The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim<a href="https://solaci.org/en/2022/09/12/heparin-pretreatment-in-steacs-treatment-a-new-old-ally/" title="Read more" >...</a>
Heparin Anticoagulation in Critically Ill COVID-19 Patients: Results that Differ from the Rest
In critically ill COVID-19 patients, an initial strategy of anticoagulation with heparin did not result in any benefit compared with standard prophylactic treatment. Thrombosis and inflammation are the main issues when discussing COVID-19 related morbidity. This led to testing whether an anticoagulation scheme could improve prognosis in critically ill COVID-19 patients. Given the dynamics of<a href="https://solaci.org/en/2021/08/18/heparin-anticoagulation-in-critically-ill-covid-19-patients-results-that-differ-from-the-rest/" title="Read more" >...</a>
Surviving Covid-19 with Good Old Heparin?
Patients hospitalized for COVID-19 are at high risk for thrombosis, particularly venous thromboembolism. This information is not new: in a meta-analysis of 66 studies, the overall prevalence of venous thromboembolism among patients with COVID-19 admitted to intensive care units was between 14.1% and 22.7%. Hypercoagulability is an early-described feature of this new virus, and so is<a href="https://solaci.org/en/2021/08/18/surviving-covid-19-with-good-old-heparin/" title="Read more" >...</a>
Anticoagulation with Heparin in Non-Critical COVID-19
In non-severe COVID-19 patients, an initial therapeutic strategy with heparin increases the chance of survival after discharge and reduces the need for respiratory and cardiovascular support compared against usual thromboprophylaxis doses. These data have been welcomed by a medical community eager to receive good news in terms of effective strategies to combat an already existing<a href="https://solaci.org/en/2021/08/18/anticoagulation-with-heparin-in-non-critical-covid-19/" title="Read more" >...</a>
Cardiovascular Events Reduction: Bivalirudin or Heparin?
The MATRIX study did not find a clear advantage of bivalirudin over unfractioned heparin to reduce major adverse cardiovascular events (MACE) or net cardiovascular adverse events (NCAE) in patients undergoing acute coronary syndrome receiving PCI. This new analyzis confirms there is no difference in ischemic and thrombotic events in patients with acute coronary syndrome<a href="https://solaci.org/en/2016/10/19/cardiovascular-events-bivalirudin-heparin/" title="Read more" >...</a>
Bivalirudin or Heparin to Decrease Cerebral Embolization Post TAVI?
Cerebral embolization is a relatively frequent complication during transcatheter aortic valve replacement (TAVR). The hypothesis behind this study is that the incidence of cerebral embolization might be decreased by anticoagulation with bivalirudin, instead of heparin. The first study objective was to determine the proportion of patients with new cerebral embolus after TAVI and<a href="https://solaci.org/en/2016/08/19/bivalirudin-or-heparin-to-decrease-cerebral-embolization-post-tavi/" title="Read more" >...</a>
New Meta-Analysis Shows Similar Mortality between Bivalirudin and Heparin
This meta-analyzis of contemporary studies comparing the safety and efficacy of bivalirudin vs. heparin showed no differences in mortality between the two drugs and, consistently with other studies, bivalirudin was associated with an increased risk of acute stent thrombosis. During ACC 2015, the MATRIX study did succeed in showing global differences between the two drugs<a href="https://solaci.org/en/2016/04/08/new-meta-analysis-shows-similar-mortality-between-bivalirudin-and-heparin/" title="Read more" >...</a>
BRAVO 3: Heparina vs Bivalirudina en pacientes que reciben TAVI
Original article Thierry Lefevre
BRIGHT: Bivalirudin versus heparin versus heparin plus tirofiban in primary angioplasty
The HORIZONS-AMI and EUROMAX studies, had already shown that bivalirudin is superior to heparin plus inhibitors IIB / IIIA glycoprotein in reducing adverse clinical events in patients suffering an ST-segment elevation myocardial infarction undergoing primary angioplasty, at the expense of increase in the rate of acute stent thrombosis. This study included 2194 patients undergoing an<a href="https://solaci.org/en/2015/06/24/congress-item-8309/" title="Read more" >...</a>
Bivalirudin superior than heparin beyond the use or not of Glycoprotein inhibitors
Bivalirudin benefits in bleeding events versus heparin plus glycoprotein IIbIIIa inhibitors is clear even though this benefit has not been fully studied at the point whether persists when glycoprotein inhibitors are used only for rescue and not routinely. This is an EUROMAX sub-analysis that included 2198 patients experiencing AMI analyzing events at 30 days. Bivalirudin<a href="https://solaci.org/en/2015/06/24/congress-item-7994/" title="Read more" >...</a>