The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Coronary interventions

Myocardial damage after ST-segment elevation myocardial infarction by use of bivalirudin or heparin: a DANAMI-3 substudy

EuroIntervention 2020;15:e1602-e1604. DOI: 10.4244/EIJ-D-19-00623

1. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark; 2. Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark


Introduction

The benefits of bivalirudin or unfractionated heparin (UFH) during primary percutaneous coronary intervention (PCI) remain controversial. Bivalirudin rather than UFH plus a routine glycoprotein IIb/IIIa receptor inhibitor (GPI) has been shown to improve overall and cardiac survival and reduce bleeding complications in patients undergoing primary PCI. Several trials comparing bivalirudin and UFH±GPI have since questioned this survival advantage and created controversy related to bivalirudin-associated improved bleeding outcome and the risk of acute stent thrombosis. Recently, the VALIDATE-SWEDEHEART bivalirudin versus heparin monotherapy in myocardial infarction during PCI trial reported no differences in myocardial infarction, major ...

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