PMID- 20636842
OWN - NLM
STAT- MEDLINE
DCOM- 20110621
LR  - 20161125
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 23
IP  - 3
DP  - 2010 Jun
TI  - Safety and efficacy of bivalirudin for percutaneous coronary intervention with 
      rotational atherectomy.
PG  - 223-9
LID - 10.1111/j.1540-8183.2010.00546.x [doi]
AB  - BACKGROUND: Although bivalirudin use in percutaneous coronary intervention (PCI) 
      results in less bleeding compared to unfractionated heparin (UFH) use, its safety 
      in patients undergoing rotational atherectomy (RA) is unknown. METHODS: A cohort 
      of 503 patients who underwent PCI with RA from 2000 to 2009 was studied. Patients 
      receiving bivalirudin (n = 322) were compared to those (n = 181) treated with UFH 
      +/- glycoprotein IIb/IIIa inhibitor (GPI) as PCI anticoagulation. Safety was 
      assessed by the frequency of major bleeding (hematocrit drop > or =15%, 
      intracerebral or gastro-intestinal bleeding) and need for transfusion. Efficacy 
      was assessed by a composite end-point of in-hospital death, Q wave myocardial 
      infarction (MI) or urgent coronary artery bypass graft (CABG). RESULTS: Those in 
      the bivalirudin group were older, more hypertensive, and had greater body mass 
      index. The UFH group was more likely to have prior MI, prior CABG, and an acute 
      coronary syndrome at baseline. GPI was used in 93 patients (52%) of the UFH 
      group. No difference was found between groups for the composite of death/Q wave 
      MI/urgent CABG (1.9% vs. 1.7%, respectively, in bivalirudin vs. UFH group; P = 
      0.2). The frequency of major bleeding (2.2% vs. 1.7%; P = 0.8) or transfusion 
      (5.6% vs. 8.7%; P = 0.9) was also similar between groups. After adjustment, 
      bivalirudin use was not associated with a reduction in death/Q wave MI/urgent 
      CABG, major bleeding, or transfusion compared to UFH. CONCLUSION: Bivalirudin use 
      seems to be as safe and effective as UFH in patients undergoing RA.
FAU - Delhaye, Cedric
AU  - Delhaye C
AD  - Department of Internal Medicine, Division of Cardiology, Washington Hospital 
      Center, Washington, DC 20010, USA.
FAU - Wakabayashi, Kohei
AU  - Wakabayashi K
FAU - Maluenda, Gabriel
AU  - Maluenda G
FAU - Ben-Dor, Itsik
AU  - Ben-Dor I
FAU - Torguson, Rebecca
AU  - Torguson R
FAU - Xue, Zhenyi
AU  - Xue Z
FAU - Suddath, William O
AU  - Suddath WO
FAU - Satler, Lowell F
AU  - Satler LF
FAU - Pichard, Augusto D
AU  - Pichard AD
FAU - Kent, Kenneth M
AU  - Kent KM
FAU - Lindsay, Joseph
AU  - Lindsay J
FAU - Waksman, Ron
AU  - Waksman R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
CIN - J Interv Cardiol. 2010 Jun;23(3):230-2. PMID: 20636843
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Atherectomy, Coronary/*adverse effects/statistics & numerical data
MH  - Body Mass Index
MH  - Cohort Studies
MH  - Confidence Intervals
MH  - Coronary Artery Disease/*drug therapy/therapy
MH  - District of Columbia
MH  - Female
MH  - Gastrointestinal Hemorrhage/chemically induced
MH  - Hematocrit
MH  - Heparin/therapeutic use
MH  - Hirudins/adverse effects
MH  - Humans
MH  - Intracranial Hemorrhages/chemically induced
MH  - Male
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Peptide Fragments/adverse effects/*therapeutic use
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Propensity Score
MH  - Recombinant Proteins/adverse effects/therapeutic use
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stents
EDAT- 2010/07/20 06:00
MHDA- 2011/06/22 06:00
CRDT- 2010/07/20 06:00
PHST- 2010/07/20 06:00 [entrez]
PHST- 2010/07/20 06:00 [pubmed]
PHST- 2011/06/22 06:00 [medline]
AID - JOIC546 [pii]
AID - 10.1111/j.1540-8183.2010.00546.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2010 Jun;23(3):223-9. doi: 10.1111/j.1540-8183.2010.00546.x.