BACKGROUND: @entity34 ( @entity34 ) is a potential treatment for ST-segment elevation @entity583 @entity1 who are not able to achieve primary percutaneous intervention (PCI) within guideline-recommended time limits. The risk for @entity548 complications with @entity34 has not been studied in the setting of routine use of two selected @entity548 avoidance strategies (BAS): bivalirudin and vascular closure devices. METHODS: We analyzed a contemporary multicenter registry (2009-2013) of consecutive @entity1 undergoing PCI as part of a 10-hospital regional algorithm involving one PCI center and nine transfer centers: @entity34 for hospitals greater than 60   min (N=140), and primary PCI if less than 60-min travel time to the PCI center (N=346). We compared the risk for Harmonizing Outcomes With Revascularization and Stents in Acute @entity583 (HORIZONS) major @entity548 among @entity1 undergoing @entity34 versus primary PCI in the setting of routine use of selected BAS and determined the independent predictors of major @entity548 in the entire cohort. RESULTS: The @entity34 @entity1 had a median travel time of 103  49   min, were more frequently female, had a higher incidence of @entity177 , and had a lower frequency of @entity1455 compared with the primary PCI group. BAS were routine and similar in both groups. Rates of @entity204 , @entity64 , and @entity63 and major @entity548 outcomes were similar between the two groups, and the length of stay was shorter in the @entity34 group. Multivariate logistic models indicated that two independent predictors of major @entity548 were @entity1167 [odds ratio (OR)=3.89, 95% confidence interval (CI): 1.2-12.1, P=0.02] and bailout glycoprotein IIb/IIIa inhibitor utilization (OR=3.29, 95% CI: 1.1-9.6, P=0.03). The @entity34 strategy in conjunction with selected BAS did not predict major @entity548 (OR=2.1, 95% CI: 0.85-5.44, P=0.11). CONCLUSION: Bleeding and @entity63 rates were similar between the @entity34 and primary PCI strategies in the setting of routine use of selected BAS; further study on a broader range of BAS including the radial approach may be warranted. @entity1167 and bailout glycoprotein IIb/IIIa inhibitor, but not @entity34 in conjunction with selected BAS, are independent predictors of @entity548 risk in a regional ST-segment elevation @entity583 population.

A regional pharmacoinvasive PCI strategy incorporating selected XXXX avoidance strategies.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia', 'ischemic'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest', 'Cardiac arrest'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'Myocardial Infarction'] @entity1455 :: ('MESH:D012770', 'Disease') :: ['cardiogenic shock'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity34 :: ('MESH:D016609', 'Disease') :: ['PIT', 'Pharmacoinvasive therapy']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
