Brachytherapy and bivalirudin evaluation study

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

Research output: Contribution to journalArticle

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Abstract

Background: Bivalirudin is shown to be a competent substitute for heparin in percutaneous coronary intervention (PCI). The safety and efficacy of bivalirudin in patients undergoing PCI and vascular brachytherapy (VBT) are not known. This study aimed to assess the safety and efficacy of bivalirudin as a single antithrombotic agent in patients undergoing PCI and VBT. Methods: A total of 152 patients enrolled in the Brachytherapy and Bivalirudin Evaluation Study underwent PCI and VBT with either gamma (n = 8) or β radiation (n = 144). The main outcome measures were in-hospital events and 30-day clinical outcomes. All patients were treated with bivalirudin (0.75 mg/kg bolus and 1.75 mg/kg per hour infusion for β radiation, 1 mg/kg bolus and 2.5 mg/kg per hour infusion for gamma radiation) as a single antithrombotic agent during the entire procedure. Results: Baseline clinical and angiographic characteristics were similar between the 2 groups. More than 90% of the patients received β radiation. In-hospital events showed a higher prevalence of acute procedural intracoronary thrombosis in patients treated with gamma- vs β radiation (25% vs. 0.7%, P < .001). Thirty-day outcomes including death, Q-wave, and non-Q-wave myocardial infarctions, subacute stent thromboses, and repeat revascularizations were similar in both groups. Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT with β emitters, may be used safely, but its use in the setting of PCI and gamma radiation may not be acceptable due to an increased incidence of acute procedural intracoronary thrombosis.

Original languageEnglish
Pages (from-to)832-837
Number of pages6
JournalAmerican Heart Journal
Volume150
Issue number4
DOIs
Publication statusPublished - 2005 Oct 1
Externally publishedYes

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Brachytherapy
Percutaneous Coronary Intervention
Fibrinolytic Agents
Blood Vessels
Gamma Rays
Thrombosis
Radiation
Safety
Stents
Heparin
bivalirudin
Myocardial Infarction
Outcome Assessment (Health Care)
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kuchulakanti, P., Wolfram, R., Torguson, R., Rha, S-W., Cheneau, E., Pinnow, E. E., ... Waksman, R. (2005). Brachytherapy and bivalirudin evaluation study. American Heart Journal, 150(4), 832-837. https://doi.org/10.1016/j.ahj.2004.11.013

Brachytherapy and bivalirudin evaluation study. / Kuchulakanti, Pramod; Wolfram, Roswitha; Torguson, Rebecca; Rha, Seung-Woon; Cheneau, Edouard; Pinnow, Ellen E.; Canos, Daniel; Satler, Lowell F.; Pichard, Augusto D.; Kent, Kenneth M.; Waksman, Ron.

In: American Heart Journal, Vol. 150, No. 4, 01.10.2005, p. 832-837.

Research output: Contribution to journalArticle

Kuchulakanti, P, Wolfram, R, Torguson, R, Rha, S-W, Cheneau, E, Pinnow, EE, Canos, D, Satler, LF, Pichard, AD, Kent, KM & Waksman, R 2005, 'Brachytherapy and bivalirudin evaluation study', American Heart Journal, vol. 150, no. 4, pp. 832-837. https://doi.org/10.1016/j.ahj.2004.11.013
Kuchulakanti P, Wolfram R, Torguson R, Rha S-W, Cheneau E, Pinnow EE et al. Brachytherapy and bivalirudin evaluation study. American Heart Journal. 2005 Oct 1;150(4):832-837. https://doi.org/10.1016/j.ahj.2004.11.013
Kuchulakanti, Pramod ; Wolfram, Roswitha ; Torguson, Rebecca ; Rha, Seung-Woon ; Cheneau, Edouard ; Pinnow, Ellen E. ; Canos, Daniel ; Satler, Lowell F. ; Pichard, Augusto D. ; Kent, Kenneth M. ; Waksman, Ron. / Brachytherapy and bivalirudin evaluation study. In: American Heart Journal. 2005 ; Vol. 150, No. 4. pp. 832-837.
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abstract = "Background: Bivalirudin is shown to be a competent substitute for heparin in percutaneous coronary intervention (PCI). The safety and efficacy of bivalirudin in patients undergoing PCI and vascular brachytherapy (VBT) are not known. This study aimed to assess the safety and efficacy of bivalirudin as a single antithrombotic agent in patients undergoing PCI and VBT. Methods: A total of 152 patients enrolled in the Brachytherapy and Bivalirudin Evaluation Study underwent PCI and VBT with either gamma (n = 8) or β radiation (n = 144). The main outcome measures were in-hospital events and 30-day clinical outcomes. All patients were treated with bivalirudin (0.75 mg/kg bolus and 1.75 mg/kg per hour infusion for β radiation, 1 mg/kg bolus and 2.5 mg/kg per hour infusion for gamma radiation) as a single antithrombotic agent during the entire procedure. Results: Baseline clinical and angiographic characteristics were similar between the 2 groups. More than 90{\%} of the patients received β radiation. In-hospital events showed a higher prevalence of acute procedural intracoronary thrombosis in patients treated with gamma- vs β radiation (25{\%} vs. 0.7{\%}, P < .001). Thirty-day outcomes including death, Q-wave, and non-Q-wave myocardial infarctions, subacute stent thromboses, and repeat revascularizations were similar in both groups. Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT with β emitters, may be used safely, but its use in the setting of PCI and gamma radiation may not be acceptable due to an increased incidence of acute procedural intracoronary thrombosis.",
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AU - Wolfram, Roswitha

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AU - Cheneau, Edouard

AU - Pinnow, Ellen E.

AU - Canos, Daniel

AU - Satler, Lowell F.

AU - Pichard, Augusto D.

AU - Kent, Kenneth M.

AU - Waksman, Ron

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N2 - Background: Bivalirudin is shown to be a competent substitute for heparin in percutaneous coronary intervention (PCI). The safety and efficacy of bivalirudin in patients undergoing PCI and vascular brachytherapy (VBT) are not known. This study aimed to assess the safety and efficacy of bivalirudin as a single antithrombotic agent in patients undergoing PCI and VBT. Methods: A total of 152 patients enrolled in the Brachytherapy and Bivalirudin Evaluation Study underwent PCI and VBT with either gamma (n = 8) or β radiation (n = 144). The main outcome measures were in-hospital events and 30-day clinical outcomes. All patients were treated with bivalirudin (0.75 mg/kg bolus and 1.75 mg/kg per hour infusion for β radiation, 1 mg/kg bolus and 2.5 mg/kg per hour infusion for gamma radiation) as a single antithrombotic agent during the entire procedure. Results: Baseline clinical and angiographic characteristics were similar between the 2 groups. More than 90% of the patients received β radiation. In-hospital events showed a higher prevalence of acute procedural intracoronary thrombosis in patients treated with gamma- vs β radiation (25% vs. 0.7%, P < .001). Thirty-day outcomes including death, Q-wave, and non-Q-wave myocardial infarctions, subacute stent thromboses, and repeat revascularizations were similar in both groups. Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT with β emitters, may be used safely, but its use in the setting of PCI and gamma radiation may not be acceptable due to an increased incidence of acute procedural intracoronary thrombosis.

AB - Background: Bivalirudin is shown to be a competent substitute for heparin in percutaneous coronary intervention (PCI). The safety and efficacy of bivalirudin in patients undergoing PCI and vascular brachytherapy (VBT) are not known. This study aimed to assess the safety and efficacy of bivalirudin as a single antithrombotic agent in patients undergoing PCI and VBT. Methods: A total of 152 patients enrolled in the Brachytherapy and Bivalirudin Evaluation Study underwent PCI and VBT with either gamma (n = 8) or β radiation (n = 144). The main outcome measures were in-hospital events and 30-day clinical outcomes. All patients were treated with bivalirudin (0.75 mg/kg bolus and 1.75 mg/kg per hour infusion for β radiation, 1 mg/kg bolus and 2.5 mg/kg per hour infusion for gamma radiation) as a single antithrombotic agent during the entire procedure. Results: Baseline clinical and angiographic characteristics were similar between the 2 groups. More than 90% of the patients received β radiation. In-hospital events showed a higher prevalence of acute procedural intracoronary thrombosis in patients treated with gamma- vs β radiation (25% vs. 0.7%, P < .001). Thirty-day outcomes including death, Q-wave, and non-Q-wave myocardial infarctions, subacute stent thromboses, and repeat revascularizations were similar in both groups. Conclusion: Bivalirudin, as a single antithrombotic agent during PCI and VBT with β emitters, may be used safely, but its use in the setting of PCI and gamma radiation may not be acceptable due to an increased incidence of acute procedural intracoronary thrombosis.

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