Bivalirudin vs. Heparin for Acute Coronary Syndrome Patients

Analysis of 1-year outcomes reveals no differences between these alternatives in patients undergoing early invasive management.

Optimal adjunctive pharmacologic therapy in early invasive strategies for acute coronary syndromes remains to be determined. The ACUITY study was a randomized, open-label, industry-sponsored trial of 13,819 moderate- and high-risk ACS patients assigned to either heparin plus GPIIb/IIIa inhibitors or bivalirudin, with or without GPIIb/IIIa inhibitors. In addition, the GPIIb/IIIa-inhibitor recipients were randomized to routine upstream treatment initiation or to deferred, selective administration at the time of catheterization. Initial 30-day results demonstrated noninferiority of bivalirudin versus heparin with respect to cardiovascular disease outcomes and decreased rates of bleeding (Journal Watch Cardiology Nov 22 2006). Deferred GPIIb/II…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)