Featured Research

from universities, journals, and other organizations

Bivalirudin versus heparin in patients planned for coronary stenting

Date:
August 15, 2014
Source:
Brigham and Women's Hospital
Summary:
An analysis of all of the previous trials to date has been conducted to better define both the benefits and risks of the competing anticoagulants. Researchers found that, compared with heparin-based regimens, bivalirudin-based regimens increased the risk of heart attack and stent thrombosis. Bivalirudin-based regimens decreased the risk of bleeding, but by how much depended on whether other blood thinners were used more with heparin than with bivalirudin.

Bivalirudin and heparin are two anticoagulant options for patients undergoing coronary stenting for ischemic heart disease. Bivalirudin, a newer anticoagulant, has been touted as being as effective as generic heparin, but with nearly half the rate of bleeding. However, several studies have hinted that, compared with heparin, bivalirudin-based regimens might not protect as well against recurrent heart attacks and might increase the risk of stents clotting off. Moreover, newer studies have questioned whether the reduction in bleeding holds up when tested on more modern background therapy. Researchers from Brigham and Women's Hospital (BWH) conducted an analysis of all of the previous trials to date to better define both the benefits and risks of the competing anticoagulants. They found that, compared with heparin-based regimens, bivalirudin-based regimens increased the risk of heart attack and stent thrombosis. Bivalirudin-based regimens decreased the risk of bleeding, but by how much depended on whether other blood thinners were used more with heparin than with bivalirudin.

Related Articles


These findings are published in The Lancet on August 15, 2014.

"Our study found that using a bivalirudin-based regimen increased the risk of major adverse cardiac events by nine percent. This risk was largely driven by an increased risk of heart attack and recurrent angina requiring further coronary stenting. There was also more than a four-fold increase in the risk of stent thrombosis in the first 24 hours in patients having a large heart attack who were treated with emergency stenting," explained Matthew Cavender, MD, MPH, an interventional fellow in BWH's Cardiovascular Division, senior research fellow in the TIMI Study Group and first author of this study. "Bivalirudin-based regimens lowered the risk of bleeding, but the magnitude of benefit was attenuated when glycoprotein IIb/IIIa inhibitor (GPI) use was similar in the two arms."

To help better define the benefits and risks of these two anticoagulants, researchers from BWH pooled data from 16 trials involving nearly 34,000 patients. They compared the effects of bivalirudin-based regimens with heparin-based regimens on ischemic and bleeding outcomes through 30 days.

"It can be challenging to wade through the seemingly disparate data in the literature. These findings should help clinicians make a more informed decision when selecting an anticoagulant to support coronary stenting in different types of patients by weighing the trade-offs between risks of thrombotic and bleeding complications," stated Marc S. Sabatine, MD, MPH, a senior physician in BWH's Cardiovascular Division, chairman of the TIMI Study Group and senior author of this study.

The researchers note that more work is needed to investigate specific strategies to minimize thrombotic complications during percutaneous coronary intervention, without substantially increasing the risk of bleeding.


Story Source:

The above story is based on materials provided by Brigham and Women's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Matthew A Cavender, Marc S Sabatine. Bivalirudin versus heparin in patients planned for percutaneous coronary intervention: a meta-analysis of randomised controlled trials. The Lancet, 2014; 384 (9943): 599 DOI: 10.1016/S0140-6736(14)61216-2

Cite This Page:

Brigham and Women's Hospital. "Bivalirudin versus heparin in patients planned for coronary stenting." ScienceDaily. ScienceDaily, 15 August 2014. <www.sciencedaily.com/releases/2014/08/140815195904.htm>.
Brigham and Women's Hospital. (2014, August 15). Bivalirudin versus heparin in patients planned for coronary stenting. ScienceDaily. Retrieved November 28, 2014 from www.sciencedaily.com/releases/2014/08/140815195904.htm
Brigham and Women's Hospital. "Bivalirudin versus heparin in patients planned for coronary stenting." ScienceDaily. www.sciencedaily.com/releases/2014/08/140815195904.htm (accessed November 28, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, November 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Rural India's Low-Cost Sanitary Pad Revolution

Rural India's Low-Cost Sanitary Pad Revolution

AFP (Nov. 28, 2014) — One man hopes his invention -– a machine that produces cheap sanitary pads –- will help empower Indian women. Duration: 01:51 Video provided by AFP
Powered by NewsLook.com
Research on Bats Could Help Develop Drugs Against Ebola

Research on Bats Could Help Develop Drugs Against Ebola

AFP (Nov. 28, 2014) — In Africa's only biosafety level 4 laboratory, scientists have been carrying out experiments on bats to understand how virus like Ebola are being transmitted, and how some of them resist to it. Duration: 01:18 Video provided by AFP
Powered by NewsLook.com
WHO Says Male Ebola Survivors Should Abstain From Sex

WHO Says Male Ebola Survivors Should Abstain From Sex

Newsy (Nov. 28, 2014) — WHO cites four studies that say Ebola can still be detected in semen up to 82 days after the onset of symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins