Impact of Chronic Kidney Disease on Early (30-Day) and Late (1-Year) Outcomes of Patients With Acute Coronary Syndromes Treated With Alternative Antithrombotic Treatment StrategiesAn ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) Substudy
Roxana Mehran, MD*,*,
Eugenia Nikolsky, MD, PhD*,
Alexandra J. Lansky, MD*,
Ajay J. Kirtane, MD, SM*,
Young-Hak Kim, MD*,
Frederick Feit, MD ,
Steven Manoukian, MD ,
Jeffrey W. Moses, MD*,
Ramin Ebrahimi, MD ,
E. Magnus Ohman, MD||,
Harvey D. White, MD¶,
Stuart J. Pocock, PhD#,
George D. Dangas, MD, PhD*,
Gregg W. Stone, MD*
* Columbia University Medical Center and the Cardiovascular Research Foundation, New York, New York
New York University School of Medicine, New York, New York
The Sarah Cannon Research Institute and The Centennial Heart Center, Nashville, Tennessee
Department of Medicine, University of California Los Angeles, Los Angeles, California
|| Department of Medicine, Duke University School of Medicine, Durham, North Carolina
¶ Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
# London School of Hygiene and Tropical Medicine, London, United Kingdom
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Figure 1 Enrollment and Randomization of the Patients in the ACUITY Trial
Patient flow in the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial: enrollment, stratification based on baseline creatinine clearance (CrCl), and randomization to 1 of 3 antithrombotic regimens (heparin plus a glycoprotein IIb/IIIa inhibitor [GPI], bivalirudin plus a GPI, or bivalirudin monotherapy with the provisional [bail-out] use of GPIs).
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Figure 2 Ischemic Outcomes by Treatment Arm at 1 Year
One-year clinical outcomes by treatment group in renally impaired patients displayed as hazard ratio (HR) (solid boxes) with 95% confidence intervals (CIs) (horizontal limit lines). GPI = glycoprotein IIb/IIIa inhibitor.
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Figure 3 Multivariable Predictors of Major Bleeding at 30 Days
Multivariable analysis of the factors associated with 30-day major bleeding among patients with renal insufficiency, displayed as odds ratio (OR) (solid boxes) with 95% confidence intervals (CIs) (horizontal limit lines). ECG = electrocardiogram; GPI = glycoprotein IIb/IIIa inhibitor.
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