The primary efficacy outcome was a composite of allcause
mortality, stroke, reinfarction or unplanned target
lesion revascularisation. It occurred in 8.7% of patients
in the bivalirudin group versus 5.7% in the heparin
group (p=0.01). The principal findings can be seen in
Table 1. In summary, the results suggest that when
compared with bivalirudin:
◆ Use of heparin was associated with a substantial reduction
in the incidence of early recurrent heart attack
◆ Use of heparin was also associated with marginally
fewer deaths and strokes
◆ Use of heparin would prevent three serious adverse
events for every 100 patients treated.
Routine use of heparin, rather than bivalirudin, could
improve outcomes for patients, while at the same time
reducing costs for health-care providers. In the study
centre alone, performing about 1000 PPCI procedures
annually, the cost saving would be about UK £500 000 per
year ($US835 000).