Linked Life Data

15757596

Source:http://linkedlifedata.com/resource/pubmed/id/15757596

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2005-3-10
pubmed:abstractText
A recent large-scale, randomized trial demonstrated the noninferiority of a strategy of bivalirudin with provisional glycoprotein (GP) IIb/IIIa inhibition compared with routine GP IIb/IIIa inhibition. There is a paucity of outcome data with bivalirudin use in the setting of real-world experience. We evaluated 6,996 patients who underwent percutaneous coronary intervention between January 2001 and December 2004 to compare early and late outcomes with a bivalirudin-based antithrombotic regimen with those with a heparin-based regimen. Propensity adjustment was performed to correct for baseline differences in patient characteristics. Bivalirudin-based therapy was used in 1,070 patients, heparin only in 801 patients, and heparin plus GP IIb/IIIa inhibitors in 5,125 patients. Compared with patients who received heparin or those who received heparin plus GP IIb/IIIa inhibitors, patients who received bivalirudin had lower incidences of bleeding (blood transfusion rate 1.7% vs 4.0%, p <0.001) and periprocedural myonecrosis (creatine kinase-MB >5 times the upper limit of normal 2.7% vs 4.3%, p = 0.016). Differences in bleeding end points remained significant after adjusting for the propensity to receive bivalirudin, but there was no difference in ischemic events. There was no difference in unadjusted long-term survival rate (log-rank test p = 0.46, total number of deaths 412, mean follow-up 17 months) or in propensity-adjusted long-term survival rate (hazard ratio 1.37, 95% confidence interval 0.90 to 2.08, p = 0.14). Compared with heparin with or without GP IIb/IIIa inhibition, the use of bivalirudin in a large consecutive patient registry at a tertiary care center was associated with fewer bleeding events and no evident increase in the incidence of ischemic complications.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
95
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
716-21
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed-meshheading:15757596-Aged, pubmed-meshheading:15757596-Angioplasty, Balloon, Coronary, pubmed-meshheading:15757596-Cohort Studies, pubmed-meshheading:15757596-Coronary Restenosis, pubmed-meshheading:15757596-Coronary Stenosis, pubmed-meshheading:15757596-Creatine Kinase, pubmed-meshheading:15757596-Creatine Kinase, MB Form, pubmed-meshheading:15757596-Drug Therapy, Combination, pubmed-meshheading:15757596-Female, pubmed-meshheading:15757596-Fibrinolytic Agents, pubmed-meshheading:15757596-Follow-Up Studies, pubmed-meshheading:15757596-Hemorrhage, pubmed-meshheading:15757596-Heparin, pubmed-meshheading:15757596-Hirudins, pubmed-meshheading:15757596-Humans, pubmed-meshheading:15757596-Isoenzymes, pubmed-meshheading:15757596-Male, pubmed-meshheading:15757596-Middle Aged, pubmed-meshheading:15757596-Myocardial Infarction, pubmed-meshheading:15757596-Ohio, pubmed-meshheading:15757596-Peptide Fragments, pubmed-meshheading:15757596-Platelet Glycoprotein GPIIb-IIIa Complex, pubmed-meshheading:15757596-Prospective Studies, pubmed-meshheading:15757596-Recombinant Proteins, pubmed-meshheading:15757596-Survival Analysis, pubmed-meshheading:15757596-Treatment Outcome
pubmed:year
2005
pubmed:articleTitle
Effectiveness and safety of bivalirudin during percutaneous coronary intervention in a single medical center.
pubmed:affiliation
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
pubmed:publicationType
Journal Article, Comparative Study