Abstract:
AIM:The purpose of our study was to evaluate the relative impact of bivalirudin on bleeding outcomes associated with trans-radial interventions (TRI) in real world practice. METHODS AND RESULTS:Data for patients undergoing percutaneous coronary intervention (PCI) between January 2010 and March 2014 at the 47 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) were utilized. Propensity matching was used within cohorts defined by access site. The impact of bivalirudin use on in-hospital outcomes was evaluated with Fisher's exact tests. Among patients undergoing trans-femoral interventions (TFI), use of bivalirudin was associated with a reduction in bleeding compared with both glycoprotein IIb/IIIa inhibitors (GPI; 1.67 vs. 3.46%, absolute risk reduction (ARR) 1.79%, odds ratio, OR, 0.47, confidence interval, CI, 0.41-0.54, number needed to treat, NNT 56, P < 0.001) and heparin (1.26 vs. 1.76%, ARR 0.5%, OR 0.71, CI 0.61-0.82, NNT 197, P < 0.001). Among patients undergoing TRI, there was a more modest absolute reduction in bleeding with bivalirudin compared with GPI (0.79 vs. 1.41%, ARR 0.62%, OR 0.56, CI 0.34-0.90, NNT 161, P = 0.016) and no difference in bleeding compared with heparin (0.46 vs. 0.46%, OR 1, CI 0.54-1.84, P = 1). CONCLUSION:Bivalirudin is markedly efficacious in reducing bleeding in patients undergoing TFI. The reduction in bleeding associated with bivalirudin use is minimal to absent in patients undergoing TRI. Given its lower cost and comparable outcomes, heparin should be the preferred anticoagulation strategy in those undergoing radial PCI.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Perdoncin E,Seth M,Dixon S,Cannon L,Khandelwal A,Riba A,David S,Wohns D,Gurm Hdoi
10.1093/eurheartj/ehv434subject
Has Abstractpub_date
2016-06-21 00:00:00pages
1902-9issue
24eissn
0195-668Xissn
1522-9645pii
ehv434journal_volume
37pub_type
杂志文章abstract::Congestive heart failure is the most common cause of death in young adults with thalassaemia major. In the present study we compared atrial natriuretic peptide levels (ANP) in 30 asymptomatic patients with thalassaemia major (aged 16.6 +/- 6.4 years), normal left ventricular diastolic cavity dimension and systolic fun...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060068
更新日期:1992-10-01 00:00:00
abstract::Antithrombotic therapy and invasive risk stratification in selected high-risk patients have improved outcomes from non-ST-segment elevation acute coronary syndromes (NSTE-ACS), but carry a risk of bleeding and blood transfusion. Although the true incidence of bleeding depends on the population studied (i.e. clinical t...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehm019
更新日期:2007-05-01 00:00:00
abstract:AIMS:To assess the safety and effects of combined treatment with vascular endothelial growth factor-A(165) plasmid (VEGF-A(165)) and granulocyte- colony stimulating factor (G-CSF) mobilization of bone marrow stem cells in patients with severe chronic ischaemic heart disease (IHD). METHODS AND RESULTS:Sixteen patients ...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehl117
更新日期:2006-08-01 00:00:00
abstract:AIMS:Our objectives were (i) to compare the discriminatory performance of the Thrombolysis in Myocardial Infarction risk score (TIMI RS), Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy risk score (PURSUIT RS), and Global Registry of Acute Cardiac Events risk score (GRAC...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehm004
更新日期:2007-05-01 00:00:00
abstract:AIMS:To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events. METHODS AND RESULTS:We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the assoc...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehy695
更新日期:2019-05-21 00:00:00
abstract:AIMS:we investigated the relationship between sublingual perfused capillary density (PCD) as a measure of tissue perfusion and outcome (i.e. occurrence of organ failure and mortality) in patients with cardiogenic shock from acute myocardial infarction. METHODS AND RESULTS:we performed a prospective study in 68 patient...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq324
更新日期:2010-12-01 00:00:00
abstract::Spectral turbulence analysis of the signal-averaged electrocardiogram is a new method for identifying patients prone to sustained monomorphic ventricular tachycardia. In contrast to analysis in the time domain, it has been claimed to be applicable in patients with bundle branch block. The aim of this study was to asse...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060851
更新日期:1995-12-01 00:00:00
abstract:AIMS:Recent data suggest that the administration of bone marrow-derived stem cells (BMSC) might improve myocardial perfusion and left ventricular (LV) function after acute myocardial infarction (AMI). The aim of this study was to assess spontaneous mobilization of BMSC expressing the haematopoietic and endothelial prog...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi164
更新日期:2005-06-01 00:00:00
abstract::To determine the neurohormonal response to angiotensin-converting enzyme (ACE) inhibition after acute myocardial infarction, 36 patients presenting within 6 h of the onset of chest pain were studied in a single regional cardiology service. In this double-blind study, 13 patients were randomized to receive captopril, 1...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060995
更新日期:1995-06-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/18.suppl_d.117
更新日期:1997-06-01 00:00:00
abstract::Type 2 diabetes mellitus (T2DM) is characterized by multiple pathophysiologic abnormalities. With time, multiple glucose-lowering medications are commonly required to reduce and maintain plasma glucose concentrations within the normal range. Type 2 diabetes mellitus individuals also are at a very high risk for microva...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehv239
更新日期:2015-09-07 00:00:00
abstract:AIMS:Collagen degradation in atherosclerotic plaques with thin fibrous caps renders them more prone to rupture. Fibroblast activation protein (FAP) plays a role in arthritis and tumour formation through its collagenase activity. However, the significance of FAP in thin-cap human fibroatheromata remains unknown. METHOD...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq519
更新日期:2011-11-01 00:00:00
abstract:AIMS:A substantial number of patients with dysfunctional but potentially viable myocardium cannot be accurately evaluated by transthoracic echocardiography due to a poor acoustic window. This study compares the diagnostic value of alternative functional imaging techniques, such as dobutamine-transoesophageal echocardio...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.1946
更新日期:2000-06-01 00:00:00
abstract:AIMS:The aim of this study was to assess the risk of intra-aortic balloon counterpulsation and to identify clinical and procedural variables that would predict complications. METHODS AND RESULTS:We analysed 381 consecutive patients who were treated between 1977 and 1995 at our catheterization laboratory and/or medical...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0802
更新日期:1998-03-01 00:00:00
abstract::A group of investigators met for two days in Santorini, Greece, to discuss progress in the field of identification and treatment of high risk/vulnerable atherosclerotic plaques and patients. Many differences in the manner in which terms are being utilized were noted. It was recognized that increased understanding of t...
journal_title:European heart journal
pub_type: 共识发展会议,杂志文章,评审
doi:10.1016/j.ehj.2004.01.002
更新日期:2004-06-01 00:00:00
abstract::Several targets for heart failure therapy may be met through different mechanisms which are not necessarily associated. In the Australia/New Zealand Heart Failure Research Collaborative Group Study, patients with chronic stable heart failure of ischaemic aetiology on treatment including ACE inhibitors were randomized ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1998-02-01 00:00:00
abstract:AIMS:Patients with atrial fibrillation (AF) present with symptoms of myocardial ischaemia despite exclusion of coronary artery disease. A small vessel disease has been suggested. We quantified myocardial perfusion, perfusion reserve, and coronary vascular resistance (CVR) in AF patients using positron emission tomograp...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm246
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Tissue Doppler echocardiography reveals characteristic patterns of myocardial velocities within systole and diastole which are not well understood. AIM:The purpose of this study was to determine the relationship of myocardial velocity patterns, as assessed by tissue Doppler echocardiography, to the contract...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015236
更新日期:1997-02-01 00:00:00
abstract::Streptococcus adjacens and S. defectivus are two recently individualized species of viridans streptococci. Both species were previously designated as nutritionally variant streptococci and characterized by their growth as small satellite colonies supported by 'helper' bacteria, or requiring complex media enriched with...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/16.suppl_b.24
更新日期:1995-04-01 00:00:00
abstract:AIMS:Anaemia is often observed in patients with chronic heart failure (CHF), and it may be associated with a worse prognosis. Aim of this study was to identify the individual mechanisms of anaemia in CHF patients. METHODS AND RESULTS:One hundred and forty-eight consecutive patients with haemoglobin concentration <13 g...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehi388
更新日期:2005-11-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/euhj.1998.1146
更新日期:1998-12-01 00:00:00
abstract:AIMS:To compare two different clopidogrel regimens on the outcomes of patients undergoing elective coronary angiography (CAG)+/-ad hoc percutaneous coronary intervention (PCI). METHODS AND RESULTS:Open-trial randomized 1028 patients with stable angina to group A ('non-selective'-clopidogrel 600 mg > 6 h before CAG; n ...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehn169
更新日期:2008-06-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061703
更新日期:1984-07-01 00:00:00
abstract:AIMS:To assess the effect of experimentally induced atrial fibrillation on coronary flow in humans. METHODS AND RESULTS:In 16 patients (10 men, mean age 43+/-13 years) with normal coronary vessels, baseline and hyperaemic blood pressure and Doppler phasic coronary flow velocity were measured, using a 0.014 inch intrac...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.2894
更新日期:2002-05-01 00:00:00
abstract:AIMS:We examined the adequacy of endogenous erythropoietin (EPO) levels for the degree of anaemia in patients with chronic heart failure (CHF) and its relation to prognosis. METHODS AND RESULTS:We studied 74 anaemic CHF patients from a cohort of 240 patients. The adequacy of endogenous EPO levels was assessed by deriv...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehn205
更新日期:2008-06-01 00:00:00
abstract::The present study applies a non-invasive method to the quantitative evaluation of left ventricular stiffness in normal subjects and in patients with ischaemic heart disease (IHD). We have studied 20 patients with IHD and 25 healthy subjects. The third heart sound (S3) was detectable in all patients. We have correlated...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059876
更新日期:1991-02-01 00:00:00
abstract:AIMS:The Occluded Artery Trial (OAT) (n = 2201) showed no benefit for routine percutaneous intervention (PCI) (n = 1101) over medical therapy (MED) (n = 1100) on the combined endpoint of death, myocardial infarction (MI), and class IV heart failure (congestive heart failure) in stable post-MI patients with late occlude...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehn486
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the frequencies of various diagnoses in patients admitted with acute chest pain, but without acute myocardial infarction, and to evaluate a non-invasive screening programme for these patients. PATIENTS:A total of 204 consecutive non-acute myocardial infarction patien...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014998
更新日期:1996-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehy870
更新日期:2019-05-14 00:00:00
abstract::In a prospective study, an elderly group of patients (n = 63, 47 male, 16 female, age 40-65 years) was examined before and after open-heart surgery under cardiopulmonary bypass: postoperatively, 19 patients (30%) showed no clinical neuropsychiatric symptoms, whereas in 35 patients (56%) mild or transient neurological ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.7.885
更新日期:1993-07-01 00:00:00