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 but did show a benefit in favor of bivalirudin when analyzing only all cause death. Neither the HEAT-PPCI nor the EUROMAX showed benefits in mortality with bivalirudin, only the latter showed a benefit in bleeding.
This meta-analyzis included more than 40,000 patients from 18 studies and did not show benefits in favor of bivalirudin, even when stratifying the analyzis according to the routine or provisional use of glycoprotein IIb/IIIa inhibitors.
