Bivalirudin in percutaneous coronary intervention: the EUROpean BiValIrudin UtiliSatION in Practice (EUROVISION) Registry.
PURPOSE
The prospective EUROVISION Registry was designed to capture patterns of use and short term outcomes in consecutive patients undergoing PCI with bivalirudin (BIV) in European centres.


METHODS
A total of 2018 consecutive BIV-treated patients were included from 58 sites in 5 countries (Germany, Italy, France, Austria, United Kingdom). In-hospital and 30-day outcomes were prospectively collected and included: death, myocardial infarction (MI), stroke, urgent revascularization (URV), major and minor bleeding, stent thrombosis (ST) and thrombocytopenia (TCP).


RESULTS
In this all-comer population, indication for PCI included STEMI (34%), NSTEMI (25%), unstable angina (16%) and stable angina (26%). Diabetes was present in 24% of patients and 30% of cases were performed via radial access. Preloading with a P2Y12 inhibitor was frequent (74%) while procedural glycoprotein inhibitor (GPI) use was low at 4.2%. Almost half (45%) of patients had received at least one additional anticoagulant prior to receiving BIV for PCI. The overall 30-day mortality was 1.0%, with low rates of MI (1.1%), URV (0.8%), ST (0.3%) and stroke (0.2%). The rate of ACUITY major bleeding was 1.6% and no TCP was reported. Dosing variations representing possible under- or over-dosing of BIV were frequent at 35%.


CONCLUSION
In this prospective registry of consecutive patients intended for PCI, use of BIV was associated with low rates of ischemic complications and excellent safety.
['Hamon|Martial|M|', 'Nienaber|Christopher A|CA|', 'Galli|Stefano|S|', 'Huber|Kurt|K|', 'Lipiecki|Janusz|J|', 'Hill|Jonathan M|JM|', 'Amabile|Nicolas|N|', 'Bernstein|Debra|D|', 'Deliargyris|Efthymios|E|', 'Lafont|Antoine|A|', 'Steg|Philippe Gabriel|PG|']
D000368:Aged D060050:Angina, Stable D000789:Angina, Unstable D000925:Anticoagulants D000991:Antithrombins D003328:Coronary Thrombosis D005060:Europe D005260:Female D006470:Hemorrhage D006629:Hirudins D006801:Humans D008297:Male D008875:Middle Aged D009203:Myocardial Infarction D017063:Outcome Assessment, Health Care D010446:Peptide Fragments D062645:Percutaneous Coronary Intervention D011994:Recombinant Proteins D012042:Registries D012307:Risk Factors D015607:Stents D020521:Stroke
Bivalirudin PCI Stent thrombosis STEMI Antithrombin