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SCAI-ACC: In Angioplasty, Bivalirudin Bests Heparin Combo

Study compared drugs used with angioplasty in acute myocardial infarction

MONDAY, March 31 (HealthDay News) -- The direct thrombin inhibitor bivalirudin (Angiomax) leads to reduced rates of major bleeding and decreased cardiovascular mortality in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PCI) compared to standard treatment with heparin plus glycoprotein IIb/IIIa inhibitors. These research findings were presented at the SCAI Annual Scientific Sessions in Partnership with the ACC i2 Summit (SCAI-ACCi2), held this week in Chicago.

Gregg W. Stone, M.D., of Columbia University Medical Center in New York City, and colleagues randomized 3,602 patients from 123 centers in 11 countries, with acute myocardial infarction undergoing primary PCI to receive either bivalirudin monotherapy or unfractionated heparin plus glycoprotein IIb/IIIa inhibitors. The patients were followed for 30 days, and outcomes were analyzed based on age, gender, diabetic status and baseline renal function.

Compared to heparin plus IIb/IIIa inhibitor treatment, bivalirudin was associated with a 40 percent reduction in major bleeding, similar rates of major adverse cardiovascular events, a 24 percent reduction in net adverse clinical events and a 38 percent reduction in cardiac-related mortality, the researchers found. These beneficial effects of bivalirudin were independent of age, gender, diabetic status and renal function.

"These data show that even with individual risk factors that might increase the chance of poor outcomes following PCI, bivalirudin resulted in better net clinical outcomes than a more complex regimen of heparin plus IIb/IIIa inhibitors," commented Stone.

This study was funded by The Medicines Company.

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