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Cerebral Embolism During Transcatheter  Aortic Valve Replacement The BRAVO-3 MRI Study
ConclusionsThis study documented cerebral embolization in nearly two-thirds of patients during contemporary TAVR. There were no significant differences in cerebral embolization for bivalirudin versus heparin anticoagulation during TAVR. (Open-Label, Randomized Trial in Patients Undergoing TAVR to Determine Safety and Efficacy of Bivalrudin vs. UFH [BRAVO-2/3]; NCT01651780)
Source: Journal of the American College of Cardiology - August 2, 2016 Category: Cardiology Source Type: research

Bivalirudin Versus Heparin Anticoagulation in Transcatheter Aortic Valve Replacement The Randomized BRAVO-3 Trial
BackgroundAnticoagulation is required during transcatheter aortic valve replacement (TAVR) procedures. Although an optimal regimen has not been determined, heparin is mainly used. Direct thrombin inhibition with bivalirudin may be an effective alternative to heparin as the procedural anticoagulant agent in this setting.ObjectivesThe goal of this study was to determine whether bivalirudin offers an alternative to heparin as the procedural anticoagulant agent in patients undergoing TAVR.MethodsA total of 802 patients with aortic stenosis were randomized to undergo transfemoral TAVR with bivalirudin versus unfractionated hepa...
Source: Journal of the American College of Cardiology - December 21, 2015 Category: Cardiology Source Type: research

Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention Pooled Patient-Level Analysis From the HORIZONS-AMI and EUROMAX Trials
BackgroundIn the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) trial, 3,602 patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) treated with bivalirudin had lower bleeding and mortality rates, but higher acute stent thrombosis rates compared with heparin + a glycoprotein IIb/IIIa inhibitor (GPI). Subsequent changes in primary PCI, including the use of potent P2Y12 inhibitors, frequent radial intervention, and pre-hospital medication administration, were incorporated into the EUROMAX (European Ambu...
Source: Journal of the American College of Cardiology - January 5, 2015 Category: Cardiology Source Type: research