Giulio Guagliumi

DUAL ANTIPLATELET THERAPY AND LONG-TERM CLINICAL OUTCOMES AFTER PRIMARY PCI: THE HORIZONS-AMI TRIAL

To assess the association of dual antiplatelet therapy (DAPT) use and long-term clinical outcomes in patients undergoing primary stenting for ST-segment elevation myocardial infarction (STEMI).nnHORIZONS-AMI was a prospective, randomized trial of paclitaxel-eluting stents (PES) vs. bare metal stents

IMPACT OF HIGH DOSE ASPIRIN IN MEN VS. WOMEN AFTER ACUTE MYOCARDIAL INFARCTION: RESULTS FROM THE HORIZONS-AMI TRIAL

Absrac Caegory: 7. CI - Adjuc harmacologyreseao Number: 2536-631Auhors: Jennifer Yu, Roxana Mehran, Georgios Vlachojannis, Usman Baber, Ke Xu, Alexandra Lansky, Cindy Grines, Giulio Guagliumi, Ran Kornowski, Bernhard Witzenbichler, George Dangas, Gregg Stone, Mount Sinai Medical Center, New York, NY, USA, Cardiovascular Research Foundation, New York, NY, USABackground: revous sudes have show ha compared o me, wome are a creased rs o bleedg aer acue myocardal arco (MI). However, he assocao bewee varyg maeace doses o aspr (AA) ad raes o bleedg as well as adverse schemc eves me vs. wome has o bee vesgaed.Methods: We examed 3 year oucomes rom he HORION-AMI ral (=3602 TEMI ps udergog prmary CI wh AA ad clopdogrel) accordg o sex, ad hgh (>200mg/day) vs. low (≤200mg/day) AA dose a hospal dscharge.Results: O 2,1 hospal survvors who uderwe prmary CI ad were dscharged o low dose AA, 1,838 (76%) were male ad 576 (2%) emale. Amogs he 61 dscharged o hgh dose AA, 86 (79%) were male ad 128 (21%) were emale. Compared wh me, wome were older wh hgher prevalece o hypereso ad hyperlpdema boh subses o AA dosage, whle me were more lely o be smoers, ad have pror MI ad coroary revascularzao. 3 year oucomes are show he Table. Formal eraco esg o deerme he mpac o AA dosage o me vs. wome was o sgica (p=0.82).Conclusion: I boh subses o AA dosage, wome had hgher raes o major bleedg ha me up o 3 year ollow-up aer he al TEMI . The hghes raes o bleedg occurred wome prescrbed hgh dose AA. There were o sgica dereces schemc edpos amog he subses o AA dosage ad sex. These daa sugges he roue use o low dose AA me ad wome aer TEMI. 3 year pos-dscharge oucomes accordg o aspr dose ad gederVarable (3-year eve raes gve)Low dose AA Me (N=1838)Hgh dose AA Me (N=86)p-valueLow dose AA Wome (N=576)Hgh dose AA Wome (N=128)p-valueNe Adverse Clcal Eves 17.8% (317) 25.% (113) 0.000 18.7% (10) 28.5% (3) 0.009MACE 17.3% (308) 23.2% (103) 0.006 17.2% (96) 2.2% (29) 0.06Moraly .3% (75) 5.0% (22) 0.51 .3% (2) 6.9% (8) 0.22Rearco 5.7% (100) 8.3% (36) 0.06 5.0% (27) 8.6% (10) 0.08roe 1.3% (23) 1.6% (7) 0.66 1.1% (6) 3.3% () 0.06TVR or schema 11.0% (192) 1.% (63) 0.06 10.8% (59) 15.% (18) 0.12e hromboss* 3.1% (51) 5.5% (22) 0.02 2.5% (12) 5.0% (5) 0.1Major Bleedg (o-CABG relaed)1.3% (22) 5.3% (23) <0.0001 2.6% (1) 11.5% (13) <0.0001Major Bleedg (cl. CABG relaed)1.6% (28) 6.0% (26) <0.0001 2.9% (16) 13.0% (15) <0.0001*Deie or robable e Thromboss as per ARC deios. MACE = moraly, rearco, schemc TVR or sroe, TVR = arge vessel revascularzao.