Safety and Efficacy of Periprocedural Heparin Plus a Short-Term Infusion of Tirofiban Versus Bivalirudin Monotherapy in Patients Who Underwent Percutaneous Coronary Intervention (from the Intermountain Heart Institute STAIR Observational Registry)

Muhlestein, Joseph B.; Hackett, Ian; May, Heidi T; Bair, Tami L; Le, Viet T; Anderson, Jeffrey L.; Whisenant, Brian; Knowlton, Kirk U.; Lappé, Donald

doi:10.1016/j.amjcard.2019.03.025

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…An observational study mainly evaluated the safety of heparin combined with short-term use of tirofiban compared with bivalirudin in PCI treatment. 31 The results indicated that there was no difference in the MACE events between the two groups. While the combination of heparin with tirofiban significantly reduced the incidence of major hemorrhages (0.7% and 4.1%, P = 0.001), the reasons for the decrease in major hemorrhages were not clear.…”

Section: Discussionmentioning

confidence: 91%

Safety of Bivalirudin Combined with Ticagrelor in the Emergency PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction

Wang

Yu-xiang

Liu

et al. 2022

Clin Appl Thromb Hemost

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Objective The present study aimed to investigate the application safety of bivalirudin combined with ticagrelor in the emergency percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods From October 1, 2018, to December 30, 2019, 210 patients with STEMI admitted to the Department of Cardiology who underwent emergency PCI were randomly divided into the bivalirudin group (group A, N = 105) and the unfractionated heparin group (group B, N = 105). Before the emergency PCI operation after admission, the loading dose of aspirin (300 mg) was given orally, and then 100 mg/d. At the same time, the loading dose of ticagrelor (180 mg) was administered orally, and then 90 mg/bid. The adverse events and the hemorrhage events 30 days after the operation were observed and recorded. Results There were five hemorrhage cases in the bivalirudin group, with one case of secondary hemorrhage and four cases of mild hemorrhage. There were 14 hemorrhages in the unfractionated heparin group with one case of secondary hemorrhage and thirteen cases of mild hemorrhage. In terms of mild hemorrhage, the hemorrhage rate in the bivalirudin group was significantly lower than that in the unfractionated heparin group (3.8% vs. 12.4%, P = 0.040). One patient died in the unfractionated heparin group, while no deaths occurred in the bivalirudin group during the thirty days of follow-up. No myocardial infarction, revascularization, or stroke occurred in the two groups within 30 days after the operation. Conclusion Compared with unfractionated heparin combined with ticagrelor in patients with STEMI undergoing emergency PCI treatment, bivalirudin combined with ticagrelor could significantly reduce the occurrence of mild hemorrhage events, and it would not increase the incidence of MACE during the 30 days of follow-up.

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Section: Discussionmentioning

confidence: 91%