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
Randomized controlled trial published in Catheter Cardiovasc Interv (2016)
Abstract
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. The primary outcome was 30-day net adverse clinical event (NACE), defined as a composite of major cardiac and cerebral events or any bleeding. RESULTS: 30-day NACE occurred in 5.7% with bivalirudin, 7.8% with heparin alone (vs. bivalirudin, P = 0.159), and 10.3% with heparin plus tifofiban (vs. bivalirudin, P = 0.004). The 30-day bleeding rate was 0.9% for bivalirudin, 2.3% for heparin (vs. bivalirudin, P = 0.057), and 5.8% for heparin plus tirofiban (vs. bivalirudin, P < 0.001). Major cardiac and cerebral events (4.9 vs. 5.7 vs. 4.6%, P = 0.899), stent thrombosis (0.5 vs. 0.5 vs. 0.7%, P = 0.899) and acquired thrombocytopenia (0.2 vs. 0.5 vs. 0.9%, P = 0.257) at 30 days were similar among three arms. The interaction test for PCI access and randomized treatment showed no significance on all bleeding (P > 0.05). CONCLUSIONS: The bleeding benefit of bivalirudin was independent of artery access. Bivalirudin lead to statistical reduction on bleeding risks in comparison to heparin plus tirofiban, and only small numerical difference in comparison to heparin, with comparable risks of ischemic events and stent thrombosis in patients with acute myocardial infarction (AMI) undergoing emergency transradial PCI. © 2016 Wiley Periodicals, Inc.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
To explore the efficiency and safety of bivalirudin in patients undergoing emergency percutaneous coronary intervention via radial access.
Por qué esto importa para la hirudoterapia
El ensayo BRIGHT examinó bivalirudina frente a heparina o heparina más tirofibán en 1723 pacientes sometidos a intervención coronaria percutánea de urgencia por acceso radial debido a infarto agudo de miocardio, con el objetivo primario de eventos clínicos adversos netos (ECAN) a 30 días. La bivalirudina mostró una reducción estadísticamente significativa del sangrado a 30 días en comparación con heparina más tirofibán (0,9% frente a 5,8%; P < 0,001), mientras que los eventos isquémicos, la trombosis del stent y la trombocitopenia fueron comparables entre las ramas; el beneficio en cuanto a sangrado fue independiente del acceso arterial. El resumen no aporta información alguna sobre sanguijuelas, hirudoterapia o compuestos derivados de la sanguijuela, y no puede establecerse ninguna conexión defendible con el ámbito de la ASH a partir de esta fuente. Este estudio es exclusivamente una comparación farmacológica de regímenes anticoagulantes en cardiología intervencionista.
Citación
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.
Wang H et al. · Catheter Cardiovasc Interv, 2016
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026