title: Bivalirudin or heparin in primary angioplasty performed through the transradial approach: results from a multicentre registry.
abstract: BACKGROUND
  Data on the effect of bivalirudin therapy in primary percutaneous coronary interventions (PCI) performed through the transradial approach are limited. The aim of our study was to evaluate bleeding complications and clinical outcomes in primary PCI performed through the transradial approach with bivalirudin therapy.
  
  
  METHODS
  We retrospectively evaluated primary PCI performed through the transradial approach from January 2008 to June 2013. Patients were divided in two groups according to the use (group 1) or not (group 2) of bivalirudin. The primary end points were major bleedings and major adverse cardiac events (MACE) within 30 days.
  
  
  RESULTS
  During the 5 years analysed, 1009 patients underwent primary PCI through the transradial approach: 154 patients were treated with bivalirudin (males 79%, age 65 ± 14 years) and 855 with heparin (males 82%, 63 ± 12 years). In group 1, the use of glycoprotein IIb/IIIa inhibitors was only 4%, compared to 55% (p<0.001) in group 2. There were no significant differences between the two groups for major bleedings (0.65% in group 1 and 1.17% in group 2, p=0.88) nor for minor bleedings (1.3% in group 1 and 1.5% in group 2, p=0.83). There were also no significant differences in MACE (7.1% in group 1 and 10.4% in group 2, p=0.27). The 30-day mortality rate was 3.9% in group 1 and 5.4% in group 2 (p=0.56).
  
  
  CONCLUSIONS
  In this registry of primary PCI performed through the transradial approach, bivalirudin was not associated with a significant reduction in major bleeding or MACE compared to heparin and provisional glycoprotein IIb/IIIa inhibitors.
authors.affiliation: Sandro Pertini Hospital, Rome, Italy alessandro.sciahbasi@fastwebnet.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciahbasi
authors.affiliation: Sandro Pertini Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rigattieri
authors.affiliation: Fatebenefratelli Hospital, Milan, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Cortese
authors.affiliation: Santo Spirito Hospital, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Belloni
authors.affiliation: Sandro Pertini Hospital, Rome, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Russo
authors.affiliation: Santo Spirito Hospital, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ferraironi
authors.affiliation: Bolognini Hospital, Seriate, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tespili
authors.affiliation: Bolognini Hospital, Seriate, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Angeletti
authors.affiliation: Santo Spirito Hospital, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ricci
authors.affiliation: Sandro Pertini Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bondanini
authors.affiliation: Sandro Pertini Hospital, Rome, Italy.
authors.forename: Francesco Rocco
authors.initials: FR
authors.lastname: Pugliese
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D000991:Antithrombins / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006629:Hirudins; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D010446:Peptide Fragments / Q000627:therapeutic use*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D019106:Postoperative Hemorrhage / Q000139:chemically induced; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin
keywords: Bivalirudin; glycoprotein IIb/IIIa inhibitors; primary PCI; transradial approach