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Bivalirudin

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https://www.readbyqxmd.com/read/27904902/a-novel-hirudin-derivative-inhibiting-thrombin-without-bleeding-for-subcutaneous-injection
#1
Bing Zhao, Yanling Zhang, Yinong Huang, Jinchao Yu, Yaran Li, Qi Wang, Yixin Ma, Hou-Yan Song, Min Yu, Wei Mo
Currently, anticoagulants would be used to prevent thrombosis. Thrombin is an effector enzyme for haemostasis and thrombosis. We designed a direct thrombin inhibitor peptide (DTIP) using molecular simulation and homology modelling and demonstrated that the C-terminus of DTIP interacts with exosite I, and N-terminus with the activity site of thrombin, respectively. DTIP interfered with thrombin-mediated coagulation in human, rat and mouse plasma (n=10 per group) and blocked clotting in human whole blood in vitro...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27902833/evaluation-of-ischemic-and-bleeding-risks-associated-with-2-parenteral-antiplatelet-strategies-comparing-cangrelor-with-glycoprotein-iib-iiia-inhibitors-an-exploratory-analysis-from-the-champion-trials
#2
Muthiah Vaduganathan, Robert A Harrington, Gregg W Stone, Efthymios N Deliargyris, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Alberto Menozzi, Jayne Prats, Steven Elkin, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
Importance: In the context of contemporary pharmacotherapy, optimal antiplatelet management with percutaneous coronary intervention (PCI) has not been well established. Objective: To compare the ischemic and bleeding risks associated with glycoprotein IIb/IIIa inhibitors (GPIs) and a potent P2Y12 antagonist, cangrelor, in patients undergoing PCI. Design, Setting, and Participants: An exploratory analysis of pooled patient-level data from the 3 phase 3 Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION PCI, CHAMPION PLATFORM, and CHAMPION PHOENIX) trials of patients undergoing elective or nonelective PCI...
November 30, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27862911/effect-of-post-primary-percutaneous-coronary-intervention-bivalirudin-infusion-on-net-adverse-clinical-events-and-mortality-a-comprehensive-pairwise-and-network-meta-analysis-of-randomized-controlled-trials
#3
Rahman Shah, Khalid Matin, Kelly C Rogers, Sunil V Rao
OBJECTIVE: To compare the efficacies of various post-percutaneous coronary intervenetion (PCI) bivalirudin doses on net adverse clinical events (NACEs) and mortality. BACKGROUND: In primary PCI, lower risk of bleeding with bivalirudin (vs. unfractionated heparin [UFH]) is counterbalanced by an increased risk of acute stent thrombosis (ST). Several randomized clinical trials (RCTs) and a recent meta-analysis suggest that acute ST risk may be eliminated without compromising the bleeding benefit, but only if the full dose, not a low dose, of bivalirudin is continued post-PCI...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27849794/151-incidence-of-venous-thromboembolism-in-ecmo-patients-receiving-bivalirudin-compared-with-heparin
#4
Courtney Khouli, Maureen Converse, I-Wen Wang
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#5
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27842901/comparison-of-heparin-bivalirudin-and-different-glycoprotein-iib-iiia-inhibitor-regimens-for-anticoagulation-during-percutaneous-coronary-intervention-a-network-meta-analysis
#6
Michael J Lipinski, Regina C Lee, Michael A Gaglia, Rebecca Torguson, Hector M Garcia-Garcia, Augusto D Pichard, Lowell F Satler, Ron Waksman
BACKGROUND/PURPOSE: Numerous GPIs are available for PCI. Although they were tested in randomized controlled trials, a comparison between the different GPI strategies is lacking. Thus, we performed a Bayesian network meta-analysis to compare different glycoprotein IIb/IIIa inhibitor (GPI) strategies with heparin and bivalirudin for percutaneous coronary intervention (PCI). METHODS: MEDLINE, Cochrane CENTRAL, and ClinicalTrials.gov were searched by two independent reviewers for randomized controlled trials comparing high-dose bolus tirofiban, abciximab, eptifibatide, heparin with provisional glycoprotein IIb/IIIa inhibitors, and bivalirudin with provisional GPI that reported clinical outcomes...
September 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27818120/efficacy-and-safety-of-prehospital-administration-of-unfractionated-heparin-enoxaparin-or-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-insights-from-the-orbi-registry
#7
Vincent Auffret, Guillaume Leurent, Dominique Boulmier, Marc Bedossa, Amer Zabalawi, Jean-Philippe Hacot, Isabelle Coudert, Emmanuelle Filippi, Philippe Castellant, Antoine Rialan, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marielle Le Guellec, Martine Gilard, Hervé Le Breton
BACKGROUND: Despite numerous studies in recent years, the best anticoagulant option for primary percutaneous coronary intervention (PCI) remains a matter of debate. AIMS: To compare in-hospital outcomes after prehospital administration of low-dose unfractionated heparin (UFH)±glycoprotein IIb/IIIa inhibitors (GPIs), enoxaparin±GPIs, or bivalirudin in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 1720 patients (median age 62...
November 3, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27793877/cost-effectiveness-of-anticoagulants-for-the-management-of-suspected-heparin-induced-thrombocytopenia-in-the-us
#8
Ahmed Aljabri, Yvonne Huckleberry, Jason Karnes, Mahdi Gharaibeh, Hussam I Kutbi, Yuval Raz, Seongseok Yun, Ivo Abraham, Brian Erstad
Despite the availability of multiple non-heparin anticoagulants for the treatment of heparin-induced thrombocytopenia (HIT), little data is available comparing the cost-effectiveness of these agents. This analysis is particularly important considering differences in risks of adverse effects, routes of administration, requirements for phlebotomy and laboratory monitoring, and overall drug costs. We conducted a cost-effectiveness analysis of argatroban, bivalirudin, and fondaparinux for the treatment of suspected HIT from the institutional perspective...
October 28, 2016: Blood
https://www.readbyqxmd.com/read/27765812/direct-thrombin-inhibitor-for-lvad-thrombosis-a-closer-look
#9
Jessica Rimsans, Katelyn W Sylvester, Jean M Connors
Available options for the treatment of advanced heart failure have expanded to include the use of mechanical circulatory assist devices to improve quality of life in those both eligible and ineligible for heart transplant. Although there have been significant advancements in device technologies, anticoagulation protocols, and multidisciplinary team management, bleeding and thrombosis are the most common adverse effects. Management strategies for pump thrombosis and their outcomes vary considerably among mechanical circulatory support centers and include intensification of antithrombotic therapy (medical) and device exchange (surgical)...
October 7, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27753600/impact-of-time-to-treatment-on-the-effects-of-bivalirudin-vs-glycoprotein-iib-iiia-inhibitors-and-heparin-in-patients-undergoing-primary-percutaneous-coronary-intervention-insights-from-the-horizons-ami-trial
#10
Mikkel M Schoos, Giuseppe De Luca, George D Dangas, Peter Clemmensen, Girma Minalu Ayele, Roxana Mehran, Gregg W Stone
AIMS: In the HORIZONS-AMI trial, bivalirudin compared to unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) improved net clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) at the cost of an increased rate of acute stent thrombosis. We sought to examine whether these effects are dependent on time to treatment. METHODS AND RESULTS: The interaction between anticoagulation regimen and symptom onset to first balloon inflation time (SBT) on the 30-day and three-year rates of major adverse cardiac events (MACE) was examined in 3,199 randomised patients according to SBT ≤3 hours versus >3 hours...
October 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27747056/risk-guided-use-of-the-direct-thrombin-inhibitor-bivalirudin-insights-from-recent-trials-and-analyses
#11
COMMENT
William B Hillegass, Gregory S Bradford
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27746016/bivalirudin-for-cardiopulmonary-bypass-in-the-setting-of-heparin-induced-thrombocytopenia-and-combined-heart-and-kidney-transplantation-diagnostic-and-therapeutic-challenges
#12
Ankeet A Choxi, Prakash A Patel, John G Augoustides, Julio Benitez-Lopez, Jacob T Gutsche, Hani Murad, Yiliam F Rodriguez-Blanco, Michael Fabbro, Kendall P Crookston, Neal S Gerstein
No abstract text is available yet for this article.
July 9, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27693166/-intracoronary-administration-of-antithrombotic-agents-via-a-perfusion-balloon-catheter-in-patients-with-st-segment-elevation-myocardial-infarction-presenting-with-massive-intraluminal-thrombus-and-failed-aspiration
#13
B Ajlani, G Gibault-Genty, G Cherif, E Blicq, S Azzaz, P Schiano, M Brami, L Sarfati, C Charbonnel, R Convers-Domart, B Livarek, J-L Georges
BACKGROUND: Massive intracoronary thrombus is associated with adverse procedural results including failed aspiration and unfavourable reperfusion. We aim to evaluate the effect of the intracoronary administration of antithrombotic agents via a perfusion catheter in patients with ST-segment elevation myocardial infarction (STEMI) presenting with a large thrombus burden and failed aspiration. METHODS: We retrospectively analyzed the thrombus burden, the TIMI grade flow, and the myocardial Blush in 25 consecutive STEMI patients with a large thrombus burden and failed manual aspiration, who received intracoronary infusion of glycoprotein IIb/IIIa inhibitors (N=17) or bivalirudine (N=8) via a 6F-infusion catheter (ClearWay™ RX) RESULTS: Mean age was 67±14 years, 16 patients (64 %) presented with anterior STEMI, and 7 (28 %) with cardiogenic shock...
September 29, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27678052/a-novel-sequential-electrostatic-hilic-spe-within-a-quantitative-method-for-bivalirudin-in-human-plasma-by-lc-srm
#14
Robert MacNeill, Vishva Acharya, Neha Patel, Gregory Parisi, Kim Katto, Robert Lovich
AIM: This work set out to realize an idea for a novel means of extracting the peptide therapeutic bivalirudin from human plasma in what would be a uniquely selective means of SPE, a mixed-mode protocol involving electrostatic interactions followed by HILIC. RESULTS: Inter and intra-assay relative error ranged from 3.52 to 8.23%, and 2.37 to 6.90%, respectively. Inter and intra-assay precision ranged from 2.64 to 7.12%, and 0.855 to 2.90%, respectively. Recoveries of 80% were attained, and there was no hint of discernible manifestation of matrix effects...
November 2016: Bioanalysis
https://www.readbyqxmd.com/read/27677503/bivalirudin-or-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-managed-invasively-with-and-without-st-elevation-matrix-randomised-controlled-trial
#15
Sergio Leonardi, Enrico Frigoli, Martina Rothenbühler, Eliano Navarese, Paolo Calabró, Paolo Bellotti, Carlo Briguori, Marco Ferlini, Bernardo Cortese, Alessandro Lupi, Salvatore Lerna, Dennis Zavallonito-Parenti, Giovanni Esposito, Simone Tresoldi, Antonio Zingarelli, Stefano Rigattieri, Cataldo Palmieri, Armando Liso, Fabio Abate, Marco Zimarino, Marco Comeglio, Gabriele Gabrielli, Alaide Chieffo, Salvatore Brugaletta, Ciro Mauro, Nicolas M Van Mieghem, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
OBJECTIVE:  To test the optimal antithrombotic regimen in patients with acute coronary syndrome. DESIGN:  Randomised controlled trial. SETTING:  Patients with acute coronary syndrome with and without ST segment elevation in 78 centres in Italy, the Netherlands, Spain, and Sweden. PARTICIPANTS:  7213 patients with acute coronary syndrome and planned percutaneous coronary intervention: 4010 with ST segment elevation and 3203 without ST segment elevation...
September 27, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27677411/efficiency-and-safety-of-bivalirudin-in-patients-undergoing-emergency-percutaneous-coronary-intervention-via-radial-access-a-subgroup-analysis-from-the-bivalirudin-in-acute-myocardial-infarction-versus-heparin-and-gpi-plus-heparin-trial
#16
Heyang Wang, Yi Li, Hongliang Cong, Shifang Ding, Bin Liu, Lu Li, Yundai Chen, Shaobin Jia, Quanmin Jing, Xin Zhao, Haiwei Liu, Zhenyang Liang, Jing Li, Dan Bao, Yaling Han
OBJECTIVES: To explore the efficiency and safety of bivalirudin in patients undergoing emergency percutaneous coronary intervention via radial access. BACKGROUND: Bivalirudin reduces bleeding risks over heparin in patients undergoing PCI. However, bleeding advantages of bivalirudin in patients undergoing transradial intervention is uncertain. METHODS: In the BRIGHT trial, 1,723 patients underwent emergency PCI via radial access, with 576 patients in the bivalirudin arm, 576 in the heparin arm and 571 in the heparin plus tirofiban arm...
September 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27624328/impact-of-bivalirudin-on-mortality-and-bleeding-complications-in-acute-coronary-syndrome-patients-undergoing-invasive-revascularization-a-real-world-experience
#17
Miklos Rohla, Ioannis Tentzeris, Matthias K Freynhofer, Serdar Farhan, Rudolf Jarai, Florian Egger, Thomas W Weiss, Johann Wojta, Alexander Geppert, Adnan Kastrati, Gregg W Stone, Kurt Huber
BACKGROUND: In a retrospective analysis of a prospective single center registry we compared the use of bivalirudin, unfractionated heparin (UFH) monotherapy, UFH + abciximab in 1240 consecutive patients with acute coronary syndrome (ACS) undergoing stent implantation. RESULTS: Bivalirudin was associated with tendentially reduced in-hospital minor or major bleeding rates compared to UFH monotherapy (5.9 % vs. 9.4 % adjusted odds ratio (OR) 0.82, 95 % confidence interval CI 0...
September 13, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27591687/heparin-versus-bivalirudin-in-st-segment-elevation-myocardial-infarction-a-scai-based-national-survey-from-us-interventional-cardiologists
#18
Harsh Golwala, Sadip Pant, Ambarish Pandey, Michael P Flaherty, Glenn A Hirsch, Ajay J Kirtane
BACKGROUND: The use of antithrombotic therapy (ATT) (bivalirudin or unfractionated heparin) is a class I recommendation for patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI). This survey was conducted to better understand current United States (US) practices in terms of preferences regarding the selection of ATT in STEMI-PPCI, particularly in light of recent clinical trials. METHODS: An electronic survey consisting of 9 focused questions was forwarded to 2676 US interventional cardiologists who were members of the Society for Cardiovascular Angiography and Interventions (SCAI)...
September 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27583038/heparin-versus-bivalirudin-in-acute-myocardial-infarction-unfractionated-heparin-monotherapy-elevated-to-primary-treatment-in-contemporary-percutaneous-coronary-intervention
#19
Osmar Antonio Centurión
Bivalirudin, a direct thrombin inhibitor, was developed as an antithrombin agent for patients undergoing percutaneous coronary interventions (PCI) with the hypothesis that it would reduce bleeding complications without compromising the rate of ischemic events compared to heparin plus GP IIb/IIIa inhibitors. Although the cumulative evidence makes a strong argument for the use of bivalirudin rather than heparin plus systematic GP IIb/IIIa inhibitors for the great majority of patients with acute myocardial infarction (AMI) undergoing PCI, the benefit observed with bivalirudin was achieved because of the major bleeding complications with the use of heparin plus GP IIb/IIIa inhibitors...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27555195/bivalirudin-anticoagulation-for-minimal-invasive-transapical-transcatheter-aortic-valve-replacement-in-a-patient-with-antiphospholipid-antibodies
#20
Andreas Koster, Stephan Ensminger, Marios Vlachojannis, Ingvild Birschmann
The occurrence of lupus anticoagulant is associated with the hazard of developing an antiphospholipid syndrome, a severe prothrombotic condition which may particularly occur after major surgical trauma. This disease requires certain considerations regarding surgical strategy and anticoagulation management. We describe the perioperative management of a patient scheduled for elective aortic valve replacement and diagnosed for having antiphospholipid antibodies. The procedure was successfully performed using a minimally invasive approach via transapical aortic valve replacement and anticoagulation with the nonreversible short-acting direct thrombin Inhibitor bivalirudin...
September 2016: Journal of Clinical Anesthesia
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