Key result
Bivalirudin bridging fondaparinux is linked to ~60% lower 180-day MACCE risk versus bridging enoxaparin.
Why the study?
The comparative safety and efficacy of bivalirudin bridging enoxaparin versus fondaparinux in patients with AMI undergoing PPCI had not been established.
Does bivalirudin bridging to fondaparinux reduce MACCE and bleeding compared to bivalirudin bridging to enoxaparin in patients with AMI undergoing PPCI?
Observational (n=482)
No
Does bivalirudin bridging to fondaparinux reduce MACCE and bleeding compared to bivalirudin bridging to enoxaparin in patients with AMI undergoing PPCI?
In patients with acute myocardial infarction undergoing primary PCI, an anticoagulation strategy of bivalirudin bridging to fondaparinux significantly reduced MACCE and bleeding events at 180 days compared to bridging to enoxaparin.
Answers are grounded in this paper and cite their sources.
May support bivalirudin bridging to fondaparinux in AMI PPCI; hypothesis-generating and requires randomized confirmation.
Introduction: This study aims to compare the safety and efficacy of bivalirudin bridging enoxaparin versus fondaparinux in patients with acute myocardial infarction (AMI) who were undergoing primary percutaneous coronary intervention (PPCI). Methods: The study is a prospective, natural, and selective interventional trial based on real-world data for 482 AMI patients. Results: At the end of the follow-up, the two groups demonstrated similar major adverse cardiovascular and cerebrovascular events (MACCE) and bleeding rates. After propensity score matching (PSM), the fondaparinux group showed greater advantages in reducing MACCE and bleeding events. Conclusions: The anticoagulation strategy of bivalirudin bridging fondaparinux seems to be superior to that of bivalirudin bridging enoxaparin in patients with AMI undergoing PPCI.
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Guo et al. (2023) conducted an observational in Acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI) (n=482). Bivalirudin bridging fondaparinux vs. Bivalirudin bridging enoxaparin (40-60 mg/day) was evaluated on Major adverse cardiovascular and cerebrovascular events (MACCE) at 180 days (HR 0.402, 95% CI 0.167-0.970, p=0.042). Bivalirudin bridging fondaparinux significantly reduced the rate of major adverse cardiovascular and cerebrovascular events at 180 days compared to bivalirudin bridging enoxaparin (HR 0.402).
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