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…
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…
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…
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…
Transradial access shows no benefit of bivalirudin
The aim of this study was to compare bivalirudin against heparin in patients with ST elevation acute myocardial infarction undergoing transradial primary PCI. Both bivalirudin and the transradial access are strategies aimed at reducing bleeding complications in patients undergoing acute MI. However, the benefit of their combined use is not year clear. Even though…
Bivalirudin reduces bleeding rate in carotid stenting
Courtesy of Dr. Carlos Fava Bivalirudin has been shown to reduce bleeding in carotid stenting and maintain its efficacy. Even though carotid stenting has shown benefits, these remain unclear. With this in mind, four studies were analyzed (one randomized) including 7,784 patients undergoing carotid stenting with unfractioned heparin vs. bivalirudin. No difference was…
Bivalirudin could be beneficial in peripheral PCI
Original Title: Bivalirudin Is Associated with Improved In-Hospital Outcomes Compared with Heparin in Percutaneous Vascular Intervention. Observational, Propensity –Matched Analysis From the Premier Hospital Database. Reference: Carey Kimmeslstiel, et al. Circ Cardiovasc Interv. 2016 Jan;9(1). Courtesy of Dr. Carlos Fava Lower limb vascular interventions are increasing in number and bleeding is one of its most…