Comparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in 'Real World' practice
Autor: | Gerald J. Clesham, John R. Davies, Paul A. Kelly, Mike Parker, Wasing Taggu, Kare H. Tang, Reto Gamma, Rajesh K. Aggarwal, Jeremy Sayer, Refai Showkathali |
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Rok vydání: | 2013 |
Předmět: |
Male
medicine.medical_specialty Time Factors Abciximab medicine.medical_treatment Myocardial Infarction Hemorrhage Kaplan-Meier Estimate Platelet Glycoprotein GPIIb-IIIa Complex Antithrombins Immunoglobulin Fab Fragments Percutaneous Coronary Intervention Risk Factors Internal medicine medicine Humans Bivalirudin Hospital Mortality Aged Proportional Hazards Models Retrospective Studies Heparin business.industry Coronary Thrombosis Cardiogenic shock Significant difference Antibodies Monoclonal Anticoagulants Percutaneous coronary intervention General Medicine Hirudins Middle Aged Device use medicine.disease Peptide Fragments Recombinant Proteins Logistic Models Treatment Outcome Cardiology Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors Major bleeding medicine.drug |
Zdroj: | Cardiovascular Revascularization Medicine. 14:289-293 |
ISSN: | 1553-8389 |
Popis: | Objective We aimed to carry out a “real world” comparison of bivalirudin plus unfractionated heparin (UFH) versus abciximab plus UFH in patients undergoing primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI). Methods We included patients who had abciximab or bivalirudin during their PPCI in our unit between Sept 2009 and Nov 2011. Results The study included 516 and 484 patients in the bivalirudin and abciximab group respectively. There were more women in the bivalirudin group (29% vs 20%, p 0.001), while cardiogenic shock (6.4% vs 10.1%, p 0.04) and thrombectomy device use (76.6% vs 82%, p 0.04) were lower in the bivalirudin group. The primary composite end point of 30-day mortality, 30-day definite stent thrombosis or non-CABG major bleeding was similar between the bivalirudin and abciximab groups (7.8% vs 9.5%, OR 0.8, 95% CI 0.5 to 1.2, p 0.4). There was also no difference in in-hospital mortality (4.1% vs 4.3%, p 0.9), 30-day mortality (5.2% vs 6.4%, p 0.5), 1-year mortality (9.1% vs 9.9%, p 0.7), 30-day stent thrombosis (1% vs 0.4%, p 0.5) and non-CABG bleeding (2.7 vs 3.7%, p 0.4) between the bivalirudin and abciximab group respectively. On Cox proportional hazard analysis after adjusting for all the co-variates, the use of bivalirudin was not a predictor of 30-day mortality (HR 1.13, 95% CI 0.7–1.9, p 0.7). Conclusion In this “real-world” observational study, there was no significant difference in the clinical outcome of PPCI for patients who had abciximab or bivalirudin after initial pre-treatment with UFH. |
Databáze: | OpenAIRE |
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