Author + information
- Perwaiz M. Meraj,
- Rajkumar Doshi,
- Amitkumar Patel,
- Bhavitha George,
- Lakhbir Kaur,
- Fatima Mozawalla,
- Tanzim Bhiuya and
- Rajiv Jauhar
Background: Bivalirudin has been shown to be superior to unfractionated heparin in patients undergoing percutaneous coronary intervention (PCI), however more recent data suggests that the benefit may not be present due to modern day PCI techniques and oral p2y12 pharmacology. The aim of this study is to determine if bivalirudin is superior to heparin monotherapy in modern day real world PCI.
Methods: 15440 patients were identified from the CathPCI database from 5 multicenter tertiary care centers in New York City from January 2011-April 2016. Patients had PCI using radial or femoral access and utilized either heparin or bivalirudin monotherapy. Primary outcome was death on discharge, while secondary outcomes were myocardial infarction (MI), stroke, tamponade, congestive heart failure (CHF), cardiogenic shock, new dialysis requirement, red blood cell transfusion and bleeding within 72 hours. The data was prospectively collected and retrospectively analyzed.
Results: The primary outcome of all cause death at discharge was higher in the UFH group as compared with bivalirudin, as were the secondary outcomes of bleeding and transfusion requirement.
Conclusions: The findings of higher bleeding complications and all cause mortality with UFH is consistent with the findings from prior sentinel bivalirudin trials, however this is in a population undergoing modern day therapy. The acuity of the patient population is demonstrable with the use of GpIIb/IIIa inhibitors and high numbers of ACS patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Antiplatelet and Antithrombotic Agents in Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1296-314
- 2017 American College of Cardiology Foundation