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Bivalirudin heparin pci

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https://www.readbyqxmd.com/read/28303632/the-comparative-safety-and-effectiveness-of-bivalirudin-versus-heparin-monotherapy-in-patients-on-dialysis-undergoing-percutaneous-coronary-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium
#1
Devraj Sukul, Milan Seth, Theodore Schreiber, Akshay Khandelwal, Louis A Cannon, Thomas A LaLonde, Hitinder S Gurm
BACKGROUND: Dialysis patients are at a higher risk of bleeding after percutaneous coronary intervention (PCI); however, due to their exclusion from randomized clinical trials, the optimal antithrombotic regimen for this population remains unknown. We sought to evaluate the comparative safety and effectiveness of bivalirudin monotherapy versus unfractionated heparin (UFH) monotherapy in dialysis patients undergoing PCI. METHODS: We included dialysis patients who underwent PCI in a multicenter registry between January 2010 and September 2015 at 47 Michigan hospitals...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28291727/bivalirudin-versus-heparin-in-women-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis-of-randomized-clinical-trials
#2
Marwan Saad, Ramez Nairooz, Ahmed Rashed, Hesham K Abdelaziz, Amgad Mentias, J Dawn Abbott
BACKGROUND: The anticoagulant of choice during percutaneous coronary intervention (PCI) in women is not well established. METHODS: An electronic search was conducted for trials that randomized patients undergoing PCI to bivalirudin versus heparin, and reported outcomes of interest in women. Random effects DerSimonian-Laird risk ratios (RR) were calculated. Main outcome was net adverse clinical events (NACE) at 30-days. Other outcomes included major adverse cardiac events (MACE), all-cause mortality, myocardial infarction (MI), target vessel revascularization (TVR), and major bleeding at 30-days...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28281731/current-patterns-of-antithrombotic-and-revascularization-therapy-in-patients-hospitalised-for-acute-coronary-syndromes-data-from-the-polish-subset-of-the-epicor-study
#3
Izabela Wojtkowska, Janina Stępińska, Małgorzata Stępień-Wojno, Mateusz Sobota, Jerzy Kopaczewski, Zygfryd Reszka, Michał Kurzelewski, Jesus Medina
BACKGROUND: Cardiovascular disease is the leading cause of mortality and morbidity in developed countries, including Poland. Antithrombotic drugs play a crucial role in the management of acute coronary syndromes (ACS). Recent clinical trials have demonstrated the efficacy and safety profiles of new antiplatelet and anticoagulant agents, which may be used as add-on therapy or replacements for older drugs. The EPICOR: (long-t E: rm follow-u P: of antithrombotic management patterns I: n acute COR: onary syndrome patients) is a prospective international observational study (NCT01171404) designed to describe the use of antithrombotic management strategies for the treatment of ACS during the acute phase and over a follow-up period of up to 2 years from the index event...
March 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28273285/one-year-mortality-for-bivalirudin-vs-heparins-plus-optional-glycoprotein-iib-iiia-inhibitor-treatment-started-in-the-ambulance-for-st-segment-elevation-myocardial-infarction-a-secondary-analysis-of-the-euromax-randomized-clinical-trial
#4
Enrico Fabris, Sinem Kilic, Arnoud W J Van't Hof, Jurrien Ten Berg, Ana Ayesta, Uwe Zeymer, Martial Hamon, Louis Soulat, Debra Bernstein, Prodromos Anthopoulos, Efthymios N Deliargyris, Philippe Gabriel Steg
Importance: Uncertainty exists regarding potential survival benefits of bivalirudin compared with heparin with routine or optional use of glycoprotein IIb/IIIa inhibitors (GPIs) in patients with ST-segment elevation myocardial infarction (STEMI). Few data are available regarding long-term mortality in the context of contemporary practice with frequent use of radial access and novel platelet adenosine diphosphate P2Y12 receptor inhibitors. Objective: To assess the effect of bivalirudin monotherapy compared with unfractionated or low-molecular-weight heparin plus optional GPIs on 1-year mortality...
March 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28249084/effect-of-short-procedural-duration-with-bivalirudin-on-increased-risk-of-acute-stent-thrombosis-in-patients-with-stemi-a-secondary-analysis-of-the-horizons-ami-randomized-clinical-trial
#5
Hector Tamez, Duane S Pinto, Ajay J Kirtane, Claire Litherland, Robert W Yeh, George D Dangas, Roxana Mehran, Efthymios N Deliargyris, Guillermo Ortiz, C Michael Gibson, Gregg W Stone
Importance: Bivalirudin has been associated with reduced bleeding and mortality during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). However, increased rates of acute stent thrombosis (AST) have been noted when bivalirudin is discontinued at the end of the procedure, which is perhaps related to this medication's short half-life. Objectives: To evaluate the clinical effect of procedure duration on AST when either bivalirudin or heparin plus glycoprotein IIb/IIIa receptor inhibitor (GPI) is used...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#6
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28160375/heparin-versus-bivalirudin-for-non-primary-percutaneous-coronary-intervention-a-post-hoc-analysis-of-the-cport-e-trial
#7
Matthew J Czarny, Chao-Wei Hwang, Daniel Q Naiman, Cynthia C Lemmon, Rani K Hasan, Thomas Wang, Thomas Aversano
OBJECTIVES: To compare bivalirudin to heparin during non-primary percutaneous coronary intervention (PCI). BACKGROUND: The optimal anticoagulant to support PCI remains uncertain. METHODS: We performed a propensity score-based analysis comparing clinical outcomes of patients receiving heparin to those receiving bivalirudin during non-primary PCI. RESULTS: Of 18,867 patients in the Cardiovascular Patient Outcomes Research Team Non-Primary PCI (CPORT-E) trial, we selected 7,913 patients undergoing non-staged PCI of whom 57...
February 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28105561/the-rise-and-fall-of-anticoagulation-with-bivalirudin-during-percutaneous-coronary-interventions-a-review-article
#8
REVIEW
Constantinos Andreou, Christos Maniotis, Michael Koutouzis
Bivalirudin is a direct thrombin inhibitor used during percutaneous coronary intervention (PCI). Treatment with bivalirudin compared to heparin plus glycoprotein IIb/IIIa inhibitors (GPI) reduced bleeding complications, but resulted in higher rates of ischemic events, including acute stent thrombosis in ST segment elevation myocardial infarction (STEMI) patients. Thus, it may be considered a reasonable alternative antithrombotic agent in patients at high risk of bleeding undergoing PCI. However its superiority over heparin alone is questioned particularly in the era of novel antiplatelet agents and transradial PCI...
January 19, 2017: Cardiology and Therapy
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
#9
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/28052306/laboratory-monitoring-of-parenteral-direct-thrombin-inhibitors
#10
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
#11
Per Grimfjärd, David Erlinge, Sasha Koul, Bo Lagerqvist, Bodil Svennblad, Christoph Varenhorst, Stefan K James
AIMS: The aim of the study was to compare outcomes in unfractionated heparin (UFH) and bivalirudin-treated patients undergoing primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: This observational study contained 20,612 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...
March 20, 2017: EuroIntervention
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
#12
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
#13
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
#14
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
#15
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/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/27842901/comparison-of-heparin-bivalirudin-and-different-glycoprotein-iib-iiia-inhibitor-regimens-for-anticoagulation-during-percutaneous-coronary-intervention-a-network-meta-analysis
#17
REVIEW
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
#18
COMPARATIVE STUDY
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
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
#19
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/27677503/bivalirudin-or-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-managed-invasively-with-and-without-st-elevation-matrix-randomised-controlled-trial
#20
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
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