| Title | Comparison of prolonged bivalirudin infusion versus intraprocedural in preventing myocardial damage after percutaneous coronary intervention in patients with angina pectoris. | | Author(s) | Cortese B, Picchi A, Micheli A, Ebert AG, Parri F, Severi S, Limbruno U | | Institution | Interventional Cardiology Unit, Ospedale della Misericordia, Grosseto, Italy. bcortese@gmail.com | | Source | Am J Cardiol 2009 Oct 15; 104(8):1063-8. | | MeSH | Aged
Angina Pectoris
Angioplasty, Transluminal, Percutaneous Coronary
Anticoagulants
Antithrombins
Delayed-Action Preparations
Dose-Response Relationship, Drug
Electrocardiography
Female
Follow-Up Studies
Hirudins
Humans
Incidence
Infusions, Intravenous
Italy
Male
Myocardial Infarction
Peptide Fragments
Prospective Studies
Recombinant Proteins
Single-Blind Method
Treatment Outcome
| | Abstract | Modern antithrombotic strategies for patients undergoing percutaneous coronary interventions (PCIs) must take into account the risk of ischemic and hemorrhagic complications. Bivalirudin decreases the risk of hemorrhagic complications after PCI; however, concerns have been raised about its efficacy in preventing ischemic complications. We evaluated the effectiveness of a prolonged intra- and postprocedural bivalirudin infusion versus a standard regimen in preventing PCI-related myocardial damage. One hundred seventy-eight consecutive patients with stable or unstable angina and complex coronary anatomy were enrolled in this single-center, randomized, single-blinded study. Patients were randomized to bolus plus bivalirudin infusion during PCI (n = 90) or bolus plus bivalirudin infusion during and after PCI (4 hours, n = 88). The primary end point was incidence of periprocedural myocardial damage (creatine kinase-MB increase >or=3 times upper limit of normal). Secondary end points were 30-day and 6-month major adverse cardiovascular events (death, new Q-wave myocardial infarction, target vessel revascularization) and in-hospital bleeding (major/minor). The 2 groups did not differ significantly in baseline and procedural characteristics. The primary end point of the study was significantly less frequent in the prolonged infusion group (6.8% vs 16.7%, p = 0.041). No significant differences for secondary end points were observed. In conclusion, in patients undergoing complex PCI, a prolonged bivalirudin infusion after PCI compared to an intraprocedural-only regimen significantly decreased the incidence of periprocedural myocardial damage. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
Randomized Controlled Trial
| | PubMed ID | 19801025 |
|
