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Bivalirudin

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https://www.readbyqxmd.com/read/29345590/what-is-the-role-for-glycoprotein-iib-iiia-inhibitor-use-in-the-catheterisation-laboratory-in-the-current-era
#1
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#2
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29342377/bivalirudin-versus-heparin-monotherapy-in-myocardial-infarction
#3
(no author information available yet)
No abstract text is available yet for this article.
January 18, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29339166/anticoagulation-in-acute-coronary-syndrome-state-of-the-art
#4
REVIEW
Michel Zeitouni, Mathieu Kerneis, Tarek Nafee, Jean-Philippe Collet, Johanne Silvain, Gilles Montalescot
Early intravenous anticoagulation is the corner stone treatment of patients admitted with an acute coronary syndrome: it antagonizes the ongoing coronary thrombosis and facilitates the percutaneous coronary intervention, hence a reduction of mortality and acute stent thrombosis. Unfractionated heparin, enoxaparin, bivalirudin and fondaparinux have been extensively studied in large randomized control trials and meta-analyses with the same objective: reducing the ischemic burden without hiking hemorrhagic events...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29336311/comparison-of-the-effects-of-p2y12-receptor-antagonists-on-platelet-function-and-clinical-outcomes-in-patients-undergoing-primary-pci-a-substudy-of-the-heat-ppci-trial
#5
Adeel Shahzad, Vikram Khanna, Ian Kemp, Matthew Shaw, Christine Mars, Robert Cooper, Keith Wilson, Nick Curzen, Rod H Stables
AIMS: The HEAT-PPCI trial compared bivalirudin and unfractionated heparin in patients undergoing Primary PCI. We report pre-specified, secondary analyses comparing the effects of P2Y12 inhibiting agents on platelet reactivity and clinical events. METHODS AND RESULTS: All patients received pre-procedural oral anti-platelet therapy. During the early stages of the trial, the P2Y12 inhibitor of choice was prasugrel with some use of clopidogrel. Later, routine therapy switched to ticagrelor...
January 16, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29304263/the-prevalence-of-adverse-ocular-hemorrhagic-events-in-patients-utilizing-oral-anticoagulant-and-antiplatelet-therapy-in-routine-clinical-practice
#6
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
https://www.readbyqxmd.com/read/29276283/bivalirudin-medication-use-evaluation-and-cost-savings-initiative
#7
Adam C Sieg, Jennifer A Gass
Bivalirudin is a parenteral anticoagulant that elicits its effect through inhibition of both free and clot bound-thrombin. Inhibition of thrombin serves as a unique mechanism for anticoagulation when compared to heparin as thrombin serves as the final common pathway for the intrinsic and extrinsic coagulation cascades. Due to unclear benefit over heparin, concerns regarding reversibility, and most importantly cost its use as a parenteral anticoagulant varies by institution. A recent drug expenditure review within our institution noted a significant increase in the contribution bivalirudin had on the overall drug budget...
September 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29228817/cangrelor-in-percutaneous-coronary-intervention-current-status-and-perspectives
#8
Dimitrios Alexopoulos, Christos Pappas, Danai Sfantou, John Lekakis
Cangrelor is an intravenously administered P2Y12 receptor antagonist with very fast, potent, and quickly reversible action. In the CHAMPION PHOENIX trial, cangrelor provided an improved anti-ischemic protection compared with clopidogrel, without increasing the risk of severe bleeding. Cangrelor is currently approved by drug regulating authorities for patients undergoing percutaneous coronary intervention (PCI) without prior treatment with a P2Y12 receptor antagonist and not receiving a glycoprotein IIb/IIIa inhibitor, while its use is endorsed with a class IIb recommendation by the European Society of Cardiology guidelines...
January 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29225903/early-clinical-outcomes-as-a-function-of-use-of-newer-oral-p2y12-inhibitors-versus-clopidogrel-in-the-euromax-trial
#9
Kurt Huber, Gregory Ducrocq, Christian W Hamm, Arnoud van 't Hof, Frédéric Lapostolle, Pierre Coste, Giovanni Gordini, Jacob Steinmetz, Freek W A Verheugt, Jennifer Adgey, Lutz Nibbe, Vojko Kaniĉ, Peter Clemmensen, Uwe Zeymer, Debra Bernstein, Jayne Prats, Efthymios N Deliargyris, Ph Gabriel Steg
Objective: To ascertain whether different oral P2Y12 inhibitors might affect rates of acute stent thrombosis and 30-day outcomes after primary percutaneous coronary intervention (pPCI). Methods: The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) randomised trial compared prehospital bivalirudin with heparin with optional glycoprotein IIb/IIIa inhibitor treatment in patients with ST-segment elevation myocardial infarction triaged to pPCI. Choice of P2Y12 inhibitor was at the investigator's discretion...
2017: Open Heart
https://www.readbyqxmd.com/read/29223437/outcomes-in-elderly-and-young-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-with-bivalirudin-versus-heparin-pooled-analysis-from-the-euromax-and-horizons-ami-trials
#10
RANDOMIZED CONTROLLED TRIAL
Khalid Qaderdan, Gerrit-Jan A Vos, Thomas McAndrew, Philippe Gabriel Steg, Christian W Hamm, Arnoud Van't Hof, Roxana Mehran, Efthymios N Deliargyris, Debra Bernstein, Gregg W Stone, Jurriën M Ten Berg
BACKGROUND: Since older age is a strong predictor of not only bleeding but also of ischemic events, understanding the risk:benefit profile of bivalirudin in the elderly undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation (STEMI) is important. For this, we aim to compare elderly with young patients, who all underwent pPCI for STEMI and randomly received either bivalirudin or heparin. METHODS: We performed a patient-level pooled analysis (n=5800) of two large randomized trials...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29206646/argatroban-and-bivalirudin-for-perioperative-anticoagulation-in-cardiac-surgery
#11
Andreas Koster, David Faraoni, Jerrold H Levy
No abstract text is available yet for this article.
December 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29205487/the-impact-of-unfractionated-heparin-or-bivalirudin-on-patients-with-stable-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#12
Fabio V Lima, Luis Gruberg, Usman Aslam, Melissa Ramgadoo, Kydanis Clase, Alessandra Trevisan, Allen Jeremias
OBJECTIVES: To compare bleeding and clinical events of patients with stable angina or silent ischemia undergoing percutaneous coronary intervention (PCI) treated with unfractionated heparin (UFH) or bivalirudin. BACKGROUND: Few direct comparisons between UFH monotherapy versus bivalirudin exist for patients with stable ischemic heart disease undergoing PCI. METHODS: A prospective, investigator-initiated, single-center, single-blinded, randomized trial of UFH versus bivalirudin was conducted...
December 4, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29191630/efficacy-and-safety-of-bivalirudin-in-coronary-artery-disease-patients-with-mild-to-moderate-chronic-kidney-disease-meta-analysis
#13
Xiaofang Zeng, A Michael Lincoff, Stefanie Schulz-Schüpke, Philippe Gabriel Steg, Yedid Elbez, Roxana Mehran, Gregg W Stone, Thomas McAndrew, Jianhui Lin, Xindan Zhang, Wenhai Shi, Han Lei, Zhicheng Jing, Wei Huang
BACKGROUND: Patients with chronic kidney disease (CKD) have elevated bleeding and ischemic outcomes. We aim to assess the short- and long-term efficacy and safety of bivalirudin compared to heparin plus glycoprotein IIb/IIIa inhibitors (GPIs) in coronary artery disease (CAD) patients with CKD. METHODS: Randomized trials were searched in PubMed, Cochrane, and Embase databases up to January 2017. Among the trials retrieved, efficacy endpoints were defined as mortality, myocardial infarction (MI), repeat revascularization, stent thrombosis, and major adverse cardiac events (MACEs)...
November 27, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29172822/antithrombotic-efficacy-of-bivalirudin-compared-to-unfractionated-heparin-during-percutaneous-coronary-intervention-for-acute-coronary-syndrome
#14
Corinne Frere, Marc Laine, Gilles Lemesle, Pierre-Emmanuel Morange, Franck Paganelli, Francoise Dignat-George, Noemie Resseguier, Regis Guieu, Laurence Camoin-Jau, Laurent Bonello
Bivalirudin is associated with an increased risk of acute stent thrombosis (AST) compared to unfractionated heparin (UFH) in acute coronary syndrome patients (ACS) during short-duration percutaneous coronary intervention (PCI). The mechanisms involved are unknown. We aimed to investigate the antithrombotic efficacy of bivalirudin compared to UFH during PCI. In a monocenter study, we prospectively enrolled 30 patients undergoing PCI for a non-ST elevation ACS. They were randomly assigned to a single intravenous (IV) bolus of UFH (70 IU/kg) or an IV bolus of bivalirudin 0...
November 27, 2017: Platelets
https://www.readbyqxmd.com/read/29171618/-experience-with-anticoagulation-with-bivalirudin-during-extracorporeal-membrane-oxygenation
#15
Nicolette Van Sint Jan, Rodrigo Díaz, Christian Fajardo, Rocio Agliatti, Marcela Palavecino, Pablo Hasbún, Tomás Regueira
No abstract text is available yet for this article.
June 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29160765/antithrombotic-treatment-in-peripheral-artery-disease
#16
Dan-Mircea Olinic, Dan Alexandru Tataru, Calin Homorodean, Mihail Spinu, Maria Olinic
This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke...
November 21, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#17
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29105331/anticoagulation-with-heparin-the-art-of-simplicity-even-in-patients-on-dialysis
#18
EDITORIAL
Jorge A Belardi, Mariano Albertal
In current PCI practice, anticoagulation with either bivalirudin or unfractionated heparin in patients with ACS share comparable efficacy and safety. Nonetheless, their individual performance in patients on dialysis remains unclear. This observational PCI study reported in-hospital clinical outcome in patients on dialysis undergoing PCI according to drug regimen: bivalirudin versus heparin. Similar clinical outcome was observed with both drug regimens.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105329/if-you-prick-us-do-we-not-bleed
#19
EDITORIAL
Ameera Ahmed, Timothy D Henry
Women have higher post PCI bleeding complications which in turn contributes to higher post PCI mortality. Bivalirudin decreases bleeding events in both men and women when compared to use of both heparin and GPI but bleeding avoidance strategies such as radial artery access or avoiding GPI may modify that benefit. The NCDR bleeding risk score incorporates gender and is predictive of both bleeding complications and mortality. The ideal strategy to reduce bleeding will depend on the specific patient, local practice patterns, and ideally cost effectiveness...
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29103603/in-hospital-outcome-comparing-bivalirudin-to-heparin-in-real-world-primary-percutaneous-coronary-intervention
#20
Matthias Hasun, Jakob Dörler, Michael Edlinger, Hannes Alber, Dirk Von Lewinski, Bernd Eber, Franz Xaver Roithinger, Rudolf Berger, Peter Siostrzonek, Georg Grimm, Werner Benzer, Wilfried Wintersteller, Kurt Huber, Herwig Schuchlenz, Franz Weidinger
Randomized controlled trials have shown conflicting results regarding the outcome of bivalirudin in primary percutaneous coronary intervention (PPCI). The aim of this study was to evaluate the in-hospital outcomes of patients receiving heparin or bivalirudin in a real-world setting of PPCI: 7,023 consecutive patients enrolled in the Austrian Acute PCI Registry were included between January 2010 and December 2014. Patients were classified according to the peri-interventional anticoagulation regimen receiving heparin (n = 6430) or bivalirudin (n = 593) with or without GpIIb/IIIa inhibitors (GPIs)...
September 20, 2017: American Journal of Cardiology
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