Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy

Pramod Kuchulakanti, Roswitha Wolfram, Rebecca Torguson, Seung-Woon Rha, Edouard Cheneau, Leonardo Clavijo, William W. Chu, Ellen E. Pinnow, Daniel Canos, Lowell F. Satler, William O. Suddath, Augusto D. Pichard, Kenneth M. Kent, Ron Waksman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Bivalirudin is replacing heparin in percutaneous coronary interventions (PCIs), including vascular brachytherapy (VBT). The aim of the study was to compare bivalirudin with eptifibatide in patients with in-stent restenosis (ISR) undergoing PCI and VBT. Methods: One hundred forty-four patients treated with bivalirudin as a single antithrombotic agent were compared with 150 patients treated with eptifibatide. Bivalirudin as a bolus of 0.75 mg/kg followed by 1.75 mg/kg/h infusion until the end of the procedure, and eptifibatide as a double bolus of 180 μg/kg followed by 2 μg/kg/min infusion for 18 h after the procedure were used. The main outcome measures were in-hospital events and 30-day clinical outcomes. Results: Baseline clinical characteristics were similar except that patients in the eptifibatide group were younger (P=.02) and had more saphenous vein graft lesions (P<.001). Patients in the bivalirudin group had a higher number of lesions in the right coronary artery (P<.001) and a higher number of vessels treated (P<.001). Postprocedure creatinine phosphokinase (CPK)-MB levels were significantly lower in the bivalirudin group (P<.03). In-hospital events showed significantly less minor bleeding (P=.01) and a trend toward lower major bleeding and major adverse cardiac events (MACE) in the bivalirudin group (P=.06). Thirty-day outcomes showed a significantly lower incidence of non-Q-wave myocardial infarction (MI) in the bivalirudin group (P=.004). Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT, is associated with significantly lower postprocedural CPK-MB elevation, minor bleeding complications, 30-day non-Q-wave MI rates, and a trend toward lower major bleeding and in-hospital MACE when compared with eptifibatide.

Original languageEnglish
Pages (from-to)154-159
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume6
Issue number4
DOIs
Publication statusPublished - 2005 Oct 1
Externally publishedYes

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Brachytherapy
Stents
Percutaneous Coronary Intervention
Hemorrhage
Blood Vessels
Fibrinolytic Agents
Creatinine
Phosphotransferases
Myocardial Infarction
bivalirudin
Saphenous Vein
Heparin
Coronary Vessels
Outcome Assessment (Health Care)
eptifibatide
Transplants
Incidence

Keywords

  • Bivalirudin
  • Brachytherapy
  • In-stent Restenosis

ASJC Scopus subject areas

  • Molecular Medicine
  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy. / Kuchulakanti, Pramod; Wolfram, Roswitha; Torguson, Rebecca; Rha, Seung-Woon; Cheneau, Edouard; Clavijo, Leonardo; Chu, William W.; Pinnow, Ellen E.; Canos, Daniel; Satler, Lowell F.; Suddath, William O.; Pichard, Augusto D.; Kent, Kenneth M.; Waksman, Ron.

In: Cardiovascular Revascularization Medicine, Vol. 6, No. 4, 01.10.2005, p. 154-159.

Research output: Contribution to journalArticle

Kuchulakanti, P, Wolfram, R, Torguson, R, Rha, S-W, Cheneau, E, Clavijo, L, Chu, WW, Pinnow, EE, Canos, D, Satler, LF, Suddath, WO, Pichard, AD, Kent, KM & Waksman, R 2005, 'Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy', Cardiovascular Revascularization Medicine, vol. 6, no. 4, pp. 154-159. https://doi.org/10.1016/j.carrev.2005.06.003
Kuchulakanti, Pramod ; Wolfram, Roswitha ; Torguson, Rebecca ; Rha, Seung-Woon ; Cheneau, Edouard ; Clavijo, Leonardo ; Chu, William W. ; Pinnow, Ellen E. ; Canos, Daniel ; Satler, Lowell F. ; Suddath, William O. ; Pichard, Augusto D. ; Kent, Kenneth M. ; Waksman, Ron. / Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy. In: Cardiovascular Revascularization Medicine. 2005 ; Vol. 6, No. 4. pp. 154-159.
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abstract = "Background: Bivalirudin is replacing heparin in percutaneous coronary interventions (PCIs), including vascular brachytherapy (VBT). The aim of the study was to compare bivalirudin with eptifibatide in patients with in-stent restenosis (ISR) undergoing PCI and VBT. Methods: One hundred forty-four patients treated with bivalirudin as a single antithrombotic agent were compared with 150 patients treated with eptifibatide. Bivalirudin as a bolus of 0.75 mg/kg followed by 1.75 mg/kg/h infusion until the end of the procedure, and eptifibatide as a double bolus of 180 μg/kg followed by 2 μg/kg/min infusion for 18 h after the procedure were used. The main outcome measures were in-hospital events and 30-day clinical outcomes. Results: Baseline clinical characteristics were similar except that patients in the eptifibatide group were younger (P=.02) and had more saphenous vein graft lesions (P<.001). Patients in the bivalirudin group had a higher number of lesions in the right coronary artery (P<.001) and a higher number of vessels treated (P<.001). Postprocedure creatinine phosphokinase (CPK)-MB levels were significantly lower in the bivalirudin group (P<.03). In-hospital events showed significantly less minor bleeding (P=.01) and a trend toward lower major bleeding and major adverse cardiac events (MACE) in the bivalirudin group (P=.06). Thirty-day outcomes showed a significantly lower incidence of non-Q-wave myocardial infarction (MI) in the bivalirudin group (P=.004). Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT, is associated with significantly lower postprocedural CPK-MB elevation, minor bleeding complications, 30-day non-Q-wave MI rates, and a trend toward lower major bleeding and in-hospital MACE when compared with eptifibatide.",
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T1 - Bivalirudin compared with IIb/IIIa inhibitors in patients with in-stent restenosis undergoing intracoronary brachytherapy

AU - Kuchulakanti, Pramod

AU - Wolfram, Roswitha

AU - Torguson, Rebecca

AU - Rha, Seung-Woon

AU - Cheneau, Edouard

AU - Clavijo, Leonardo

AU - Chu, William W.

AU - Pinnow, Ellen E.

AU - Canos, Daniel

AU - Satler, Lowell F.

AU - Suddath, William O.

AU - Pichard, Augusto D.

AU - Kent, Kenneth M.

AU - Waksman, Ron

PY - 2005/10/1

Y1 - 2005/10/1

N2 - Background: Bivalirudin is replacing heparin in percutaneous coronary interventions (PCIs), including vascular brachytherapy (VBT). The aim of the study was to compare bivalirudin with eptifibatide in patients with in-stent restenosis (ISR) undergoing PCI and VBT. Methods: One hundred forty-four patients treated with bivalirudin as a single antithrombotic agent were compared with 150 patients treated with eptifibatide. Bivalirudin as a bolus of 0.75 mg/kg followed by 1.75 mg/kg/h infusion until the end of the procedure, and eptifibatide as a double bolus of 180 μg/kg followed by 2 μg/kg/min infusion for 18 h after the procedure were used. The main outcome measures were in-hospital events and 30-day clinical outcomes. Results: Baseline clinical characteristics were similar except that patients in the eptifibatide group were younger (P=.02) and had more saphenous vein graft lesions (P<.001). Patients in the bivalirudin group had a higher number of lesions in the right coronary artery (P<.001) and a higher number of vessels treated (P<.001). Postprocedure creatinine phosphokinase (CPK)-MB levels were significantly lower in the bivalirudin group (P<.03). In-hospital events showed significantly less minor bleeding (P=.01) and a trend toward lower major bleeding and major adverse cardiac events (MACE) in the bivalirudin group (P=.06). Thirty-day outcomes showed a significantly lower incidence of non-Q-wave myocardial infarction (MI) in the bivalirudin group (P=.004). Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT, is associated with significantly lower postprocedural CPK-MB elevation, minor bleeding complications, 30-day non-Q-wave MI rates, and a trend toward lower major bleeding and in-hospital MACE when compared with eptifibatide.

AB - Background: Bivalirudin is replacing heparin in percutaneous coronary interventions (PCIs), including vascular brachytherapy (VBT). The aim of the study was to compare bivalirudin with eptifibatide in patients with in-stent restenosis (ISR) undergoing PCI and VBT. Methods: One hundred forty-four patients treated with bivalirudin as a single antithrombotic agent were compared with 150 patients treated with eptifibatide. Bivalirudin as a bolus of 0.75 mg/kg followed by 1.75 mg/kg/h infusion until the end of the procedure, and eptifibatide as a double bolus of 180 μg/kg followed by 2 μg/kg/min infusion for 18 h after the procedure were used. The main outcome measures were in-hospital events and 30-day clinical outcomes. Results: Baseline clinical characteristics were similar except that patients in the eptifibatide group were younger (P=.02) and had more saphenous vein graft lesions (P<.001). Patients in the bivalirudin group had a higher number of lesions in the right coronary artery (P<.001) and a higher number of vessels treated (P<.001). Postprocedure creatinine phosphokinase (CPK)-MB levels were significantly lower in the bivalirudin group (P<.03). In-hospital events showed significantly less minor bleeding (P=.01) and a trend toward lower major bleeding and major adverse cardiac events (MACE) in the bivalirudin group (P=.06). Thirty-day outcomes showed a significantly lower incidence of non-Q-wave myocardial infarction (MI) in the bivalirudin group (P=.004). Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT, is associated with significantly lower postprocedural CPK-MB elevation, minor bleeding complications, 30-day non-Q-wave MI rates, and a trend toward lower major bleeding and in-hospital MACE when compared with eptifibatide.

KW - Bivalirudin

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KW - In-stent Restenosis

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