PMID- 23972537
OWN - NLM
STAT- MEDLINE
DCOM- 20140422
LR  - 20181202
IS  - 1878-0938 (Electronic)
IS  - 1878-0938 (Linking)
VI  - 14
IP  - 5
DP  - 2013 Sep-Oct
TI  - Comparison of bivalirudin with heparin versus abciximab with heparin for primary 
      percutaneous coronary intervention in "Real World" practice.
PG  - 289-93
LID - S1553-8389(13)00114-0 [pii]
LID - 10.1016/j.carrev.2013.07.006 [doi]
AB  - OBJECTIVE: We aimed to carry out a "real world" comparison of bivalirudin plus 
      unfractionated heparin (UFH) versus abciximab plus UFH in patients undergoing 
      primary percutaneous coronary intervention (PPCI) for ST elevation myocardial 
      infarction (STEMI). METHODS: We included patients who had abciximab or 
      bivalirudin during their PPCI in our unit between Sept 2009 and Nov 2011. 
      RESULTS: The study included 516 and 484 patients in the bivalirudin and abciximab 
      group respectively. There were more women in the bivalirudin group (29% vs 20%, p 
      0.001), while cardiogenic shock (6.4% vs 10.1%, p 0.04) and thrombectomy device 
      use (76.6% vs 82%, p 0.04) were lower in the bivalirudin group. The primary 
      composite end point of 30-day mortality, 30-day definite stent thrombosis or 
      non-CABG major bleeding was similar between the bivalirudin and abciximab groups 
      (7.8% vs 9.5%, OR 0.8, 95% CI 0.5 to 1.2, p 0.4). There was also no difference in 
      in-hospital mortality (4.1% vs 4.3%, p 0.9), 30-day mortality (5.2% vs 6.4%, p 
      0.5), 1-year mortality (9.1% vs 9.9%, p 0.7), 30-day stent thrombosis (1% vs 
      0.4%, p 0.5) and non-CABG bleeding (2.7 vs 3.7%, p 0.4) between the bivalirudin 
      and abciximab group respectively. On Cox proportional hazard analysis after 
      adjusting for all the co-variates, the use of bivalirudin was not a predictor of 
      30-day mortality (HR 1.13, 95% CI 0.7-1.9, p 0.7). CONCLUSION: In this 
      "real-world" observational study, there was no significant difference in the 
      clinical outcome of PPCI for patients who had abciximab or bivalirudin after 
      initial pre-treatment with UFH.
CI  - (c) 2013.
FAU - Showkathali, Refai
AU  - Showkathali R
AD  - Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, United 
      Kingdom. Electronic address: refais@gmail.com.
FAU - Davies, John R
AU  - Davies JR
FAU - Parker, Michael
AU  - Parker M
FAU - Taggu, Wasing
AU  - Taggu W
FAU - Tang, Kare H
AU  - Tang KH
FAU - Clesham, Gerald J
AU  - Clesham GJ
FAU - Gamma, Reto A
AU  - Gamma RA
FAU - Sayer, Jeremy W
AU  - Sayer JW
FAU - Aggarwal, Rajesh K
AU  - Aggarwal RK
FAU - Kelly, Paul A
AU  - Kelly PA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20130822
PL  - United States
TA  - Cardiovasc Revasc Med
JT  - Cardiovascular revascularization medicine : including molecular interventions
JID - 101238551
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Immunoglobulin Fab Fragments)
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)
RN  - X85G7936GV (Abciximab)
SB  - IM
MH  - Abciximab
MH  - Aged
MH  - Antibodies, Monoclonal/adverse effects/*therapeutic use
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Antithrombins/adverse effects/*therapeutic use
MH  - Coronary Thrombosis/etiology/mortality/*prevention & control
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hirudins/adverse effects
MH  - Hospital Mortality
MH  - Humans
MH  - Immunoglobulin Fab Fragments/adverse effects/*therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/blood/diagnosis/mortality/*therapy
MH  - Peptide Fragments/adverse effects/*therapeutic use
MH  - *Percutaneous Coronary Intervention/adverse effects/mortality
MH  - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors/metabolism
MH  - Proportional Hazards Models
MH  - Recombinant Proteins/adverse effects/therapeutic use
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adjunctive therapy
OT  - GP2b3a inhibitor
OT  - HORIZONS-AMI
OT  - STEMI
EDAT- 2013/08/27 06:00
MHDA- 2014/04/23 06:00
CRDT- 2013/08/27 06:00
PHST- 2013/04/30 00:00 [received]
PHST- 2013/07/06 00:00 [revised]
PHST- 2013/07/11 00:00 [accepted]
PHST- 2013/08/27 06:00 [entrez]
PHST- 2013/08/27 06:00 [pubmed]
PHST- 2014/04/23 06:00 [medline]
AID - S1553-8389(13)00114-0 [pii]
AID - 10.1016/j.carrev.2013.07.006 [doi]
PST - ppublish
SO  - Cardiovasc Revasc Med. 2013 Sep-Oct;14(5):289-93. doi: 
      10.1016/j.carrev.2013.07.006. Epub 2013 Aug 22.