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The clinical and economic impact of bivalirudin for percutaneous coronary intervention

Nikesh Malik1, Anthony H Gershlick

  • 1Department of Cardiovascular Sciences, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.

Expert Review of Pharmacoeconomics & Outcomes Research
|November 14, 2013
PubMed

Insights

Bivalirudin (BVR), a direct thrombin inhibitor, is effective and safe for acute coronary syndrome patients undergoing percutaneous coronary intervention. It offers reduced bleeding complications compared to heparin and glycoprotein IIb/IIIa inhibitors, proving cost-effective.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis Research

Background:

  • Bivalirudin (BVR) is a direct thrombin inhibitor.
  • It is used as an antithrombotic agent with aspirin and ADP-receptor blockers for acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To evaluate the efficacy and safety of BVR compared to heparin plus glycoprotein IIb/IIIa inhibitors in ACS patients undergoing PCI.
  • To assess the cost-effectiveness of BVR in this patient population.

Main Methods:

  • Review of randomized clinical trials comparing BVR to heparin plus glycoprotein IIb/IIIa inhibitors.
  • Analysis of economic data regarding BVR versus heparin plus glycoprotein IIb/IIIa inhibitors.

Main Results:

  • BVR demonstrated at least equivalent efficacy in reducing ischemic endpoints compared to heparin plus glycoprotein IIb/IIIa inhibitors.
  • BVR consistently showed a lower rate of bleeding complications.
  • Economic analyses indicated BVR is cost-effective.

Conclusions:

  • Bivalirudin is a clinically effective and safe antithrombotic agent for ACS patients undergoing PCI.
  • Its favorable bleeding profile and cost-effectiveness support its inclusion in clinical guidelines.
  • Ongoing research is exploring BVR's role with newer oral antiplatelet agents.

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