Bivalirudin Use and One‐Month Outcome in the Context of Contemporary Antiplatelet Treatment: Insights from the Greek Antiplatelet Registry. Issue 3 (June 2014)

• Record Type: Journal Article
• Authors: Alexopoulos, Dimitrios; Xanthopoulou, Ioanna; Deftereos, Spyridon; Sitafidis, George; Kanakakis, Ioannis; Hamilos, Michalis; Karayannis, George; Angelidis, Christos; Stavrou, Katerina; Vavuranakis, Manolis; Goudevenos, John A.; Stefanadis, Christodoulos
• Is Part Of: Cardiovascular therapeutics. Volume 32:Issue 3(2014:Jun.)
• Page Start: 120
• Page End: 126
• Publication Date: 2014-06
• Subjects: Cardiovascular pharmacology -- Periodicals; Cardiovascular agents -- Periodicals; Cardiovascular system -- Diseases -- Chemotherapy -- Periodicals; Cardiovascular Agents -- Periodicals; Cardiovascular Diseases -- drug therapy -- Periodicals; Agents cardiovasculaires -- Périodiques; Appareil cardiovasculaire -- Maladies -- Chimiothérapie -- Périodiques; 616.1005
• DOI: 10.1111/1755-5922.12068
• Languages: English
• ISSNs: 1755-5914

Abstract

<abstract abstract-type="main" id="cdr12068-abs-0001"> <title>Summary</title> <sec id="cdr12068-sec-0001" sec-type="section"> <title>Aims</title> <p>Little is known about the use of bivalirudin in "real life". In the context of contemporary antiplatelet treatment, we aimed to assess bivalirudin treatment patterns and short‐term (one‐month) outcome.</p> </sec> <sec id="cdr12068-sec-0002" sec-type="section"> <title>Methods</title> <p>Greek Antiplatelet Registry (GRAPE) is a prospective, observational, multicenter cohort study of consecutive, moderate‐to‐high‐risk acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI). We assessed bivalirudin treatment patterns and predictive factors for its use. Combined in‐hospital and one‐month major adverse cardiovascular events (MACE, including death, myocardial infarction, urgent revascularization, and stroke), and bleeding events according to Bleeding Academic Research Consortium (BARC) criteria were analyzed after propensity matching.</p> </sec> <sec id="cdr12068-sec-0003" sec-type="section"> <title>Results</title> <p>Of 2047 registered patients, 480 (23.4%) were treated with bivalirudin. Multivariate analysis (C statistic 0.77, 0.75–0.80 95% CIs, <italic>P </italic>< 0.001) revealed as factors favoring bivalirudin use primary PCI, radial arterial access, presentation with positive biomarkers and use of novel P2Y12 inhibitor, whereas IIb/IIIa inhibitor administration did not. Regional trends also affected bivalirudin's choice. In 370 propensity‐matched pairs of patients who received or not bivalirudin, MACE, BARC type 1, 2 and 3 did not differ between groups: 4.1%, 21.9%, 3.2%, 3.5% and 5.1%, 18.9%, 2.7%, 4.3%, respectively, <italic>P </italic>= nonsignificant for all.</p> </sec> <sec id="cdr12068-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In a "real life", contemporary antiplatelet treatment registry, clinical, laboratory and logistic factors affect bivalirudin's choice, while there are no differences in one‐month outcome between bivalirudin‐treated and non‐bivalirudin‐treated patients.</p> </sec> </abstract>