Impact of bivalirudin on post-procedural epicardial blood flow, risk of stent thrombosis and mortality after percutaneous coronary intervention
Fiedler KA, Ndrepepa G, Schulz S, Floh S, Hoppmann P, Kufner S, Bernlochner I, Byrne RA, Schunkert H, Laugwitz KL, Kastrati A (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 11
Pages Range: e1275-e1282
Journal Issue: 11
Abstract
Aims: We aimed to assess the association of bivalirudin with post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow, acute (≤24 hours) and 30-day stent thrombosis (ST), and one-year mortality. Methods and results: The study included 11,623 patients undergoing percutaneous coronary intervention (PCI). The primary outcomes were post-procedural TIMI flow grade ≤2 and definite acute ST. In groups treated with bivalirudin (n=3,135), abciximab plus unfractionated heparin (UFH; n=3,539) and UFH alone (n=4,949), post-procedural TIMI was ≤2 in 5.2%, 3.2% and 3.2% of patients, respectively (adjusted odds ratio [OR]=1.96 [95% confidence interval] 1.47-2.56 for bivalirudin versus abciximab plus UFH and OR=1.56 [1.20-2.04] for bivalirudin versus UFH). Definite acute ST occurred in two patients (0.06%) treated with bivalirudin, two patients (0.06%) treated with abciximab plus UFH, and seven patients (0.14%) treated with UFH (p=0.47). Bivalirudin was not associated with increased risk of 30-day ST (hazard ratio [HR]=1.20 [0.59-2.43] versus abciximab plus UHF, and HR=0.93 [0.48-1.82] versus UFH) or one-year mortality (HR=0.95 [0.70-1.28] versus abciximab plus UHF, and HR=1.05 [0.78-1.41] versus UFH). Conclusions: Bivalirudin was associated with higher risk of suboptimal post-PCI TIMI flow but not with increased risk of acute or 30-day definite ST or one-year mortality compared with abciximab plus UFH or UFH alone.
Involved external institutions
Germany (DE)How to cite
APA:
Fiedler, K.A., Ndrepepa, G., Schulz, S., Floh, S., Hoppmann, P., Kufner, S.,... Kastrati, A. (2016). Impact of bivalirudin on post-procedural epicardial blood flow, risk of stent thrombosis and mortality after percutaneous coronary intervention. EuroIntervention, 11(11), e1275-e1282. https://doi.org/10.4244/EIJV11I11A249
MLA:
Fiedler, K. Anette, et al. "Impact of bivalirudin on post-procedural epicardial blood flow, risk of stent thrombosis and mortality after percutaneous coronary intervention." EuroIntervention 11.11 (2016): e1275-e1282.
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