AHA 2016: Study shows similar outcomes with tirofiban or bivalirudin during PCIs

Patients had similar rates of 30-day bleeding and 1-year death, MI or urgent target vessel revascularization whether they received anticoagulation with tirofiban or bivalirudin during PCIs, according to an observational study.

Lead researcher Joseph B. Muhlestein, MD, Intermountain Medical Center Heart Institute in Salt Lake City, presented the results Nov. 13 in an oral abstract session at the American Heart Association Scientific Sessions in New Orleans.

The researchers examined 857 patients who underwent successful PCIs without cardiogenic shock from 2013 to 2015. The groups were well balanced. The mean age was approximately 65 years old, and more than 70 percent of patients were males.

All of the patients also were antioagulated with heparin, while 402 received tirofiban and 455 received bivalirudin.

At 30 days, the thrombolysis in myocardial infarction major bleeding rates were 1.2 percent in the tirofiban group and 3.1 percent in the bivalirudin group. That difference was not statistically significant.

After a year, the rates of death were 3.4 percent in the tirofiban group and 5.5 percent in the bivalirudin group. Meanwhile, the 1-year rates of MI were 2.9 percent and 3 percent, respectively, while the 1-year rates of urgent target vessel revascularization were 2 percent and 1.5 percent, respectively. None of the differences at a year were statistically significant.

“Bivalirudin has been considered the gold standard for reducing bleeding during percutaneous coronary intervention, but our study shows heparin plus short-term tirofiban is just as good and possibly better,” Muhlestein said in a news release. “The results certainly justify a randomized clinical trial to explore identified trends.”