Unfractionated heparin versus bivalirudin in patients undergoing primary percutaneous coronary intervention: a SWEDEHEART study

Grimfjärd, PerUppsala University,Uppsala universitet,Kardiologi,Västerås Univ, Dept Cardiol, Västerås, Sweden.,Västmanland Hospital (author)

Unfractionated heparin versus bivalirudin in patients undergoing primary percutaneous coronary intervention : a SWEDEHEART study

Aims: The aim of the stud was to compare outcomes in unfractionated heparin (UM) and bivalirudintreated patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results: This observational study contained 20,612 PPCT patients treated with either GM monotherapv or bivalirudin with or without concomitant UFE. Patients with oral anticoagulant or glycoprotein IIb/IIIa inhibitor (GPI) treatment were excluded. The primary outcome measure was definite early stent thrombosis (Si) that occurred at low and similar rates in UNA only and bivalirudin-treated patients: 0.9% vs. 0.8% (adjusted hazard ratio [HR] 1.08, 95% confidence interval [CI]: 0.7-1.65). All-cause death at 30 days occurred in 6.9% vs. 5.4% of patients (adjusted HR 1.23, 95% Cl: 1.05-1.44) and within 365 days in 12.1% vs. 8.9% (adjusted HR 1.34, 95% CI: 1.19-1.52) in the two groups, respectively. The incidence of major bleeding within 30 days was 0.8% vs. 0.6% (adjusted HR 1.54, 95% CI: 0.97-2.45). The incidence of reinfarction within 365 days and stroke within 30 days was similar between groups. Conclusions: In this large, nationwide observational study we found low and similar rates of early ST in UFH only and bivalirudin-treated patients undergoing primary PCI. Mortality was higher in IJFH compared with bivalirudin-treated patients.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
adjunctive pharmacotherapy
drug-eluting stent
STEMI
stent thrombosis
coronary intervention
bivalirudin
Unfractionated heparin

Erlinge, DavidLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)kard-der (author)
Koul, SashaLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)med-sku (author)
Lagerqvist, Bo,1952-Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital(Swepub:uu)bolager (author)
Svennblad, BodilUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Ortopedi,Uppsala University Hospital(Swepub:uu)bosve677 (author)
Varenhorst, Christoph,1977-Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital(Swepub:uu)chrva923 (author)
James, Stefan K.,1964-Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital(Swepub:uu)stjam367 (author)
Uppsala universitetKardiologi (creator_code:org_t)

By the author/editor: Grimfjärd, Per; Erlinge, David; Koul, Sasha; Lagerqvist, Bo, ...; Svennblad, Bodil; Varenhorst, Chri ...; show more...; James, Stefan K. ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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