PMID- 29477790
OWN - NLM
STAT- MEDLINE
DCOM- 20190722
LR  - 20190722
IS  - 1878-0938 (Electronic)
IS  - 1878-0938 (Linking)
VI  - 19
IP  - 6
DP  - 2018 Sep
TI  - Bivalirudin versus unfractionated heparin in peripheral vascular interventions.
PG  - 695-699
LID - S1553-8389(18)30012-5 [pii]
LID - 10.1016/j.carrev.2018.01.010 [doi]
AB  - BACKGROUND: A number of studies suggest that bivalirudin (BIV) is associated with 
      similar efficacy but reduced bleeding when compared with unfractionated heparin 
      (UFH) in patients undergoing peripheral vascular interventions (PVI). METHODS: A 
      comprehensive literature search was conducted with the electronic databases 
      MEDLINE, EMBASE and CENTRAL. These were queried to identify studies comparing BIV 
      with UFH in PVI. Study endpoints included total bleeding events, major and minor 
      bleeding events and procedural success. Random-effects meta-analysis method was 
      used to pool endpoint odds ratios (OR) for both UFH and BIV with 95% confidence 
      intervals (CI). RESULTS: A total of 12,335 patients (70.6 years; 59.7% male) were 
      included from seven observational cohort studies (two prospective and five 
      retrospective) comparing outcomes between BIV and UFH during PVI between January 
      2000 and May 2017. Compared with BIV, UFH was associated with significantly 
      higher total bleeding, (OR 1.52 with 95% CI 1.11 to 2.09, p = 0.009), major 
      bleeding (OR 1.38 with 95% CI 1.13 to 1.68, p = 0.002), and minor bleeding (OR 
      1.51 with 95% CI 1.09 to 2.08, p = 0.01). Procedural success rates were not 
      different between the two groups (BIV vs HEP: OR 0.90 with 95% CI 0.49 to 1.64, 
      p = 0.72) CONCLUSION: Compared with BIV, UFH was associated with more bleeding 
      when used during PVI. There was no significant difference in procedural success 
      between the two anticoagulation strategies.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Omran, Jad
AU  - Omran J
AD  - University of California San Diego, La Jolla, CA, USA.
FAU - Enezate, Tariq
AU  - Enezate T
AD  - University of Missouri-Columbia, Columbia, MO, USA.
FAU - Abdullah, Obai
AU  - Abdullah O
AD  - University of Missouri-Columbia, Columbia, MO, USA.
FAU - Al-Dadah, Ashraf S
AU  - Al-Dadah AS
AD  - Prairie Cardiovascular Consultants, Springfield, IL, USA.
FAU - Aronow, Herbert D
AU  - Aronow HD
AD  - The Warren Alpert Medical School of Brown University, Providence, RI, USA.
FAU - Mustapha, Jihad
AU  - Mustapha J
AD  - Metro Health System, University of Michigan Health, Wyoming, MI, USA.
FAU - Saab, Fadi
AU  - Saab F
AD  - Metro Health System, University of Michigan Health, Wyoming, MI, USA.
FAU - Brilakis, Emmanouil S
AU  - Brilakis ES
AD  - Minneapolis Heart Institute, Minneapolis, MN, USA.
FAU - Reeves, Ryan R
AU  - Reeves RR
AD  - University of California San Diego, La Jolla, CA, USA.
FAU - Bhatt, Deepak L
AU  - Bhatt DL
AD  - Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, 
      Boston, MA, USA.
FAU - Mahmud, Ehtisham
AU  - Mahmud E
AD  - University of California San Diego, La Jolla, CA, USA. Electronic address: 
      EMAHMUD@mail.ucsd.edu.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20180131
PL  - United States
TA  - Cardiovasc Revasc Med
JT  - Cardiovascular revascularization medicine : including molecular interventions
JID - 101238551
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/adverse effects/*therapeutic use
MH  - Antithrombins/adverse effects/*therapeutic use
MH  - *Endovascular Procedures/adverse effects
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Hirudins/adverse effects
MH  - Humans
MH  - Male
MH  - Observational Studies as Topic
MH  - Peptide Fragments/adverse effects/*therapeutic use
MH  - Peripheral Vascular Diseases/blood/diagnosis/*therapy
MH  - Recombinant Proteins/adverse effects/therapeutic use
MH  - Risk Assessment
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Bivalirudin
OT  - Heparin
OT  - Peripheral vascular interventions
EDAT- 2018/02/27 06:00
MHDA- 2019/07/23 06:00
CRDT- 2018/02/26 06:00
PHST- 2017/12/31 00:00 [received]
PHST- 2018/01/15 00:00 [revised]
PHST- 2018/01/19 00:00 [accepted]
PHST- 2018/02/27 06:00 [pubmed]
PHST- 2019/07/23 06:00 [medline]
PHST- 2018/02/26 06:00 [entrez]
AID - S1553-8389(18)30012-5 [pii]
AID - 10.1016/j.carrev.2018.01.010 [doi]
PST - ppublish
SO  - Cardiovasc Revasc Med. 2018 Sep;19(6):695-699. doi: 10.1016/j.carrev.2018.01.010. 
      Epub 2018 Jan 31.