@article{JTD22128,
author = {Mahesh Anantha-Narayanan and Dixitha Anugula and Nagarjuna R. Gujjula and Yogesh N. V. Reddy and Janani Baskaran and Manu Kaushik and Venkata M. Alla and Ganesh Raveendran},
title = {Bivalirudin versus heparin in percutaneous coronary intervention—a systematic review and meta-analysis of randomized trials stratified by adjunctive glycoprotein IIb/IIIa strategy},
journal = {Journal of Thoracic Disease},
volume = {10},
number = {6},
year = {2018},
keywords = {},
abstract = {Background: Bivalirudin has been shown to be associated with less major bleeding than heparin in patients undergoing percutaneous coronary intervention (PCI); but the confounding effect of concomitant glycoprotein IIb/IIIa inhibitors (GPI) limits meaningful comparison. We performed a systematic review and meta-analysis to compare bivalirudin to heparin, with and without adjunctive GPI in PCI.
Methods: We searched PubMed, Cochrane, EMBASE, CINAHL and WOS from January 2000 to December 2017 for clinical trials comparing bivalirudin to heparin, with and without adjunctive GPI during PCI. Cochrane’s Q statistics were used to determine heterogeneity. Random effects model was used.
Results: Twenty-six comparison groups (22 original studies and 4 subgroup analyses) with 53,364 patients were included. Mean follow-up was 192±303 days. There was no difference between the two groups in all-cause mortality [risk ratio (RR: 0.93; 95% CI: 0.82–1.05, P=0.260), target vessel revascularization (TVR) (RR: 1.17; 95% CI: 0.93–1.46, P=0.174) or stroke (RR: 0.91; 95% CI: 0.71–1.18, P=0.490). Major bleeding was lower in the bivalirudin group with concomitant GPI in one or both arms (RR: 0.64; 95% CI: 0.53–0.77, P},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/22128}
}