PMID- 23102380
OWN - NLM
STAT- MEDLINE
DCOM- 20130708
LR  - 20220318
IS  - 0019-4832 (Print)
IS  - 0019-4832 (Linking)
VI  - 64
IP  - 5
DP  - 2012 Sep-Oct
TI  - Safety and efficacy of bivalirudin with glycoprotein IIb/IIIa for high-risk 
      percutaneous coronary intervention.
PG  - 444-8
LID - S0019-4832(12)00098-3 [pii]
LID - 10.1016/j.ihj.2012.07.022 [doi]
AB  - AIMS: The aim of the study was to assess the safety and efficacy of bivalirudin + 
      glycoprotein (Gp) IIb/IIIa inhibitor as compared to unfractionated heparin (UFH) 
      + Gp IIb/IIIa inhibitor in high risk patients undergoing elective percutaneous 
      coronary intervention (PCI). The primary end point was time to sheath removal and 
      ambulation where as peri-procedure myocardial damage, access site bleeding and 
      major adverse cardiac events (MACE) rates were secondary end points. METHODS: One 
      hundred and one high risk patients undergoing elective PCI were randomly assigned 
      to either bivalirudin + GpIIb/IIIa inhibitor or UFH + Gp IIb/IIIa inhibitor. PCI 
      was performed by standard technique and activated clotting time was monitored 
      immediately on arrival to recovery area and every 60 min thereafter. Sheath were 
      pulled out once ACT was below 150 seconds and patients were mobilized 6hrs after 
      sheath were removed. Peri-procedure myocardial damage was assessed by serial Trop 
      I levels. RESULTS: Patient assigned to bivalirudin + tirofiban has significantly 
      reduced time to sheath removal and ambulation as compared to those who received 
      UFH + tirofiban (p < 0.0001) although peak Act did not differ in the groups. Peak 
      Trop I levels were significantly lower in bivalirudin + tirofiban group (p = 
      0.023) and peri-procedure Trop I elevation occurred in significantly lower number 
      of patients treated with bivalirudin + tirofiban (p = 0.029). CONCLUSIONS: The 
      combination of bivalirudin + tirofiban was safe and effective as compared to UFH 
      + tirofiban in high risk patients undergoing elective PCI.
CI  - Copyright (c) 2012 Cardiological Society of India. All rights reserved.
FAU - Deshpande, Niteen V
AU  - Deshpande NV
AD  - Spandan Heart Institute and Research Center, Nagpur, Maharashtra, India.
FAU - Pratiti, Rebecca
AU  - Pratiti R
FAU - Admane, Parag
AU  - Admane P
FAU - Mukherjee, Debabrata
AU  - Mukherjee D
FAU - Mardikar, Harshawardhan M
AU  - Mardikar HM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20120727
PL  - India
TA  - Indian Heart J
JT  - Indian heart journal
JID - 0374675
RN  - 0 (Antithrombins)
RN  - 0 (Biomarkers)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Recombinant Proteins)
RN  - 0 (Troponin I)
RN  - 42HK56048U (Tyrosine)
RN  - 9005-49-6 (Heparin)
RN  - GGX234SI5H (Tirofiban)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Aged
MH  - Antithrombins/adverse effects/*therapeutic use
MH  - Biomarkers/blood
MH  - Coronary Thrombosis/blood/etiology/*prevention & control
MH  - Drug Therapy, Combination
MH  - Female
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - Hemorrhage/chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hirudins/adverse effects
MH  - Humans
MH  - India
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/blood/etiology/prevention & control
MH  - Peptide Fragments/adverse effects/*therapeutic use
MH  - Percutaneous Coronary Intervention/*adverse effects
MH  - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Recombinant Proteins/adverse effects/therapeutic use
MH  - Time Factors
MH  - Tirofiban
MH  - Treatment Outcome
MH  - Troponin I/blood
MH  - Tyrosine/adverse effects/*analogs & derivatives/therapeutic use
MH  - Whole Blood Coagulation Time
PMC - PMC3860907
EDAT- 2012/10/30 06:00
MHDA- 2013/07/09 06:00
PMCR- 2012/09/01
CRDT- 2012/10/30 06:00
PHST- 2012/04/24 00:00 [received]
PHST- 2012/06/18 00:00 [revised]
PHST- 2012/07/17 00:00 [accepted]
PHST- 2012/10/30 06:00 [entrez]
PHST- 2012/10/30 06:00 [pubmed]
PHST- 2013/07/09 06:00 [medline]
PHST- 2012/09/01 00:00 [pmc-release]
AID - S0019-4832(12)00098-3 [pii]
AID - 10.1016/j.ihj.2012.07.022 [doi]
PST - ppublish
SO  - Indian Heart J. 2012 Sep-Oct;64(5):444-8. doi: 10.1016/j.ihj.2012.07.022. Epub 
      2012 Jul 27.