Similar Success Rates with Bivalirudin and Unfractionated Heparin in Bare-Metal Stent Implantation

Hallak, Omar; Shams, Soheila; Broce, Mike; Lavigne, P. Scott; Lucas, B. Daniel; Elhabyan, Abdul-Karim; Reyes, Bernardo

doi:10.1007/s00270-007-9038-1

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…The ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial (7) reported no statistically significant differences in major or minor bleeding rates when the use of bivalirudin alone was compared with the use of UFH; however, when UFH was used in combination with a GP IIb/IIIa inhibitor, significant differences in major (3% vs. 5.7%, p Ͻ 0.001) and minor (3.7% vs. 6.4%, p Ͻ 0.001) bleeding were found. A small, retrospective PPI study showed no statistical differences in rates of major and minor bleeding when bivalirudin was compared with low-dose UFH (10). Therefore, the higher bleeding complications seen in the coronary studies mentioned might be secondary to the higher doses of UFH used and/or the use of GP IIb/IIIa inhibitors.…”

Section: Discussionmentioning

confidence: 80%

Comparison of Safety and Efficacy of Bivalirudin Versus Unfractionated Heparin in Percutaneous Peripheral Intervention

Sheikh¹,

Ahmed²,

Mori³

et al. 2009

JACC: Cardiovascular Interventions

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Section: Discussionmentioning

confidence: 80%

Comparison of Safety and Efficacy of Bivalirudin Versus Unfractionated Heparin in Percutaneous Peripheral Intervention

Sheikh¹,

Ahmed²,

Mori³

et al. 2009

JACC: Cardiovascular Interventions

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“…Of these, 16 were selected for further review. Ultimately, 11 retrospective observational studies 11,18–27 satisfied all inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Bivalirudin versus heparin in patients undergoing percutaneous peripheral interventions: A systematic review and meta-analysis

et al. 2018

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Background Bivalirudin may be an effective alternative anticoagulant to heparin for use in percutaneous peripheral interventions. We aimed to compare the safety and efficacy of bivalirudin versus heparin as the procedural anticoagulant agent in patients undergoing percutaneous peripheral intervention. Methods For this meta-analysis and systematic review, we conducted a search in PubMed, Medline, Embase, and Cochrane for all the clinical studies in which bivalirudin was compared to heparin as the procedural anticoagulant in percutaneous peripheral interventions. Outcomes studied included all-cause mortality, all-bleeding, major and minor bleeding, and access site complications. Results Eleven studies were included in the analysis, totaling 20,137 patients. There was a significant difference favoring bivalirudin over heparin for all-cause mortality (risk ratio 0.58, 95% CI 0.39–0.87), all-bleeding (risk ratio 0.62, 95% CI 0.50–0.78), major bleeding (risk ratio 0.61, 95% CI 0.39–0.96), minor bleeding (risk ratio 0.66, 95% CI 0.47–0.92), and access site complications (risk ratio 0.66, 95% CI 0.51–0.84). There was no significant difference in peri-procedural need for blood transfusions (risk ratio 0.79, 95% CI 0.57–1.08), myocardial infarction (risk ratio 0.87, 95% CI 0.59–1.28), stroke (risk ratio 0.77, 95% CI 0.59–1.01), intracranial bleeding (risk ratio 0.77, 95% CI 0.29–2.02), or amputations (OR 0.75, 95% CI 0.53–1.05). Conclusion Our meta-analysis suggests that bivalirudin use for percutaneous peripheral interventions is associated with lower all-cause mortality, bleeding, and access site complications as compared to heparin. Further large randomized trials are needed to confirm the current results.

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Bivalirudin versus unfractionated heparin in peripheral vascular interventions

Omran

Enezate

Abdullah

et al. 2018

Cardiovascular Revascularization Medicine

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Similar Success Rates with Bivalirudin and Unfractionated Heparin in Bare-Metal Stent Implantation

Cited by 4 publications

References 30 publications

Comparison of Safety and Efficacy of Bivalirudin Versus Unfractionated Heparin in Percutaneous Peripheral Intervention

Comparison of Safety and Efficacy of Bivalirudin Versus Unfractionated Heparin in Percutaneous Peripheral Intervention

Bivalirudin versus heparin in patients undergoing percutaneous peripheral interventions: A systematic review and meta-analysis

Bivalirudin versus unfractionated heparin in peripheral vascular interventions

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