{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:18:22Z","timestamp":1762917502941},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,3,14]],"date-time":"2014-03-14T00:00:00Z","timestamp":1394755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Primary percutaneous coronary intervention (<jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>) is the preferred reperfusion strategy for patients with <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\u2010segment elevation myocardial infarction (<jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>). Effective and safe adjunct antithrombotic therapy is a major determinant for short\u2010 and long\u2010term outcomes after primary <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>. Two separate studies have shown significant benefits vs conventional therapy for 2 recently approved drugs. In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (<jats:styled-content style=\"fixed-case\">HORIZONS\u2010AMI<\/jats:styled-content>) trial, bivalirudin after pretreatment with clopidogrel resulted in improved net clinical outcome compared with heparin plus glycoprotein <jats:styled-content style=\"fixed-case\">IIb<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IIIa<\/jats:styled-content> inhibitors. However, during the first 24\u2009hours after <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>, there was an increase in stent thrombosis rates with bivalirudin. In the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel\u2014Thrombolysis In Myocardial Infarction (<jats:styled-content style=\"fixed-case\">TRITON\u2010TIMI<\/jats:styled-content>) 38 trial, prasugrel was superior to clopidogrel in patients with acute coronary syndrome with and without <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\u2010segment elevation. The synergic actions of prasugrel and bivalirudin may maximize the benefit of antithrombotic therapy for <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content> patients undergoing primary <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>. However, no specifically designed studies have so far compared the combination of prasugrel plus bivalirudin with that of clopidogrel plus unfractionated heparin in these patients. The Bavarian Reperfusion Alternatives Evaluation (<jats:styled-content style=\"fixed-case\">BRAVE<\/jats:styled-content>) 4 study is a randomized, open\u2010label, multicenter trial aimed to test the hypothesis that a strategy based on prasugrel plus bivalirudin is superior to a strategy based on clopidogrel plus unfractionated heparin in terms of net clinical outcome in <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content> patients with planned primary <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>.<\/jats:p>","DOI":"10.1002\/clc.22268","type":"journal-article","created":{"date-parts":[[2014,3,14]],"date-time":"2014-03-14T22:52:40Z","timestamp":1394837560000},"page":"270-276","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of Prasugrel and Bivalirudin vs Clopidogrel and Heparin in Patients With <scp>ST<\/scp>\u2010Segment Elevation Myocardial Infarction: Design and Rationale of the Bavarian Reperfusion Alternatives Evaluation (<scp>BRAVE<\/scp>) 4 Trial"],"prefix":"10.1002","volume":"37","author":[{"given":"Stefanie","family":"Schulz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gert","family":"Richardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl\u2010Ludwig","family":"Laugwitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony H.","family":"Gershlick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Morath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Neudecker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"T\u00f6lg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tareq","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter","family":"Hauschke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Braun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heribert","family":"Schunkert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Kastrati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julinda","family":"Mehilli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Bavarian Reperfusion Alternatives Evaluation (BRAVE) 4 Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs289"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604253341702"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.2.215"},{"key":"e_1_2_7_5_1","first-page":"339","article-title":"Stent Anticoagulation Restenosis Study Investigators. 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