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Bivalirudin heparin pci

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https://www.readbyqxmd.com/read/28160375/heparin-versus-bivalirudin-for-non-primary-percutaneous-coronary-intervention-a-post-hoc-analysis-of-the-cport-e-trial
#1
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
#2
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
#3
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
#4
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
#5
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/27970389/tct-218-factors-influencing-the-risk-of-major-bleeding-with-bivalirudin-compared-with-unfractionated-heparin-in-percutaneous-coronary-intervention
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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/27591687/heparin-versus-bivalirudin-in-st-segment-elevation-myocardial-infarction-a-scai-based-national-survey-from-us-interventional-cardiologists
#16
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
#17
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/27543467/trends-in-use-of-anti-thrombotic-agents-and-outcomes-in-patients-with-non-st-segment-elevation-myocardial-infarction-nstemi-managed-with-an-invasive-strategy
#18
S A Wayangankar, M T Roe, A Y Chen, R S Gupta, R P Giugliano, L K Newby, J A de Lemos, K P Alexander, T A Sanborn, J F Saucedo
OBJECTIVE: To analyze trends in utilization of anti-thrombotic agents (ATA) and in-hospital clinical outcomes in non-ST-elevation myocardial infarction (NSTEMI) patients managed with an invasive strategy from 2007 to 2010. METHODS & RESULTS: Using ACTION Registry(®)-GWTG™ data, we analyzed trends in use of ATA and in-hospital clinical outcomes among 64,199 NSTEMI patients managed invasively between 2007 and 2010. ATA included unfractionated heparin (UFH), low molecular weight heparin (LMWH), glycoprotein IIb/IIIa inhibitors (GPI) and bivalirudin...
July 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27526953/hemorrhagic-and-ischemic-outcomes-of-heparin-vs-bivalirudin-in-carotid-artery-stenting-a-meta-analysis-of-studies
#19
Jad Omran, Obai Abdullah, Mazen Abu-Fadel, William A Gray, Belal Firwana, Douglas E Drachman, Ehtisham Mahmud, Herebert D Aronow, Christopher J White, Ashraf S Al-Dadah
INTRODUCTION: Bivalirudin, has been shown to have comparable efficacy and better safety profile when compared to unfractionated heparin (UFH) in percutaneous coronary interventions. Bivalirudin's safety in carotid artery stenting (CAS) was associated with better outcomes than heparin in some studies. In this Meta analysis we examine the hemorrhagic and ischemic outcomes associated with Bivalirudin compared to UFH during CAS. METHODS: A comprehensive literature search was conducted with the electronic databases MEDLINE, EMBASE, and CENTRAL...
August 16, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27526661/bivalirudin-versus-unfractionated-heparin-during-peripheral-vascular-interventions-a-propensity-matched-study
#20
Daniel Ortiz, Maharaj Singh, Arshad Jahangir, Suhail Allaqaband, Jayant Khitha, Tanvir K Bajwa, Mark W Mewissen
OBJECTIVES: This study aimed to compare the association of access site complications and the use of unfractionated heparin versus bivalirudin during subinguinal peripheral vascular intervention. BACKGROUND: Compared to unfractionated heparin, bivalirudin has been associated with fewer bleeding complications in patients undergoing percutaneous coronary intervention but more ischemic events. The safety and efficacy of direct thrombin inhibitors in peripheral vascular interventions is not well defined...
August 16, 2016: Catheterization and Cardiovascular Interventions
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