Related Experiment Video
Updated: Jun 28, 2025
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
5.0K
Ticagrelor vs clopidogrel when coadministered with bivalirudin in patients with acute coronary syndrome undergoing
Yang Li1, Yi Li1, Miaohan Qiu1
1Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China.
Research and Practice in Thrombosis and Haemostasis
|April 16, 2024
Summary
Bivalirudin plus ticagrelor significantly reduced ischemic events and stroke in acute coronary syndrome patients undergoing percutaneous coronary intervention compared to bivalirudin plus clopidogrel, without increasing bleeding risk.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Optimal perioperative antithrombotic strategy for acute coronary syndrome (ACS) during percutaneous coronary intervention (PCI) is debated.
- Real-world data on bivalirudin combined with ticagrelor versus clopidogrel in ACS patients undergoing PCI is limited.
Purpose of the Study:
- To evaluate the safety and effectiveness of bivalirudin plus ticagrelor compared to bivalirudin plus clopidogrel.
- To assess the incidence of ischemic events and bleeding in ACS patients undergoing PCI.
Main Methods:
- Retrospective cohort study of 7234 ACS patients undergoing PCI between March 2016 and March 2019.
- Patients received bivalirudin periprocedurally with either ticagrelor or clopidogrel.
- Comparison of 12-month incidence rates for ischemia, all-cause death, and Bleeding Academic Research Consortium (BARC) types 2, 3, and 5 bleeding.
Main Results:
- Bivalirudin plus ticagrelor (n=2274) was associated with significantly lower ischemic events (1.74% vs 2.84%) and stroke (0.05% vs 1.01%) compared to bivalirudin plus clopidogrel (n=4960).
- No significant increase in BARC type 2,3,5 bleeding (4.49% vs 3.76%) or BARC type 3,5 bleeding (2.84% vs 2.02%) was observed with ticagrelor.
- These benefits were consistent across subgroups.
Conclusions:
- Bivalirudin plus ticagrelor is a safe and effective initial treatment strategy for ACS patients undergoing PCI.
- This combination reduces the risk of ischemic events without a significant increase in bleeding complications.
- Findings support the use of bivalirudin plus ticagrelor in real-world ACS PCI settings.
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
522
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
522
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
689
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
689
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
170
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
170
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
498
Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
498