Does bivalirudin reduce the composite end point of death, myocardial infarction, urgent target-vessel revascularization, or major bleeding in patients with stable and unstable angina who underwent PCI after pretreatment with clopidogrel compared to unfractionated heparin?
In patients undergoing PCI for angina pretreated with clopidogrel, bivalirudin does not improve net clinical outcomes compared to unfractionated heparin, although it reduces major bleeding.
In patients with stable and unstable angina who underwent PCI after pretreatment with clopidogrel, bivalirudin did not provide a net clinical benefit (i.e., it did not reduce the incidence of the composite end point of death, myocardial infarction, urgent target-vessel revascularization, or major bleeding) as compared with unfractionated heparin, but it did significantly reduce the incidence of major bleeding. (ClinicalTrials.gov number, NCT00262054.)
Kastrati et al. (Wed,) studied this question.