Document Detail


A Comparative Study of Bivalirudin Plus Clopidogrel versus Bivalirudin Plus Prasugrel in Primary Angioplasty Using Propensity Score Matching.
MedLine Citation:
PMID:  23952746     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: In primary angioplasty, bivalirudin is superior to treatment with heparin plus glycoprotein inhibitors for reducing cardiovascular events, although bivalirudin increases the risk of stent thrombosis. Our hypothesis is that the use of prasugrel plus bivalirudin in primary angioplasty would reduce stent thrombosis and cardiovascular events.
METHOD: Consecutive patients with acute ST-segment elevation myocardial infarction who were treated by primary angioplasty within 12 hours of the onset of symptoms received bivalirudin plus clopidogrel (Group A) or bivalirudin plus prasugrel (Group B). We compared the groups using propensity score matching. The combined end-point was cardiac death, thrombosis, acute myocardial infarction, and cerebrovascular accident at 30 days.
RESULTS: We assessed 168 patients. The approach was preferentially radial (95.7%). No differences in baseline characteristics were observed between Groups A (n = 70) and B (n = 70). The total mortality and rate of major bleeding complications at 30 days were 0% for both of the groups. The rate of acute and subacute thrombosis was 4.3% in Group A and 0% in Group B (P = 0.08). We observed an increased rate of events in Group A (5.7%) versus Group B (0%) (P = 0.042).
CONCLUSIONS: The administration of bivalirudin plus prasugrel in primary percutaneous coronary intervention reduces cardiovascular effects compared to bivalirudin plus clopidogrel without increasing major bleeding complications during the first 30 days following primary angioplasty performed with a preferentially radial approach.
Authors:
Luis S Díaz de la Llera; José-M Cubero Gómez; Diego Rangel; Juan Parejo; Juan Acosta; Agustín Fernández-Cisnal; Francisco Zafra; Javier Benezet
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-18
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  -     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-8-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013, Wiley Periodicals, Inc.
Affiliation:
Haemodynamic and Interventional Cardiology Unit, University Hospital Virgen del Rocio, Seville, Spain.
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