PMID- 25138183
OWN - NLM
STAT- MEDLINE
DCOM- 20150611
LR  - 20161125
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 10
IP  - 4
DP  - 2014 Aug
TI  - Comparison of bivalirudin and heparin in patients undergoing rotational 
      atherectomy: a subanalysis of the randomised ROTAXUS trial.
PG  - 458-65
LID - EIJV10I4A79 [pii]
LID - 10.4244/EIJV10I4A79 [doi]
AB  - AIMS: Bivalirudin has emerged as a meaningful alternative to heparin in patients 
      undergoing percutaneous coronary intervention (PCI). To date, it is unclear 
      whether bivalirudin has advantages in patients undergoing rotational atherectomy 
      (RA). METHODS AND RESULTS: The current subgroup analysis of the ROTAXUS trial 
      compared patients receiving bivalirudin (n=129) to those receiving unfractionated 
      heparin (UFH) (n=111). Efficacy was assessed by the frequency of periprocedural 
      myocardial infarction (MI) and safety by the frequency of major access-site 
      bleeding (ASB). Baseline characteristics were similar. Periprocedural MI occurred 
      less frequently in the bivalirudin group (22% vs. 37.5%, p=0.02), while ASB did 
      not differ significantly (2.3% vs. 5.5%, p=0.20). This effect was larger in the 
      RA group, where bivalirudin significantly reduced periprocedural MI (15.7% vs. 
      38.7%, p=0.01) with a trend towards reduced major ASB (2.9% vs. 10.2%, p=0.09). 
      In the control group without RA, bivalirudin was not superior to UFH regarding 
      periprocedural MI (28.6% vs. 36.6%, p=0.42) and major ASB (1.7% vs. 1.7%, 
      p=0.99). CONCLUSIONS: This analysis suggests a differential benefit of 
      bivalirudin in patients treated with RA. Patients receiving bivalirudin during RA 
      showed significantly less periprocedural MI and fewer ASB compared to patients 
      treated with UFH.
FAU - Akin, Ibrahim
AU  - Akin I
AD  - Herzzentrum, Segeberger Kliniken GmbH, Bad Segeberg, Germany.
FAU - Khattab, Ahmed A
AU  - Khattab AA
FAU - Buttner, Heinz Joachim
AU  - Buttner HJ
FAU - Toelg, Ralph
AU  - Toelg R
FAU - Geist, Volker
AU  - Geist V
FAU - Neumann, Franz-Josef
AU  - Neumann FJ
FAU - Richardt, Gert
AU  - Richardt G
FAU - Abdel-Wahab, Mohamed
AU  - Abdel-Wahab M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Antithrombins/*therapeutic use
MH  - *Atherectomy, Coronary/methods
MH  - Coronary Artery Disease/therapy
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/*therapeutic use
MH  - Hirudins
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - Peptide Fragments/*therapeutic use
MH  - Percutaneous Coronary Intervention/methods
MH  - Recombinant Proteins/therapeutic use
MH  - Treatment Outcome
EDAT- 2014/08/21 06:00
MHDA- 2015/06/13 06:00
CRDT- 2014/08/21 06:00
PHST- 2014/08/21 06:00 [entrez]
PHST- 2014/08/21 06:00 [pubmed]
PHST- 2015/06/13 06:00 [medline]
AID - EIJV10I4A79 [pii]
AID - 10.4244/EIJV10I4A79 [doi]
PST - ppublish
SO  - EuroIntervention. 2014 Aug;10(4):458-65. doi: 10.4244/EIJV10I4A79.