Heparin vs. Bivalirudin: Stent Placement Tx Debate Continues
There is still no definitive consensus about which anticoagulant is more effective during cardiac stent placement despite numerous existing studies, an editorial concluded in the New England Journal of Medicine.
Editorial author Peter Berger, MD, Senior Vice President for Clinical Research at the North Shore-LIJ Health System, outlined the ongoing comparison of heparin and bivalirudin. Both anticoagulants are used to prevent life-threatening thrombosis during cardiac stent placement procedures. So far, studies have demonstrated conflicting results with some claiming bivalirudin causes fewer bleeding complications than heparin, while others have shown that low-dose heparin is just as safe.
Dr. Berger's editorial accompanies the MATRIX trial where many different blood thinners were compared. The trial also examined whether an extended use of bivalirudin of 4–6 hours post- catheterization is more beneficial than immediate discontinuation. The study showed that a longer infusion of bivalirudin was not any more effective than a shorter infusion.
Dr. Berger concluded that choosing which trial to believe is controversial and that it will be "interesting to see whether doctors accept the results of the MATRIX Trial or wait for more studies" in choosing which anticoagulant they prefer.
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