2 Differing Medications Used During Heart Procedure are Safe, Effective

Two differing blood clot prevention medications are just as safe and effective for patients undergoing percutaneous coronary intervention.

Percutaneous coronary intervention is a non-surgical procedure to open blood vessels narrowed by plaque buildup. Two differing blood clot prevention medications are just as safe and effective for patients undergoing percutaneous coronary intervention, revealed a new study.

The scientific community has proposed both medications as potentially superior to longer-term anticoagulation treatments for patients undergoing the procedure.

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Two differing blood clot prevention medications are just as safe and effective for patients undergoing percutaneous coronary intervention.

The new study by researchers from the Intermountain Medical Center Heart Institute in Salt Lake City sought to discover which of the two short-term treatment methods - using the drug heparin combined with a short-term (less than six hours) infusion of tirofiban, or short-term periprocedural bivalirudin, another medication that helps prevent blood clots during the procedure - was more effective.

Through this observational study of patients undergoing successful elective percutaneous coronary intervention, the Intermountain researchers found that the risk after 30 days of major bleeding, and one-year risk of death, heart attack and urgent repeat PCI, was low and not significantly different between the two treatment methods.

Results of the study were presented during the American Heart Association Scientific Sessions in New Orleans.

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Heart attack patients who were most prone to bleeding were more likely to be treated via transfemoral access, which is known to result in more significant post-procedure bleeding.

"Bivalirudin has been considered the gold standard for reducing bleeding during percutaneous coronary intervention, but our study shows heparin plus short-term tirofiban is just as good and possibly better," said Intermountain Medical Center Heart Institute cardiologist J. Brent Muhlestein, the lead author on the study. "The results certainly justify a randomized clinical trial to explore identified trends."

Researchers studied results from patients who underwent percutaneous coronary intervention between January 2013 and December 2015. Of the 857 patients enrolled in the study, 402 received heparin plus short-term tirofiban treatment and 455 received bivalirudin. The patients were between the ages of 51 and 78.

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Nearly 42 percent of the deaths occurring within 30 days of percutaneous coronary interventions (PCI) were attributable to complications from the procedure.

There was a slight reduction in major bleeding and death with the use of heparin plus short-term tirofiban over bivalirudin alone, but due to the overall low incidence of adverse events, the difference did not reach statistical significance.

The 30-day incidence of TIMI major bleeding score was 1.2% for patients treated with heparin and tirofiban and 3.1% for bivalirudin patients.

Mortality Risk Similar for Bypass Surgery and Latest Drug-Coated Stents
The risk of death is same in patients that received newer drug-coated stents, which keep blocked coronary arteries open, and also in those that underwent bypass surgery.

Source-Eurekalert