Assessing the Impact of Using Heparin and Bivalirudin on Clinical Outcome of Subjects Undergoing Percutaneous Coronary Intervention: A Meta-Analysis.
Background: Bivalirudin is increasingly used as an alternative to heparin in patients undergoing percutaneous coronary intervention (PCI) due to its potential for reducing adverse clinical outcomes. This meta-analysis aimed to compare the effectiveness and safety of bivalirudin versus heparin across...
| Publicado en: | Iranian Journal of Public Health Vol. 54; no. 12; pp. 2579 - 2595 |
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| Autores principales: | , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Tehran University of Medical Sciences
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191502579&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191502579 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 22516085 6N6F jtl: Iranian Journal of Public Health issn: 22516085 maglogo: N pubinfo: dt: Dec2025 vid: 54 iid: 12 pid: 21783 pub: Tehran University of Medical Sciences artinfo: ui: 191502579 191502579 191502579 10.18502/ijph.v54i12.20812 191502579 ppf: 2579 ppct: 16 formats: tig: atl: Assessing the Impact of Using Heparin and Bivalirudin on Clinical Outcome of Subjects Undergoing Percutaneous Coronary Intervention: A Meta-Analysis. aug: au: Yu, Yan Sun, Xiaojian Su, Mengchao affil: Department of Cardiac Intensive Care Unit, Yantai YuHuangDing Hospital, Yantai, Shandong, China sug: subj: Bivalirudin Therapeutic Use Heparin Therapeutic Use Percutaneous Coronary Intervention Methods Myocardial Infarction Drug Therapy Drug Efficacy Patient Safety Human Systematic Review Meta Analysis Male Female Aged Aged, 80 and Over PubMed Cochrane Library Embase Checklists Descriptive Statistics Data Analysis Software Confidence Intervals Non-ST Elevated Myocardial Infarction Hemorrhage Mortality Hemorrhage Risk Factors Risk Assessment Thrombosis Stents Stroke Prevention and Control Anticoagulants Therapeutic Use Adverse Drug Event After Care Aged: 65+ years Aged, 80 & over Male Female ab: Background: Bivalirudin is increasingly used as an alternative to heparin in patients undergoing percutaneous coronary intervention (PCI) due to its potential for reducing adverse clinical outcomes. This meta-analysis aimed to compare the effectiveness and safety of bivalirudin versus heparin across various clinical outcomes. Method: A total of 27 studies were included, comprising 63,624 patients: 30,492 received Bivalirudin, and 33,132 received Heparin. Key endpoints analyzed include net adverse clinical events (NACE), major adverse clinical events, major bleeding, mortality, stroke, and stent thrombosis. Data were pooled using a randomeffects model, and heterogeneity was assessed using the I² statistic. Publication bias was evaluated using Begg's and Egger's tests. Results: Bivalirudin significantly reduced the risk of major bleeding (MD=-0.4445, 95% CI [-0.6276, -0.2615], P<0.0001, I²=76.79%) compared to Heparin. However, no significant differences were found for major adverse clinical events (MD=-0.0993, P=0.3194) or mortality (MD=-0.1959, P=0.0893). There was moderate heterogeneity in most analyses, particularly for NACE (I²=68.24%) and stent thrombosis (I²=55.33%). No significant differences were observed for stroke prevention or stent thrombosis. Subgroup analyses demonstrated significant reductions in major bleeding with Bivalirudin, particularly in STEMI patients (log OR=- 0.37, P<0.0001), though no differences in MACE or stent thrombosis were observed. High heterogeneity in NSTEMI populations (I²=81.4%) underscores the need for individualized therapy. Conclusion: Although bivalirudin significantly lowers major bleeding compared with Heparin, it shows no clear advantage in mortality or other major clinical outcomes. Substantial heterogeneity across studies indicates variability in patient populations and procedural settings. Further research is needed to define its optimal role in specific PCI subgroups. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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