Abstract | BACKGROUND: METHODS AND RESULTS: We evaluated the outcome of 64,052 patients who underwent percutaneous coronary intervention from 2007 to 2009 at 33 hospitals in Michigan and were treated with bivalirudin (28,378) or with heparin and glycoprotein IIb/IIIa inhibitors (35,674). Propensity-matched analysis was adjusted for the nonrandomized use of the 2 strategies. Patients treated with bivalirudin were older, had a lower glomerular filtration rate, and had more comorbidities. Use of bivalirudin was associated with fewer transfusions (2.8% versus 4.2%; P<0.0001), gastrointestinal bleeds (0.5% versus 1.3%; P<0.0001), and vascular complications (1.0% versus 2.5%; P<0.0001), with no difference in survival. Bleeding complications were more common with worsening renal function, but use of bivalirudin was associated with less bleeding across the continuum of renal dysfunction. CONCLUSIONS:
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Authors | Emily Perdoncin, Min Zhang, Arthur Riba, Thomas A LaLonde, Cindy L Grines, Hitinder S Gurm |
Journal | Circulation. Cardiovascular interventions
(Circ Cardiovasc Interv)
Vol. 6
Issue 6
Pg. 688-93
(Dec 2013)
ISSN: 1941-7632 [Electronic] United States |
PMID | 24280966
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antithrombins
- Hirudins
- Peptide Fragments
- Platelet Aggregation Inhibitors
- Platelet Glycoprotein GPIIb-IIIa Complex
- Recombinant Proteins
- bivalirudin
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Topics |
- Aged
- Antithrombins
(adverse effects, therapeutic use)
- Blue Cross Blue Shield Insurance Plans
- Comorbidity
- Coronary Artery Disease
(epidemiology, therapy)
- Female
- Hemorrhage
(epidemiology)
- Hirudins
(adverse effects)
- Humans
- Incidence
- Kidney
(physiopathology)
- Male
- Michigan
- Middle Aged
- Peptide Fragments
(adverse effects, therapeutic use)
- Percutaneous Coronary Intervention
- Platelet Aggregation Inhibitors
(adverse effects, therapeutic use)
- Platelet Glycoprotein GPIIb-IIIa Complex
(antagonists & inhibitors)
- Recombinant Proteins
(adverse effects, therapeutic use)
- Renal Insufficiency, Chronic
(complications, epidemiology, physiopathology)
- Retrospective Studies
- Risk Factors
- Severity of Illness Index
- Treatment Outcome
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