Comparison of bivalirudin versus heparin in percutaneous coronary intervention for patients with acute coronary syndrome: A meta-analysis.
Medicine (Baltimore)Sep 25, 2026
Clinical ResearchCardiology
Chen Yang, Zhen Ning, Weiming Liang et al.
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In 30 seconds
This meta-analysis compared bivalirudin and heparin in patients with acute coronary syndrome undergoing percutaneous coronary intervention, including 11 RCTs and 17 cohort studies with 584,249 patients. Bivalirudin significantly reduced all-cause mortality (RR = 0.86) and major bleeding (RR = 0.74) compared to heparin, with no significant differences in major adverse cardiovascular events.
Key findings
- Bivalirudin reduced all-cause mortality in-hospital (RR = 0.86) compared to heparin.
- Bivalirudin significantly decreased major bleeding (RR = 0.74) versus heparin in-hospital.
- At 30-day follow-up, bivalirudin reduced cardiovascular mortality (RR = 0.81) compared to heparin.
- Bivalirudin lowered net adverse clinical events (RR = 0.79) compared to heparin at 30 days.
Why it matters
The findings suggest that bivalirudin may be a safer alternative to heparin in terms of mortality and bleeding risk for patients with acute coronary syndrome undergoing PCI, which is crucial for optimizing patient outcomes.