Comparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in “Real World” practice

Parker, Michael and Davies, John R. and Showkathali, Refai and Taggu, Wasing and Tang, Kare H. and Clesham, Gerald J. and Gamma, Reto A. and Sayer, Jeremy W. and Aggarwal, Rajesh K. and Kelly, Paul A. (2013) Comparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in “Real World” practice. Cardiovascular Revascularization Medicine. ISSN 1553-8389

Full text not available from this repository.

Abstract

Objective: We aimed to carry out a “real world” comparison of bivalirudin plus unfractionated heparin (UFH) versus abciximab plus UFH in patients undergoing primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI). Methods: We included patients who had abciximab or bivalirudin during their PPCI in our unit between Sept 2009 and Nov 2011. Results: The study included 516 and 484 patients in the bivalirudin and abciximab group respectively. There were more women in the bivalirudin group (29% vs 20%, p 0.001), while cardiogenic shock (6.4% vs 10.1%, p 0.04) and thrombectomy device use (76.6% vs 82%, p 0.04) were lower in the bivalirudin group. The primary composite end point of 30-day mortality, 30-day definite stent thrombosis or non-CABG major bleeding was similar between the bivalirudin and abciximab groups (7.8% vs 9.5%, OR 0.8, 95% CI 0.5 to 1.2, p 0.4). There was also no difference in in-hospital mortality (4.1% vs 4.3%, p 0.9), 30-day mortality (5.2% vs 6.4%, p 0.5), 1-year mortality (9.1% vs 9.9%, p 0.7), 30-day stent thrombosis (1% vs 0.4%, p 0.5) and non-CABG bleeding (2.7 vs 3.7%, p 0.4) between the bivalirudin and abciximab group respectively. On Cox proportional hazard analysis after adjusting for all the co-variates, the use of bivalirudin was not a predictor of 30-day mortality (HR 1.13, 95% CI 0.7–1.9, p 0.7). Conclusion: In this “real-world” observational study, there was no significant difference in the clinical outcome of PPCI for patients who had abciximab or bivalirudin after initial pre-treatment with UFH.

Item Type: Journal Article
Additional Information: Citation: Showkathali, R., Davies, J.R., Parker, M., Taggu, W., Tang, K.H., Clesham, G.J., Gamma, R.A., Sayer, J.W., Aggarwal, R.K. and Kelly, P.A., 2013. Comparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in “Real World” practice. Cardiovascular Revascularization Medicine, 14(5), pp.289-293..
Faculty: Faculty of Health, Social Care & Education (for research post September 2011)
Depositing User: Mr I Walker
Date Deposited: 29 Nov 2013 13:12
Last Modified: 07 Jul 2016 12:51
URI: http://arro.anglia.ac.uk/id/eprint/305951

Actions (login required)

Edit Item Edit Item