Safety and efficacy of bivalirudin with glycoprotein IIb/IIIa for high-risk percutaneous coronary intervention.

Aims: The aim of the study was to assess the safety and efficacy of bivalirudin + glycoprotein (Gp) IIb/IIIa inhibitor as compared to unfractionated heparin (UFH) + Gp IIb/IIIa inhibitor in high risk patients undergoing elective percutaneous coronary intervention (PCI). The primary end point was time to sheath removal and ambulation where as peri-procedure myocardial damage, access site bleeding and major adverse cardiac events (MACE) rates were secondary end points.

Methods: One hundred and one high risk patients undergoing elective PCI were randomly assigned to either bivalirudin + GpIIb/IIIa inhibitor or UFH + Gp IIb/IIIa inhibitor.

Changing management of acute MI--perspectives from India.

Management of acute myocardial infarction (AMI) in India essentially rests on the established reperfusion strategies with unique adaptations compelled by the socioeconomic structure of the country. Due to limited availability of trained interventionists coupled with financial limitations, thrombolysis remains the most utilised reperfusion therapy for AMI. Patient education through the active participation of physicians concerning the early detection of symptoms suggestive of AMI can enhance the impact of thrombolysis on the outcomes by narrowing the door-to-needle time.