Effectiveness and Safety of Bivalirudin During Percutaneous Coronary Intervention in Acute Coronary Syndrome in the Real World: CARTAGOMAX Study
| Autor: | Mármol-Lozano R, Bonilla-Pacheco Yi, Jaulent-Huertas L, Dau-Villareal Df, Castillo-Moreno Ja, Ruiz-Abellón Mdel C, Abellán-Huerta J, Giner-Caro Ja, Picó-Aracil F, Cascón-Pérez Jd |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome medicine.drug_class medicine.medical_treatment 030204 cardiovascular system & hematology Antithrombins 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Internal medicine Medicine Bivalirudin Humans 030212 general & internal medicine Longitudinal Studies Prospective Studies Acute Coronary Syndrome Mortality Prospective cohort study Stroke Aged Pharmacology Intraoperative Care business.industry Incidence (epidemiology) Anticoagulant Percutaneous coronary intervention Heparin Hirudins Middle Aged medicine.disease Peptide Fragments Recombinant Proteins Treatment Outcome Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug Follow-Up Studies |
| Zdroj: | Journal of cardiovascular pharmacology. 68(3) |
| ISSN: | 1533-4023 |
| Popis: | The CARTAGOMAX study assessed the safety and efficacy of bivalirudin during real-world cardiac intervention. This was a single-center prospective study. Patients with acute coronary syndrome undergoing percutaneous coronary intervention were anticoagulated with bivalirudin alone or unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor. Propensity score matching was performed to control for baseline imbalances and yielded 1168 patients. There was lower incidence of the composite outcome of death from any cause or major bleeding at 30 days (P = 0.005), 6 months (P = 0.005), and 12 months (P = 0.001) of follow-up in the bivalirudin group, compared with the heparin plus glycoprotein inhibitor group. The administration of bivalirudin was associated with lower rate of all-cause mortality at 1 year of follow-up (P = 0.009). The incidence of major bleeding was lower in the bivalirudin group at 1, 6, and 12 months of follow-up (P = 0.002, P = 0.013 and P = 0.017, respectively). The incidence of stroke and reinfarction were similar between groups during follow-up. The rate of stent thrombosis were slightly higher in the bivalirudin group, without reaching statistical significance at 1 and 12 months of follow-up (P = 0.06, P = 0.04, P = 0.07 at 1, 6, and 12 months, respectively). The CARTAGOMAX study found that the use of bivalirudin during percutaneous coronary intervention was associated with lower incidence of the composite outcome of death from any cause or major bleeding during follow-up. The use of bivalirudin was associated with similar rates of stroke, reinfarction, and stent thrombosis compared with heparin plus glycoprotein inhibitor. Bivalirudin proved to be a safe and effective anticoagulant during percutaneous coronary intervention. |
| Databáze: | OpenAIRE |
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