{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T04:08:56Z","timestamp":1754194136543,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T00:00:00Z","timestamp":1547337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the efficacy of post\u2010primary percutaneous coronary intervention (PCI) bivalirudin infusion (at full PCI dose) to prevent stent thrombosis (ST) compared with heparin monotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Early randomized controlled trials (RCTs) have shown that compared with heparin use, bivalirudin use during primary PCI is associated with an increased risk of ST. However, bivalirudin was stopped in those trials at the end of the procedure and glycoprotein IIb<jats:bold>\/<\/jats:bold>IIIa inhibitors (GPIs) were routinely used with heparin. The increased risk of ST may be eliminated by continuing bivalirudin infusion post\u2010procedure for few hours. Indeed, in most recent trials, a trend of lower ST risk has been observed with a post\u2010procedure infusion of bivalirudin compared with heparin monotherapy (without the routine use of GPI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Relevant RCTs were included and risk ratios (RRs) were calculated using random effect models. The primary outcome of interest was the risk of early definite ST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four RCTs involving 13,505 patients were included in this meta\u2010analysis. Compared with heparin monotherapy, bivalirudin (with a post\u2010procedure infusion) was associated with a 55% decrease in the risk of early definite ST (RR: 0.45, 95% confidence interval: 0.23\u20130.85; <jats:italic>P<\/jats:italic>\u2009=\u20090.015). There was no difference in the risk of early ST between bivalirudin (with a post\u2010procedure infusion) and heparin with GPI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For primary PCI, a bivalirudin\u2010based anticoagulant strategy (with post procedure infusion) is associated with a lower risk of early definite ST compared with treatment with heparin monotherapy (without GPI).<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28065","type":"journal-article","created":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T10:23:23Z","timestamp":1547375003000},"page":"210-215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Bivalirudin with a post\u2010procedure infusion versus heparin monotherapy for the prevention of stent thrombosis"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5048-538X","authenticated-orcid":false,"given":"Rahman","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Medicine University of Tennessee, School of Medicine  Memphis Tennessee"},{"name":"Department of Cardiology Veterans Affairs Medical Center  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel B.","family":"Latham","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Tennessee, School of Medicine  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer M.","family":"Porta","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Tennessee, School of Medicine  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arshi","family":"Naz","sequence":"additional","affiliation":[{"name":"Department of Medicine Sir Syed College of Medical Sciences  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Matin","sequence":"additional","affiliation":[{"name":"Department of Medicine Virginia Commonwealth University  Richmond Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil V.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Cardiology Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.109.884478"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708191"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311096"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu214"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.2323"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.10.006"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.11.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.03.031"},{"issue":"3","key":"e_1_2_8_12_1","first-page":"285","article-title":"Bivalirudin in acute coronary syndromes","volume":"374","author":"Shah R","year":"2016","journal-title":"N Engl J Med"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26859"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706443"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.685313"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"volume-title":"Methods for Meta\u2010Analysis in Medical Research","year":"2000","author":"Sutton A","key":"e_1_2_8_18_1"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4002"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu182"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60924-7"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507854"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.112.972323"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2008.01.021"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1586\/erc.10.158"},{"key":"e_1_2_8_26_1","unstructured":"Safety labeling changes approved by FDA Center for Drug Evaluation and Research (CDER).2016.http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2016\/020873s036lbl.pdf. 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