Document Detail

Anticoagulation with the direct thrombin inhibitor argatroban in patients presenting with acute coronary syndromes.
MedLine Citation:
PMID:  19213062     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study examined the efficacy and safety of the direct thrombin inhibitor argatroban in patients presenting with acute coronary syndromes undergoing cardiac catheterization. BACKGROUND: Argatroban is a direct-thrombin inhibitor approved for use in percutaneous coronary intervention in patients with heparin-induced thrombocytopenia. Few studies have examined its use in patients undergoing cardiac catheterization for acute coronary syndromes. We performed a retrospective cohort study of patients presenting with acute coronary syndromes who received argatroban anticoagulation during cardiac catheterization. METHODS: Consecutive patients presenting with acute coronary syndromes who received argatroban while undergoing cardiac catheterization from 2002 to 2005 were included. Patient characteristics and in-hospital outcomes were examined retrospectively via detailed chart review. The primary endpoints of the study were combined death, myocardial infarction or urgent revascularization, and major bleeding during the index hospitalization. RESULTS: A total of 144 patients presenting with an acute coronary syndrome received argatroban during cardiac catheterization within the study period: 25% presented with ST-elevation myocardial infarction and 75% presented with non-ST-elevation acute coronary syndrome. The combined endpoint of death, myocardial infarction or urgent revascularization occurred in 13.2% of patients during the hospitalization. Major bleeding occurred in 2.1% of patients. CONCLUSIONS: In this cohort of patients presenting with acute coronary syndromes, patients receiving argatroban during cardiac catheterization had a moderate rate of adverse cardiac events and a very low rate of major bleeding.
Robert W Yeh; Suzanne J Baron; Joanne L Healy; Eugene Pomerantsev; Iris A McNulty; Ignacio Cruz-Gonzalez; Ik-Kyung Jang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  74     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  359-64     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
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MeSH Terms
Acute Coronary Syndrome / blood,  complications,  drug therapy,  mortality,  therapy*
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects,  mortality
Anticoagulants / adverse effects,  therapeutic use*
Heart Catheterization* / adverse effects,  mortality
Hemorrhage / chemically induced
Middle Aged
Myocardial Infarction / blood,  etiology,  prevention & control
Odds Ratio
Pipecolic Acids / adverse effects,  therapeutic use*
Retrospective Studies
Risk Assessment
Thrombin / antagonists & inhibitors*
Treatment Outcome
Reg. No./Substance:
0/Anticoagulants; 0/Pipecolic Acids; 74863-84-6/argatroban; EC
Comment In:
Catheter Cardiovasc Interv. 2009 Aug 1;74(2):365-6   [PMID:  19642185 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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