PMID- 36530956
OWN - NLM
STAT- MEDLINE
DCOM- 20221220
LR  - 20221221
IS  - 1755-5922 (Electronic)
IS  - 1755-5914 (Print)
IS  - 1755-5914 (Linking)
VI  - 2022
DP  - 2022
TI  - Safety and Efficacy of Bivalirudin versus Unfractionated Heparin Monotherapy in 
      Patients with CAD and DM Undergoing PCI: A Retrospective Observational Study.
PG  - 5352087
LID - 10.1155/2022/5352087 [doi]
LID - 5352087
AB  - INTRODUCTION: Optimal anticoagulants for patients with diabetes mellitus (DM) 
      undergoing percutaneous coronary intervention (PCI) are unclear. This 
      retrospective observational study is aimed at evaluating efficacy and safety of 
      bivalirudin versus unfractionated heparin (UFH) monotherapy in patients with DM 
      undergoing PCI. METHODS: A total of 3890 diabetic patients receiving PCI in the 
      General Hospital of Northern Theater Command were divided into the bivalirudin 
      group (n = 869) and the UFH group (n = 3021) according to different anticoagulant 
      therapy regimens. Indication for PCI was in accordance with current guidelines 
      including national cardiovascular data registry. The primary endpoint was 30-day 
      net adverse clinical events (NACEs). The secondary endpoints included 30-day 
      major adverse cardiac and cerebral events (MACCEs), bleeding events defined 
      according to the Bleeding Academic Research Consortium (BARC) definition, and 
      stent thrombosis (ST). Patients were matched by propensity score at a ratio of 
      1 : 1. RESULTS: After propensity score matching, the bivalirudin group was 
      associated with a lower incidence of NACEs (3.0% vs. 6.0%, P = 0.003) than the 
      UFH group. The incidence of MACCE (1.7% vs. 3.3%, P = 0.033) was significantly 
      lower in the bivalirudin group, mainly due to a lower mortality rate (0.6% vs. 
      2.0%, P = 0.010). In addition, patients in the bivalirudin group had less 
      bleeding (1.4% vs. 3.0%, P = 0.022) than those in the UFH group, although BARC 2, 
      3, and 5 bleeding (0.1% vs. 0.6%, P = 0.218) was numerically lower. CONCLUSION: 
      In diabetic patients undergoing PCI, bivalirudin was significantly associated 
      with reduced risks of 30-day NACE and MACCE, mainly driven by the lower rates of 
      bleeding and mortality, compared with heparin monotherapy.
CI  - Copyright (c) 2022 Jing Li et al.
FAU - Li, Jing
AU  - Li J
AUID- ORCID: 0000-0002-4912-5977
AD  - The Graduate School of Harbin Medical University, Harbin, China.
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Chen, Sanbao
AU  - Chen S
AUID- ORCID: 0000-0003-1279-0559
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Ma, Sicong
AU  - Ma S
AUID- ORCID: 0000-0002-2233-9967
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Yang, Mingque
AU  - Yang M
AUID- ORCID: 0000-0002-3253-183X
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Qi, Zizhao
AU  - Qi Z
AUID- ORCID: 0000-0003-4427-4399
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Na, Kun
AU  - Na K
AUID- ORCID: 0000-0003-3679-8248
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Qiu, Miaohan
AU  - Qiu M
AUID- ORCID: 0000-0003-2077-5770
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Li, Yi
AU  - Li Y
AUID- ORCID: 0000-0003-1658-404X
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
FAU - Han, Yaling
AU  - Han Y
AUID- ORCID: 0000-0003-4569-6737
AD  - The Graduate School of Harbin Medical University, Harbin, China.
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 
      Liaoning Province, China.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20221130
PL  - England
TA  - Cardiovasc Ther
JT  - Cardiovascular therapeutics
JID - 101319630
RN  - TN9BEX005G (bivalirudin)
RN  - 9005-49-6 (Heparin)
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Recombinant Proteins)
SB  - IM
MH  - Humans
MH  - Heparin/adverse effects
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Antithrombins/adverse effects
MH  - Hirudins/adverse effects
MH  - Peptide Fragments/adverse effects
MH  - Anticoagulants/adverse effects
MH  - Hemorrhage/chemically induced
MH  - Fibrinolytic Agents/therapeutic use
MH  - *Diabetes Mellitus/drug therapy
MH  - Recombinant Proteins/adverse effects
MH  - Treatment Outcome
PMC - PMC9729030
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2022/12/20 06:00
MHDA- 2022/12/21 06:00
PMCR- 2022/11/30
CRDT- 2022/12/19 03:40
PHST- 2022/05/05 00:00 [received]
PHST- 2022/11/10 00:00 [revised]
PHST- 2022/11/12 00:00 [accepted]
PHST- 2022/12/19 03:40 [entrez]
PHST- 2022/12/20 06:00 [pubmed]
PHST- 2022/12/21 06:00 [medline]
PHST- 2022/11/30 00:00 [pmc-release]
AID - 10.1155/2022/5352087 [doi]
PST - epublish
SO  - Cardiovasc Ther. 2022 Nov 30;2022:5352087. doi: 10.1155/2022/5352087. eCollection 
      2022.