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ISAR-REACT 3 Pits Bivalirudin vs. Unfractionated Heparin in PCI
Date:3/29/2008

Will direct thrombin inhibitor excel with high-dose clopidogrel on board?

CHICAGO, March 29 /PRNewswire/ -- A large randomized trial will shed light on the ideal combination of medications for preventing unwanted blood clotting during and shortly after percutaneous coronary intervention (PCI). Specifically, study investigators expect to determine whether bivalirudin, a direct inhibitor of the clotting protein thrombin, is better than unfractionated heparin, an indirect thrombin inhibitor, in patients who have also been treated with high-dose clopidogrel.

The Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 3 (ISAR-REACT 3) study is being presented today in a Late-Breaking Clinical Trials session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC).

Bivalirudin has outperformed unfractionated heparin in some previous studies of PCI, but it's not clear how the two anti-clotting medications measure up when used in combination with what has become standard protocol in the cardiac catheterization laboratory: preloading with a 600-mg dose of clopidogrel, a medication that prevents clotting by inhibiting platelets.

"The distinguishing feature of our study is that a double-blind comparison of the two different anti-thrombotic regimens was performed against a backdrop of optimal oral anti-platelet loading therapy," said Adnan Kastrati, MD, a professor of cardiology and head of the catheterization laboratory at Deutsches Herzzentrum and Technical University, Munich, Germany. "We hypothesized that in patients who were optimally pre-treated with clopidogrel, bivalirudin would continue to prove superior to unfractionated heparin, at least
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SOURCE SCAI-ACCi2
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