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anticoagulant in percutaneous coronary intervention for all type of patients, clinical trials results

bivalirudin versus heparin + GP2b3a inhibitors
ACUITY (Stone) (bivalirudin alone), 2006
NCT00093158
bivalirudin alone
versus
unfractionated heparin or enoxaparin plus a glycoprotein IIb/IIIa inhibitor
patients with acute coronary syndromes open
Follow-up duration: 30 days
HORIZONS-AMI (Stone), 2008
NCT00433966
Bivalirudin
versus
Heparin plus GP IIb/IIIa inhibitor
patients with ST-segment elevation myocardial infarction who presented within 12 hours after the onset of symptoms and who were undergoing primary PCIopen
Follow-up duration: 30 days
11 countries
REPLACE-2, 2003
bivalirudin, with glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibition on a provisional basis for complications during PCI
versus
heparin plus planned Gp IIb/IIIa blockade
patients undergoing urgent or elective PCI double blind
Follow-up duration: 30 days
9 countries
bivalirudin versus UFH
ARMYDA BIVALVE,
bivalirudin (0.75 mg/kg bolus followed by 1.75 mg/kg per hour during the procedure)
versus
unfractionated heparin (75 IU/kg)
patients at high bleeding risk (over 75 years of age, diabetes, reduced renal function) scheduled for PCI
BAT (Bittl), 1995
bivalirudin immediately before angioplasty.
versus
heparin immediately before angioplasty
patients undergoing urgent angioplasty for unstable or postinfarction anginadouble blind
Follow-up duration: hospital stay
US
ISAR-REACT 3, 2008
NCT00262054
UFH bolus of 140 U/kg
versus
bivalirudin (bolus of 0.75 mg/kg, followed by infusion of 1.75 mg/kg/hr)
troponin-negative patients undergoing PCIdouble blind
Follow-up duration: 30 days (mean)
REPLACE-1, 2004
bivalirudin (0.75 mg/kg bolus, 1.75 mg/kg/h infusion during the procedure
versus
heparin (70 U/kg initial bolus) adjusted to ACT of 200 to 300s
patients undergoing elective or urgent revascularization
Follow-up duration: hospital stay (48h min)
US
bivalirudin versus UFH plus tirofiban
NAPLES (Tavano), 2009
bivalirudin monotherapy
versus
unfractionated heparin plus tirofiban
patients with diabetes mellitus undergoing elective percutaneous coronary interventionopen
Follow-up duration: 30 days
Italy
bivalirudin + eptifibatide versus heparin + GP2b3a inhibitors
Kleiman, 2002
bivalirudin + eptifibatide
versus
heparin + eptifibatide
patients who underwent elective percutaneous coronary intervention open
dalteparin versus UFH
Natarajan (without antiGp2b3a), 2003
Dalteparin 100 IU/kg bolus
versus
UFH 100 IU/kg bolus
Elective or urgent PCI
dalteparin versus UFH + anti Gp2b3a
Natarajan (+ antiGp2b3a), 2003
Dalteparin 70 IU/kg bolus + GP IIb/IIIa inhibitorse/p
versus
UFH 70 IU/kg bolus +GPIIb/IIIa inhibitors
enoxaparin versus UFH
ATOLL, 2010
IV enoxaparin
versus
UFH
patients undergoing PCI for acute STEMI open
Follow-up duration: 30 days
Austria, France, Germany, and US
Brieger,
enoxaparin
versus
unfractionated heparin
patients undergoing percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI)
CRUISE, 2003
Enoxaparin 0.75 mg/kg bolus
versus
UFH 60 IU/kg bolus, then titrated to ACT > 200
Urgent or elective PCIopen
Follow-up duration: 2,7 +30 days
Drozd, 2001
Enoxaparin 1 mg/kg bolus
versus
UFH 100 IU/kg bolus
PCI for stable angina
Follow-up duration: 24hrs, 30 days
Dudek, 2000
Enoxaparin 1 mg/kg bolus
versus
UFH titrated to ACT > 300
PCI
Follow-up duration: 3à days
Dudek b (enox alone), 2000
Enoxaparin 1 mg/kg bolus
versus
UFH titrated to ACT > 300
PTCA complex lesionsCI
Galeote, 2001
Enoxaparin 0.75 mg/kg bolus
versus
UFH 70 U/kg bolus, then titrated to ACT > 200
PTCA patients with stable/unstable angina or AMI
Rabah, 1999
Enoxaparin 1 mg/kg bolus
versus
UFH 10,000 IU bolus, then titrated to ACT > 300
PCI for stable anginaopen
STEEPLE, 2006
NCT00077844
enoxaparin (0.5 or 0.75 mg per kilogram of body weight)
versus
unfractionated heparin (adjusted for activated clotting time)
elective percutaneous coronary intervention.open
enoxaparin+abciximab versus UFH
Dubek b (+abciximal), 2001
Enoxaparin 0.75 mg/kg bolus + abciximab
versus
UFH titrated to ACT > 300
reviparin versus UFH
REDUCE, 1996
Reviparin 7,000 IU anti-Xa
versus
UFH 10,000 IU bolus
PTCA with stable/unstable anginadouble blind
Follow-up duration: 3 days
Europe and Canada

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