Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy
| Autor: | Rebecca Torguson, Pramod K. Kuchulakanti, Daniel A. Canos, Kenneth M. Kent, Ron Waksman, Edouard Cheneau, Leonardo C. Clavijo, William O. Suddath, William W. Chu, Ellen Pinnow, Lowell F. Satler, Roswitha Wolfram, Seung-Woon Rha, Augusto D. Pichard |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Brachytherapy Eptifibatide Platelet Glycoprotein GPIIb-IIIa Complex Coronary Angiography Antithrombins Coronary Restenosis Bolus (medicine) Restenosis Internal medicine medicine Humans Bivalirudin Myocardial infarction Infusions Intravenous Retrospective Studies business.industry Anticoagulants General Medicine Heparin Hirudins Middle Aged medicine.disease Peptide Fragments Recombinant Proteins Treatment Outcome Conventional PCI Cardiology Female Peptides Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors Mace Follow-Up Studies medicine.drug |
| Zdroj: | Cardiovascular Revascularization Medicine. 6:154-159 |
| ISSN: | 1553-8389 |
| Popis: | Bivalirudin is replacing heparin in percutaneous coronary interventions (PCIs), including vascular brachytherapy (VBT). The aim of the study was to compare bivalirudin with eptifibatide in patients with in-stent restenosis (ISR) undergoing PCI and VBT.One hundred forty-four patients treated with bivalirudin as a single antithrombotic agent were compared with 150 patients treated with eptifibatide. Bivalirudin as a bolus of 0.75 mg/kg followed by 1.75 mg/kg/h infusion until the end of the procedure, and eptifibatide as a double bolus of 180 microg/kg followed by 2 microg/kg/min infusion for 18 h after the procedure were used. The main outcome measures were in-hospital events and 30-day clinical outcomes.Baseline clinical characteristics were similar except that patients in the eptifibatide group were younger (P=.02) and had more saphenous vein graft lesions (P.001). Patients in the bivalirudin group had a higher number of lesions in the right coronary artery (P.001) and a higher number of vessels treated (P.001). Postprocedure creatinine phosphokinase (CPK)-MB levels were significantly lower in the bivalirudin group (P.03). In-hospital events showed significantly less minor bleeding (P=.01) and a trend toward lower major bleeding and major adverse cardiac events (MACE) in the bivalirudin group (P=.06). Thirty-day outcomes showed a significantly lower incidence of non-Q-wave myocardial infarction (MI) in the bivalirudin group (P=.004).Bivalirudin, as a single antithrombotic agent during PCI and VBT, is associated with significantly lower postprocedural CPK-MB elevation, minor bleeding complications, 30-day non-Q-wave MI rates, and a trend toward lower major bleeding and in-hospital MACE when compared with eptifibatide. |
| Databáze: | OpenAIRE |
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