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Anticoagulant Saves Money Compared to Standard Therapy

Bivalirudin produces similar efficacy, has lower hospital costs than traditional therapy

FRIDAY, Nov. 21 (HealthDay News) -- The anticoagulant agent bivalirudin is an efficacious and cost-effective alternative to traditional therapy, according to the results of an economic evaluation published in the Nov. 25 issue of the Journal of the American College of Cardiology.

Duane S. Pinto, M.D., from Harvard Medical School in Boston, and colleagues compared the economic impact of bivalirudin with that of other treatments for patients with moderate- and high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS). The investigators used the results of the ACUITY trial, in which 7,851 patients were randomized to receive one of three therapies: heparin plus glycoprotein IIb/IIIa receptor inhibitors (GPI); bivalirudin plus GPI; or bivalirudin monotherapy.

The investigators found that ischemic events did not vary significantly among the groups. Major bleeding was lower with bivalirudin monotherapy, and length of stay was shortest with bivalirudin monotherapy or bivalirudin plus catheterization laboratory GPI. In addition, the aggregate costs of hospital stay were lowest with bivalirudin monotherapy, mostly because patients on the therapy had less major and minor bleeding, the researchers report.

"These findings represent the first prospective economic evaluation of alternative antithrombotic strategies for NSTE-ACS in patients undergoing early invasive management," the authors write, adding that bivalirudin monotherapy may provide both clinical and economic advantages over current standard therapy.

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