Advanced

Unfractionated heparin versus bivalirudin in patients undergoing primary percutaneous coronary intervention : A SWEDEHEART study

Grimfjärd, Per; Erlinge, David LU ; Koul, Sasha LU ; Lagerqvist, Bo; Svennblad, Bodil; Varenhorst, Christoph and James, Stefan K. (2017) In EuroIntervention 12(16). p.2009-2017
Abstract

Aims: The aim of the study was to compare outcomes in unfractionated heparin (UFH) and bivalirudin-treated patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results: This observational study contained 20,612 PPCI patients treated with either UFH monotherapy or bivalirudin with or without concomitant UFH. Patients with oral anticoagulant or glycoprotein IIb/IIIa inhibitor (GPI) treatment were excluded. The primary outcome measure was definite early stent thrombosis (ST) that occurred at low and similar rates in UFH only and bivalirudin-treated patients: 0.9% vs. 0.8% (adjusted hazard ratio [HR] 1.08, 95% confidence interval [CI]: 0.7-1.65). All-cause death at 30 days occurred in 6.9% vs. 5.4% of patients... (More)

Aims: The aim of the study was to compare outcomes in unfractionated heparin (UFH) and bivalirudin-treated patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results: This observational study contained 20,612 PPCI patients treated with either UFH monotherapy or bivalirudin with or without concomitant UFH. Patients with oral anticoagulant or glycoprotein IIb/IIIa inhibitor (GPI) treatment were excluded. The primary outcome measure was definite early stent thrombosis (ST) that occurred at low and similar rates in UFH only and bivalirudin-treated patients: 0.9% vs. 0.8% (adjusted hazard ratio [HR] 1.08, 95% confidence interval [CI]: 0.7-1.65). All-cause death at 30 days occurred in 6.9% vs. 5.4% of patients (adjusted HR 1.23, 95% CI: 1.05-1.44) and within 365 days in 12.1% vs. 8.9% (adjusted HR 1.34, 95% CI: 1.19-1.52) in the two groups, respectively. The incidence of major bleeding within 30 days was 0.8% vs. 0.6% (adjusted HR 1.54, 95% CI: 0.97-2.45). The incidence of reinfarction within 365 days and stroke within 30 days was similar between groups. Conclusions: In this large, nationwide observational study we found low and similar rates of early ST in UFH only and bivalirudin-treated patients undergoing primary PCI. Mortality was higher in UFH compared with bivalirudin-treated patients.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coronary intervention, bivalirudin , Unfractionated heparin
in
EuroIntervention
volume
12
issue
16
pages
9 pages
publisher
Société Europa Edition
external identifiers
  • scopus:85016099067
  • pmid:28044990
ISSN
1774-024X
DOI
10.4244/EIJ-D-16-00884
language
English
LU publication?
yes
id
560a83ea-2b2f-40f5-af26-76a01944481d
date added to LUP
2017-04-23 15:14:15
date last changed
2017-08-13 05:06:55
@article{560a83ea-2b2f-40f5-af26-76a01944481d,
  abstract     = {<p>Aims: The aim of the study was to compare outcomes in unfractionated heparin (UFH) and bivalirudin-treated patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results: This observational study contained 20,612 PPCI patients treated with either UFH monotherapy or bivalirudin with or without concomitant UFH. Patients with oral anticoagulant or glycoprotein IIb/IIIa inhibitor (GPI) treatment were excluded. The primary outcome measure was definite early stent thrombosis (ST) that occurred at low and similar rates in UFH only and bivalirudin-treated patients: 0.9% vs. 0.8% (adjusted hazard ratio [HR] 1.08, 95% confidence interval [CI]: 0.7-1.65). All-cause death at 30 days occurred in 6.9% vs. 5.4% of patients (adjusted HR 1.23, 95% CI: 1.05-1.44) and within 365 days in 12.1% vs. 8.9% (adjusted HR 1.34, 95% CI: 1.19-1.52) in the two groups, respectively. The incidence of major bleeding within 30 days was 0.8% vs. 0.6% (adjusted HR 1.54, 95% CI: 0.97-2.45). The incidence of reinfarction within 365 days and stroke within 30 days was similar between groups. Conclusions: In this large, nationwide observational study we found low and similar rates of early ST in UFH only and bivalirudin-treated patients undergoing primary PCI. Mortality was higher in UFH compared with bivalirudin-treated patients.</p>},
  author       = {Grimfjärd, Per and Erlinge, David and Koul, Sasha and Lagerqvist, Bo and Svennblad, Bodil and Varenhorst, Christoph and James, Stefan K.},
  issn         = {1774-024X},
  keyword      = {coronary intervention, bivalirudin ,Unfractionated heparin},
  language     = {eng},
  month        = {03},
  number       = {16},
  pages        = {2009--2017},
  publisher    = {Société Europa Edition},
  series       = {EuroIntervention},
  title        = {Unfractionated heparin versus bivalirudin in patients undergoing primary percutaneous coronary intervention : A SWEDEHEART study},
  url          = {http://dx.doi.org/10.4244/EIJ-D-16-00884},
  volume       = {12},
  year         = {2017},
}