Document Detail


Brachytherapy and bivalirudin evaluation study.
MedLine Citation:
PMID:  16209990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bivalirudin is shown to be a competent substitute for heparin in percutaneous coronary intervention (PCI). The safety and efficacy of bivalirudin in patients undergoing PCI and vascular brachytherapy (VBT) are not known. This study aimed to assess the safety and efficacy of bivalirudin as a single antithrombotic agent in patients undergoing PCI and VBT. METHODS: A total of 152 patients enrolled in the Brachytherapy and Bivalirudin Evaluation Study underwent PCI and VBT with either gamma (n = 8) or beta radiation (n = 144). The main outcome measures were in-hospital events and 30-day clinical outcomes. All patients were treated with bivalirudin (0.75 mg/kg bolus and 1.75 mg/kg per hour infusion for beta radiation, 1 mg/kg bolus and 2.5 mg/kg per hour infusion for gamma radiation) as a single antithrombotic agent during the entire procedure. RESULTS: Baseline clinical and angiographic characteristics were similar between the 2 groups. More than 90% of the patients received beta radiation. In-hospital events showed a higher prevalence of acute procedural intracoronary thrombosis in patients treated with gamma- vs beta radiation (25% vs. 0.7%, P < .001). Thirty-day outcomes including death, Q-wave, and non-Q-wave myocardial infarctions, subacute stent thromboses, and repeat revascularizations were similar in both groups. CONCLUSION: Bivalirudin, as a single antithrombotic agent during PCI and VBT with beta emitters, may be used safely, but its use in the setting of PCI and gamma radiation may not be acceptable due to an increased incidence of acute procedural intracoronary thrombosis.
Authors:
Pramod Kuchulakanti; Roswitha Wolfram; Rebecca Torguson; Seung-Woon Rha; Edouard Cheneau; Ellen E Pinnow; Daniel Canos; Lowell F Satler; Augusto D Pichard; Kenneth M Kent; Ron Waksman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  150     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-07     Completed Date:  2005-11-28     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  832-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Washington Hospital Center, Washington, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Anticoagulants / therapeutic use*
Brachytherapy / adverse effects*
Coronary Stenosis / radiotherapy*,  therapy
Female
Hirudins
Humans
Male
Middle Aged
Peptide Fragments / therapeutic use*
Recombinant Proteins / therapeutic use
Thrombosis / etiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Hirudins; 0/Peptide Fragments; 0/Recombinant Proteins; 128270-60-0/bivalirudin

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


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