acc2014 1
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Acc2014 1TRANSCRIPT
Date of preparation April 2014 │BRI001081
ACC.14Annual Scientific Sessions of the American College of Cardiology
Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
Disclaimer
• AstraZeneca abides by the Medicines Australia Code of Conduct (Edition 17) and AstraZeneca Global Policies, and as such will not engage in the promotion of unregistered products or unapproved indications.
• These highlights have been suggested by a group of cardiologists who attended ACC.14, compiled by an external medical writer and sponsored by AstraZeneca.
• Statements of fact and opinions expressed are those of the speakers individually and, unless expressly stated to the contrary, are not the opinion or position of AstraZeneca. AstraZeneca does not endorse or approve, and assumes no responsibility for, the content, accuracy, or completeness of the information presented. Presentations are intended for educational purposes only and do not replace independent professional judgement.
• Please refer to the appropriate approved Product Information before prescribing any agents mentioned in these highlights.
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
HEAT PPCI: Heparin vs bivalirudin in primary PCI
Commentary:
Professor David BriegerConcord Hospital, Sydney
Late-breaking trial
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
• HEAT PPCI reflects contemporary practice in terms of heparin dose rates, the selective use of abciximab, a high rate of radial access and a high proportion of patients treated with ticagrelor as the second antiplatelet agent.
• Bivalirudin was associated not only with an increase in the primary endpoint of MACE but in each of its components, especially reinfarction and target lesion revascularisation.
• HEAT PPCI can be interpreted as demonstrating the efficacy and safety of heparin, at a much lower cost than bivalirudin.
• HEAT PPCI reinforces concerns about an increased rate of stent thrombosis associated with bivalirudin.
Commentary: Professor David Brieger
Date of preparation April 2014 │BRI001081
ACC.14Washington DC
29-31 March 2014
• There was vigorous discussion by the panel at the ACC presentation about the ethics of seeking consent to use patients’ data after randomisation (‘delayed consent’), and whether the adjustments to the bivalirudin dose in response to ACT was adequate (it was used at the manufacturer’s recommended dose).
• The data add to a growing number of studies suggesting a lack of advantage of bivalirudin over heparin in contemporary practice.
Commentary: Professor David Brieger