Navigation Links
Newer Anticlotting Drug Safe, Effective for Heart Surgeries

Bivalirudin lowers bleeding risk for patients undergoing bypass, study finds

TUESDAY, Dec. 4 (HealthDay News) -- A newer kind of anticlotting drug is safe over the long run when used during coronary emergencies such as heart attacks.

The drug, a "direct thrombin inhibitor" called bivalirudin, is used to keep blood flowing freely during cardiac procedures such as bypass surgery.

"We had a lot of success reducing complications with this class of drug," said study co-researcher Dr. A. Michael Lincoff, director of cardiovascular research at the Cleveland Clinic.

The team reported its findings in the Dec. 5 issue of the Journal of the American Medical Association. The study was funded by The Medicines Company of Parsippany, N.J., and the Danish company Nycomed, which have each helped develop bivalirudin.

The news may be important for the two million or more Americans who undergo bypass operations and similar procedures each year, Lincoff said. Bivalirudin not only reduces the incidence of excess bleeding that can be associated with anticoagulant use, it also is less expensive than older anticoagulant drugs, he said.

Those drugs, called GP IIb/IIIa inhibitors, act on platelets, blood cells involved in clotting. The new agent used in the trial, bivalirudin (brand named Angiomax), acts directly on molecules such as thrombin that cause clotting.

"Previous studies with patients in elective situations have shown that bivalirudin was just as effective at reducing bleeding," Lincoff said. "The question was whether it held for patients with unstable heart disease over the long run."

The study looked at the use of anticoagulants in patients undergoing procedures for conditions collectively known as acute coronary syndromes.

First results of the trial, which included 13,819 people who underwent procedures at 450 institutions, showed no difference in outcomes within the first month after surgery. And the current report found no significant difference over the year that followed the procedure. For example, all-cause mortality was 3.9 percent for those using the older drugs versus 3.8 percent for those who got bivalirudin. The mortality rate for patients who got combined therapy with the older drugs and bivalirudin was 3.9 percent.

The major advantage of bivalirudin is that it decreases the incidence of excess bleeding -- always a problem when anticoagulants are used, Lincoff said. Excess bleeding during a procedure is associated with a higher risk of long-term mortality.

"About 4 to 5 percent of patients have bleeding complications from older anticoagulant use," Lincoff said. "With 1.25 million hospital admissions a year for acute coronary syndromes and over one million a year for non-emergency procedures, that is quite a large number."

Bivalirudin has a number of advantages over the older treatment, said Dr. Gregg W. Stone, professor of medicine at Columbia University and lead author of the journal report.

"It causes much less bleeding, it leads to less need for blood transfusions, it leads to more streamlined care and less expensive hospital costs," he said. "Now this new data coming in suggests that it can reduce mortality and save lives.

Stone said he is using the drug in about 95 percent of his cases. In the other 5 percent, fear that a blood vessel might rupture leads to use of heparin, an anticoagulant whose activity can be reversed quickly to prevent a major hemorrhage.

Dr. Christopher Granger, professor of medicine at Duke University Medical Center, said the one-year report is "important because it really reinforces what we learned from the 30-day report from the trial. Any differences in outcome seen early didn't result in changes in how we interpreted those outcomes in the long run."

The initial report showed a slight increase in blood vessel blockage and a 50 percent reduction in bleeding episodes with bivalirudin, Granger said. "The question was, does it make a difference?" he said. "The answer from this manuscript is that it doesn't. The effects neutralize each other.

"Bivalirudin is a particularly attractive option for patients showing up in the catheter lab early with a coronary syndrome," he said.

More information

There's more on acute coronary syndromes at the American Heart Association.

SOURCES: Gregg W. Stone, M.D., professor of medicine, Columbia University, New York City, and director of the Cardiovascular Research and Education Center for Interventional Vascular Therapy, New York-Presbyterian Hospital/Columbia University Medical Center, New York City; A. Michael Lincoff, M.D., director, cardiovascular research, Cleveland Clinic; Christopher Granger, M.D., professor of medicine, Duke University Medical Center; Dec. 5, 2007, Journal of the American Medical Association

Copyright©2007 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Newer antidepressants led to less, not more, teen suicides
2. Newer Antibiotic Speeds TB Healing
3. Newer radiation treatment easier for some throat cancer patients
4. Anticlotting drug found to be safe in sickle cell patients
5. DNA vaccine against multiple sclerosis appears safe, potentially beneficial
6. Aspartame is safe, study says
7. Human Urine Safe, Productive Fertilizer
8. Hylands Homeopathic Medicine Offers Parents Safe, All-Natural Option to Alleviate the Symptoms of Colds
9. Blood-incompatible infant heart transplants safe, may save more lives
10. Finding Ways for Seniors to Stay Safe, Healthy... and Home
11. New treatment effective in counteracting cocaine-induced symptoms
Post Your Comments:
Related Image:
Newer Anticlotting Drug Safe, Effective for Heart Surgeries
(Date:6/26/2016)... ... June 26, 2016 , ... On June 10-11, 2016, A Forever ... Cereal Festival and World’s Longest Breakfast Table in Battle Creek, MI, where the rehabilitation ... as home to some of the world’s leading providers of cereal and other breakfast ...
(Date:6/25/2016)... ... 2016 , ... Experts from the American Institutes for Research ... June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR experts ... planning, healthcare costs and patient and family engagement. , AIR researchers will be ...
(Date:6/25/2016)... CA (PRWEB) , ... June 25, 2016 , ... As ... with Magna Cum Laude and his M.D from the David Geffen School of Medicine ... and returned to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may suffer ... unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid ... healthy coping following a traumatic event. , Trauma sufferers tend to feel a range ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with ... Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... -- Dehaier Medical Systems Ltd. (NASDAQ: DHRM ... sells medical devices and wearable sleep respiratory products in ... agreement with Hongyuan Supply Chain Management Co., Ltd. (hereinafter ... 2016, to develop Dehaier,s new Internet medical technology business. ... leverage Hongyuan Supply Chain,s sales platform to reach Dehaier,s ...
(Date:6/24/2016)... PUNE, India , June 24, 2016 ... "Pen Needles Market by Type (Standard Pen Needles, Safety ... 12mm), Therapy (Insulin, GLP-1, Growth Hormone), Mode of Purchase ... published by MarketsandMarkets, This report studies the market for ... is expected to reach USD 2.81 Billion by 2021 ...
(Date:6/24/2016)... , June 24, 2016  Arkis BioSciences, a ... invasive and more durable cerebrospinal fluid treatments, today ... The Series-A funding is led by Innova Memphis, ... and other private investors.  Arkis, new financing will ... and the market release of its in-licensed Endexo® ...
Breaking Medicine Technology: