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Advanced Age, Antithrombotic Strategy, and Bleeding in Non–ST-Segment Elevation Acute Coronary Syndromes

Results From the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) Trial

Renato D. Lopes, MD, PhD^_*,_*, Karen P. Alexander, MD^_*, Steven V. Manoukian, MD, Michel E. Bertrand, MD, Frederick Feit, MD, Harvey D. White, MD^||, Charles V. Pollack, Jr, MD, MA^¶, James Hoekstra, MD^#, Bernard J. Gersh, MB, ChB, DPhil^_**, Gregg W. Stone, MD and E. Magnus Ohman, MD^_*

^_* Duke University Medical Center, Durham, North Carolina
The Sarah Cannon Research Institute and Centennial Heart Center, Nashville, Tennessee
Hopital Cardiologique, Lille, France
New York University School of Medicine, New York, New York
^|| Auckland City Hospital, Auckland, New Zealand
^¶ Pennsylvania Hospital, Philadelphia, Pennsylvania
^# Wake Forest University, Winston-Salem, North Carolina
^_** Mayo Clinic, Rochester, Minnesota
Columbia University Medical Center, and The Cardiovascular Research Foundation, New York, New York

View larger version (19K): [in this window] [in a new window] [Download PPT slide]   Figure 1 NNT With Bivalirudin Alone Versus Heparin Plus GP IIb/IIIa Inhibitors to Avoid 1 Non-CABG Major Bleeding Event Data shown by age group and antithrombotic strategy. (A) The number needed to treat (NNT) overall. (B) The NNT among percutaneous coronary intervention-treated patients. CABG = coronary artery bypass graft; GPI = glycoprotein inhibitor.

View larger version (18K): [in this window] [in a new window] [Download PPT slide]   Figure 2 NNT With Bivalirudin Alone Versus Heparin Plus GP IIb/IIIa Inhibitors to Avoid 1 Non-CABG Major Bleeding Event Among Patients Without Excess Dose Data shown by age group and antithrombotic strategy after excluding patients who received excess dose of antithrombotic therapies (n = 436) based on renal function. (A) The NNT overall. (B) The NNT among percutaneous coronary intervention-treated patients. Abbreviations as in Figure 1.

View larger version (20K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Mortality Rates Among Patients With and Without ACUITY Non-CABG Major Bleeding Data shown by age group. (A) Rates of 30-day mortality. (B) Rates of 1-year mortality. ACUITY = Acute Catheterization and Urgent Intervention Triage Strategy; other abbreviations as in Figure 1.