Evaluation of Procedure-Related Bleeding Risk in XXXX Receiving Bivalirudin During Percutaneous Coronary Intervention.

@entity1 @entity715 @entity583 @entity548
BACKGROUND: Bivalirudin has historically been considered an attractive anticoagulant during percutaneous coronary intervention (PCI) because of reduced @entity548 complications reported by early trials. Bivalirudin use during PCIs has been a subject of controversy because of conflicting data and recent findings. OBJECTIVE:: To evaluate the clinical characteristics of @entity1 receiving bivalirudin to determine if an opportunity to improve use exists based on risk of procedure-related @entity548 . METHODS:: This was a single-center, retrospective, observational study (n = 100) of all adult @entity1 who received bivalirudin during cardiac catheterization at St John Hospital and Medical Center from June to August 2013. The risk of @entity548 complications associated with PCI was estimated using a clinical risk algorithm developed from the National Cardiovascular Data Registry (NCDR). RESULTS: Treatment with bivalirudin was safe and effective. Of the 100 @entity1 who received bivalirudin, only 34% were identified as having a high risk of procedure-related @entity548 according to the NCDR clinical risk algorithm. There was no incidence of stent @entity715 noted and only 1 case of provisional glycoprotein IIb/IIIa inhibitor use. No episodes of Thrombolysis in @entity583 (TIMI) major @entity548 were noted in the study population; however, 1 @entity1 met TIMI minor @entity548 criteria. Limitations of this study include small sample size and retrospective nature of the study. CONCLUSION: Opportunities to establish a more cost-effective use of bivalirudin may exist through implementation of protocols incorporating the NCDR risk assessment model.
