Unfractionated heparin versus bivalirudin in patients undergoing primary percutaneous coronary intervention : A SWEDEHEART study
(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.
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- author
- Grimfjärd, Per ; Erlinge, David LU ; Koul, Sasha LU ; Lagerqvist, Bo ; Svennblad, Bodil ; Varenhorst, Christoph and James, Stefan K.
- organization
- publishing date
- 2017-03-01
- 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
-
- pmid:28044990
- pmid:28044990
- scopus:85016099067
- 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
- 2024-06-23 15:47:28
@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}}, keywords = {{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}}, doi = {{10.4244/EIJ-D-16-00884}}, volume = {{12}}, year = {{2017}}, }