Impact of advanced age on the safety and effectiveness of bivalirudin in patients with acute myocardial infarction undergoing primary angioplasty: The HORIZONS AMI trial Dariusz Dudek, Krzyszto Zmudka, Bernhard Witzenbichler, Giulio Guagliumi, Jan Z. Peruga, Bruce R. Brodie, Ran Kornowski, Franz Hartmann, Martin Mockel, Andrzej Ochala, Helen Parise, Roxana Mehran, Gregg W. Stone

Methods A total of 3602 patients at 123 centers in 11 countries with AMI undergoing primary PCI were randomized to bivalirudin monotherapy or unfractionated heparin plus glycoprotein IIb/IIIa inhibitors. Outcomes were analyzed according to age above or below the median of 60.2 years: Bivalirudin (n=1800) age ≤60.2 years (n=923) age >60.2 years (n=877) UFH+GPI (n=1802) age ≤60.2 years (n=885) age >60.2 years (n=917) Dudek et al ACC 2008

Outcomes, Age ≤ 60.2 years *P<0.05 P=0.168 P=0.0012* P=0.354 Dudek et al ACC 2008

Outcomes, Age > 60.2 years P=0.156 P=0.013* P=0.512 P=0.033* *P<0.05 Dudek et al ACC 2008

Conclusions In patients with AMI undergoing primary PCI, bivalirudin monotherapy significantly reduces major bleeding and net adverse clinical events, effects which are independent of age. Dudek et al ACC 2008