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Document type:
Journal Article; Article
Author(s):
Fiedler, K Anette; Ndrepepa, Gjin; Schulz, Stefanie; Floh, Simone; Hoppmann, Petra; Kufner, Sebastian; Bernlochner, Isabell; Byrne, Robert A; Schunkert, Heribert; Laugwitz, Karl-Ludwig; Kastrati, Adnan
Title:
Impact of bivalirudin on post-procedural epicardial blood flow, risk of stent thrombosis and mortality after percutaneous coronary intervention.
Abstract:
We aimed to assess the association of bivalirudin with post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow, acute (<=24 hours) and 30-day stent thrombosis (ST), and one-year mortality.The study included 11,623 patients undergoing percutaneous coronary intervention (PCI). The primary outcomes were post-procedural TIMI flow grade <=2 and definite acute ST. In groups treated with bivalirudin (n=3,135), abciximab plus unfractionated heparin (UFH; n=3,539) and UFH alone (n=4,949), post-procedural TIMI was <=2 in 5.2%, 3.2% and 3.2% of patients, respectively (adjusted odds ratio [OR]=1.96 [95% confidence interval] 1.47-2.56 for bivalirudin versus abciximab plus UFH and OR=1.56 [1.20-2.04] for bivalirudin versus UFH). Definite acute ST occurred in two patients (0.06%) treated with bivalirudin, two patients (0.06%) treated with abciximab plus UFH, and seven patients (0.14%) treated with UFH (p=0.47). Bivalirudin was not associated with increased risk of 30-day ST (hazard ratio [HR]=1.20 [0.59-2.43] versus abciximab plus UHF, and HR=0.93 [0.48-1.82] versus UFH) or one-year mortality (HR=0.95 [0.70-1.28] versus abciximab plus UHF, and HR=1.05 [0.78-1.41] versus UFH).Bivalirudin was associated with higher risk of suboptimal post-PCI TIMI flow but not with increased risk of acute or 30-day definite ST or one-year mortality compared with abciximab plus UFH or UFH alone.
Journal title abbreviation:
EuroIntervention
Year:
2016
Journal volume:
11
Journal issue:
11
Pages contribution:
e1275-82
Language:
eng
Fulltext / DOI:
doi:10.4244/EIJV11I11A249
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/26865445
Print-ISSN:
1774-024X
TUM Institution:
I. Medizinische Klinik und Poliklinik (Kardiologie); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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