horizons –ami

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Harmonizing Outcomes with Harmonizing Outcomes with RevascularIZatiON and Stents (HORIZONS) RevascularIZatiON and Stents (HORIZONS) Trial Trial HORIZONS Trial HORIZONS Trial

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HORIZONS –AMI A Prospective, Multicenter Randomized Trial of Heparin Plus GPIIb/ IIIa Inhibitors vs. Bivalirudiin STEMI: Final 3-year results from the HORIZONS-AMI Trial. Stone GW et al. Lancet 2011: Published online June 13, DOI:10.1016/S0140-6736(11)60764-2. Background. - PowerPoint PPT Presentation

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Page 1: HORIZONS –AMI

Harmonizing Outcomes with RevascularIZatiON and Harmonizing Outcomes with RevascularIZatiON and Stents (HORIZONS) TrialStents (HORIZONS) Trial

Harmonizing Outcomes with RevascularIZatiON and Harmonizing Outcomes with RevascularIZatiON and Stents (HORIZONS) TrialStents (HORIZONS) Trial

HORIZONS TrialHORIZONS TrialHORIZONS TrialHORIZONS Trial

Page 2: HORIZONS –AMI

www. Clinical trial results.org

HORIZONS Trial: Study DesignHORIZONS Trial: Study DesignHORIZONS Trial: Study DesignHORIZONS Trial: Study Design

Antithrombotic TherapyAntithrombotic TherapyRandomized 1:1Randomized 1:1

Antithrombotic TherapyAntithrombotic TherapyRandomized 1:1Randomized 1:1

UFH + IIb/IIIa InhibitorUFH + IIb/IIIa Inhibitorn=1700n=1700

UFH + IIb/IIIa InhibitorUFH + IIb/IIIa Inhibitorn=1700n=1700

3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy 3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy then ~88% (3000) patients randomized 3:1 to target vessel stenting then ~88% (3000) patients randomized 3:1 to target vessel stenting

1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent 1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent randomized patients only, yearly follow-up for 5 years for all patients.randomized patients only, yearly follow-up for 5 years for all patients.

3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy 3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy then ~88% (3000) patients randomized 3:1 to target vessel stenting then ~88% (3000) patients randomized 3:1 to target vessel stenting

1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent 1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent randomized patients only, yearly follow-up for 5 years for all patients.randomized patients only, yearly follow-up for 5 years for all patients.

Presented at TCT 2005Presented at TCT 2005Presented at TCT 2005Presented at TCT 2005

Bivalirudin + Bail-Out IIb/IIIa InhibitorBivalirudin + Bail-Out IIb/IIIa Inhibitorn=1700n=1700

Bivalirudin + Bail-Out IIb/IIIa InhibitorBivalirudin + Bail-Out IIb/IIIa Inhibitorn=1700n=1700

Hypothesis 1: Bivalirudin compared to UFH + routine IIb/IIIa will reduce the Hypothesis 1: Bivalirudin compared to UFH + routine IIb/IIIa will reduce the composite rate of death, reinfarction, TVR, stroke, and major bleeding at 30 dayscomposite rate of death, reinfarction, TVR, stroke, and major bleeding at 30 days

Hypothesis 1: Bivalirudin compared to UFH + routine IIb/IIIa will reduce the Hypothesis 1: Bivalirudin compared to UFH + routine IIb/IIIa will reduce the composite rate of death, reinfarction, TVR, stroke, and major bleeding at 30 dayscomposite rate of death, reinfarction, TVR, stroke, and major bleeding at 30 days

Target Vessel Stenting to DES vs Target Vessel Stenting to DES vs BMS BMS Randomized 3:1Randomized 3:1

Target Vessel Stenting to DES vs Target Vessel Stenting to DES vs BMS BMS Randomized 3:1Randomized 3:1

Page 3: HORIZONS –AMI

www. Clinical trial results.org

HORIZONS Trial: Study DesignHORIZONS Trial: Study DesignHORIZONS Trial: Study DesignHORIZONS Trial: Study Design

Hypothesis 2: Use of polymer-based slow-release paclitaxel-eluting TAXUS stent Hypothesis 2: Use of polymer-based slow-release paclitaxel-eluting TAXUS stent will safely reduce the 1 year rate of ischemia-driven TLRwill safely reduce the 1 year rate of ischemia-driven TLR

Hypothesis 2: Use of polymer-based slow-release paclitaxel-eluting TAXUS stent Hypothesis 2: Use of polymer-based slow-release paclitaxel-eluting TAXUS stent will safely reduce the 1 year rate of ischemia-driven TLRwill safely reduce the 1 year rate of ischemia-driven TLR

Presented at TCT 2005Presented at TCT 2005Presented at TCT 2005Presented at TCT 2005

Target Vessel StentingTarget Vessel StentingRandomized 3:1Randomized 3:1

Target Vessel StentingTarget Vessel StentingRandomized 3:1Randomized 3:1

TAXUS stentTAXUS stentn=2250n=2250

TAXUS stentTAXUS stentn=2250n=2250

Bare metal Express stentBare metal Express stentn=750n=750

Bare metal Express stentBare metal Express stentn=750n=750

Antithrombotic TherapyAntithrombotic TherapyRandomized 1:1Randomized 1:1

Antithrombotic TherapyAntithrombotic TherapyRandomized 1:1Randomized 1:1

3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy 3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy then ~88% (3000) patients randomized 3:1 to target vessel stenting then ~88% (3000) patients randomized 3:1 to target vessel stenting

1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent 1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent randomized patients only, yearly follow-up for 5 years for all patients.randomized patients only, yearly follow-up for 5 years for all patients.

3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy 3400 patients undergoing primary PCI first randomized 1:1 to anti-thrombotic therapy then ~88% (3000) patients randomized 3:1 to target vessel stenting then ~88% (3000) patients randomized 3:1 to target vessel stenting

1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent 1, 6, and 12 month follow-up for all patients undergoing primary randomization, angiography at 13 months for 1500 stent randomized patients only, yearly follow-up for 5 years for all patients.randomized patients only, yearly follow-up for 5 years for all patients.