Interventional Diagnosis and Treatment of CAD in 2014
Interventional Diagnosis and Treatment of CAD in 2014
Evaluation of: Hamon M, Nienaber C, Galli S et al. Bivalirudin in percutaneous coronary intervention: The EUROpean BiValIrudin UtiliSatION in Practice (EUROVISION) Registry. Int. J. Cardiol. 173(2), 290–294 (2014).
Bivalirudin is a direct thrombin inhibitor which is approved for use in percutaneous coronary intervention (PCI). The EUROVISION registry assessed short-term clinical outcomes in PCI patients treated in centers in Austria, France, Germany, Italy and the UK.
Data were collected for 2018 consecutive patients treated with bivalirudin in 58 centers and included in-hospital and 30-day efficacy outcomes (death, myocardial infarction, stroke and unplanned revascularization) and safety outcomes (stent thrombosis and major bleeding). Approximately a quarter of patients had PCI for stable angina and a third of patients had PCI for ST-elevation myocardial infarction with a third having radial access and a third bare-metal stenting.
The registry demonstrated a low overall 30-day mortality of 1.0% with a composite of death/myocardial infarction/stroke/urgent revascularization of only 2.9% at 30 days. The major bleeding rate was 1.6% but this was threefold higher in those with renal impairment. Reassuringly they did not observe a high rate of stent thrombosis at 30 days (only two out of 2018 patients).
The results are consistent with the HORIZONS-AMI data. Bivalirudin appears to be safe for all-comers PCI albeit with the inherent limitations of a registry study. These findings may allay some of the fears surrounding data emerging from HEAT-PPCI, which concluded that bivalirudin was inferior to heparin, largely driven by a higher acute stent thrombosis rate in the bivalirudin arm.
EUROVISION Registry: Bivalirudin use in European practice
Evaluation of: Hamon M, Nienaber C, Galli S et al. Bivalirudin in percutaneous coronary intervention: The EUROpean BiValIrudin UtiliSatION in Practice (EUROVISION) Registry. Int. J. Cardiol. 173(2), 290–294 (2014).
Bivalirudin is a direct thrombin inhibitor which is approved for use in percutaneous coronary intervention (PCI). The EUROVISION registry assessed short-term clinical outcomes in PCI patients treated in centers in Austria, France, Germany, Italy and the UK.
Data were collected for 2018 consecutive patients treated with bivalirudin in 58 centers and included in-hospital and 30-day efficacy outcomes (death, myocardial infarction, stroke and unplanned revascularization) and safety outcomes (stent thrombosis and major bleeding). Approximately a quarter of patients had PCI for stable angina and a third of patients had PCI for ST-elevation myocardial infarction with a third having radial access and a third bare-metal stenting.
The registry demonstrated a low overall 30-day mortality of 1.0% with a composite of death/myocardial infarction/stroke/urgent revascularization of only 2.9% at 30 days. The major bleeding rate was 1.6% but this was threefold higher in those with renal impairment. Reassuringly they did not observe a high rate of stent thrombosis at 30 days (only two out of 2018 patients).
The results are consistent with the HORIZONS-AMI data. Bivalirudin appears to be safe for all-comers PCI albeit with the inherent limitations of a registry study. These findings may allay some of the fears surrounding data emerging from HEAT-PPCI, which concluded that bivalirudin was inferior to heparin, largely driven by a higher acute stent thrombosis rate in the bivalirudin arm.
