Association of Prerandomization Anticoagulant Switching With Bleeding in the Setting of Percutaneous Coronary Intervention (A REPLACE-2 Analysis)

Gibson, C. Michael; Ten, Yuli; Murphy, Sabina A.; Ciaglo, Lauren N.; Southard, Matthew C.; Lincoff, A. Michael; Waksman, Ron

doi:10.1016/j.amjcard.2007.01.053

Cited by 25 publications

(9 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In randomized trials of patients undergoing percutaneous coronary intervention for stable and acute coronary syndromes, bivalirudin results in a lower incidence of bleeding, and, in the setting of ST elevation myocardial infarction, is associated with lower cardiovascular and overall 30-day mortality when compared with UFH. [6][7][8][9] Although the relative safety of bivalirudin has been extensively studied in percutaneous coronary intervention, limited data are available comparing bivalirudin with UFH in CAS. 10,11 Although a small, single-center randomized study 11 demonstrated lower bleeding rates with bivalirudin compared with UFH among patients undergoing CAS, large-scale, real-world data regarding its comparative safety and effectiveness are currently lacking.…”

mentioning

confidence: 99%

Hemorrhagic and Ischemic Outcomes After Bivalirudin Versus Unfractionated Heparin During Carotid Artery Stenting

Wayangankar

Abu‐Fadel

Aronow

et al. 2013

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

The objective of our study was to examine the incidence of in-hospital hemorrhagic and in-hospital and 30-day ischemic outcomes among patients in the CARE Registry who underwent CAS and were treated with either bivalirudin or UFH. We hypothesized that the use of bivalirudin for CAS would be associated Background-The direct thrombin inhibitor, bivalirudin, is associated with similar efficacy and superior safety in patients undergoing percutaneous coronary intervention. However, the role of direct thrombin inhibitors in carotid artery stenting is not well defined. The objective of this study was to compare the safety and effectiveness of bivalirudin and unfractionated heparin (UFH) for carotid artery stenting. We hypothesized that bivalirudin would be associated with less in-hospital postprocedure bleeding than UFH but similar rates of in-hospital and 30-day ischemic outcomes. Methods and Results-We compared the incidence of in-hospital hemorrhagic and in-hospital/30-day ischemic outcomes among patients in the CARE Registry who underwent carotid artery stenting between May 2005 and March 2012 using bivalirudin or UFH. Propensity score matching was used to obtain a balanced cohort of 3555 patients in each treatment group. Patients treated with bivalirudin had a significantly lower incidence of bleeding or hematoma requiring red blood cell transfusions (0.9% versus 1.5%; odds ratio, 0.57 [0.36-0.89]; P=0.01) when compared with UFH-treated patients. The incidence of in-hospital and 30-day ischemic outcomes, including death, myocardial infarction, stroke, transient ischemic attack, and the composite outcome, death/myocardial infarction/stroke, did not differ significantly between groups. Conclusions-Bivalirudin was associated with lower rates of hemorrhagic outcomes compared with UFH during the index hospitalization for carotid artery stenting. In-hospital and 30-day ischemic events were similar between the 2 groups. Randomized comparisons of these agents are needed to confirm these findings. (Circ Cardiovasc Interv. 2013;6:131-138.)

show abstract

mentioning

confidence: 99%

Hemorrhagic and Ischemic Outcomes After Bivalirudin Versus Unfractionated Heparin During Carotid Artery Stenting

Wayangankar

Abu‐Fadel

Aronow

et al. 2013

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

show abstract

“…In the REPLACE-2 (Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events) trial, among patients randomized to receive bivalirudin, there was no difference in major bleeding between patients receiving prior UFH (n ϭ 287) or ENOX (n ϭ 258) and patients not receiving prior antithrombin therapy (n ϭ 2,345). Cumulative distribution curves suggest that the duration of time between discontinuation of UFH or ENOX did not affect bleeding rates (14).…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Switching From Either Unfractionated Heparin or Enoxaparin to Bivalirudin in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes Managed With an Invasive Strategy

White

Chew

Hoekstra

et al. 2008

Journal of the American College of Cardiology

Self Cite

View full text Add to dashboard Cite

Switching from UFH/ENOX to bivalirudin monotherapy results in comparable ischemic outcomes and an approximately 50% reduction in major bleeding compared with consistent UFH/ENOX plus a GP IIb/IIIa inhibitor. Patients naive to antithrombin therapy administered bivalirudin monotherapy had a significant reduction in bleeding and similar rates of ischemia compared with naive patients initiated with UFH or ENOX plus a GP IIb/IIIa inhibitor.

show abstract

“…A strategy of switching to bivalirudin monotherapy, either before (48) or at the time of PCI (49), was shown to be safer and as effective as UFH or enoxaparin ϩ GPI regardless of whether preceding anticoagulation had been initiated before randomization or not.…”

Section: Anticoagulant Agentsmentioning

confidence: 98%

The Year in Non–ST-Segment Elevation Acute Coronary Syndrome

Giugliano

Braunwald²

2008

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Association of Prerandomization Anticoagulant Switching With Bleeding in the Setting of Percutaneous Coronary Intervention (A REPLACE-2 Analysis)

Cited by 25 publications

References 3 publications

Hemorrhagic and Ischemic Outcomes After Bivalirudin Versus Unfractionated Heparin During Carotid Artery Stenting

Hemorrhagic and Ischemic Outcomes After Bivalirudin Versus Unfractionated Heparin During Carotid Artery Stenting

Safety and Efficacy of Switching From Either Unfractionated Heparin or Enoxaparin to Bivalirudin in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes Managed With an Invasive Strategy

The Year in Non–ST-Segment Elevation Acute Coronary Syndrome

Contact Info

Product

Resources

About