What does this research mean for the field?

Long-term clinical outcomes up to 1 year with bivalirudin and provisional Gp IIb/IIIa blockade are comparable to heparin plus planned Gp IIb/IIIa inhibition during percutaneous coronary intervention. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 10, 2004JAMA

Long-term Efficacy of Bivalirudin and Provisional Glycoprotein IIb/IIIa Blockade vs Heparin and Planned Glycoprotein IIb/IIIa Blockade During Percutaneous Coronary Revascularization<SUBTITLE>REPLACE-2 Randomized Trial</SUBTITLE>

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Why the study?

Does bivalirudin with provisional Gp IIb/IIIa inhibition reduce death, myocardial infarction, or repeat revascularization compared to heparin with planned Gp IIb/IIIa inhibition in patients undergoing urgent or elective PCI?

Structured PICO

Population

6010 patients undergoing urgent or elective PCI

Intervention

Intravenous bivalirudin (0.75 mg/kg bolus, 1.75 mg/kg per hour for the duration of PCI) with provisional Gp IIb/IIIa inhibition; both groups received daily aspirin and a thienopyridine for at least 30 days after PCI

Comparator

Heparin (65 U/kg bolus) with planned Gp IIb/IIIa inhibition (abciximab or eptifibatide); both groups received daily aspirin and a thienopyridine for at least 30 days after PCI

Outcome

Incidence of death, myocardial infarction, or repeat revascularization by 6 months and death by 12 months after enrollmentcomposite

Bivalirudin with provisional Gp IIb/IIIa blockade provides comparable long-term clinical outcomes up to 1 year compared to heparin plus planned Gp IIb/IIIa inhibition during contemporary PCI.

Discussion

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Implication

Bivalirudin with provisional GP IIb/IIIa yields comparable 1-year mortality after PCI; extends 30-day noninferiority to longer-term outcomes.

Cite This Study

A. Michael Lincoff (2004) studied this question.

synapsesocial.com/papers/6a0c006cd48675e4942326d1 https://doi.org/10.1001/jama.292.6.696

Topics

Dual antiplatelet therapy

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Implication

Bivalirudin with provisional GP IIb/IIIa yields comparable 1-year mortality after PCI; extends 30-day noninferiority to longer-term outcomes.

Long-term Efficacy of Bivalirudin and Provisional Glycoprotein IIb/IIIa Blockade vs Heparin and Planned Glycoprotein IIb/IIIa Blockade During Percutaneous Coronary Revascularization<SUBTITLE>REPLACE-2 Randomized Trial</SUBTITLE>

Structured PICO

Discussion

Implication

Cite This Study

Topics

Long-term Efficacy of Bivalirudin and Provisional Glycoprotein IIb/IIIa Blockade vs Heparin and Planned Glycoprotein IIb/IIIa Blockade During Percutaneous Coronary Revascularization<SUBTITLE>REPLACE-2 Randomized Trial</SUBTITLE>

Structured PICO

Discussion

Implication

Cite This Study

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