In:
Cardiovascular Therapeutics, Wiley, Vol. 35, No. 3 ( 2017-06)
Kurzfassung:
This study aimed to evaluate the effect of prolonged full‐dose bivalirudin infusion in real‐world population with ST ‐elevation myocardial infarction ( STEMI ). Background Subgroup data as well as meta‐analysis from randomized clinical trials have shown the potency of postprocedural full‐dose infusion (1.75 mg/kg/h) of bivalirudin on attenuating acute stent thrombosis ( ST ) after primary percutaneous coronary intervention ( PCI ). Methods In this multicenter retrospective observational study, 2047 consecutive STEMI patients treated with bivalirudin during primary PCI were enrolled in 65 Chinese centers between July 2013 and May 2016. The primary outcome was acute ST defined as ARC definite/probable within 24 hours after the index procedure, and the secondary endpoints included total ST , major adverse cardiac or cerebral events ( MACCE , defined as death, reinfarction, stroke, and target vessel revascularization), and any bleeding at 30 days. Results Among 2047 STEMI patients, 1123 (54.9%) were treated with postprocedural bivalirudin full‐dose infusion (median 120 minutes) while the other 924 (45.1%) received low‐dose (0.25 mg/kg/h) or null postprocedural infusion. A total of three acute ST (0.3%) occurred in STEMI patients with none or low‐dose prolonged infusion of bivalirudin, but none was observed in those treated with post‐ PCI full‐dose infusion (0.3% vs 0.0%, P =.092). Outcomes on MACCE (2.1% vs 2.7%, P =.402) and total bleeding (2.1% vs 1.4%, P =.217) at 30 days showed no significant difference between the two groups, and no subacute ST was observed. Conclusion Post‐ PCI full‐dose bivalirudin infusion is safe and has a trend to protect against acute ST in STEMI patients undergoing primary PCI in real‐world settings.
Materialart:
Online-Ressource
ISSN:
1755-5914
,
1755-5922
DOI:
10.1111/cdr.2017.35.issue-3
DOI:
10.1111/1755-5922.12251
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2017
ZDB Id:
2417088-4