PMID- 21487123
OWN - NLM
STAT- MEDLINE
DCOM- 20111013
LR  - 20161125
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 97
IP  - 18
DP  - 2011 Sep
TI  - Unfractionated heparin administration in patients treated with bivalirudin during 
      primary percutaneous coronary intervention is associated lower mortality and 
      target lesion thrombosis: a report from the Swedish Coronary Angiography and 
      Angioplasty Registry (SCAAR).
PG  - 1484-8
LID - 10.1136/hrt.2011.224709 [doi]
AB  - BACKGROUND: Bivalirudin reduces bleeding events and is associated with a lower 
      mortality than the combination of unfractionated heparin (UFH) and glycoprotein 
      IIb/IIIa inhibitor during primary percutaneous coronary intervention (PCI). 
      However, the effect of adding UFH in patients with ST elevation myocardial 
      infarction (STEMI) treated with bivalirudin during primary PCI is unknown. 
      METHODS: Patients enrolled in the national Swedish Coronary Angiography and 
      Angioplasty Registry who underwent primary PCI due to STEMI with bivalirudin as 
      anticoagulant were evaluated. Patients were divided into two groups: those 
      treated with bivalirudin only and those treated with bivalirudin plus a bolus 
      dose of UFH. RESULTS: 2996 patients were included in the study: 1928 (64%) 
      received only bivalirudin and 1068 (36%) received bivalirudin plus a bolus dose 
      of UFH. The primary combined endpoint of death or target lesion thrombosis at 30 
      days occurred more often in the bivalirudin group (11.3% vs 6.5%, OR 0.55, 95% CI 
      0.41 to 0.72, p<0.001). This difference remained significant after adjustment (HR 
      0.64, 95% CI 0.44 to 0.95, p=0.03). Death at 30 days and definite target lesion 
      thrombosis at 30 days did not differ between the two groups after adjustment 
      (9.2% vs 5.1%, adjusted HR 0.66, 95% CI 0.42 to 1.03, p=0.07 and 2.3% vs 1.5%, 
      adjusted HR 0.59, 95% CI 0.27 to 1.33, p=0.21, respectively). CONCLUSION: An 
      additional bolus dose of UFH is associated with a lower rate of death or definite 
      target lesion thrombosis at 30 days in patients undergoing primary PCI with 
      bivalirudin as anticoagulant.
FAU - Koutouzis, Michael
AU  - Koutouzis M
AD  - Department of Cardiology, Sahlgrenska University Hospital, 4 Bruna straket, 41345 
      Gothenburg, Sweden. koutouzismike@yahoo.gr
FAU - Lagerqvist, Bo
AU  - Lagerqvist B
FAU - James, Stefan
AU  - James S
FAU - Omerovic, Elmir
AU  - Omerovic E
FAU - Matejka, Goran
AU  - Matejka G
FAU - Grip, Lars
AU  - Grip L
FAU - Albertsson, Per
AU  - Albertsson P
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20110412
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Glycoprotein GPIb-IX Complex)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
CIN - Heart. 2011 Sep;97(18):1459-60. PMID: 21708817
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/*administration & dosage
MH  - Antithrombins/*administration & dosage
MH  - Coronary Angiography
MH  - Coronary Thrombosis/*prevention & control
MH  - Drug Therapy, Combination
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Hirudins/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*therapy
MH  - Peptide Fragments/*administration & dosage
MH  - Platelet Glycoprotein GPIb-IX Complex/antagonists & inhibitors
MH  - Recombinant Proteins/administration & dosage
EDAT- 2011/04/14 06:00
MHDA- 2011/10/14 06:00
CRDT- 2011/04/14 06:00
PHST- 2011/04/14 06:00 [entrez]
PHST- 2011/04/14 06:00 [pubmed]
PHST- 2011/10/14 06:00 [medline]
AID - hrt.2011.224709 [pii]
AID - 10.1136/hrt.2011.224709 [doi]
PST - ppublish
SO  - Heart. 2011 Sep;97(18):1484-8. doi: 10.1136/hrt.2011.224709. Epub 2011 Apr 12.