Login
- Dokumenttyp:
- Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Article
- Autor(en):
- Ndrepepa, G; Schulz, S; Keta, D; Mehilli, J; Birkmeier, A; Massberg, S; Laugwitz, KL; Neumann, FJ; Seyfarth, M; Berger, PB; Schömig, A; Kastrati, A
- Titel:
- Bleeding after percutaneous coronary intervention with Bivalirudin or unfractionated Heparin and one-year mortality.
- Abstract:
- Compared to unfractionated heparin (UFH), bivalirudin decreases bleeding during percutaneous coronary interventions (PCIs). We sought to investigate the association between periprocedural bleeding and 1-year mortality as a function of antithrombotic therapy with bivalirudin or UFH. This analysis of the association between bleeding with bivalirudin or UFH and 1-year mortality included the 4,570 patients with negative biomarkers enrolled in the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT 3) trial. Major or minor bleeding occurred in 555 patients (12.1%): 225 patients treated with bivalirudin (9.8%) and 330 patients treated with UFH (14.5%, p <0.001). There were 82 deaths (1.8%) within the first year after PCI: 29 deaths occurred in patients who had bled, and 53 deaths occurred in patients who had not bled (Kaplan-Meier estimates of 1-year mortality 5.2% and 1.3%, odds ratio 4.12, 95% confidence interval 2.59 to 6.54, p <0.001). One year after PCI, there were 15 deaths in patients who bled with bivalirudin versus 14 deaths in patients who bled with UFH (Kaplan-Meier estimates of 1-year mortality 6.7% vs 4.2%, odds ratio 1.61, 95% confidence interval 0.76 to 3.40, p = 0.20). Major bleeding occurred in 70 patients (3.0%) treated with bivalirudin and 104 patients treated with UFH (4.5%, p = 0.008). One-year mortality was 11.4% (n = 8) in patients with major bleeding with bivalirudin versus 4.8% (n = 5) in patients with major bleeding with UFH (p = 0.10). In conclusion, these data suggest that in patients with negative biomarkers undergoing PCI, bivalirudin decreases bleeding after PCI compared to UFH, without affecting 1-year mortality in those who had bled.
- Zeitschriftentitel:
- Am J Cardiol
- Jahr:
- 2010
- Band / Volume:
- 105
- Heft / Issue:
- 2
- Seitenangaben Beitrag:
- 163-7
- Sprache:
- eng
- Volltext / DOI:
- doi:10.1016/j.amjcard.2009.08.668
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/20102912
- Print-ISSN:
- 0002-9149
- TUM Einrichtung:
- I. Medizinische Klinik und Poliklinik (Kardiologie)
BibTeX