Effect of bivalirudin compared with unfractionated heparin plus abciximab on infarct size and myocardial recovery after primary percutaneous coronary intervention: The horizons-AMI CMRI substudy

Catheterization and Cardiovascular Interventions, 04/20/2012

In conclusion, in the HORIZONS–AMI Cardiac magnetic resonance imaging (CMRI) substudy, cardiac magnetic resonance imaging within 7 days and at 6 months after primary percutaneous coronary intervention (PCI) did not demonstrate significant differences in infarct size, MVO, LVEF, or LV volume indices in patients treated with bivalirudin compared with unfractionated heparin plus abciximab.

Methods

  • Cardiac magnetic resonance imaging was performed within 7 days and after 6 months in 51 randomized patients from a single center in HORIZONS–AMI trial (N = 28 bivalirudin, N = 23 heparin plus abciximab).
  • Infarct size, microvascular obstruction (MVO), left ventricular ejection fraction (LVEF), and LV end–diastolic and end–systolic volume indices were evaluated.

Results

  • Infarct size was not significantly different after treatment with bivalirudin compared with heparin plus abciximab either within 7 days (median 9.3% [interquartile range 4.9%, 26.6%] vs. 20.0% [5.9%, 28.2%], P = 0.28) or at 6 months 6.7% [3.8%, 20.0%] vs. 8.2% [1.8%, 16.5%], P = 0.73).
  • MVO was present in 28.6% versus 34.8% of patients respectively (P = 0.63).
  • LVEF and LV volume indices also did not significantly differ between the two groups at either time period, nor were differences in myocardial recovery evident.

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