Final 3 year results from the landmark HORIZONS-AMI trial published in the Lancet

June 13, 2011, Cardiovascular Research Foundation

Data from the landmark HORIZONS-AMI clinical trial demonstrated that the administration of the anticoagulant medication bivalirudin enhanced survival compared to the use of heparin plus a glycoprotein (GP) IIb/IIIa inhibitor in heart attack patients undergoing angioplasty after 3 years. Use of a drug-eluting stent (paclitaxel) was also shown to be more effective than a bare-metal stent, with equivalent safety. Final 3-year results of the trial were published in the June 13, 2011, issue of The Lancet.

After 3 years, treatment with bivalirudin alone compared to plus a GP IIb/IIIa inhibitor resulted in significantly reduced rates of all-cause mortality (5.9% vs. 7.7%), (2.9% vs. 5.1%), reinfarction (6.2% vs. 8.2%) and major bleeding not related to bypass (6.9% vs. 10.5%). There were no significant differences in the incidence of ischemia-driven target vessel revascularization, stent thrombosis, stroke, or composite adverse events.

In addition, at 3 years, the implantation of a paclitaxel-eluting stent compared to a bare-metal stent resulted in significantly lower rates of ischemia-driven target lesion revascularization (9.4% vs. 15.1%) with no significant differences in the rates of death, reinfarction, stroke, or stent thrombosis.

"The results at 3 years demonstrate that use of bivalirudin alone, as opposed to a combination of heparin and a GP IIb/IIIa inhibitor, can save lives. The reported reduction in all-cause mortality seen in the trial equates to 18 lives saved per 1,000 treated with bivalirudin," said Gregg W. Stone, MD, Professor of Medicine at Columbia University College of Physicians and Surgeons, Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center and Co-Director of the Medical Research and Education Division at the Cardiovascular Research Foundation (CRF). Dr. Stone is the principal investigator of the HORIZONS-AMI trial.

"Additionally, results of the trial showed that patients who received a paclitaxel-eluting stent had a 40% reduction in risk of ischemia-driven target lesion revascularization after 3 years compared with those patients given a bare-metal stent," Dr. Stone said.

While previous studies of drug-eluting stents have often focused on their use in patients with stable or unstable chest pain, this is the largest study to focus on the appropriate use of anticoagulation medications and drug-eluting stents in patients experiencing the most dangerous form of heart attack (ST-elevation myocardial infarction).

Sponsored by the Cardiovascular Research Foundation, with research grant support from Boston Scientific Corporation and The Medicines Company, the HORIZONS AMI (Harmonizing Outcomes with RevascularIZatiON and Stents in Acute Myocardial Infarction) trial enrolled 3,602 patients presenting with a to hospitals in 11 countries. More than 120 national and international interventional cardiology centers participated in the trial.

Three-year results of the trial were first reported at the 2010 Transcatheter Cardiovascular Therapeutics (TCT) annual scientific symposium, sponsored by CRF.

Related Stories

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.