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Bivalirudin

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https://www.readbyqxmd.com/read/28102475/prospective-evaluation-of-a-bivalirudin-to-warfarin-transition-nomogram
#1
Benjamin Hohlfelder, Katelyn W Sylvester, Jessica Rimsans, David DeiCicchi, Jean M Connors
Bivalirudin may cause a falsely prolonged international normalized ratio (INR) that complicates the discontinuation of bivalirudin when used as a bridge to warfarin. To prospectively validate our novel bivalirudin to warfarin transition nomogram, adult patients who received bivalirudin as a bridge to warfarin between July 2015 and June 2016 were prospectively evaluated, utilizing our predictive nomogram. The major outcome of our analysis was the correlation between the predicted change in INR upon bivalirudin discontinuation based on the nomogram, and the actual change in INR upon bivalirudin discontinuation...
January 19, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28095453/bivalirudin-versus-heparin-plus-glycoprotein-iib-iiia-inhibitors-in-women-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-controlled-trials
#2
Haiyan Xu, Bingjian Wang, Jing Yang, Shuren Ma, Xiongwei Xie
Bivalirudin has been shown to be safe and efficacious compared with heparin plus glycoprotein IIb/IIIa inhibitor (GPI) in patients undergoing percutaneous coronary intervention (PCI). Whether bivalirudin would have the beneficial effects in female patients undergoing PCI remains unknown. We searched the literature for randomized controlled trials that assessed bivalirudin versus heparin plus GPI therapy in female patients undergoing PCI. The primary efficacy end point was major adverse cardiovascular events (MACE) within 30 days...
2017: PloS One
https://www.readbyqxmd.com/read/28074815/effect-of-heparin-and-bivalirudin-on-the-kinetics-of-clot-formation-viscoelastic-coagulation-testing
#3
Suruchi Hasija, Poonam Malhotra Kapoor
No abstract text is available yet for this article.
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28057952/direct-thrombin-inhibitor-resistance-and-possible-mechanisms
#4
Maria Cardinale, Michael Ha, Michael H Liu, David P Reardon
Objective: To report 3 cases in which doses of bivalirudin higher than commonly used in clinical practice were required in order to achieve therapeutic anticoagulation as monitored by the activated partial thromboplastin time (aPTT). Case Summary: The medical records of 3 patients who required large doses of bivalirudin to remain therapeutic were thoroughly reviewed. In all 3 patients, bivalirudin was initiated at a rate appropriate for the patients' renal function and titrated using a nurse-driven protocol with recommended dose adjustments based on aPTT...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28052306/laboratory-monitoring-of-parenteral-direct-thrombin-inhibitors
#5
Elizabeth M Van Cott, A Joshua Roberts, William E Dager
Argatroban and bivalirudin are parenteral direct inhibitors of the activity of thrombin, but, unlike heparin, can inhibit both soluble as well as clot-bound thrombin. These agents do not require antithrombin as a cofactor for activity. The parenteral direct thrombin inhibitors (DTIs) can be used in a variety of settings, including heparin-induced thrombocytopenia (HIT) or an allergy to heparin, and patients requiring anticoagulation for an invasive cardiovascular intervention. Both agents have a relatively short half-life in patients without organ system failure and are typically administered by continuous infusion...
January 4, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28044990/unfractionated-heparin-versus-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-a-swedeheart-study
#6
Per Grimfjärd, David Erlinge, Sasha Koul, Bo Lagerqvist, Bodil Svennblad, Christoph Varenhorst, Stefan K James
AIMS: To compare outcome in unfractionated heparin (UFH) and bivalirudin treated patients undergoing primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: This observational study contained 20,614 PPCI patients treated with either UFH monotherapy or bivalirudin with or without concomitant UFH. Patients with oral anticoagulant or glycoprotein IIb/IIIa-inhibitor (GPI) treatment were excluded. The primary outcome measure was definite early stent thrombosis (ST) that occurred at low and similar rates in UFH only and bivalirudin treated patients: 0...
January 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28043990/low-dose-bivalirudin-anticoagulation-for-lung-transplantation-with-extracorporeal-membrane-oxygenation-in-a-patient-with-acute-heparin-induced-thrombocytopenia
#7
Andreas Koster, Jost Niedermeyer, Jan Gummert, Andre Renner
A patient scheduled for lung transplantation needed veno-venous extracorporeal membrane oxygenation (ECMO) and developed acute heparin-induced thrombocytopenia (HIT). After 21 days on ECMO support, lung transplantation was successfully performed using veno-arterial ECMO with bivalirudin anticoagulation. The target activating clotting time values of 160-180 s resulted in low bivalirudin infusion rates of 0.1 mg/kg/h. Diffuse bleeding stopped quickly after ending the continuous bivalirudin infusion.
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27970389/tct-218-factors-influencing-the-risk-of-major-bleeding-with-bivalirudin-compared-with-unfractionated-heparin-in-percutaneous-coronary-intervention
#8
Ahmed Mahmoud, Islam Elgendy
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970388/tct-215-meta-analysis-of-randomized-trials-comparing-bivalirudin-versus-unfractionated-heparin-for-percutaneous-coronary-intervention-through-trans-radial-approach
#9
Ahmed Mahmoud, Islam Elgendy
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970382/tct-210-bivalirudin-versus-heparin-in-women-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-clinical-trials
#10
Marwan Saad, Amgad Gamal, Ramez Nairooz
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970325/tct-156-bivalirudin-versus-heparin-in-primary-percutaneous-coronary-intervention-a-meta-analysis
#11
Mahesh Anantha Narayanan, Yogesh Nv Reddy, Dixitha Anugula, Nagarjuna Gujjula, Apurva Badheka, Abhishek Deshmukh, Manu Kaushik, Ganesh Raveendran
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970136/tct-750-bivalirudin-versus-heparin-anticoagulation-in-transcatheter-aortic-valve-interventions-a-systematic-review-and-a-meta-analysis
#12
Rasha Al-Bawardy, Maday Gonzalez, Jerson Munoz Mendoza, Miguel Alvarez, Daniel Pu, Aman Shah, Arrash Fard, Divyanshu Mohananey, Harish Ramakrishna, Pedro Villablanca
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27943368/rapid-and-durable-response-to-intravenous-immunoglobulin-in-delayed-heparin-induced-thrombocytopenia-a-case-report
#13
Brandon Z Lei, Joseph J Shatzel, Merav Sendowski
BACKGROUND: Heparin-induced thrombocytopenia (HIT) results in platelet consumption and a virulent thrombotic state, which generally responds to cessation of heparin and initiation of anticoagulation. Rarely, delayed HIT can occur and/or persist after heparin is discontinued. STUDY DESIGN AND METHODS: A 47-year-old male developed delayed HIT with severe thrombocytopenia and thrombosis after cardiac surgery. Thrombocytopenia developed and persisted after heparin cessation and did not improve despite sequential use of argatroban followed by bivalirudin...
December 9, 2016: Transfusion
https://www.readbyqxmd.com/read/27904902/a-novel-hirudin-derivative-inhibiting-thrombin-without-bleeding-for-subcutaneous-injection
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
December 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
#20
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...
December 2016: Archives of Cardiovascular Diseases
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