Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy
- Authors
- Kuchulakanti P.; Wolfram R.; Torguson R.; Rha S.-W.; Cheneau E.; Clavijo L.; Chu W.W.; Pinnow E.E.; Canos D.; Satler L.F.; Suddath W.O.; Pichard A.D.; Kent K.M.; Waksman R.
- Issue Date
- 2005
- Keywords
- Bivalirudin; Brachytherapy; In-stent Restenosis
- Citation
- Cardiovascular Revascularization Medicine, v.6, no.4, pp 154 - 159
- Pages
- 6
- Indexed
- SCOPUS
- Journal Title
- Cardiovascular Revascularization Medicine
- Volume
- 6
- Number
- 4
- Start Page
- 154
- End Page
- 159
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/20100
- DOI
- 10.1016/j.carrev.2005.06.003
- ISSN
- 1553-8389
- Abstract
- Background: Bivalirudin is replacing heparin in percutaneous coronary interventions (PCIs), including vascular brachytherapy (VBT). The aim of the study was to compare bivalirudin with eptifibatide in patients with in-stent restenosis (ISR) undergoing PCI and VBT. Methods: One hundred forty-four patients treated with bivalirudin as a single antithrombotic agent were compared with 150 patients treated with eptifibatide. Bivalirudin as a bolus of 0.75 mg/kg followed by 1.75 mg/kg/h infusion until the end of the procedure, and eptifibatide as a double bolus of 180 μg/kg followed by 2 μg/kg/min infusion for 18 h after the procedure were used. The main outcome measures were in-hospital events and 30-day clinical outcomes. Results: Baseline clinical characteristics were similar except that patients in the eptifibatide group were younger (P=.02) and had more saphenous vein graft lesions (P<.001). Patients in the bivalirudin group had a higher number of lesions in the right coronary artery (P<.001) and a higher number of vessels treated (P<.001). Postprocedure creatinine phosphokinase (CPK)-MB levels were significantly lower in the bivalirudin group (P<.03). In-hospital events showed significantly less minor bleeding (P=.01) and a trend toward lower major bleeding and major adverse cardiac events (MACE) in the bivalirudin group (P=.06). Thirty-day outcomes showed a significantly lower incidence of non-Q-wave myocardial infarction (MI) in the bivalirudin group (P=.004). Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT, is associated with significantly lower postprocedural CPK-MB elevation, minor bleeding complications, 30-day non-Q-wave MI rates, and a trend toward lower major bleeding and in-hospital MACE when compared with eptifibatide. © 2005 Elsevier Inc. All rights reserved.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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