Comparison of Bivalirudin and Heparin in Patients Undergoing Percutaneous Coronary Intervention: A Retrospective Analysis
DOI:
https://doi.org/10.70749/ijbr.v3i5.1210Keywords:
Bivalirudin, Heparin, Percutaneous Coronary Intervention, Anticoagulation, Bleeding Risk, MACEAbstract
Introduction: Anticoagulation must be optimized for both thrombotic and bleeding events in order to determine the risk of percutaneous coronary intervention (PCI). UFH or unfractionated heparin and bivalirudin are classical agents for use in in-patient treatment with some differences in safety and efficacy. Objective: The aim of the study was to evaluate the safety and effectiveness of bivalirudin against UFH for patients undergoing PCI at Department of Cardiology, Hayatabad Medical Complex, Peshawar. Materials and Method: The study involved 320 patients who underwent PCI in the period from July, 2023 to December, 2023. The subjects were further sub-grouped based on the anticoagulant they received, either bivalirudin or UFH. Major adverse cardiac events and bleeding events were also compared and analyzed. Results: Major bleeding was lower in the bivalirudin group in comparison to UFH (4.9% vs. 10.1%, p=0.04); MACE, success of the procedure was similar. Conclusion: Bivalirudin is a safe and effective alternative to UFH in PCI, particularly in patients at high bleeding risk.
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Li, J., Chen, S., Ma, S., Yang, M., Qi, Z., Na, K., Qiu, M., Li, Y. and Han, Y., 2022. Safety and efficacy of bivalirudin versus unfractionated heparin monotherapy in patients with CAD and DM undergoing PCI: A retrospective observational study. Cardiovascular Therapeutics, 2022(1), p.5352087.
https://doi.org/10.1155/2022/5352087
Zhang, J., Chen, Z., Wang, D., Li, C., Luo, F. and He, Y., 2024. Bivalirudin versus heparin in contemporary percutaneous coronary interventions for patients with acute coronary syndrome: a systematic review and meta-analysis. Cardiology Journal, 31(2), pp.309-320.
https://doi.org/10.5603/cj.90956
Zhang, Y., Zhang, Y., Chang, C., Yan, S., Chen, Z., Zhang, L., Chen, K. and Liu, G., 2021. Efficacy and safety of bivalirudin during percutaneous coronary intervention in chronic total occlusion: A retrospective study. Clinical Therapeutics, 43(5), pp.844-851.
https://doi.org/10.1016/j.clinthera.2021.03.004
Li, J., Liu, X., Ma, S., Na, K., Qi, Z., Xu, Y., Qiu, M., Han, Y. and Li, Y., 2022. Effectiveness and safety of bivalirudin in elderly patients with coronary artery disease undergoing percutaneous coronary intervention: A real‐world study. Catheterization and Cardiovascular Interventions, 99, pp.1448-1455.
https://doi.org/10.1002/ccd.30099
Zhai, Y., Shang, H., Li, Y., Zhang, N., Zhang, J. and Wu, S., 2025. The efficacy and safety of bivalirudin and heparin in patients with acute coronary syndrome: a systematic review and meta-analysis. Systematic Reviews, 14(1), p.39.
https://doi.org/10.1186/s13643-025-02782-7
Bai, Z., Wang, Z., Feng, Q., Zhang, Y., Zhang, M., Hou, A., Wu, Y., Qin, Z. and Chai, L., 2023. Bivalirudin vs heparin in cardiac-cerebral ischemic and bleeding events among Chinese STEMI patients during percutaneous coronary intervention: a retrospective cohort study. Brazilian Journal of Medical and Biological Research, 56, p.e13013.
https://doi.org/10.1590/1414-431x2023e13013
Chai, L., Liu, J., Zhang, Y., Zhang, M., Wang, Z., Wu, Y., Bai, Z. and Qin, Z., 2023. Comparison of net adverse clinical events between bivalirudin and heparin as anticoagulants for percutaneous coronary intervention in Chinese patients. Experimental and Therapeutic Medicine, 26(5), p.530.
https://doi.org/10.3892/etm.2023.12229
Li, Y., Li, J., Guan, C., Su, S., Wang, Z., Liu, H., Yang, Y., Gao, R., Yuan, J. and Zhao, X., 2023. One-year clinical outcomes of bivalirudin versus unfractionated heparin in patients with type 2 diabetes undergoing elective percutaneous coronary intervention. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 17(10), p.102858.
https://doi.org/10.1016/j.dsx.2023.102858
Ma, M., Liang, S., Zhu, J., Dai, M., Jia, Z., Huang, H. and He, Y., 2022. The efficacy and safety of bivalirudin versus heparin in the anticoagulation therapy of extracorporeal membrane oxygenation: a systematic review and meta-analysis. Frontiers in Pharmacology, 13, p.771563.
https://doi.org/10.3389/fphar.2022.771563
Li, Q., Li, H., Liu, Z. and Duan, L., 2024. Bivalirudin versus Heparin on net adverse clinical events, major adverse Cardiac and cerebral events, and bleeding in Elderly Chinese patients treated with percutaneous coronary intervention. The Tohoku Journal of Experimental Medicine, 262(2), pp.115-124.
https://doi.org/10.1620/tjem.2023.j085
Faour, A., Collins, N., Williams, T., Khan, A., Juergens, C.P., Lo, S., Walters, D.L., Chew, D.P. and French, J.K., 2021. Reperfusion After Fibrinolytic Therapy (RAFT): An open-label, multi-centre, randomised controlled trial of bivalirudin versus heparin in rescue percutaneous coronary intervention. Plos one, 16(10), p.e0259148.
https://doi.org/10.1371/journal.pone.0259148
Wang, P.P., Muyesaier, A. and LI, X.F., 2023. The effect of bivalirudin on coronary microcirculation and short-term prognosis evaluation in acute coronary syndrome patients undergoing percutaneous coronary intervention. Chinese Journal of Interventional Cardiology, pp.915-920.
Giuliano, K., Bigelow, B.F., Etchill, E.W., Velez, A.K., Ong, C.S., Choi, C.W., Bush, E., Cho, S.M. and Whitman, G.J., 2021. Extracorporeal membrane oxygenation complications in heparin-and bivalirudin-treated patients. Critical care explorations, 3(7), p.e0485.
https://doi.org/10.1097/cce.0000000000000485
Wang, Q., Liu, Y., Yang, L., Zhou, T., Zhang, Q., Zhang, Z., Sun, D. and Wang, X., 2024. Reduced-dose of bivalirudin (without the post-procedure infusion) in patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. BMC Cardiovascular Disorders, 24(1), p.713.
https://doi.org/10.1186/s12872-024-04399-5
Tong, Y., Rouzhahong, J., Zhou, W., Wang, R., Wang, Y., Ren, Y., Guo, J., Li, Y., Wang, Z. and Song, Y., 2023. Comparison of bivalirudin versus heparin in adult extracorporeal membrane oxygenation anticoagulant therapy: a retrospective case-control study. The International Journal of Artificial Organs, 46(3), pp.162-170.
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