PMID- 28044990
OWN - NLM
STAT- MEDLINE
DCOM- 20171101
LR  - 20180402
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 12
IP  - 16
DP  - 2017 Mar 20
TI  - Unfractionated heparin versus bivalirudin in patients undergoing primary 
      percutaneous coronary intervention: a SWEDEHEART study.
PG  - 2009-2017
LID - EIJ-D-16-00884 [pii]
LID - 10.4244/EIJ-D-16-00884 [doi]
AB  - AIMS: The aim of the study was to compare outcomes in unfractionated heparin 
      (UFH) and bivalirudin-treated patients undergoing primary percutaneous coronary 
      intervention (PPCI). METHODS AND RESULTS: This observational study contained 
      20,612 PPCI patients treated with either UFH monotherapy or bivalirudin with or 
      without concomitant UFH. Patients with oral anticoagulant or glycoprotein 
      IIb/IIIa inhibitor (GPI) treatment were excluded. The primary outcome measure was 
      definite early stent thrombosis (ST) that occurred at low and similar rates in 
      UFH only and bivalirudin-treated patients: 0.9% vs. 0.8% (adjusted hazard ratio 
      [HR] 1.08, 95% confidence interval [CI]: 0.7-1.65). All-cause death at 30 days 
      occurred in 6.9% vs. 5.4% of patients (adjusted HR 1.23, 95% CI: 1.05-1.44) and 
      within 365 days in 12.1% vs. 8.9% (adjusted HR 1.34, 95% CI: 1.19-1.52) in the 
      two groups, respectively. The incidence of major bleeding within 30 days was 0.8% 
      vs. 0.6% (adjusted HR 1.54, 95% CI: 0.97-2.45). The incidence of reinfarction 
      within 365 days and stroke within 30 days was similar between groups. 
      CONCLUSIONS: In this large, nationwide observational study we found low and 
      similar rates of early ST in UFH only and bivalirudin-treated patients undergoing 
      primary PCI. Mortality was higher in UFH compared with bivalirudin-treated 
      patients.
FAU - Grimfjard, Per
AU  - Grimfjard P
AD  - Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
FAU - Erlinge, David
AU  - Erlinge D
FAU - Koul, Sasha
AU  - Koul S
FAU - Lagerqvist, Bo
AU  - Lagerqvist B
FAU - Svennblad, Bodil
AU  - Svennblad B
FAU - Varenhorst, Christoph
AU  - Varenhorst C
FAU - James, Stefan K
AU  - James SK
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
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 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
CIN - EuroIntervention. 2017 Mar 20;12 (16):1930-1932. PMID: 28317787
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty, Balloon, Coronary/methods
MH  - Anticoagulants/*therapeutic use
MH  - Antithrombins/*therapeutic use
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/*therapeutic use
MH  - Hirudins
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/surgery
MH  - Peptide Fragments/*therapeutic use
MH  - *Percutaneous Coronary Intervention/methods
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/therapeutic use
MH  - Recombinant Proteins/therapeutic use
MH  - Treatment Outcome
EDAT- 2017/01/04 06:00
MHDA- 2017/11/02 06:00
CRDT- 2017/01/04 06:00
PHST- 2017/01/04 06:00 [pubmed]
PHST- 2017/11/02 06:00 [medline]
PHST- 2017/01/04 06:00 [entrez]
AID - EIJ-D-16-00884 [pii]
AID - 10.4244/EIJ-D-16-00884 [doi]
PST - ppublish
SO  - EuroIntervention. 2017 Mar 20;12(16):2009-2017. doi: 10.4244/EIJ-D-16-00884.