In-Hospital Outcome Comparing Bivalirudin to Heparin in Real-World Primary Percutaneous Coronary Intervention
Comparative study published in Am J Cardiol (2017)
Abstract
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). In-hospital mortality (odds ratio [OR] 1.13, 95% confidence interval [CI] 0.57 to 2.25, p = 0.72), major adverse cardiovascular events (OR 1.18, 95% CI 0.65 to 2.14, p = 0.59), net adverse clinical events (OR 1.01, 95% CI 0.57 to 1.77, p = 0.99), and TIMI non-coronary artery bypass graft-related major bleeding (OR 0.41, 95% CI 0.09 to 1.86, p = 0.25) were not significantly different between the groups. However, we detected potential effect modifications of anticoagulants on mortality by GPIs (OR 0.12, 95% CI 0.01 to 1.07, p = 0.06) and access site (OR 0.25, 95% CI 0.06 to 1.03, p = 0.06) favoring bivalirudin in femoral access. In conclusion, this large real-world cohort of PPCI, heparin-based anticoagulation showed similar results of short-term mortality compared with bivalirudin. We observed a potential effect modification by additional GPI use and access favoring bivalirudin over heparin in femoral, but not radial, access.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
7,023 Austrian Acute PCI Registry patients; no significant differences between bivalirudin and heparin in mortality, MACE, or major bleeding; potential bivalirudin advantage in femoral access.
Почему это важно для гирудотерапии
This study evaluated in-hospital outcomes in 7,023 consecutive patients enrolled in the Austrian Acute PCI Registry (2010–2014) who received heparin (n=6,430) or bivalirudin (n=593) during primary percutaneous coronary intervention. No significant differences were found in mortality, major adverse cardiovascular events, net adverse clinical events, or major bleeding between groups, though potential effect modifications favoring bivalirudin were observed with femoral access and glycoprotein IIb/IIIa inhibitor use. The abstract makes no mention of leeches, hirudin, or leech-derived materials, and provides no basis for any connection to hirudotherapy or the leech secretome. This is a clinical cardiology study with no demonstrable relevance to ASH's domain.
Цитирование
In-Hospital Outcome Comparing Bivalirudin to Heparin in Real-World Primary Percutaneous Coronary Intervention.
Hasun M et al. · Am J Cardiol, 2017
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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