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Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation.
Pediatr Crit Care Med
January 2025
Department of Pediatrics, Division of Critical Care, University of Texas Southwestern Medical Center, Dallas, TX.
Objectives: To test feasibility of a randomized controlled trial (RCT) with an endpoint of time at goal anticoagulation in children on extracorporeal membrane oxygenation (ECMO) randomized to receive bivalirudin vs. unfractionated heparin.
Design: Open-label pilot RCT (NCT03318393) carried out 2018-2021.
Bivalirudin vs Heparin Anticoagulation in STEMI: Confirmation of the BRIGHT-4 Results.
J Am Coll Cardiol
October 2024
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; YNHH/ Yale Center for Outcomes Research and Evaluation (CORE), New Haven, Connecticut, USA.
Article Synopsis
- - The BRIGHT-4 study showed that using bivalirudin with a high-dose infusion after PCI led to lower overall mortality and bleeding risks compared to heparin, without raising rates of reinfarction or stent thrombosis in STEMI patients.
- - A meta-analysis of six trials involving over 15,000 patients found that while bivalirudin reduced overall and cardiac mortality and major bleeding, it was associated with higher rates of reinfarction and stent thrombosis compared to heparin.
- - When specifically looking at a subset of trials similar to the BRIGHT-4 approach, bivalirudin also showed a decrease in 30-day mortality and major bleeding, with comparable rates of reinfar
Bivalirudin versus heparin in patients with or without bail-out GPI use: a pre-specified subgroup analysis from the BRIGHT-4 trial.
BMC Med
September 2024
Icahn School of Medicine at Mount Sinai, Zena and Michael A Wiener Cardiovascular Institute, New York, NY, USA.
Article Synopsis
- The study looked at two medicines, bivalirudin and heparin, to see which one is safer and better for patients with a serious heart problem called STEMI who are getting a treatment called PCI.
- Many patients didn't use a certain type of medicine (GPI) during the treatment, and those on bivalirudin had better results with fewer deaths and less bleeding.
- However, for those who needed the GPI medicine, there weren't big differences in the results between the two treatments.
Bivalirudin versus heparin in patients undergoing percutaneous coronary intervention in acute coronary syndromes.
Crit Pathw Cardiol
July 2024
Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, New York.
Introduction: Data on outcomes between unfractionated heparin and bivalirudin anticoagulation during percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS) remains inconclusive. We aimed to systematically analyze PCI outcomes comparing unfractionated heparin and bivalirudin.
Methods: We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through January 2024 for studies evaluating PCI outcomes comparing unfractionated heparin and bivalirudin.
Bivalirudin Versus Heparin Monotherapy in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Study-level Meta-analysis of Randomized Controlled Trials.
Cardiovasc Drugs Ther
July 2024
Department of Cardiology, Tang Du Hospital, Air Force Medical University, Shaanxi, China.
Aims: The present meta-analysis focused on investigating whether bivalirudin plus post-PCI infusion was safer and more effective than heparin monotherapy in patients who developed ST-segment elevation myocardial infarction (STEMI) and who underwent primary percutaneous coronary intervention (PCI).
Methods: The PubMed, EMBASE, Cochrane Library, and Web of Science databases were systemically searched to identify randomized controlled trials (RCTs) comparing bivalirudin and heparin for treating STEMI patients who underwent primary PCI. The Cochrane quality assessment tool was used to assess the quality of the enrolled studies.
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