AIM: Post-procedural anticoagulation (AC) for routine prophylaxis may be administered after primary percutaneous coronary intervention (PCI) in @entity583 ( @entity583 ), but the risks and benefits of this practice are uncertain. We therefore sought to assess the utility of routine post-procedural AC after primary PCI. METHODS AND RESULTS: @entity1 undergoing primary PCI in the Harmonizing Outcomes with Revascularization and Stents in Acute @entity583 (HORIZONS-AMI) trial were grouped according to whether they received post-PCI AC for routine prophylaxis. Outcomes were assessed using propensity-adjusted multivariable analysis. Among 2932 @entity1 in whom primary PCI for @entity583 was performed, 869 (29.6%) received post-PCI AC for routine prophylaxis (median duration four days) and 2063 (70.4%) received no post-PCI AC. Time from PCI to ambulation was similar in both groups (median 0.9 vs 1.0 days, p=0.40), although hospitalization was prolonged in @entity1 receiving AC for routine prophylaxis (median 6.0 vs 4.0 days, p<0.0001). After propensity-adjustment, @entity1 who received and did not receive AC for routine prophylaxis after PCI experienced similar rates of 30-day adverse @entity63 and major @entity548 events. @entity1150 or @entity1151 developed rarely (0.3%) within 30 days, and were not significantly reduced by use of post-PCI AC for routine prophylaxis. CONCLUSIONS: In this large-scale prospective study, use of post-procedural AC for routine prophylaxis was relatively common, and was not associated with improved clinical outcomes, although the duration of hospitalization was prolonged. These data suggest that post-PCI AC for routine prophylaxis may not provide benefit after successful primary PCI in @entity1 in whom early ambulation is likely.

Is routine post-procedural anticoagulation warranted after primary percutaneous coronary intervention in XXXX ? Insights from the HORIZONS-AMI trial.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity1151 :: ('MESH:D011655', 'Disease') :: ['pulmonary emboli'] @entity1150 :: ('MESH:D020246', 'Disease') :: ['Deep venous thrombosis'] @entity583 :: ('MESH:D009203', 'Disease') :: ['STEMI', 'Myocardial Infarction', 'ST-segment elevation myocardial infarction']
@entity583 :: (MESH:D009203,Disease) :: ['ST-segment elevation myocardial infarction']
