BRIGHT: Bivalirudin Monotherapy vs. Heparin Monotherapy vs. Heparin Plus Tirofiban in AMI Patients Undergoing Coronary Intervention
In patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), treatments of bivalirudin alone was found to be superior to both heparin monotherapy and heparin plus tirofiban in reducing a primary endpoint of death, reinfarction, ischemia-driven TVR, stroke or bleeding at 30 days and one year, according to results of the BRIGHT trial presented Sept. 15 at TCT 2014.
The study enrolled 2,194 patients at 82 Chinese sites from August 2012 to June 2013, comparing bivalirudin alone (n=735), heparin alone (n=729), or heparin plus tirofiban (n=730). At 30 days, net adverse cardiovascular results were significantly reduced in the bivalirudin versus the heparin/heparin plus tirofiban-inhibitor groups. A similar pattern was seen in bivalirudin’s reduction of major and minor bleeding events, thrombocytopenia, and adverse ischemic events.
Further, with the use of a routine post-PCI bivalirudin infusion, the rates of stent thrombosis were similar with bivalirudin, heparin, and heparin plus a glycoprotein IIb/IIIa inhibitor.
Keywords: Stroke, Myocardial Infarction, Platelet Aggregation Inhibitors, Heparin, Fibrinolytic Agents, Hirudins, Tyrosine, Percutaneous Coronary Intervention, Stents, Thrombosis, Recombinant Proteins, Peptide Fragments, Thrombocytopenia
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