Bivalirudin, brand name Angiomax, a "direct thrombin inhibitor", is used to prevent blood clots and keep blood flowing freely during cardiac procedures such as bypass surgery.
In a study funded by The Medicines Company of Parsippany, N.J. and the Danish company Nycomed, which have each helped develop bivalirudin, researchers found that the drug not only reduced the incidences of excess bleeding that can sometimes be associated with anticoagulant use but that it was also less expensive than older anticoagulants. Older drugs, called GP llb/lla inhibitors, act on platelets, the blood cells involved in clotting, whereas bivalirudin acts directly on clotting molecules such as thrombin.
"We had a lot of success reducing complications with this class of drug," said study co-researcher Dr. A. Michael Lincoff, director of cardiovascular research at the Cleveland Clinic. "Previous studies with patients in elective situations have shown that bivalirudin was just as effective at reducing bleeding. The question was whether it held for patients with unstable heart disease over the long run. About 4 to 5 percent of patients have bleeding complications from older anticoagulant use. With 1.25 million hospital admissions a year for acute coronary syndromes and over one million a year for non-emergency procedures, that is quite a large number," said Lincoff.
Results of the first trial, involving 13,819 patients, showed no difference in outcomes within the first month of surgery and no significant difference in the first year following surgery. However, the advantage of bivalirudin was that it decreased the incidence of excess bleeding which is associated with a higher risk of long-term mortality.
"It causes much less bleeding, it leads to less need for blood transfusions, it leads to more streamlined care and less expensive hospital costs," said Dr. Gregg W. Stone, professor of medicine at Columbia University and lead author of the journal report. "Now this new data coming in suggests that it can reduce mortality and save lives."
[Source: MedlinePlus]
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