Ischaemic events and bleeding in patients undergoing percutaneous coronary intervention with concomitant bivalirudin treatment.
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.
Madsen
Jan Kyst
JK
Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark.
Chevalier
Bernard
B
Darius
Harald
H
Rutsch
Wolfgang
W
Wójcik
Jaroslaw
J
Schneider
Steffen
S
Allikmets
Kristina
K