Key result
Bivalirudin shows no benefit over unfractionated heparin for in-hospital net adverse clinical events.
Why the study?
No evidence exists on the impact of bivalirudin in patients with acute coronary syndrome undergoing rotational atherectomy.
Does bivalirudin reduce in-hospital net adverse clinical events in patients with acute coronary syndrome undergoing rotational atherectomy compared to unfractionated heparin?
Cohort (n=157)
No
Does bivalirudin reduce in-hospital net adverse clinical events in patients with acute coronary syndrome undergoing rotational atherectomy compared to unfractionated heparin?
In a real-world setting, bivalirudin exhibits a similar safety and efficacy profile to unfractionated heparin in patients with acute coronary syndrome undergoing rotational atherectomy.
No difference in net adverse events observed; leaves open bivalirudin’s role versus heparin in ACS rotational atherectomy.
BACKGROUND: No evidence exists on the impact of bivalirudin in patients with the acute coronary syndrome undergoing rotational atherectomy. This study aimed to evaluate the impact of bivalirudin on patients with acute coronary syndrome undergoing rotational atherectomy. METHODS: This was a retrospective cohort study conducted in our hospital between January 2017 and December 2019. The study included patients with acute coronary syndrome undergoing rotational atherectomy. Furthermore, 2 cohorts were included in this study (bivalirudin cohort and control cohort unfractionated heparin). The primary end-point was in-hospital net adverse clinical events. The secondary endpoint was all-cause mortality at 23 months. RESULTS: The study included 157 patients with 33 (21.0%) in the bivalirudin cohort and 124 (79.0%) in the control cohort. Net adverse clinical events during hospitalization in the bivalirudin cohort were higher than that in the control cohort [9 (27.3%) vs. 14 (11.3%), P = .021]. However, there was no significant difference in all-cause mortality at 23 months between the 2 cohorts [25 (20.2%) vs. 10 (30.3%), P =.214]. After adjusting for potential confounders, the usage of bivalirudin was not associated with net adverse clinical event (odds ratio = 0.90; 95% CI: 0.18-4.45; P =.890), and the hazard ratio for all-cause mortality at 23 months was 1.01 (95% CI: 0.33-3.15; P =.983). CONCLUSION: Bivalirudin appears to exhibit a similar impact as unfractionated heparin on patients with acute coronary syndrome undergoing rotational atherectomy in real-life setting.
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Longwei Li (2023) conducted a cohort in Acute coronary syndrome undergoing rotational atherectomy (n=157). Bivalirudin vs. Unfractionated heparin was evaluated on In-hospital net adverse clinical events (OR 0.90, 95% CI 0.18-4.45, p=.890). Bivalirudin use was not associated with a significant difference in in-hospital net adverse clinical events compared to unfractionated heparin (adjusted OR 0.90; 95% CI 0.18-4.45; P=0.890).
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