Bivalirudin versus heparin during coronary angioplasty for unstable or postinfarction angina: Final report reanalysis of the Bivalirudin Angioplasty Study.

Abstract

BACKGROUND:

This study was a reanalysis of the Bivalirudin Angioplasty Study, which compared bivalirudin with high-dose heparin during coronary angioplasty for unstable angina.

METHODS:

Differences in rates of death, myocardial infarction, or repeat revascularization were compared at 7, 90, and 180 days after angioplasty with intention-to-treat analysis.

RESULTS:

The combined end point occurred in 135 of 2161 patients (6.2%) in the bivalirudin group and in 169 of 2151 patients (7.9%) in the heparin group at 7 days (P =.039). Differences persisted between the groups at 90 days (P =.012) and 180 days (P =.153). Bleeding occurred in 76 patients (3.5%) in the bivalirudin group versus 199 (9.3%) in the heparin group (P <.001).

CONCLUSIONS:

This analysis supports the hypothesis that bivalirudin reduces ischemic complications and bleeding after angioplasty. Further trials are needed to evaluate bivalirudin versus heparin in conjunction with platelet-glycoprotein IIb/IIIa inhibitors and for coronary stenting.

• Authors: J A Bittl, B R Chaitman, F Feit, W Kimball, E J Topol
• Journal: American heart journal (Am Heart J) Vol. 142 Issue 6 Pg. 952-9 (Dec 2001) ISSN: 1097-6744 [Electronic] United States
• PMID: 11717596 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Hirudins
• Peptide Fragments
• Recombinant Proteins
• Heparin
• Aspirin
• bivalirudin

Topics

• Actuarial Analysis
• Adult
• Aged
• Aged, 80 and over
• Angina Pectoris (etiology, mortality, therapy)
• Angina, Unstable (mortality, therapy)
• Angioplasty, Balloon, Coronary (methods)
• Aspirin (administration & dosage)
• Female
• Follow-Up Studies
• Heparin (therapeutic use)
• Hirudin Therapy
• Hirudins (analogs & derivatives)
• Humans
• Logistic Models
• Male
• Middle Aged
• Myocardial Infarction (complications)
• Odds Ratio
• Peptide Fragments (therapeutic use)
• Randomized Controlled Trials as Topic
• Recombinant Proteins (therapeutic use)
• Survival Rate