Safety of bivalirudin in primary percutaneous coronary intervention following thrombolytic therapy




Background


Thrombolytic therapy is still used for patients presenting with ST-elevation myocardial infarction. The safety and efficacy of bivalirudin (BIV) for primary percutaneous coronary intervention (PCI) in these patients have not been established. This study aimed to compare the safety of BIV vs. unfractionated heparin (UFH) in patients undergoing primary PCI following initial management with thrombolytic therapy.




Methods


A series of 104 consecutive patients treated with primary PCI, who received full-dose thrombolytic therapy within 6 h prior to the intervention, was identified and retrospectively analyzed. The use of intraprocedural UFH and BIV was compared for in-hospital bleeding and ischemic events.




Methods


A series of 104 consecutive patients treated with primary PCI, who received full-dose thrombolytic therapy within 6 h prior to the intervention, was identified and retrospectively analyzed. The use of intraprocedural UFH and BIV was compared for in-hospital bleeding and ischemic events.




Results


This series includes 47 patients (45%) treated with BIV and 57 patients (55%) treated with UFH. The baseline characteristics were similar in both groups. Patients on BIV more frequently received low-molecular-weight heparin and were more frequently preloaded with clopidogrel. Intraprocedural glycoprotein IIb/IIIa inhibitors were used only in UFH patients. Incidence of TIMI major bleeding was similar. Other bleeding events and ischemic endpoints were more frequent in patients treated with UFH, but results did not reach statistical significance ( Table 1 ).


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Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on Safety of bivalirudin in primary percutaneous coronary intervention following thrombolytic therapy

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