MONDAY, Aug. 31 (HealthDay News) -- In patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention, bivalirudin is associated with a significantly lower one-year rate of net adverse clinical events than standard treatment, according to a study published online Aug. 30 in The Lancet and presented at the European Society of Cardiology Congress 2009, held from Aug. 29 to Sept. 2 in Barcelona, Spain.
Roxana Mehran, M.D., of the Columbia University Medical Center in New York City, and colleagues randomly assigned 3,602 patients to receive either bivalirudin or heparin plus a glycoprotein IIb/IIIa inhibitor (GPI).
After one year, the researchers found that the bivalirudin group had a significantly lower rate of net adverse clinical events than the heparin-GPI group (15.6 versus 18.3 percent) due to a lower rate of major bleeding (5.8 versus 9.2 percent). They also found that the bivalirudin group had a lower one-year rate of cardiac morality (2.1 versus 3.8 percent) and all-cause mortality (3.5 versus 4.8 percent).
"The reduction in mortality in the bivalirudin group compared with the control group might be attributable to the prevention of iatrogenic hemorrhagic complications," the authors write. "The rates of all-cause mortality, cardiac mortality, and stroke were all five times higher in patients who had major bleeding than in those who did not. Additionally, the rate of reinfarction in patients who had major bleeding was twice the rate in those without major bleeding."
The study was supported by Boston Scientific Corporation and The Medicines Company; several authors reported financial relationships with the two companies.
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