Introduction

While bivalirudin use in patients undergoing percutaneous coronary intervention (PCI) results in less bleeding compared to unfractionated heparin (UFH), its safety in patients undergoing rotational atherectomy (RA) is unknown. This study attempted to examine the safety and efficacy of bivalirudin for this population.

Methods

A cohort of 503 patients who underwent PCI with RA from 2000 to 2009 were studied. Of these, patients receiving bivalirudin ( n =322) were compared to those ( n =181) treated with UFH±glycoprotein IIb/IIIa inhibitor (GPI) as PCI anticoagulation. Safety was assessed by the frequency of major bleeding (hematocrit drop ≥15%, intracerebral or gastrointestinal bleeding) and need for transfusion. Efficacy was assessed by a composite end point of in-hospital death, Q-wave myocardial infarction (MI), or urgent coronary artery bypass graft (CABG).

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