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Katherine L Zaleski, James A DiNardo, Viviane G Nasr
Bivalirudin (Angiomax; The Medicines Company, Parsippany, NJ), a direct thrombin inhibitor, has found increasing utilization as a heparin alternative in the pediatric population, most commonly for the treatment of thrombosis secondary to heparin-induced thrombocytopenia. Due to the relative rarity of heparin-induced thrombocytopenia as well as the lack of Food and Drug Administration-approved indications in this age group, much of what is known regarding the pharmacokinetics and pharmacodynamics of bivalirudin in this population has been extrapolated from adult data...
February 14, 2018: Anesthesia and Analgesia
Dattanand M Sudarshana, Eleni K Konstantinou, Sruthi Arepalli, Fabiana Q Silva, Andrew P Schachat, Justis P Ehlers, Rishi P Singh
BACKGROUND AND OBJECTIVE: Previous literature assessing ocular hemorrhagic complications of anticoagulant/antiplatelet medications in routine clinical practice is limited. This study evaluates the prevalence of spontaneous ocular hemorrhagic events associated with anticoagulation/antiplatelet therapy. PATIENTS AND METHODS: A retrospective study was performed to identify patients taking anticoagulants (rivaroxaban [Xarelto; Janssen Pharmaceuticals, Beerse, Belgium], bivalirudin [Angiomax; The Medicines Company, Parsippany, NJ], lepirudin [Refludan; Bayer HealthCare Pharmaceuticals, Berlin, Germany], dabigatran [Pradaxa; Boehringer Ingelheim, Ingelheim am Rhein, Germany], and argatroban) and antiplatelet agents (clopidogrel [Plavix; Bristol-Myers Squibb, New York City, NY], prasugrel [Effient; Lilly Medical, Indianapolis, IN], and ticagrelor [Brilinta; AstraZeneca, Cambridge, UK]) who presented for an eye examination...
January 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
Melorin Mehrzad, Rasikh Tuktamyshov, Raman Mehrzad
AIM: To review the early and more recent studies of Bivalirudin, to assess the safety, effectiveness, and cost benefits of this drug. METHODS: Literature search of MEDLINE and PubMed databases from 1990 to 2017 using keywords as "bivalirubin" and "angiomax", combined with the words "safety", "effectiveness", "efficiency", "side effects", "toxicity", "adverse effect", and "adverse drug reaction"...
September 26, 2017: World Journal of Cardiology
Ožbej Zupančič, Julia Anita Grießinger, Hung Thanh Lam, Andreas Bernkop-Schnürch
It was the aim of this study to incorporate a model peptide bivalirudin in self-emulsifying drug delivery system (SEDDS) and compare its storage stability with conventional aqueous solutions. Firstly, bivalirudin lipophilicity was increased via hydrophobic ion pairing using anionic or cationic surfactants. The chosen bivalirudin docusate complex (BIV/AOT) was incorporated into SEDDS composed of 40% (w/w) Cremophor EL, 20% (w/w) Capmul PG-8, and 40% (w/w) propylene glycol with a drug payload of 0.20% (w/w)...
May 2017: Journal of Pharmaceutical Sciences
Gennaro Giustino, Roxana Mehran, Sameer Bansilal, Frederick Feit, Michael Lincoff, Efthymios N Deliargyris, Ajay J Kirtane, Philippe Généreux, Bjorn Redfors, Jayne Prats, Debra Bernstein, Sorin J Brener, Simona Skerjanec, Alexandra J Lansky, Dominic P Francese, George D Dangas, Gregg W Stone
Optimal antithrombotic pharmacotherapy in patients affected by diabetes mellitus (DM) undergoing percutaneous coronary intervention is unclear. We sought to evaluate the safety and efficacy of bivalirudin compared with heparin plus a glycoprotein IIb/IIIa inhibitor (GPI) in patients with DM undergoing percutaneous coronary intervention. We pooled patient-level data from the Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events-2, Acute Catheterization and Urgent Intervention Triage strategy, and Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trials...
July 1, 2016: American Journal of Cardiology
Upendra Kaul, Ajay Dua, Arvind K Sethi, Priyadarshini Arambam, Ashok Seth
AIMS: The study was planned to compare Anti-thrombotic strategies for patients undergoing PCI in a real world population with an emphasis on occurrence of major bleeding, composite ischemic end points and economic outcomes. METHODS: The present study is a single center, prospective, observational study in consecutive patients undergoing PCI at Fortis Escorts Heart Institute (FEHI) and describes Authors' experience with three different Anti-Thrombotic Strategies in a real world population...
July 2015: Indian Heart Journal
Fabio Mangiacapra, Elisabetta Ricottini, Emanuele Barbato, Chiara Demartini, Aaron Peace, Giuseppe Patti, Vincenzo Vizzi, Bernard De Bruyne, William Wijns, Germano Di Sciascio
BACKGROUND: Growing evidence suggests that platelet reactivity (PR) may predict bleeding. We investigate the incremental value of PR in predicting bleeding after percutaneous coronary intervention (PCI) via the femoral approach over a validated bleeding risk score (BRS) of clinical and procedural variables. METHODS AND RESULTS: A total of 800 patients undergoing elective PCI via the femoral approach were included. PR was measured before PCI with the VerifyNow P2Y12 assay and low PR was defined as a P2Y12 reaction unit value ≤ 178...
May 2015: Circulation. Cardiovascular Interventions
Bharathi Scott, Christopher W Tam, Roger S Moon
No abstract text is available yet for this article.
December 2015: Journal of Cardiothoracic and Vascular Anesthesia
Nassima Amarouche, Leslie Boudesocque, Nicolas Borie, Matthieu Giraud, Luciano Forni, Alessandro Butte, Florence Edwards, Jean-Hugues Renault
A new type 1 ternary biphasic system composed of cyclopentyl methyl ether, dimethylformamide and water was developed, characterized and successfully used for the purification of a lipophilic, protected peptide by pH-zone refining centrifugal partition chromatography. The protected peptide is an 8-mer, key intermediate in bivalirudin (Angiomax®) synthesis and shows a very low solubility in the solvents usually used in liquid chromatography. All ionic groups, except the N-terminal end of the peptide, are protected by a benzyl group...
June 2014: Journal of Separation Science
Sanjiv Sharma, Shirish Patel, Ashok Behl, Sarabjeet Singh, Rasham Sandhu, Neil Bhambi, Rohan Sharma, Brijesh Bhambi
The authors describe 2 cases of extensive intracoronary thrombus formation leading to acute closure of the left main where bivalirudin (Angiomax) was used as the anticoagulant during percutaneous coronary intervention leading to mortality. Both cases had similarity in the cascade of complications of coronary dissection leading to slow flow and prolonged procedure time with compromise of antegrade flow in the coronary artery and a final catastrophic development of extensive intracoronary thrombosis extending into the left main and nonintervened vessel (left anterior descending or circumflex) followed by ventricular fibrillation and death...
July 2014: American Journal of Therapeutics
Walter Alexander
Topics include comparisons of bivalirudin (Angiomax) and unfractionated heparin in reducing bleeding, prasugrel (Effient) and clopidogrel (Plavix) in acute myocardial infarction, aspirin for critical limb ischemia, and mobilized CD34+ cells for angina.
December 2012: P & T: a Peer-reviewed Journal for Formulary Management
Gjin Ndrepepa, Tibor Schuster, Martin Hadamitzky, Robert A Byrne, Julinda Mehilli, Franz-Josef Neumann, Gert Richardt, Stefanie Schulz, Karl-Ludwig Laugwitz, Steffen Massberg, Albert Schömig, Adnan Kastrati
BACKGROUND: The Bleeding Academic Research Consortium (BARC) has recently proposed a unified definition of bleeding in patients receiving antithrombotic therapy. We investigated the relationship between bleeding events as defined by BARC and 1-year mortality in patients undergoing percutaneous coronary intervention (PCI) and assessed whether the BARC bleeding definition is superior to existing bleeding definitions in regard to mortality prediction in patients after PCI procedures. METHODS AND RESULTS: This study represents a patient-level pooled analysis of 12 459 patients recruited in 6 randomized trials of patients undergoing PCI...
March 20, 2012: Circulation
Roxana Mehran, Stuart Pocock, Eugenia Nikolsky, George D Dangas, Tim Clayton, Bimmer E Claessen, Adriano Caixeta, Frederick Feit, Steven V Manoukian, Harvey White, Michel Bertrand, E Magnus Ohman, Helen Parise, Alexandra J Lansky, A Michael Lincoff, Gregg W Stone
OBJECTIVES: This study sought to develop a risk score predictive of bleeding in patients undergoing percutaneous coronary intervention (PCI) and to investigate the impact of bleeding on subsequent mortality. BACKGROUND: Bleeding complications after PCI have been independently associated with early and late mortality. METHODS: This study represents a patient-level pooled analysis including 17,034 patients undergoing PCI from 3 large, randomized trials of bivalirudin versus heparin plus glycoprotein IIb/IIIa inhibitors, including the REPLACE-2 (Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events), ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy), and HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trials...
June 2011: JACC. Cardiovascular Interventions
Freek W A Verheugt, Steven R Steinhubl, Martial Hamon, Harald Darius, Philippe Gabriel Steg, Marco Valgimigli, Steven P Marso, Sunil V Rao, Anthony H Gershlick, A Michael Lincoff, Roxana Mehran, Gregg W Stone
OBJECTIVES: The aim of this study was to evaluate the relative frequency of access and nonaccess site bleeding, the association of these events with 1-year mortality, and the impact of randomized antithrombotic therapy. BACKGROUND: Post-percutaneous coronary intervention (PCI) bleeding has been strongly associated with subsequent mortality. The extent to which access versus nonaccess site bleeding contributes to this poor prognosis and the role of antithrombotic therapies remains poorly understood...
February 2011: JACC. Cardiovascular Interventions
David A Van De Car, Sunil V Rao, E Magnus Ohman
Among the current agents in the class of direct thrombin inhibitors, bivalirudin (Angiomax(®), The Medicines Company, NJ, USA) has seen increased use in cardiovascular medicine over the past decade through its primary indication as an anticoagulant used during percutaneous coronary interventions. Bivalirudin has been further investigated and used as the anticoagulation strategy in the setting of cardiac and endovascular surgical procedures and is frequently utilized in the management of patients with heparin-induced thrombocytopenia...
December 2010: Expert Review of Cardiovascular Therapy
Ameer E Hassan, Muhammad Zeeshan Memon, Alexandros L Georgiadis, Gabriela Vazquez, M Fareed K Suri, Adnan I Qureshi
BACKGROUND: Bivalirudin (Angiomax) is a direct thrombin inhibitor used in interventional cardiology due to its several distinct advantages over heparin, most notably a shorter half-life and a potentially superior safety profile. Bivalirudin is also safe to use in patients with active or remote heparin-induced thrombocytopenia. Our objective was to evaluate the safety and tolerability of high-intensity anticoagulation using bivalirudin during neuroendovascular procedures. METHODS: The bivalirudin dosing regimens reported in the cardiac literature were modified empirically for two different activated clotting time (ACT) target ranges...
August 2011: Neurocritical Care
Vikram S Kashyap, Paul D Bishop, James F Bena, Karen Rosa, Timur P Sarac, Kenneth Ouriel
OBJECTIVE: Replacing heparin with bivalirudin has been beneficial in patients undergoing coronary intervention and coronary artery bypass. The use of this alternative anticoagulant during peripheral bypass operations has not been studied. Concerns over distal thrombosis using this direct thrombin inhibitor (DTI) prompted a single-arm, open-label, pilot prospective trial of bivalirudin in patients undergoing lower extremity bypass to assess perioperative safety and efficacy. METHODS: Between 2006 and 2007, 18 patients met criteria for enrollment and underwent primary lower extremity bypass using bivalirudin...
August 2010: Journal of Vascular Surgery
T Caruba, A Chaïb, N Danchin, S Rahal, D Bégué, E Durand, P Prognon, A Lafont, B Sabatier
Bivalirudin, with provisional GP IIb/IIIa inhibitor use allows the same protection against ischemic complications while reducing the hemorrhagic complications compared with the systematic association of a GP IIb/IIIa inhibitor plus heparin (The Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events-2 [Replace-2]). In clinical practice, the use of heparin is not systematically associated with a GP IIb/IIIa inhibitor. That's why we studied the clinical and economic interest of bivalirudin only versus heparin (UFH) only...
April 2010: Annales de Cardiologie et D'angéiologie
Alaide Chieffo, Gloria Melzi, Renata Rogacka, Angela Ferrari, Flavio Airoldi, John Cosgrave, Iassen Michev, Matteo Montorfano, Mauro Carlino, Giancarlo Vitrella, Giuseppe Biondi Zoccai, Antonio Colombo
OBJECTIVE: This open label, prospective, non-comparative trial is the first to evaluate the safety and feasibility of bivalirudin (Angiomax(R), the Medicines Company, Parsippany, NJ), during PCI with implantation of the sirolimus eluting stent (Cypher, Cordis a J & J, Warren, NJ) or the paclitaxel eluting stent (Taxus, Boston Scientific, Natick, MA). METHODS: Patients who were referred for elective PCI suitable for stent implantation were recruited. Bivalirudin was administrated as a bolus of 1...
May 2005: EuroIntervention
Jie Chao, Wen-Yi Huang, Jing Wang, Shou-Jun Xiao, Yan-Chun Tang, Jian-Ning Liu
The recently arising antithrombin drug, angiomax, was successfully conjugated with a 5'-amino oligonucleotide through click chemistry. This oligo-angiomax conjugate was assembled into a two-dimensional DNA lattice with other oligonucleotides together. Besides the plane sheet of DNA lattices, an interesting angiomax-involved DNA tubing structure, constructed by 40 to 50 angiomax stripes which are parallel to the longitudinal axis of the tube, was also imaged. After incubation of thrombins with the angiomax-involved DNA lattice, the binding of thrombins to arrayed angiomax peptides was observed...
April 13, 2009: Biomacromolecules
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