A Meta-analysis of Clinical Trials Evaluating the Impact of Bivalirudin-based Anticoagulation for Primary Percutaneous Coronary on Long-Term Mortality.
Antithrombins
/ adverse effects
Evidence-Based Medicine
Female
Hemorrhage
/ chemically induced
Hirudins
/ adverse effects
Humans
Male
Middle Aged
Peptide Fragments
/ adverse effects
Percutaneous Coronary Intervention
/ adverse effects
Randomized Controlled Trials as Topic
Recombinant Proteins
/ adverse effects
Risk Assessment
Risk Factors
ST Elevation Myocardial Infarction
/ diagnosis
Time Factors
Treatment Outcome
Journal
Journal of cardiovascular pharmacology
ISSN: 1533-4023
Titre abrégé: J Cardiovasc Pharmacol
Pays: United States
ID NLM: 7902492
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
received:
27
11
2020
accepted:
16
03
2021
pubmed:
1
5
2021
medline:
5
1
2022
entrez:
30
4
2021
Statut:
ppublish
Résumé
Bivalirudin and heparin are the principal anticoagulants used during primary percutaneous coronary intervention (PCI) for patients experiencing ST-elevation myocardial infarctions. Based on previous meta-analyses, bivalirudin improves 30-day mortality rates compared with heparin, especially when vascular access is predominantly femoral. However, no meta-analysis has yet reported whether this mortality benefit with bivalirudin persists beyond 30 days. Scientific databases and websites were searched to find randomized controlled trials, and risk ratios (RRs) were calculated using random effect models. Data from 4 trials were analyzed. Compared with heparin ± glycoprotein IIb/IIIa inhibitors, bivalirudin decreased all-cause mortality [RR, 0.81; 95% confidence interval (CI), 0.69-0.94; P = 0.008], cardiac mortality (RR, 0.72; 95% CI, 0.60-0.88; P = 0.001), and net adverse clinical events (RR, 0.83; 95% CI, 0.72-0.97; P = 0.016) at 1 year. In conclusion, a bivalirudin-based anticoagulation strategy during primary percutaneous coronary intervention significantly decreases the 1-year risks for all-cause mortality, cardiac mortality, and net adverse clinical events compared with heparin ± glycoprotein IIb/IIIa inhibitor.
Identifiants
pubmed: 33929388
doi: 10.1097/FJC.0000000000001029
pii: 00005344-202107000-00007
doi:
Substances chimiques
Antithrombins
0
Hirudins
0
Peptide Fragments
0
Recombinant Proteins
0
bivalirudin
TN9BEX005G
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
e40-e44Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors report no conflict of interest.
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