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Antithrombotic treatment in peripheral artery disease.
Abstract This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke. In symptomatic PAD, dual antiplatelet therapy (DAPT) with clopidogrel and aspirin does not prov...
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - November 21, 2017 Category: Surgery Authors: Olinic DM, Tataru DA, Homorodean C, Spinu M, Olinic M Tags: Vasa Source Type: research

Patients treated with bivalirudin still at higher risk of stent thrombosis: a comprehensive meta-analysis of randomized clinical trials of bivalirudin and heparin for percutaneous coronary interventions.
CONCLUSIONS: Advantages of bivalirudin are undoubtedly related to GPI use in the heparin arms. Bivalirudin-based regimens are more beneficial when compared with heparin and planned GPI use in terms of NACE and major bleedings. It was not observed when compared to heparin and provisional GPI use. Regardless of adjunctive GPI use, stent thrombosis episodes were significantly more common in bivalirudin treated subjects. Therefore the safety and economic issues may urge revision of this aspect of current clinical practice and guidelines. PMID: 29350380 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - January 19, 2018 Category: Cardiology Authors: Grajek S, Michlak M, Gwizdała A, Araszkiewicz A, Grygier M, Hiczkiewicz J, Lesiak M Tags: Kardiol Pol Source Type: research

Efficacy and safety of bivalirudin for percutaneous coronary intervention in acute coronary syndromes: a meta-analysis of randomized-controlled trials
ConclusionsCompared with heparin, bivalirudin was associated with a similar incidence of ischemic events following PCI for ACS. An association of bivalirudin with decreased bleeding was not seen with balanced use of GPI.
Source: Clinical Research in Cardiology - April 13, 2018 Category: Cardiology Source Type: research

Impact of Sex on Comparative Outcomes of Bivalirudin versus Unfractionated Heparin in Patients with Acute Coronary Syndromes Undergoing Invasive Management A pre-specified analysis of the MATRIX trial.
CONCLUSIONS: In ACS patients, the rates of MACE and NACE were not significantly lower with bivalirudin than with UFH in both sexes.The rate of the composite of urgent TVR,definite ST,or NACE was not significantly lower with a post-PCI bivalirudin infusion than with no post-PCI infusion in both sexes. PMID: 29769167 [PubMed - as supplied by publisher]
Source: EuroIntervention - May 19, 2018 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial
Publication date: Available online 25 August 2018Source: The LancetAuthor(s): Marco Valgimigli, Enrico Frigoli, Sergio Leonardi, Pascal Vranckx, Martina Rothenbühler, Matteo Tebaldi, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Paolo Rubartelli, Carlo Briguori, Giuseppe Andó, Maurizio Ferrario, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Marco Nazzaro, Alessandro Lupi, Bernardo CorteseSummaryBackgroundThe Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (MATRIX) programme was designed to assess the comparative safety and effectiveness of ra...
Source: The Lancet - August 25, 2018 Category: General Medicine Source Type: research

Bivalirudin versus heparin in patients undergoing percutaneous peripheral interventions: A systematic review and meta-analysis.
CONCLUSION: Our meta-analysis suggests that bivalirudin use for percutaneous peripheral interventions is associated with lower all-cause mortality, bleeding, and access site complications as compared to heparin. Further large randomized trials are needed to confirm the current results. PMID: 30501582 [PubMed - as supplied by publisher]
Source: Vascular - December 1, 2018 Category: Surgery Authors: Olmedo W, Villablanca PA, Sanina C, Walker J, Weinreich M, Brevik J, Avendano R, Bravo CA, Romero J, Ramakrishna H, Babaev A, Attubato M, Hernandez-Suarez DF, Cox-Alomar P, Pyo R, Krishnan P, Wiley J Tags: Vascular Source Type: research

Patients treated with bivalirudin are still at higher risk of stent thrombosis: a comprehensive meta-analysis of randomised clinical trials of bivalirudin and heparin for percutaneous coronary interventions.
CONCLUSIONS: The advantages of bivalirudin are undoubtedly related to GPI use in the heparin arms. Bivalirudin-based regimens are more beneficial when compared with heparin and planned GPI use in terms of NACE and major bleedings; this was not observed when compared to heparin and provisional GPI use. Regardless of adjunctive GPI use, stent thrombosis episodes were significantly more common in bivalirudin-treated subjects. Therefore, the safety and economic issues may urge revision of this aspect of current clinical practice and guidelines. PMID: 29350380 [PubMed - indexed for MEDLINE]
Source: Kardiologia Polska - December 12, 2018 Category: Cardiology Authors: Grajek S, Michalak M, Gwizdała A, Araszkiewicz A, Grygier M, Hiczkiewicz J, Lesiak M Tags: Kardiol Pol Source Type: research

Periprocedural Bivalirudin Versus Unfractionated Heparin During Percutaneous Coronary Intervention Following Fibrinolysis for ST-Segment Elevation Myocardial Infarction.
CONCLUSION: The periprocedural use of bivalirudin vs UFH was associated with similar rates of MACE and bleeding. Given the expense of bivalirudin and lack of demonstrable clinical superiority, UFH remains the first-line periprocedural anticoagulant in a pharmacoinvasive strategy. PMID: 31786531 [PubMed - in process]
Source: The Journal of Invasive Cardiology - December 2, 2019 Category: Cardiology Tags: J Invasive Cardiol 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

Heparin-Induced Thrombocytopenia after Total Knee Replacement.
Authors: Salášek M, Šlechtová J, Pavelk T Abstract Heparin-induced thrombocytopenia is a rare complication of treatment with both unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Antibodies against the complex heparin-platelet factor 4 are the main cause of pathogenesis, resulting in the activation of thrombocytes, coagulation, endothelium, monocytes, neutrophils and subsequent highly prothrombotic state. The prothrombotic state can result not only in venous but also in arterial thrombosis at different locations (which is manifested apart from venous thromboembolic disease also by acute lim...
Source: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca - May 13, 2020 Category: Orthopaedics Tags: Acta Chir Orthop Traumatol Cech Source Type: research

Bivalirudin in patients undergoing percutaneous coronary intervention and independent predictors of postoperative adverse events in these patients: A real world retrospective study
The efficacy and safety of bivalirudin in percutaneous coronary intervention (PCI) has always been a hot topic in perioperative antithrombotic therapy, but there are still some controversies. So studies are needed to provide more evidence, especially the real world study which includes patients excluded from previous RCT studys. Our study aimed to investigate these information and analyze the independent predictors of postoperative adverse events. A retrospective study enrolled 1416 patients underwent PCI in Tianjin Chest Hospital from May 2016 to October 2017. The incidence of stent-thrombosis and net clinical adverse ...
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Efficacy and Safety of Bivalirudin During Percutaneous Coronary Intervention in Chronic Total Occlusion: A Retrospective Study
The objective of this study was to examine the efficacy and safety of bivalirudin during percutaneous coronary intervention (PCI) in patients with CTO.METHODS: This trial used a retrospective cohort study design. Medical information from 736 patients with CTO who underwent PCI with bivalirudin or UFH at the First Affiliated Hospital of Zhengzhou University from July 2019 to September 2020 was extracted and analyzed. The primary end point was the 30-day incidence of net adverse clinical events (NACEs), and the secondary end point was the major adverse cardiovascular events (MACEs), which were related to safety and efficacy,...
Source: Clinical Therapeutics - April 3, 2021 Category: Drugs & Pharmacology Authors: Yanghui Zhang Yahao Zhang Chao Chang Shumei Yan Zheng Chen Lishuai Zhang Kui Chen Guizhi Liu Source Type: research

Neutrophil extracellular traps (NETs) in patients with STEMI. Association with percutaneous coronary intervention and antithrombotic treatments
CONCLUSIONS: NETs were elevated in STEMI patients, increased by pPCI and decreased thereafter. One of the most specific NETs markers was associated with cardiovascular outcomes.PMID:35306431 | DOI:10.1016/j.thromres.2022.03.002
Source: Cell Research - March 20, 2022 Category: Cytology Authors: Maria Ferr é-Vallverdú Ana Mar ía Latorre Mar ía Paz Fuset Elena S ánchez Isabel Madrid Francisco Ten Juana Vall és Mar ía Teresa Santos Santiago Bonanad Antonio Moscard ó Source Type: research

Bivalirudin or Unfractionated Heparin for Anticoagulation in Pediatric Patients on Continuous Flow Ventricular Assist Device Support: Single-Center Retrospective Cohort Study
Conclusions: Use of bivalirudin for anticoagulation in patients on CF-VAD support was associated with lesser odds of hemorrhagic complications compared with use of UFH. Bivalirudin “washout” was successful in medical management of six of eight cases of possible pump thrombosis.
Source: Pediatric Critical Care Medicine - October 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

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