eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
1/2019
vol. 15
 
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abstract:
Original paper

Safety of bivalirudin versus unfractionated heparin in endovascular revascularization of peripheral arteries in short- and long-term follow-up

Joanna Wojtasik-Bakalarz, Paweł Kleczyński, Wojciech Zasada, Tomasz Rakowski, Salech Arif, Krzysztof Bartuś, Dariusz Dudek, Stanisław Bartuś

Adv Interv Cardiol 2019; 15, 1 (55): 91–97
Online publish date: 2019/01/30
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Introduction
Patients with peripheral artery disease (PAD) are considered as a high-risk group for hemorrhagic events.

Aim
To assess the safety of bivalirudin vs. unfractionated heparin (UFH) in percutaneous peripheral interventions (PPI) in short- and long-term follow-up.

Material and methods
The retrospective single-center, observational study included 160 patients, undergoing PPI. Patients were divided into 2 groups based on the use of anticoagulation – unfractionated heparin (UFH group) or bivalirudin (Biv. group) – and observed up to 5 years.

Results
The UFH group consisted of 101 patients and the Biv. group consisted of 59. We registered the following end points during in-hospital observation: 1 death (0.63% Biv, p = 0.18), 12 hematomas at puncture site (0.63% Biv. vs. 7.05% UFH, p = 0.04), 2 pseudoaneurysms (1.27% UFH, p = 0.29), thrombosis (0.63% UFH, p = 0.45), 1 bleeding from puncture site (0.63% UFH, p = 0.45). The total number of hemorrhagic complications was 1.24% in the Biv. group and 8.07% in the UFH group (p = 0.04). During long-term follow-up of 65.7 ±36.4 months the all-cause mortality rate was higher in the Biv. group (8.59% Biv vs. 0% in UFH group, p = 0.009). Regression analysis showed that bivalirudin administration is a risk factor for increased mortality risk (p = 0.003, OR = 15, 95% CI: 3.3–107.8).

Conclusions
Usage of UFH was associated with a higher number of hemorrhagic complications, especially hematomas at the puncture site in comparison to patients receiving bivalirudin.

keywords:

bivalirudin, heparin, peripheral artery disease, long-term mortality

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