Safety, efficiency and cost effectiveness of Bivalirudin: A systematic review

Table 2 Major studies comparing bivalirudin and heparin

Trial name	Type of trial	Number of patients	Bleeding risk	Thrombosis risk	Mortality benefit	Comments
REPLACE-2	Randomized, double blind	6010	Favors bivalirudin	Bivalirudin noninferior	Bivalirudin noninferior
ACUITY	Randomized, open-label	13819	Favors bivalirudin	Comparable	Comparable
ARMYDA-7 BIVALVE	Randomized, open-label	401	Favors bivalirudin	Comparable	Comparable	Primarily decrease in access site bleeding in bivalirudin group
HORIZONS-AMI	Randomized, open-label, multicenter	3602	Favors bivalirudin	Comparable	Favors bivalirudin	Heparin group was given glycoprotein IIb/IIIa inhibitors
NAPLES	Randomized, open-label	355	Favors bivalirudin	Comparable	No deaths in study period	All patients with diabetes mellitus. Heparin group was given tirofiban
ISAR-REACT 4	Randomized, double-blind	1721	Favors bivalirudin	Comparable	Comparable	Heparin group was given abciximab
NAPLES III	Randomized, double-blind	837	Comparable	Not studied	Not studied	Femoral approach access in PCI
EUROMAX	Randomized, open-label	2218	Favors bivalirudin	Favors heparin	Comparable	GP IIb/IIIa inhibitor was optional in heparin group
HEAT-PPCI	Randomized, open-label	1829	Comparable	Favors heparin	Favors heparin	Use of GP IIb/IIIa was option in both groups
BRIGHT	Randomized, open-label	2194	Favors bivalirudin	Comparable	Comparable
MATRIX	Randomized, open-label	7213	Favors bivalirudin	Favors heparin	Favors bivalirudin	Post-PCI infusion of bivalirudin didn’t affect the outcome

PCI: Percutaneous coronary intervention.