PMID- 25753749
OWN - NLM
STAT- MEDLINE
DCOM- 20160520
LR  - 20220408
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 86
IP  - 3
DP  - 2015 Sep
TI  - Comparison of heparin and bivalirudin in patients undergoing percutaneous 
      coronary intervention without use of glycoprotein IIb/IIIa inhibitors.
PG  - 390-6
LID - 10.1002/ccd.25911 [doi]
AB  - OBJECTIVES: The primary objective of this study is the compare the association 
      between bleeding and the use unfractionated heparin (UFH) versus bivalirudin 
      during percutaneous coronary intervention (PCI). BACKGROUND: In patients 
      undergoing PCI, the risk of bleeding with use of bivalirudin compared with UFH in 
      the absence of glycoprotein IIb/IIIa inhibitors is not well defined. METHODS: 
      Patients undergoing PCI with either UFH or bivalirudin monotherapy at a single 
      institution between 2007 and 2014 were included (n = 6,143). Propensity score 
      matching was used to adjust for baseline characteristics yielding 2,984 well 
      matched patients (1,492 in each group). The primary endpoint was major 
      non-coronary artery bypass graft (non-CABG) related bleeding as defined by a 
      Bleeding Academic Consortium type 3 or 5. Secondary outcomes included combined 
      major and minor bleeding, in-hospital death, periprocedural myocardial 
      infarction, and recurrent ischemia requiring urgent revascularization (repeat 
      PCI). RESULTS: In the propensity matched cohort, there was no difference in major 
      bleeding between UFH and bivalirudin monotherapy (1.8% versus 2.4%, P = 0.305). 
      Combined major and minor bleeding was also similar between the two groups (4.3% 
      versus 4.3%, P = 1.0). Likewise, no differences were observed between the 
      bivalirudin and UFH groups in terms of in-hospital death (0.4% versus 0.5%, 
      P = 0.592), periprocedural myocardial infarction (1.5% versus 2.0%, P = 0.332) 
      and repeat PCI (0.7% versus 0.8%, P = 0.669). CONCLUSION: Among patients 
      undergoing PCI, there was no significant difference in rate of bleeding between 
      bivalirudin and heparin monotherapy in a real-world setting.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Abtahian, Farhad
AU  - Abtahian F
AD  - Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 
      Boston, Massachuttes.
FAU - Waldo, Stephen
AU  - Waldo S
AD  - Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 
      Boston, Massachuttes.
FAU - Jang, Ik-Kyung
AU  - Jang IK
AD  - Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 
      Boston, Massachuttes.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20150330
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
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
CIN - Catheter Cardiovasc Interv. 2015 Sep;86(3):397-9. PMID: 26276232
MH  - Aged
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Antithrombins/adverse effects/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hemorrhage/*chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hirudins/adverse effects
MH  - Humans
MH  - Male
MH  - Peptide Fragments/adverse effects/*therapeutic use
MH  - *Percutaneous Coronary Intervention
MH  - Propensity Score
MH  - Recombinant Proteins/adverse effects/therapeutic use
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - anticoagulation
OT  - bleeding
EDAT- 2015/03/11 06:00
MHDA- 2016/05/21 06:00
CRDT- 2015/03/11 06:00
PHST- 2014/08/06 00:00 [received]
PHST- 2015/02/28 00:00 [accepted]
PHST- 2015/03/11 06:00 [entrez]
PHST- 2015/03/11 06:00 [pubmed]
PHST- 2016/05/21 06:00 [medline]
AID - 10.1002/ccd.25911 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2015 Sep;86(3):390-6. doi: 10.1002/ccd.25911. Epub 
      2015 Mar 30.