayland, Massachusetts.
PY - 2011/6/15
Y1 - 2011/6/15
N2 - Although clopidogrel pretreatment benefits patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes, these benefits are less well established among patients undergoing elective PCIin particular, when they are treated with the direct thrombin inhibitor, bivalirudin. We used data from the multicenter Evaluation of Drug Eluting stents and ischemic Events registry to assess the association between clopidogrel pretreatment and PCI-related complications among patients undergoing elective PCI with bivalirudin as the antithrombotic regimen. The primary end point was the composite of in-hospital death or myocardial infarction. From January 2005 and December 2007, 4,681 patients underwent elective PCI at 55 United States centers, and 1,913 (41%) received bivalirudin as the planned anticoagulant. Clopidogrel pretreatment was used in 923 patients (48%). The incidence of in-hospital death or myocardial infarction was similar among patients who did and did not receive clopidogrel pretreatment (5.5% vs 5.8%, p = 0.83). This result was unchanged in propensity-adjusted analyses (adjusted odds ratio for pretreatment 0.91, 95% confidence interval 0.60 to 1.39, p = 0.66). Also, no differences were seen in the in-hospital bleeding events (1.0% vs 1.0%, p = 0.94) or 1-year ischemic complications between the 2 treatment groups (7.5% vs 8.3%, p = 0.26). In conclusion, among unselected patients undergoing elective PCI with bivalirudin as the planned anticoagulant, clopidogrel pretreatment was common but was not associated with a reduced risk of ischemic complications.
AB - Although clopidogrel pretreatment benefits patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes, these benefits are less well established among patients undergoing elective PCIin particular, when they are treated with the direct thrombin inhibitor, bivalirudin. We used data from the multicenter Evaluation of Drug Eluting stents and ischemic Events registry to assess the association between clopidogrel pretreatment and PCI-related complications among patients undergoing elective PCI with bivalirudin as the antithrombotic regimen. The primary end point was the composite of in-hospital death or myocardial infarction. From January 2005 and December 2007, 4,681 patients underwent elective PCI at 55 United States centers, and 1,913 (41%) received bivalirudin as the planned anticoagulant. Clopidogrel pretreatment was used in 923 patients (48%). The incidence of in-hospital death or myocardial infarction was similar among patients who did and did not receive clopidogrel pretreatment (5.5% vs 5.8%, p = 0.83). This result was unchanged in propensity-adjusted analyses (adjusted odds ratio for pretreatment 0.91, 95% confidence interval 0.60 to 1.39, p = 0.66). Also, no differences were seen in the in-hospital bleeding events (1.0% vs 1.0%, p = 0.94) or 1-year ischemic complications between the 2 treatment groups (7.5% vs 8.3%, p = 0.26). In conclusion, among unselected patients undergoing elective PCI with bivalirudin as the planned anticoagulant, clopidogrel pretreatment was common but was not associated with a reduced risk of ischemic complications.
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U2 - 10.1016/j.amjcard.2011.02.331
DO - 10.1016/j.amjcard.2011.02.331
M3 - Article
C2 - 21640216
AN - SCOPUS:79957955953
VL - 107
SP - 1751
EP - 1756
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 12
ER -