Bivalirudin Versus Heparin During Intervention in Acute Coronary Syndrome: A Systematic Review of Randomized Trials
(Source: Cardiovascular and Haematological Disorders - Drug Targets)
Source: Cardiovascular and Haematological Disorders - Drug Targets - March 1, 2020 Category: Cardiology Authors: Bhogal, Sukhdeep Mukherjee, Debabrata Bagai, Jayant Truong, Huu T. Panchal, Hemang B. Murtaza, Ghulam Zaman, Mustafa Sachdeva, Rajesh Paul, Timir K. Tags: Review article Source Type: research

The Use of Bivalirudin in Pediatric Cardiac Surgery and in the Interventional Cardiology Suite
Anticoagulation is an essential component for patients undergoing cardiopulmonary bypass or extracorporeal membrane oxygenation and for those with ventricular assist devices. However, thrombosis and bleeding are common complications. Heparin continues to be the agent of choice for most patients, likely owing to practitioners ’ comfort and experience and the ease with which the drug's effects can be reversed. However, especially in pediatric cardiac surgery, there is increasing interest in using bivalirudin as the primary anticoagulant. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 29, 2020 Category: Anesthesiology Authors: Dheeraj Goswami, Matthew DiGiusto, Rajeev Wadia, Sean Barnes, Jamie Schwartz, Diana Steppan, Kristen Nelson-McMillan, Richard Ringel, Jochen Steppan Tags: Review Article Source Type: research

Clinical Outcomes of Bivalirudin Versus Heparin in Elderly Patients Undergoing Percutaneous Coronary Intervention: a Systematic Review and Meta-analysis of Randomized Controlled Trials
AbstractPurposeThe aim of this study was to explore the safety and efficacy of bivalirudin in elderly patients undergoing percutaneous coronary intervention (PCI).MethodsAn electronic search was conducted for randomized controlled trials with outcomes of interest in the elderly ( ≥ 65 years of age). Pooled risk ratios (RR) and 95% confidence interval (CI) using random effects Der Simonian–Laird models were calculated. Primary outcomes were net adverse clinical events (NACE) and major bleeding events at 30 days. Secondary outcomes were major adverse cardiac events (MA CE) at 30 days. MACE, all...
Source: Cardiovascular Drugs and Therapy - February 26, 2020 Category: Cardiology Source Type: research

Adjuvant antithrombotic therapy in ST-elevation myocardial infarction: Contemporaneous Portuguese cross-sectional data
ConclusionsIn 2016, according to data from these national registries, almost all patients with STEMI were treated with aspirin and 76% with dual antiplatelet agents, mostly clopidogrel. GP IIb/IIIa inhibitors were used in few patients, and UFH was the most prevalent parenteral anticoagulant drug.ResumoIntroduçãoO tratamento do enfarte agudo do miocárdio com elevação do segment ST (EAMCSST) baseia-se na ativação da via verde coronária, na administração de terapêutica médica adjuvante e na reperfusão através de angioplastia prim&...
Source: Revista Portuguesa de Cardiologia - February 21, 2020 Category: Cardiology Source Type: research

Heparin vs bivalirudin anticoagulation for extracorporeal membrane oxygenation
ConclusionsThis study suggests that UFH and bivalirudin are associated with similar rates of thrombosis, major bleeding, and mortality events in patients supported by ECMO. However, it was observed that bivalirudin consistently maintained aPTT within the therapeutic range in comparison to UFH. (Source: Journal of Cardiac Surgery)
Source: Journal of Cardiac Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Haya Kaseer, Matthew Soto ‐Arenall, Devang Sanghavi, John Moss, Robert Ratzlaff, Si Pham, Pramod Guru Tags: ORIGINAL ARTICLE Source Type: research

Efficacy and safety of bivalirudin vs heparin in patients with coronary heart disease undergoing percutaneous coronary intervention: A meta-analysis of randomized controlled trials
Background: This meta-analysis is to evaluate the efficacy and safety of bivalirudin in patients with ST-elevation myocardial infarction (STEMI). Methods: PubMed, Cochrane Library, Embase, CNKI, CBMdisc, and VIP database were searched. Randomized controlled trial (RCT) was selected and the meta-analysis was conducted by RevMan 5.1. The primary efficacy endpoint was the incidence of major adverse cardiovascular events (MACE) and the primary safety endpoint was the incidence of major bleeding. Secondary efficacy endpoints were myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST), stoc...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Evaluation of intravenous direct thrombin inhibitor monitoring tests: Correlation with plasma concentrations and clinical outcomes in hospitalized patients
AbstractThe parenterally administered direct thrombin inhibitors (DTIs) argatroban and bivalirudin are effective anticoagulants for acute heparin-induced thrombocytopenia (HIT) treatment. The activated partial thromboplastin time (aPTT) has classically been used as the monitoring test to assess degree of anticoagulation, however concerns exist with using aPTT to monitor DTI therapy. In this observational study plasma samples from DTI treated patients were analyzed by aPTT, dilute thrombin time (dTT) and ecarin chromogenic assay (ECA) to delineate results into concordant and discordant groups. Discordant samples were furthe...
Source: Journal of Thrombosis and Thrombolysis - January 18, 2020 Category: Hematology Source Type: research

Pooling the Evidence at the Patient Level: End of the Bivalirudin Saga?
PMID: 31899923 [PubMed - as supplied by publisher] (Source: Thrombosis and Haemostasis)
Source: Thrombosis and Haemostasis - January 3, 2020 Category: Hematology Authors: Capodanno D, Angiolillo DJ Tags: Thromb Haemost Source Type: research

Bivalirudin anticoagulation to overcome heparin resistance in a neonate with cerebral sinovenus thrombosis
Anticoagulation in a neonate is a challenge and the availability of anticoagulant options is extremely limited. Here we describe the use of a direct thrombin inhibitor, bivalirudin, in a full-term neonate with symptomatic cerebral sinovenous thrombosis complicated by bilateral thalamic hemorrhagic stroke and intraventricular hemorrhage, who could not be effectively treated with sodium heparin due to heparin resistance (HR) and showed thrombosis regression after start of bivalirudin treatment, without worsening of the hemorrhage. While the use of bivalirudin in neonates has been previously described, the indication of cereb...
Source: Blood Coagulation and Fibrinolysis - January 1, 2020 Category: Hematology Tags: CASE REPORTS Source Type: research

Recommendations for clinical laboratory testing for antithrombin deficiency; Communication from the SSC of the ISTH.
Abstract Hereditary deficiency of antithrombin, a natural anticoagulant, causes a thrombophilia with a high risk for venous thromboembolism. Guidance for laboratory testing to diagnose antithrombin deficiency include the use of an activity assay for initial testing, performing an antigen test and activity-to-antigen ratio when the activity level is low, using pediatric reference ranges until the age of 6 months, excluding acquired causes of low antithrombin (e.g. liver dysfunction, proteinuria, heparin, disseminated intravascular coagulation, thrombosis, surgery) or falsely normal/elevated results (e.g. argat...
Source: Thrombosis and Haemostasis - January 1, 2020 Category: Hematology Authors: Van Cott EM, Orlando C, Moore GW, Cooper PC, Meijer P, Marlar R, Subcommittee on Plasma Coagulation Inhibitors Tags: J Thromb Haemost Source Type: research

Initial conservative management strategy of HeartWare left ventricular assist device thrombosis with intravenous heparin or bivalirudin.
ler S Abstract INTRODUCTION AND OBJECTIVES: Pump thrombosis is a serious left ventricular assist device complication, though there are no guidelines regarding its treatment. The main aim of this study was to describe a strategy of intravenous anticoagulation as the initial treatment in these patients and then to compare intravenous heparin with bivalirudin. METHODS: All consecutive patients who received a HeartWare left ventricular assist device from July 2009 to March 2019 were retrospectively analysed. Patients developing a pump thrombosis were selected, and treatment, outcomes and complications were record...
Source: The International Journal of Artificial Organs - December 30, 2019 Category: Transplant Surgery Authors: Bouzas-Cruz N, Gonzalez-Fernandez O, Ferrera-Durán C, Woods A, Robinson-Smith N, Tovey S, Jungschleger J, Booth K, Shah A, Parry G, MacGowan GA, Schueler S Tags: Int J Artif Organs Source Type: research

Myocardial Damage After ST-Segment Elevation Myocardial Infarction According to the Use of Bivalirudin or Heparin. A Cardiac Magnetic Resonance Substudy of the DANAMI3 trial.
Authors: Schoos MM, Nepper-Christensen L, Ahtarovski KA, Kyhl K, Göransson C, Holmvang L, Kelbæk H, Helqvist S, Høfsten DE, Køber L, Vejlstrup N, Lønborg J, Engstrøm T PMID: 31845893 [PubMed - as supplied by publisher] (Source: EuroIntervention)
Source: EuroIntervention - December 19, 2019 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Monitoring bivalirudin therapy in children on extracorporeal circulatory support devices: Thromboelastometry versus routine coagulation testing
Bivalirudin is an alternative to heparin anticoagulation in infants and children in the setting of extracorporeal life support (ECLS). While activated partial thromboplastin time (aPTT) is widely accepted as the standard test to monitor bivalirudin therapy, the usefulness of thromboelastometry (ROTEM) to monitor bivalirudin infusion in the setting of ECLS is unknown. (Source: Thrombosis Research)
Source: Thrombosis Research - December 12, 2019 Category: Hematology Authors: Jun Teruya, Lisa Hensch, Karen Bruzdoski, Iki Adachi, Shiu-Ki Hui, Vadim Kostousov Tags: Full Length Article Source Type: research

Safety and efficacy of bivalirudin monotherapy in patients with non-ST-segment elevation acute coronary syndromes with positive biomarkers undergoing percutaneous coronary intervention: a report from the Acute Catheterization and Urgent Intervention Triage Strategy trial
Conclusion Compared with heparin plus GPI or bivalirudin plus GPI, bivalirudin monotherapy provides similar protection from ischemic events with less major bleeding at 30 days among patients with NSTE-ACS and positive biomarkers. (Source: Coronary Artery Disease)
Source: Coronary Artery Disease - December 10, 2019 Category: Cardiology Tags: Adjunctive Pharmacology Source Type: research

Individual Patient Data Pooled Analysis of Randomized Trials of Bivalirudin versus Heparin in Acute Myocardial Infarction: Rationale and Methodology.
CONCLUSION:  We have created a large individual patient database of bivalirudin versus heparin RCTs in patients with AMI undergoing PCI. This endeavor may help identify the optimal periprocedural anticoagulation regimen for patient groups with different relative risks of adverse ischemic versus bleeding events, including those with ST-segment and non-ST-segment elevation MI, radial versus femoral access, use of a prolonged bivalirudin infusion or glycoprotein inhibitors, and others. Adherence to standardized techniques and rigorous validation processes should increase confidence in the accuracy and robustness of the r...
Source: Thrombosis and Haemostasis - December 9, 2019 Category: Hematology Authors: Bikdeli B, McAndrew T, Crowley A, Chen S, Mehdipoor G, Redfors B, Liu Y, Zhang Z, Liu M, Zhang Y, Francese DP, Erlinge D, James SK, Han Y, Li Y, Kastrati A, Schüpke S, Stables RH, Shahzad A, Steg PG, Goldstein P, Frigoli E, Mehran R, Valgimigli M, Stone Tags: Thromb Haemost Source Type: research

Periprocedural Bivalirudin Versus Unfractionated Heparin During Percutaneous Coronary Intervention Following Fibrinolysis for ST-Segment Elevation Myocardial Infarction.
Authors: Rashid MK, Singh K, Bernick J, Wells GA, Hibbert B, Russo J, So DY, Le May MR, CAPITAL PCI Group Abstract BACKGROUND: A pharmacoinvasive strategy for ST-segment elevation myocardial infarction (STEMI) management combines the use of fibrinolysis with the routine transfer to coronary angiography, with percutaneous coronary intervention (PCI) if needed. This method reduces the risk of major adverse cardiovascular event (MACE) compared with fibrinolysis alone; however, it is associated with higher bleeding risk. We sought to assess the bivalirudin compared with unfractionated heparin (UFH) used during PCI as p...
Source: The Journal of Invasive Cardiology - December 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Risk Factors and Outcomes Associated with Prolonged Subtherapeutic Anticoagulation with Bivalirudin: a Retrospective Cohort Study
ConclusionsYounger age, normal renal function, and nonadherence to the dosing protocol when targeting therapeutic anticoagulation is associated with increased risk of failure to achieve ETA. This confers an elevated risk of thromboembolism when using bivalirudin for the management of HIT or other coagulation disorders. (Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy)
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - October 6, 2019 Category: Drugs & Pharmacology Authors: Libby A Orzel, Erik E. Abel, Danielle M. Blais, Tzu ‐Fei Wang, Kyle A Porter, Pamela K. Burcham Tags: ORIGINAL RESEARCH ARTICLE Source Type: research

Role of Bivalirudin for Anticoagulation in Adult Perioperative Cardiothoracic Practice
Bivalirudin, a direct thrombin inhibitor with a fast onset of action and short half-life, is often referred to as an alternative anticoagulant to a heparin/protamine regimen. Bivalirudin demonstrated promising results as an anticoagulant in cardiac surgery with and without cardiopulmonary bypass, postcardiotomy extracorporeal membrane oxygenation, interventional cardiology and endovascular procedures, and particularly in the treatment of patients with heparin-induced thrombocytopenia undergoing high-risk cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 11, 2019 Category: Anesthesiology Authors: Gabor Erdoes, Erik Ortmann, Blanca Martinez Lopez De Arroyabe, Catherine Reid, Andreas Koster Tags: Review Article Source Type: research

Bivalirudin Use With Percutaneous Ventricular Assist Device in Suspected Heparin-Induced Thrombocytopenia.
PMID: 31510760 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)
Source: The Annals of Pharmacotherapy - September 11, 2019 Category: Drugs & Pharmacology Authors: Robinson ZS, Vega J, Fox NS Tags: Ann Pharmacother Source Type: research

Pharmacokinetic and Pharmacodynamic Modeling and Simulation Analysis of CTB-001, a Recently Developed Generic of Bivalirudin
ConclusionsThe modeling and simulation analysis well-characterized the PK and PD of CTB-001 in healthy Koreans, which will be valuable for identifying optimal dosing regimens of CBT-001. (Source: Pharmaceutical Research)
Source: Pharmaceutical Research - August 8, 2019 Category: Drugs & Pharmacology Source Type: research

Comparison of Clinical Outcomes: Bivalirudin With Transfemoral Access Versus Heparin With Transradial Access in Patients With ST segment Elevation Myocardial Infarction
Introduction: The best combination of access site and anticoagulant used during primary percutaneous coronary intervention (PCI) in patients presenting with ST segment elevation myocardial infarction is not known. Methods: We conducted a retrospective cohort study of all patients>18 years of age who underwent primary PCI in 2 large regional ST segment elevation myocardial infarction centers in Massachusetts between 2012 and 2014. The cohort was divided into 3 groups: bival/fem, hep/rad, or off-protocol, based on anticoagulation and access used. We used multiple logistic regression model to compare major cardiovascu...
Source: Critical Pathways in Cardiology - July 26, 2019 Category: Cardiology Tags: Original Articles Source Type: research

Titration of Bivalirudin Infusion in the Pediatric Cardiac Catheterization Laboratory: A Case Report
Bivalirudin is a direct thrombin inhibitor that is used as a procedural anticoagulant during percutaneous coronary interventions and cardiac surgery for patients with heparin-resistant thrombosis or heparin-induced thrombocytopenia. There is a robust literature describing its safety and efficacy in adults; however, its use in the pediatric population is relatively rare, with dosing extrapolated from adult data. In this case report, we describe a 4-year-old with complex congenital heart disease and history of heparin-induced thrombocytopenia who required bivalirudin dose uptitration during cardiac catheterization. (Source: ...
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Bivalirudin and ECLS: Commentary and Considerations
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 1, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Bivalirudin in Extracorporeal Life Support: Response and Considerations
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 1, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Role of and Recent Evidence for Antiplatelet Therapy in Prevention of Cardiovascular Disease in Diabetes
AbstractPurpose of ReviewWhen treating patients with diabetes mellitus (DM), the benefits of antiplatelet therapy in preventing cardiovascular disease must be weighed against an increased risk of bleeding. Recent trials have sought to determine both the optimal anti-platelet regimen for patients with DM, and who specifically requires medication among the DM population. This paper will review recent trials and evidence recommending the use of antiplatelet therapy in the prevention of cardiovascular disease in patients with diabetes.Recent FindingsSeven notable trials assessed the effectiveness of antiplatelet therapy in the...
Source: Current Cardiology Reports - June 28, 2019 Category: Cardiology Source Type: research

Bivalirudin versus Heparin during intervention in Acute Coronary Syndrome: A Systematic Review of Randomized Trials.
CONCLUSION: Bivalirudin demonstrates its superiority over heparin plus GPI with better clinical outcomes in terms of preventing bleeding complications, thus making it as an anticoagulation of choice particularly in patients at high risk of bleeding. Further studies are warranted for head to head comparison of bivalirudin to heparin monotherapy to establish an optimal heparin dosing regimen and post-PCI bivalirudin infusion to affirm its beneficial effect in reducing acute ST. PMID: 31241442 [PubMed - as supplied by publisher] (Source: Cardiovascular and Hematological Disorders Drug Targets)
Source: Cardiovascular and Hematological Disorders Drug Targets - June 27, 2019 Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research

Potential Role of Direct Oral Anticoagulants in the Management of Heparin ‐induced Thrombocytopenia
This article is protected by copyright. All rights reserved. (Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy)
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - June 24, 2019 Category: Drugs & Pharmacology Authors: Ashley Barlow, Brooke Barlow, Travis Reinaker, Justin Harris Tags: Review of Therapeutics Source Type: research

A systematic review and meta-analysis of bivalirudin application in peripheral endovascular procedures
The direct thrombin inhibitor bivalirudin (BIV) was shown to be superior to unfractionated heparin (UFH) in percutaneous coronary interventions for reducing procedural blood loss. The aim of this study was to compare outcome profiles of BIV and UFH in peripheral endovascular procedures (PEPs) by synthesizing the currently available data. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - June 21, 2019 Category: Surgery Authors: Yirui Hu, Anastasia Yian Liu, Li Zhang, Xianren Wu, Shuai Shi, James R. Elmore, Xiaopeng Zhang Tags: Review article Source Type: research

Invited commentary
The systemic review and meta-analysis by Hu et  al suggests that the direct thrombin inhibitor bivalirudin is superior to unfractionated heparin (UFH) in peripheral endovascular procedures. Specifically, bivalirudin had lower odds ratios of periprocedural mortality, major adverse cardiovascular events, net adverse clinical events, perioperative myocardial infarction, major vascular complications, and minor vascular complications. These are intriguing data, given the fact that probably most vascular surgeons still primarily use UFH periprocedurally for intraluminal interventions, usually to maintain an activated clotti...
Source: Journal of Vascular Surgery - June 21, 2019 Category: Surgery Authors: Peter K. Henke Tags: Review article Source Type: research

Use of bivalirudin as a primary anticoagulant in a child during Berlin Heart EXCOR ventricular assist device support.
We describe our experience of bivalirudin use, a newer direct thrombin inhibitor, in an infant who was supported with Berlin Heart EXCOR VAD (Berlin VAD) as bridge to transplant for 122 days without complications and without need for pump exchange. An 11-month-old girl with dilated cardiomyopathy with acute heart failure was awaiting cardiac transplant. Lack of improvement despite maximizing medical therapy and anticipating a prolonged waitlist time, she was supported with Berlin LVAD as a bridge to transplant. Anticoagulation with bivalirudin was started and titrated with a goal partial thromboplastin time of 60-90...
Source: Perfusion - June 21, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Medar SS, Hsu DT, Lamour JM, Bansal N, Peek GJ Tags: Perfusion Source Type: research

Revacept, a Novel Inhibitor of Platelet Adhesion, in Patients Undergoing Elective PCI-Design and Rationale of the Randomized ISAR-PLASTER Trial.
ors Abstract Despite dual antiplatelet therapy patients undergoing percutaneous coronary intervention (PCI) continue to experience periprocedural ischemic events. In addition, all currently used antithrombotic drugs increase the bleeding risk. Thus, there is an unmet clinical need for antithrombotic strategies with improved efficacy and no increase in bleeding. Revacept is a novel, lesion-directed antithrombotic drug that does not interfere with the function of circulating platelets. This dimeric fusion protein of the extracellular domain of glycoprotein VI (the major platelet collagen receptor) and the human Fc-f...
Source: Thrombosis and Haemostasis - June 21, 2019 Category: Hematology Authors: Schüpke S, Hein-Rothweiler R, Mayer K, Janisch M, Sibbing D, Ndrepepa G, Hilz R, Laugwitz KL, Bernlochner I, Gschwendtner S, Kupka D, Gori T, Zeiher AM, Schunkert H, Massberg S, Kastrati A, ISAR-PLASTER-Trial Investigators Tags: Thromb Haemost Source Type: research

Adjuvant antithrombotic therapy in ST-elevation myocardial infarction: A narrative review
This article reviews the major pharmacologic features of, and clinical evidence on, adjuvant medical therapy in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. These drugs include oral antiplatelets (aspirin and P2Y12 inhibitors such as clopidogrel, prasugrel and ticagrelor), intravenous antiplatelet agents (the P2Y12 inhibitor cangrelor, GP IIb/IIIa inhibitors such as abciximab, eptifibatide and tirofiban), and intravenous anticoagulant agents (unfractionated heparin, low molecular weight heparin and bivalirudin).ResumoNeste artigo foram analisadas as princ...
Source: Revista Portuguesa de Cardiologia - June 13, 2019 Category: Cardiology Source Type: research

Diagnosis and management of heparin-induced thrombocytopenia: a consensus statement from the Thrombosis and Haemostasis Society of Australia and New Zealand HIT Writing Group.
Abstract INTRODUCTION: Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder that occurs following the administration of heparin and is caused by antibodies to platelet factor 4 and heparin. Diagnosis of HIT is essential to guide treatment strategies using non-heparin anticoagulants and to avoid unwanted and potential fatal thromboembolic complications. This consensus statement, formulated by members of the Thrombosis and Haemostasis Society of Australia and New Zealand, provides an update on HIT pathogenesis and guidance on the diagnosis and management of patients with suspected or confirmed HIT. ...
Source: Med J Aust - June 2, 2019 Category: General Medicine Authors: Joseph J, Rabbolini D, Enjeti AK, Favaloro E, Kopp MC, McRae S, Pasalic L, Chee Wee T, Ward CM, Chong BH Tags: Med J Aust Source Type: research

Response to the letter to the editor: anticoagulant activity of bivalirudin.
Authors: Laine M, Paganelli F, Bonello L PMID: 31090465 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - May 17, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Commentary: Filling the gap: Can ventricular assist devices support hearts with a single ventricle?
Philip and colleagues1 report the successful experience of bridging an infant with hypoplastic left heart syndrome to heart transplantation using an Excor ventricular assist device (VAD) (Berlin Heart Inc, The Woodlands, Tex).1 The authors describe an innovative strategy for supporting failing stage 1 single ventricle physiology in small patients (2.5-3.75  kg). Innovations include the choice of a pulsatile pump, the use of bivalirudin for anticoagulation, pulmonary artery banding, and atrial cannulation. (Source: The Journal of Thoracic and Cardiovascular Surgery)
Source: The Journal of Thoracic and Cardiovascular Surgery - May 16, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Emilie Jean-St-Michel, Mjaye Mazwi, Aamir Jeewa Tags: Commentary Source Type: research

Bivalirudin infusion in patients with acute coronary syndrome after stenting.
Authors: Li W, Mai L, Cai X, Li M, Huang Y PMID: 31056962 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - May 7, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Impact of anticoagulation strategy and agents on extracorporeal membrane oxygenation therapy.
Abstract INTRODUCTION: Extracorporeal membrane oxygenation mandates balancing the risk of thromboembolic complications with bleeding. We aimed to evaluate pragmatic anticoagulation regimens during extracorporeal membrane oxygenation and compare thromboembolic and bleeding outcomes. METHODS: This retrospective, single-center study reviewed patients on venovenous or venoarterial extracorporeal membrane oxygenation for a minimum of 24 hours over a 5-year period. The primary outcome was composite thromboembolic events per day of extracorporeal membrane oxygenation. Secondary outcomes included composite ble...
Source: Perfusion - May 6, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Macielak S, Burcham P, Whitson B, Abdel-Rasoul M, Rozycki A Tags: Perfusion Source Type: research

Direct-Thrombin Inhibitor Utilization in Patients With Heparin-Induced Thrombocytopenia and Undergoing Catheter-Directed Thrombolysis: A Summary of Published Case Reports
Conclusions: The use of DTIs might be safe and effective in selected patients with heparin-induced thrombocytopenia and undergoing CDT. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - April 12, 2019 Category: Nursing Tags: ARTICLES: Outcomes Source Type: research

Microfluidic Point-of-Care Ecarin-Based Clotting and Chromogenic Assays for Monitoring Direct Thrombin Inhibitors.
Authors: Alouidor B, Sweeney RE, Tat T, Wong RK, Yoon JY Abstract Direct thrombin inhibitors (DTIs), such as bivalirudin and dabigatran, have maintained steady inpatient and outpatient use as substitutes for heparin and warfarin, respectively, because of their high bioavailability and relatively safe "on-therapy" range. Current clinical methods lack the capacity to directly quantify plasma DTI concentrations across wide ranges. At present, the gold standard is the ecarin clotting time (ECT), where ecarin maximizes thrombin activity and clotting time is evaluated to assess DTIs' anticoagulation capability....
Source: Journal of Extra-Corporeal Technology - April 3, 2019 Category: Cardiovascular & Thoracic Surgery Tags: J Extra Corpor Technol Source Type: research

Bivalirudin Anticoagulation for an Infant with Hyperbilirubinemia and Elevated Plasma-Free Hemoglobin on ECMO.
We report a case of a 2-month-old male child who was placed on ECMO for severe acute respiratory distress syndrome. His ECMO course was complicated by severe hemolysis and hyperbilirubinemia, which precluded accurate monitoring of heparin activity. Bivalirudin was successfully used for anticoagulation in this patient. PMID: 30936585 [PubMed - in process] (Source: Journal of Extra-Corporeal Technology)
Source: Journal of Extra-Corporeal Technology - April 3, 2019 Category: Cardiovascular & Thoracic Surgery Tags: J Extra Corpor Technol Source Type: research

Autoimmune heparin-induced thrombocytopenia and venous limb gangrene after aortic dissection repair: in vitro and in vivo effects of intravenous immunoglobulin.
CONCLUSION: Our clinical and laboratory observations support dose-dependent efficacy of IVIG for decreasing PLT activation and thus correcting thrombocytopenia in aHIT. Our case experience and literature review suggests dosing of 1 g/kg IVIG × 2 for patients with severe aHIT. PMID: 30903805 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - March 23, 2019 Category: Hematology Authors: Arcinas LA, Manji RA, Hrymak C, Dao V, Sheppard JI, Warkentin TE Tags: Transfusion Source Type: research

Bivalirudin use in acute coronary syndrome patients undergoing percutaneous coronary interventions in Poland: Clinical update from expert group of the Association on Cardiovascular Interventions of the Polish Cardiac Society.
ojakowski W, Wójcik J, Dudek D PMID: 30882184 [PubMed - in process] (Source: Cardiology Journal)
Source: Cardiology Journal - March 20, 2019 Category: Cardiology Authors: Kołtowski Ł, Legutko J, Filipiak KJ, Dziewierz A, Bartuś S, Buszman P, Buszman P, Ciećwierz D, Dąbrowski M, Dobrzycki S, Gil R, Gorący J, Grygier M, Jaguszewski M, Kochman J, Kubica J, Kuliczkowki W, Lodziński P, Ochała A, Reczuch K, Witkowski A, Tags: Cardiol J Source Type: research

Comparison of Unfractionated Heparin and Bivalirudin for Treatment of Suspected Device Thrombosis during Heart Mate II Support
Although intravenous anticoagulation is the mainstay medical therapy employed during CF LVAD thrombosis, the comparative impact of indirect thrombin inhibition with unfractionated heparin (UH) and direct thrombin inhibition with bivalirudin (BV) is unknown. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: K. Shah, D.B. Sims, S. Forest, T. Chinnadurai, Y. Xia, A. Luke, D. Nnani, C. Castillo, M. Taveras, S. Vukelic, S.R. Patel, J. Shin, D.J. Goldstein, U.P. Jorde, O. Saeed Tags: 1066 Source Type: research

Use of Bivalirudin in Pediatric Patients on Ventricular Assist Device Support
Little reported data exist regarding bivalirudin anticoagulation in pediatric patients supported with ventricular assist devices (VAD). (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: K. Puri, H.P. Tunuguntla, T.J. Humlicek, W.J. Dreyer, S.W. Denfield, A.G. Cabrera, S. Hui, L. Hensch, J.F. Price, S. Choudhry, I. Adachi, J. Teruya Tags: 1215 Source Type: research

Time in Therapeutic Range Using Bivalirudin for Pediatric Ventricular Assist Devices
The optimal antithrombosis regime for children on ventricular assist devices (VADs) is controversial and the neurologic event rate remains unacceptably high. Bivalirudin, a direct thrombin inhibitor (DTI), may confer advantages over unfractionated heparin but has not been well-studied in this population. The primary aim of this study was to describe the percent time in therapeutic range for activated partial thromboplastin time (aPTT) using bivalirudin in a cohort of children on VADs. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: J.J. Daugherty, C. Heyrend, B. Kay, E.R. Griffiths, L. May Tags: 1214 Source Type: research

Safety and Efficacy of Peri-Procedural Heparin Plus a Short-Term Infusion of Tirofiban Versus Bivalirudin Monotherapy in Patients Undergoing Percutaneous Coronary Intervention (From the Intermountain Heart Institute STAIR Observational Registry)
Glycoprotein IIb/IIIa inhibitors, used as a standard intravenous bolus followed by a prolonged infusion for 12-18 hours, reduces ischemic complications during percutaneous coronary interventions (PCI) but often at a cost of increased bleeding. Today, when dual oral antiplatelet therapy is routine, heparin use plus short-term (bolus alone or with a (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - March 15, 2019 Category: Cardiology Authors: Joseph B. Muhlestein, Ian S. Hackett, Heidi T. May, Tami L. Bair, Viet T. Le, Jeffrey L. Anderson, Brian Whisenant, Kirk U. Knowlton, Donald L. Lapp é Source Type: research

Safety and Efficacy of Periprocedural Heparin Plus a Short-Term Infusion of Tirofiban Versus Bivalirudin Monotherapy in Patients Who Underwent Percutaneous Coronary Intervention (from the Intermountain Heart Institute STAIR Observational Registry)
Glycoprotein IIb/IIIa inhibitors, used as a standard intravenous bolus followed by a prolonged infusion for 12 to 18 hours, reduces ischemic complications during percutaneous coronary interventions (PCI) but often at a cost of increased bleeding. Today, when dual oral antiplatelet therapy is routine, heparin use plus short-term (bolus alone or with a (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - March 15, 2019 Category: Cardiology Authors: Joseph B. Muhlestein, Ian S. Hackett, Heidi T. May, Tami L. Bair, Viet T. Le, Jeffrey L. Anderson, Brian Whisenant, Kirk U. Knowlton, Donald L. Lapp é Source Type: research

Outcomes of Abdominal Surgery in Patients With Mechanical Ventricular Assist Devices: A Multi-institutional Study
Conclusion: VAD patients have an acceptable risk profile for abdominal surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - March 7, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research