{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:13:41Z","timestamp":1780485221796,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,10,28]],"date-time":"2014-10-28T00:00:00Z","timestamp":1414454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,2,15]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the relationship of femoral vascular closure device (VCD) use to bleeding and ischemic events in patients undergoing primary percutaneous coronary intervention (PCI) for ST\u2010segment elevation myocardial infarction (STEMI) via different anticoagulation strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>It is unknown whether femoral VCD reduce major bleeding after primary PCI for STEMI using bivalirudin anticoagulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared VCD\u2010treated patients with propensity\u2010matched controls in the HORIZONS\u2010AMI trial with respect to net adverse clinical events (NACE), defined as the composite of major bleeding unrelated to coronary artery bypass graft surgery (CABG) and major adverse cardiac events (comprised of death, reinfarction, ischemia\u2010driven target vessel revascularization, and stroke), at 30 days and 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 3,602 patients enrolled in HORIZONS\u2010AMI, 2,948 underwent primary PCI via femoral arterial access and 896 (30%) received VCDs, of whom 642 were included in our model along with 642 propensity\u2010matched controls. At 30 days, VCD\u2010treated patients had significantly less NACE (6.7% vs. 10.8%, HR: 0.61, 95% CI: 0.42\u20130.89, <jats:italic>P<\/jats:italic>\u2009=\u20090.009), driven by a lower rate of non\u2010CABG related major bleeding (5.0% vs. 8.1%, HR: 0.61, 95% CI: 0.39\u20130.94, <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Bleeding reduction was maintained at one year and consistent in magnitude regardless of randomization to bivalirudin or unfractionated heparin plus a glycoprotein IIb\/IIIa inhibitor (<jats:italic>P<\/jats:italic> for interaction\u2009=\u20090.84).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients undergoing transfemoral primary PCI for STEMI, VCD use was associated with significantly lower non\u2010CABG major bleeding irrespective of anticoagulation strategy. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25663","type":"journal-article","created":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T16:33:42Z","timestamp":1409589222000},"page":"371-379","source":"Crossref","is-referenced-by-count":13,"title":["Femoral vascular closure device use, bivalirudin anticoagulation, and bleeding after primary angioplasty for STEMI: Results from the <scp>HORIZONS<\/scp>\u2010<scp>AMI<\/scp> trial"],"prefix":"10.1002","volume":"85","author":[{"given":"Timothy A.","family":"Sanborn","sequence":"first","affiliation":[{"name":"NorthShore University HealthSystem  Evanston Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew I.","family":"Tomey","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai New York New York"},{"name":"Cardiovascular Research Foundation New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"G\u00e9n\u00e9reux","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York New York"},{"name":"Columbia University Medical Center New York New York"},{"name":"H\u00f4pital du Sacr\u00e9\u2010Coeur de Montr\u00e9al Montr\u00e9al 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York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Kornowski","sequence":"additional","affiliation":[{"name":"Rabin Medical Center  Petach\u2010Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Dudek","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Jagiellonian University Medical College Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Nikolsky","sequence":"additional","affiliation":[{"name":"Rambam Health Care Campus and the Technion \u2013 Israel Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York New York"},{"name":"Columbia University Medical Center New York New 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