Circulation. Cardiovascular interventions
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Circ Cardiovasc Interv · Apr 2013
Multicenter Study Comparative StudyHemorrhagic and ischemic outcomes after bivalirudin versus unfractionated heparin during carotid artery stenting: a propensity score analysis from the NCDR.
The direct thrombin inhibitor, bivalirudin, is associated with similar efficacy and superior safety in patients undergoing percutaneous coronary intervention. However, the role of direct thrombin inhibitors in carotid artery stenting is not well defined. The objective of this study was to compare the safety and effectiveness of bivalirudin and unfractionated heparin (UFH) for carotid artery stenting. We hypothesized that bivalirudin would be associated with less in-hospital postprocedure bleeding than UFH but similar rates of in-hospital and 30-day ischemic outcomes. ⋯ Bivalirudin was associated with lower rates of hemorrhagic outcomes compared with UFH during the index hospitalization for carotid artery stenting. In-hospital and 30-day ischemic events were similar between the 2 groups. Randomized comparisons of these agents are needed to confirm these findings.
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Circ Cardiovasc Interv · Feb 2013
Review Meta AnalysisContrast-induced acute kidney injury and risk of adverse clinical outcomes after coronary angiography: a systematic review and meta-analysis.
Contrast-induced acute kidney injury (CI-AKI) has been associated with mortality, although it has been suggested this association may be attributable to confounding. We performed a systematic review and meta-analysis to characterize the associations between CI-AKI and subsequent clinical outcomes. ⋯ CI-AKI is associated with an increased risk of mortality, cardiovascular events, renal failure, and prolonged hospitalization. However, the association between CI-AKI and mortality is strongly confounded by baseline clinical characteristics that simultaneously predispose to both kidney injury and mortality, and the risk attributable to CI-AKI is much lower than that reported from unadjusted studies.
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Circ Cardiovasc Interv · Dec 2012
Randomized Controlled Trial Comparative StudyRandomized assessment of ticagrelor versus prasugrel antiplatelet effects in patients with ST-segment-elevation myocardial infarction.
Ticagrelor and prasugrel provide stronger platelet inhibition compared with clopidogrel. Direct pharmacodynamic comparison between them has not yet been reported in ST-segment-elevation myocardial infarction patients. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT01463163.