Bivalirudin as compared to unfractionated heparin in patients undergoing percutaneous coronary revascularization: A meta-analysis of 22 randomized trials

Thrombosis Research
Monica VerdoiaGiuseppe De Luca

Abstract

Bivalirudin has gained ground against unfractionated heparin (UFH) in percutaneous coronary interventions (PCI), due to a reported better safety profile. However, whether bivalirudin may provide also advantages in clinical outcome beyond the known benefits in major bleedings, is still a debated matter and was, therefore, the aim of present meta-analysis of randomized trials, evaluating efficacy and safety of bivalirudin as compared with UFH in PCI. Literature archives (Pubmed, EMBASE, Cochrane) and main scientific sessions were scanned. Primary endpoint was overall mortality. Secondary endpoints were: 1) mortality within 30-days; 2) overall and within 30-days non fatal myocardial infarction; 3) overall and within 30-days stent thrombosis. Safety endpoints were major bleedings (per protocol definition or TIMI classification). A prespecified analysis was conducted according to clinical presentation (Elective, ACS, STEMI). A total of 22 randomized clinical were finally included, involving 40156 patients randomized to bivalirudin (52.9%) or to UFH (47.1%). Death occurred in 1100 (2.8%) of patients, with no difference between bivalirudin and UFH (2.7% vs 2.8% OR[95%C]=0.94[0.83,-.06], p=0.32, phet=0.48). The results did not change a...Continue Reading

References

Jan 1, 1994·The Journal of Clinical Investigation·J J ZwagingaT J Rabelink
Aug 22, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·C CapozzoloM Chiariello
Feb 9, 2002·Clinical Therapeutics·Timothy D Gladwell
Aug 16, 2006·Circulation·John W EikelboomSalim Yusuf
Mar 4, 2008·Progress in Cardiovascular Diseases·Giuseppe De LucaPaolo Marino
May 6, 2008·Thrombosis Research·Antonius A C M HeestermansJurriën M ten Berg
Jun 23, 2009·JACC. Cardiovascular Interventions·Emilio Di LorenzoGiuseppe Rosato
Jun 1, 2010·Journal of Thrombosis and Thrombolysis·Giuseppe De LucaDavid Antoniucci
Jun 2, 2010·Journal of the American College of Cardiology·Roxana MehranGregg W Stone
Nov 26, 2011·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Eliano Pio NavareseStefano De Servi
May 9, 2012·Current Opinion in Cardiology·Ziad SergieGregg W Stone
Sep 18, 2012·The American Journal of Cardiology·Jimmy MacHaalanyOlivier F Bertrand
Oct 30, 2012·Indian Heart Journal·Niteen V DeshpandeHarshawardhan M Mardikar
Feb 16, 2013·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Rhidian SheltonDaniel Blackman
Mar 5, 2013·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Stefanie SchulzFranz-Josef Neumann
Mar 16, 2013·International Journal of Cardiology·Giuseppe De LucaHarry Suryapranata

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Citations

May 21, 2016·Revista Española De Cardiología·Monica VerdoiaGiuseppe De Luca
Jun 29, 2016·Revista Española De Cardiología·Giuseppe Gargiulo, Marco Valgimigli
Oct 31, 2017·Angiology·Monica VerdoiaUNKNOWN Novara Atherosclerosis Study Group (NAS)
Dec 22, 2020·Journal of Atherosclerosis and Thrombosis·Federica NegroUNKNOWN Novara Atherosclerosis Study Group (NAS)

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