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Bivalirudin heparin pci

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https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#1
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29765614/bivalirudin-versus-heparin-in-primary-pci-clinical-outcomes-and-cost-analysis
#2
Pierre Deharo, Thomas W Johnson, Hazim Rahbi, Raveen Kandan, Ruth Bowles, Abdul Mozid, Stephen Dorman, Julian W Strange, Andreas Baumbach
Background: The evidence for benefits of bivalirudin over heparin has recently been challenged. We aimed to analyse the safety and cost-effectiveness following reintroduction of heparin instead of bivalirudin as the standard anticoagulation for primary percutaneous coronary intervention (PPCI) in a high-volume centre. Methods and results: This analysis was an open-label, prospective registry including all patients admitted to our centre for PPCI from April 2014 to April 2016...
2018: Open Heart
https://www.readbyqxmd.com/read/29563377/exploration-of-bivalirudin-use-during-percutaneous-coronary-intervention-for-high-bleeding-risk-patients-with-chronic-total-occlusion
#3
Chenguang Li, Yi Shen, Rende Xu, Yuxiang Dai, Shufu Chang, Hao Lu, Lei Ge, Jianying Ma, Juying Qian, Junbo Ge
The safety and efficacy of bivalirudin during percutaneous coronary intervention (PCI) in high bleeding risk patients with chronic total occlusion lesions (CTO) has not been studied till date. The use of bivalirudin may increase the thrombotic events during CTO-PCI.Between May 2013 and April 2014, a total of 117 high bleeding risk patients with CTOs underwent PCI. Bivalirudin was used in 89 cases with different strategies, including standard usage, combination of heparin, and additional bolus of bivalirudin on the basis of standard usage...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29555534/myocardial-reperfusion-for-acute-myocardial-infarction-under-an-optimized-antithrombotic-medication-what-can-you-expect-in-daily-practice
#4
Samuel Pinelli, Nelly Agrinier, Nidhal Bouchahda, Pierre Adrien Metzdorf, Edoardo Camenzind, Batric Popovic
AIMS: To assess both epicardiac macrovascular as well as microvascular and tissue reperfusion following different intravenous preadmission antithrombotic strategies prior primary PCI in STEMI patients. METHODS AND RESULTS: Consecutive STEMI patients (n = 488) undergoing pPCI received prehospitally either bivalirudin (n = 179), bivalirudin and periprocedural GPIIb/IIIa inhibitors (GPI) (n = 109), heparin (n = 99) or heparin and periprocedural GPI (n = 101)...
February 27, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29432119/anticoagulant-use-among-patients-with-end-stage-renal-disease-undergoing-percutaneous-coronary-intervention-an-analysis-from-the-national-cardiovascular-data-registry
#5
Jeffrey B Washam, Lisa A Kaltenbach, Daniel M Wojdyla, Manesh R Patel, Andrew J Klein, J Dawn Abbott, Sunil V Rao
BACKGROUND: Patients with end-stage renal disease undergoing percutaneous coronary intervention (PCI) have largely been excluded from trials of antithrombotic therapies leaving little data to guide agent choice in this population. METHODS AND RESULTS: The National Cardiovascular Data Registry CathPCI Registry was used to identify patients with end-stage renal disease undergoing PCI who received monotherapy with either bivalirudin or unfractionated heparin (UFH) (n=71 675)...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29394998/predictors-of-left-ventricular-ejection-fraction-improvement-after-primary-stenting-in-st-segment-elevation-myocardial-infarction-from-the-harmonizing-outcomes-with-revascularization-and-stents-in-acute-myocardial-infarction-trial
#6
Gregory W Serrao, Alexandra J Lansky, Roxana Mehran, Gregg W Stone
The predictors of improvement in left ventricular ejection fraction (LVEF) after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) are poorly understood. We sought to determine the prevalence and clinical and angiographic predictors of LVEF improvement after primary PCI in STEMI. In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction trial, 3,602 patients presenting with STEMI were randomized to heparin + a glycoprotein IIb/IIIa inhibitor versus bivalirudin...
March 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29350380/patients-treated-with-bivalirudin-are-still-at-higher-risk-of-stent-thrombosis-a-comprehensive-meta-analysis-of-randomised-clinical-trials-of-bivalirudin-and-heparin-for-percutaneous-coronary-interventions
#7
Stefan Grajek, Michał Michalak, Adrian Gwizdała, Aleksander Araszkiewicz, Marek Grygier, Jarosław Hiczkiewicz, Maciej Lesiak
BACKGROUND: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous. AIM: The aim of the study was to compare the impact of bivalirudin and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis. METHODS: A total of 18 randomised clinical trials involving 41,752 subjects were included...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29339166/anticoagulation-in-acute-coronary-syndrome-state-of-the-art
#8
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 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
#9
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 percutaneous coronary intervention (PPCI). The aim of this study was to report pre-specified, secondary analyses comparing the effects of P2Y12 inhibiting agents on platelet reactivity and clinical events. METHODS AND RESULTS: All patients received preprocedural oral antiplatelet therapy. During the early stages of the trial, the P2Y12 inhibitor of choice was prasugrel with some use of clopidogrel...
March 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29225903/early-clinical-outcomes-as-a-function-of-use-of-newer-oral-p2y-12-inhibitors-versus-clopidogrel-in-the-euromax-trial
#10
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
#11
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/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/29172822/antithrombotic-efficacy-of-bivalirudin-compared-to-unfractionated-heparin-during-percutaneous-coronary-intervention-for-acute-coronary-syndrome
#13
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/29105331/anticoagulation-with-heparin-the-art-of-simplicity-even-in-patients-on-dialysis
#14
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
#15
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
#16
MULTICENTER STUDY
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)...
December 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29055661/bivalirudin-versus-heparin-without-glycoprotein-inhibition-in-percutaneous-coronary-intervention-a-comparison-of-ischemic-and-hemorrhagic-outcomes-over-10years
#17
Hannah I Chaudry, Theodore B Curran, Bruce W Andrus, Sheila M Conley, James T DeVries
OBJECTIVE: The choice of antithrombotic agent used during percutaneous coronary intervention (PCI) is controversial. While earlier studies suggested a reduction in bleeding events with bivalirudin, these studies were confounded by the concomitant use of glycoprotein IIbIIIa inhibitors (GPI) in the heparin group. More recent studies have challenged the superiority of bivalirudin, pointing to an increased risk of stent thrombosis. Real-world data remains limited. METHODS: We queried our institutional catheterization laboratory database for all PCI cases performed between January 2003 and December 2012 using only heparin or only bivalirudin (no use of GPI)...
September 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28905866/anticoagulation-therapy-bivalirudin-not-superior-to-heparin-in-pci
#18
Gregory B Lim
No abstract text is available yet for this article.
November 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#19
Christian Boehnel, Hans Rickli, Lukas Graf, Micha T Maeder
OBJECTIVES: We aimed to summarize the evidence for periprocedural and long-term strategies to both minimize the bleeding risk and ensure sufficient anticoagulation and antiaggregation in hemophilia patients undergoing coronary angiography with or without percutaneous coronary interventions (PCI). BACKGROUND: Hemophilia patients undergoing coronary angiography and PCI are at risk of bleeding due to deficiency of the essential clotting factors VIII or IX combined with the need of peri-interventional anticoagulation and antiaggregation and dual antiplatelet therapy (DAPT) after PCI...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28891164/heparin-or-bivalirudin-for-non-primary-pci-beware-of-neat-and-simple-answers%C3%A2
#20
EDITORIAL
Efthymios N Deliargyris, Carey Kimmelstiel
The debate regarding the choice of heparin or bivalirudin as the preferred anticoagulant in PCI is still ongoing Nonrandomized registry data are severely limited for comparative analyses and should therefore always be interpreted with caution Clinicians should resist simplistic data interpretations or populist cries relating to cost, but rather focus on valid benefit:risk analyses for their clinical decision making.
September 1, 2017: Catheterization and Cardiovascular Interventions
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