title: Ischaemic events and bleeding in patients undergoing percutaneous coronary intervention with concomitant bivalirudin treatment.
abstract: OBJECTIVE
  The European ImproveR registry aimed to characterise the patient population undergoing percutaneous coronary intervention (PCI) with bivalirudin treatment in a routine clinical setting and to evaluate associated ischaemic and bleeding events.
  
  
  RESULTS
  A total of 3,799 evaluable patients, aged > 18 years, were enrolled in 102 centres across 12 European countries from January 2005 to June 2006. The population was elderly (median age, 67.2 years; 24% > 75 years) and comprised 27.1% female patients, 27.9% with diabetes and 14.9% with renal impairment. Forty-nine percent of patients presented with acute coronary syndromes (ACS), 22% of these with ST-segment elevation myocardial infarction (STEMI). In-hospital and 30-day rates of major adverse cardiac events (death, myocardial infarction or urgent revascularisation) were 2.3% and 5.6%, respectively. In-hospital ischaemic complications were associated with a STEMI diagnosis and age > 65 years. In-hospital significant bleeding occurred in 1.7% of patients and was associated with renal impairment, female gender and glycoprotein IIb/IIIa inhibitor use.
  
  
  CONCLUSIONS
  The ImproveR registry population is characterised by a high proportion of elderly patients and patients with diabetes, renal impairment and ACS. In clinical practice, bivalirudin effectively suppresses ischaemic complications while maintaining a low rate of haemorrhagic consequences, as expected from randomised trials.
authors.affiliation: Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: Jan Kyst
authors.initials: JK
authors.lastname: Madsen
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Harald
authors.initials: H
authors.lastname: Darius
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rutsch
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Wójcik
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.forename: Kristina
authors.initials: K
authors.lastname: Allikmets