Bivalirudin use in patients undergoing percutaneous coronary intervention for acute myocardial infarction. Insights from the prospective, multi-centre EUROVISION registry.

Acute cardiac care Pub Date : 2014-12-01 Epub Date: 2014-08-07 DOI:10.3109/17482941.2014.944542
U Limbruno, A Picchi, S Galli, K Huber, J Lipiecki, D Bernstein, E Deliargyris, P Anthopoulos, C Nienaber, M Hamon
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引用次数: 1

Abstract

Background: The effectiveness of bivalirudin in patients undergoing percutaneous coronary intervention for acute myocardial infarction has been tested in clinical trials, but its use in a real-world scenario has never been reported.

Methods: From the total number of patients enrolled in the EUROVISION registry, 678 subjects affected by ST-elevation myocardial infarction were selected and included in the analysis. Posology and usage patterns of bivalirudin, as evaluated by dose and time of drug bolus and infusion administered, were evaluated. The 30-day outcome has been assessed by efficacy and safety endpoints.

Results: All patients received an initial intravenous bolus of bivalirudin (0.70±0.25 mg/kg) followed by an infusion (1.58±0.47 mg/kg/h; duration: 60 [30, 107] min) in 99.3% of cases. An additional bolus (0.49±0.06 mg/kg) was administered in 9.3% of patients. Bivalirudin infusion was prolonged after procedure in 62.2%. Death occurred in 2.1% of patients, non-fatal myocardial reinfarction in 0.3%, unplanned revascularization in 0.6% and non-fatal stroke in 0.4%. Acute stent thrombosis was not observed. Major bleeding occurred in 1.5% of patients.

Conclusions: Bivalirudin usage in the setting of primary PCI provided excellent results in terms of 30-day outcome even in a real-world population.

比伐鲁定在急性心肌梗死经皮冠状动脉介入治疗中的应用。从前瞻性的,多中心的欧洲电视网注册表的见解。
背景:比伐鲁定在经皮冠状动脉介入治疗急性心肌梗死患者中的有效性已经在临床试验中进行了测试,但其在现实世界中的使用从未有过报道。方法:从EUROVISION注册的患者总数中,选择678名st段抬高型心肌梗死患者纳入分析。通过给药剂量和时间来评价比伐鲁定的病理学和使用模式。30天的结果通过疗效和安全性终点进行评估。结果:所有患者首次静脉注射比伐鲁定(0.70±0.25 mg/kg),随后静脉滴注比伐鲁定(1.58±0.47 mg/kg/h);病程:99.3%为60[30,107]分钟。9.3%的患者给予额外的丸剂(0.49±0.06 mg/kg)。术后比伐鲁定输注时间延长的占62.2%。死亡发生率为2.1%,非致死性心肌再梗死发生率为0.3%,计划外血运重建率为0.6%,非致死性卒中发生率为0.4%。未观察到急性支架血栓形成。1.5%的患者出现大出血。结论:即使在现实世界的人群中,在初次PCI治疗中使用比伐鲁定在30天的预后方面也有很好的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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