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

Grimfjärd, Per (author)
Uppsala University,Uppsala universitet,Kardiologi,Västerås Univ, Dept Cardiol, Västerås, Sweden.,Västmanland Hospital
Erlinge, David (author)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
Koul, Sasha (author)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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Lagerqvist, Bo, 1952- (author)
Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
Svennblad, Bodil (author)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Ortopedi,Uppsala University Hospital
Varenhorst, Christoph, 1977- (author)
Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
James, Stefan K., 1964- (author)
Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
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 (creator_code:org_t)
2017
2017
English.
In: EuroIntervention. - 1774-024X .- 1969-6213. ; 12:16, s. 2009-2017
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

adjunctive pharmacotherapy
drug-eluting stent
STEMI
stent thrombosis
coronary intervention
bivalirudin
Unfractionated heparin

Publication and Content Type

ref (subject category)
art (subject category)

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