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Bivalirudin heparin pci

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28878581/optical-coherence-tomographic-evaluation-of-hyperacute-bivalirudin-induced-coronary-stent-thrombosis
#12
Jorge L Peñalver, Wassim Shatila, Emerson Perin
Thrombus formation after stent deployment has been linked to the use of heparin and of antithrombotic agents, such as bivalirudin, during percutaneous coronary intervention. Fluoroscopy has been used to identify stent thrombosis, typically after patients become symptomatic. We describe our use of optical coherence tomography to diagnose and evaluate intraprocedural stent thrombosis in a 68-year-old man who was given bivalirudin just before a percutaneous coronary procedure. This imaging method enabled immediate therapeutic intervention...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28855222/practice-patterns-and-in-hospital-outcomes-associated-with-bivalirudin-use-among-patients-with-non-st-segment-elevation-myocardial-infarction-undergoing-percutaneous-coronary-intervention-in-the-united-states
#13
Eric A Secemsky, Ajay Kirtane, Sripal Bangalore, Ion S Jovin, Dhavalkumar Patel, Enrico G Ferro, Neil J Wimmer, Matthew Roe, David Dai, Laura Mauri, Robert W Yeh
BACKGROUND: Practice patterns in anticoagulant strategies used during percutaneous coronary intervention (PCI) in the United States for patients with non-ST-segment-elevation myocardial infarction and the comparative outcomes between bivalirudin and unfractionated heparin (UFH) have not been well described. METHODS AND RESULTS: Trends in anticoagulant use were examined among 553 562 PCIs performed by 9254 operators at 1538 hospitals for non-ST-segment-elevation myocardial infarction from 2009 to 2014 within the CathPCI Registry...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28844201/bivalirudin-versus-heparin-monotherapy-in-myocardial-infarction
#14
RANDOMIZED CONTROLLED TRIAL
David Erlinge, Elmir Omerovic, Ole Fröbert, Rikard Linder, Mikael Danielewicz, Mehmet Hamid, Eva Swahn, Loghman Henareh, Henrik Wagner, Peter Hårdhammar, Iwar Sjögren, Jason Stewart, Per Grimfjärd, Jens Jensen, Mikael Aasa, Lotta Robertsson, Pontus Lindroos, Jan Haupt, Helena Wikström, Anders Ulvenstam, Pallonji Bhiladvala, Bo Lindvall, Anders Lundin, Tim Tödt, Dan Ioanes, Truls Råmunddal, Thomas Kellerth, Leszek Zagozdzon, Matthias Götberg, Jonas Andersson, Oskar Angerås, Ollie Östlund, Bo Lagerqvist, Claes Held, Lars Wallentin, Fredrik Scherstén, Peter Eriksson, Sasha Koul, Stefan James
BACKGROUND: The comparative efficacy of various anticoagulation strategies has not been clearly established in patients with acute myocardial infarction who are undergoing percutaneous coronary intervention (PCI) according to current practice, which includes the use of radial-artery access for PCI and administration of potent P2Y12 inhibitors without the planned use of glycoprotein IIb/IIIa inhibitors. METHODS: In this multicenter, randomized, registry-based, open-label clinical trial, we enrolled patients with either ST-segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) who were undergoing PCI and receiving treatment with a potent P2Y12 inhibitor (ticagrelor, prasugrel, or cangrelor) without the planned use of glycoprotein IIb/IIIa inhibitors...
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28766879/bivalirudin-in-percutaneous-coronary-intervention-for-chronic-total-occlusion-a-single-center-pilot-study
#15
Chenguang Li, Rende Xu, Yi Shen, Yuxiang Dai, Feng Zhang, Jianying Ma, Lei Ge, Juying Qian, Junbo Ge
BACKGROUND: Bivalirudin has been reported to be an alternative to unfractionated heparin (UFH) for anticoagulation during percutaneous coronary intervention (PCI) and associated with less bleeding risk. However, the feasibility of bivalirudin during PCI of chronic total occlusion lesions (CTO) remains unknown. OBJECTIVE: To evaluate the efficacy and safety of bivalirudin versus UFH in CTO PCI. METHODS: In this prospective and randomized controlled trial in single center, CTO patients with high bleeding risk were randomized to treatment with bivalirudin (bolus 0...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28744215/safety-and-effectiveness-of-bivalirudin-in-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#16
REVIEW
Abdul Hafeez Ahmad Hamdi, Ahmad Fauzi Dali, Thimarul Huda Mat Nuri, Muhammad Syafiq Saleh, Noor Nabila Ajmi, Chin Fen Neoh, Long Chiau Ming, Amir Heberd Abdullah, Tahir Mehmood Khan
Recent clinical trials have shown that while bivalirudin exhibits similar efficacy with heparin, it offers several advantages over heparin, such as a better safety profile. We aimed to evaluate the efficacy and safety of bivalirudin use during Percutaneous Coronary Intervention (PCI) in the treatment of angina and acute coronary syndrome (ACS). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, PubMed, EMBASE, and Science Direct from January 1980 to January 2016...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28723739/efficacy-and-safety-of-bivalirudin-versus-heparin-in-patients-with-diabetes-mellitus-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-controlled-trials
#17
COMPARATIVE STUDY
Juan Zhang, Xinchun Yang
BACKGROUND: The efficacy and safety of bivalirudin (Biva) versus heparin in patients with diabetes mellitus (DM) who undergo percutaneous coronary intervention (PCI) remain controversial. Our meta-analysis was undertaken to evaluate the efficacy and safety of Biva compared with those of heparin in patients with diabetes undergoing PCI. METHODS: We searched PubMed, EMBASE, Cochrane Library, and Clinical Trials.gov databases for randomized controlled trials (RCTs)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639987/antithrombotic-strategies-in-the-catheterization-laboratory-for-patients-with-acute-coronary-syndromes-undergoing-percutaneous-coronary-interventions-insights-from-the-employed-antithrombotic-therapies-in-patients-with-acute-coronary-syndromes-hospitalized
#18
Leonardo De Luca, Giuseppe Musumeci, Sergio Leonardi, Lucio Gonzini, Claudio Cavallini, Paolo Calabrò, Ciro Mauro, Luisa Cacciavillani, Stefano Savonitto, Stefano De Servi
AIMS: In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). METHODS: EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy...
August 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28624360/association-between-arterial-access-site-and-anticoagulation-strategy-on-major-bleeding-and-mortality-a-historical-cohort-analysis-in-the-veteran-population
#19
Jayant Bagai, Bert Little, Subhash Banerjee
BACKGROUND: Studies have shown reduction in major bleeding with trans-radial intervention (TRI) compared with trans-femoral intervention (TFI), and with use of bivalirudin compared with heparin+glycoprotein IIb/IIIa inhibitors (GPI). We compared major bleeding, mortality and the interaction between arterial access site and the anticoagulant used for PCI in Veterans. METHODS: A retrospective cohort of 1192 consecutive patients who underwent PCI at a VA hospital between 2006 and 2012 was divided into TFI-heparin (n=192), TFI-bivalirudin (n=272), TRI-heparin (n=274) and TRI-bivalirudin (n=454) groups...
June 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28612420/bivalirudin-or-heparin-for-radial-access
#20
EDITORIAL
John A Bittl
Bivalirudin is a reasonable choice during transradial PCI for acute MI when bleeding risk is high and clopidogrel or cangrelor is used Heparin is reasonable during transradial PCI when bleeding risk is low and high-intensity antiplatelet therapy is used Future studies are required to define the utility of post-PCI bivalirudin infusions.
June 1, 2017: Catheterization and Cardiovascular Interventions
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