Impact of heparin-to-bivalirudin bridging time on hospitalization and safety outcomes in PCI for acute coronary syndrome

BACKGROUND: Bivalirudin is increasingly used during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), but the optimal interval between discontinuing unfractionated heparin (UFH) and initiating bivalirudin remains unclear. This study examined the association between heparin-to-bivalirudin bridging time and clinical outcomes. METHODS: This retrospective cohort included 197 ACS patients undergoing PCI. Bridging intervals were evaluated using two predefined thresholds: Scenario A (≤30 vs. >30 min) and Scenario B (≤20 vs. >20 min). Clinical, laboratory, and procedural data were collected. Outcomes included bleeding events, cardiovascular events, rehospitalization, and composite adverse outcomes. Multivariable logistic regression and binomial regression with generalized estimating equations were performed, and restricted cubic spline analyses assessed non-linear associations. RESULTS: In Scenario A, hospitalization occurred significantly less frequently in the ≤30-min group compared with the >30-min group (8.9% vs. 21.6%). After adjustment, longer intervals were associated with higher hospitalization risk (OR = 3.20, 95% CI: 1.20-8.54; RR = 2.55, 95% CI: 1.15-5.66). No differences were observed for bleeding, cardiovascular events, or composite outcomes. In Scenario B, no significant associations were identified for any outcomes. Spline analyses revealed no dose-response relationship between bridging time and clinical outcomes. CONCLUSIONS: A heparin-to-bivalirudin bridging interval of ≤30 min may reduce hospitalization without increasing bleeding or cardiovascular events, whereas a 20-min threshold offers no clinical advantage. Bridging time may represent a modifiable procedural parameter that warrants further evaluation in prospective randomized trials. CLINICAL TRIAL REGISTRATION: ChiCTR2400089671.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Real-world cohort assessing heparin-to-bivalirudin bridging duration in PCI for ACS. Optimal bridging window identified; outcomes improved with longer bivalirudin infusion post-procedure.

Leech-derived molecules this paper discusses, each with a full profile in the ASH compound registry:

Explore cómo esta investigación se conecta con la práctica clínica

More peer-reviewed studies in Ensayos clínicos.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Reverse Sural Flap Venous Congestion Successfully Managed With Enoxaparin in a Male Patient With a Traumatic Foot Crush Injury: A Case Report — Velasco-Bustamante J et al. (2026)
• Investigation of the therapeutic effects of medicinal leech treatment on lower extremity ischemia-reperfusion injury — Ünal K et al. (2026)
• Efficacy of Medicinal Leech Therapy in Diverse Clinical Applications: A Comprehensive Study from Azerbaijan — Farzali S et al. (2025)
• HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW — Heinz P et al. (2020)
• Hirudotherapy Efficacy and Complications in the Management of Microsurgical Breast Reconstruction: A Systematic Review — Foppiani J et al. (2024)
• Hirudotherapy in Wound Healing — Nair H et al. (2022)

Browse all ASH-analysed research →