Ischaemic events and bleeding in patients undergoing percutaneous coronary intervention with concomitant bivalirudin

Jan Kyst Madsen1, Bernard Chevalier, Harald Darius

  • 1Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark.

Insights

The ImproveR registry shows bivalirudin effectively reduces ischemic events in high-risk patients undergoing percutaneous coronary intervention (PCI), with low bleeding rates observed in real-world practice.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
  • Bivalirudin is an anticoagulant used during PCI.
  • Real-world data on bivalirudin use in diverse patient populations is valuable.

Purpose of the Study:

  • To characterize the patient population undergoing PCI with bivalirudin in a routine clinical setting.
  • To evaluate the ischemic and bleeding events associated with bivalirudin treatment.

Main Methods:

  • The European ImproveR registry enrolled 3,799 patients across 102 centers in 12 European countries.
  • Data was collected from January 2005 to June 2006.
  • Patient characteristics, procedural details, and clinical outcomes were analyzed.

Main Results:

  • The study population was elderly (median age 67.2 years) with significant comorbidities including diabetes (27.9%) and renal impairment (14.9%).
  • Acute coronary syndromes (ACS) were prevalent (49%), including ST-segment elevation myocardial infarction (STEMI) (22%).
  • In-hospital major adverse cardiac events were 2.3%, and 30-day events were 5.6%. In-hospital bleeding occurred in 1.7% of patients.

Conclusions:

  • The ImproveR registry highlights a patient profile with high prevalence of elderly individuals, diabetes, renal impairment, and ACS undergoing PCI.
  • Bivalirudin demonstrated effectiveness in suppressing ischemic complications.
  • The observed low rate of hemorrhagic consequences aligns with findings from randomized trials.
Abstract

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