PMID- 34653957
OWN - NLM
STAT- MEDLINE
DCOM- 20211108
LR  - 20211108
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 33
IP  - 11
DP  - 2021 Nov
TI  - Evaluation of Bivalirudin-Associated Major Adverse Cardiac and Hemorrhagic Events 
      in Acute Coronary Syndrome Patients on Chronic Dialysis Following Percutaneous 
      Coronary Intervention.
PG  - E877-E883
LID - JIC20211015-2 [pii]
AB  - BACKGROUND AND AIM: Patients with chronic dialysis dependency undergoing 
      percutaneous coronary intervention (PCI) are at a greater risk of hemorrhagic and 
      ischemic events. Due to their exclusion from randomized clinical trials, the 
      optimal antithrombotic regimen for this population remains unknown. Bivalirudin 
      has been associated with fewer hemorrhagic complications than unfractionated 
      heparin (UFH) in patients undergoing PCI. We evaluated major adverse cardiac 
      event (MACE) and hemorrhagic event rates for an antithrombotic regimen using 
      bivalirudin or UFH during PCI in acute coronary syndrome (ACS) patients with 
      chronic dialysis dependency. METHODS: A retrospective study was performed, 
      including 211 patients on dialysis undergoing PCI due to ACS from January 2014 to 
      April 2019 at the China-Japan Friendship Hospital. Patients were divided into 2 
      groups based on anticoagulation regimen: the bivalirudin group (86 cases) or the 
      UFH group (125 cases) during and after PCI. Statistical analyses were used to 
      compare MACE and hemorrhagic events between groups at 30 days after PCI. RESULTS: 
      No patients experienced stent thrombosis within 30 days after PCI regardless of 
      anticoagulant. There was no difference in the incidence of MACE in the 
      bivalirudin group compared with the UFH group (6.98% vs 8.80%, respectively; 
      P>.05). The rate of hemorrhagic events in the bivalirudin group was significantly 
      lower than in the UHP group (5.81% vs 18.4%, respectively; P<.05), particularly 
      for rates of mild bleeding (4.65% vs 15.2%, respectively; P<.05). There were no 
      significant differences in rates of severe bleeding between the bivalirudin and 
      UFH groups (1.16% vs 4.00%, respectively; P>.05), although fewer severe 
      hemorrhagic events occurred in the bivalirudin group. CONCLUSION: Bivalirudin was 
      associated with fewer bleeding events following PCI in individuals with end-stage 
      renal disease on dialysis.
FAU - Fu, Dongliang
AU  - Fu D
FAU - Liu, Mengru
AU  - Liu M
FAU - Gao, Tong
AU  - Gao T
FAU - Li, Chunyan
AU  - Li C
FAU - Liao, Jiangquan
AU  - Liao J
FAU - Shao, Mingjing
AU  - Shao M
FAU - Xiao, Xiang
AU  - Xiao X
FAU - Yang, Peng
AU  - Yang P
FAU - Li, Xianlun
AU  - Li X
FAU - Jiang, Hong
AU  - Jiang H
AD  - China-Japan Friendship Hospital, Yinghua Dongjie 2, Chaoyang District, Beijing 
      100029, China. drjh68@163.com.
LA  - eng
PT  - Journal Article
DEP - 20211015
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
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  - *Acute Coronary Syndrome/complications/surgery
MH  - Anticoagulants/adverse effects
MH  - Antithrombins/adverse effects
MH  - Heparin/adverse effects
MH  - Hirudins/adverse effects
MH  - Humans
MH  - Peptide Fragments/adverse effects
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Recombinant Proteins
MH  - Renal Dialysis/adverse effects
MH  - Retrospective Studies
OTO - NOTNLM
OT  - acute coronary syndrome
OT  - bivalirudin
OT  - cardiovascular events
OT  - dialysis
OT  - hemorrhage
OT  - percutaneous coronary intervention
EDAT- 2021/10/16 06:00
MHDA- 2021/11/09 06:00
CRDT- 2021/10/15 20:31
PHST- 2021/10/16 06:00 [pubmed]
PHST- 2021/11/09 06:00 [medline]
PHST- 2021/10/15 20:31 [entrez]
AID - JIC20211015-2 [pii]
PST - ppublish
SO  - J Invasive Cardiol. 2021 Nov;33(11):E877-E883. Epub 2021 Oct 15.