Cardiovascular Business - May/June 2008 - (Page 17)

Clinical Study Digest Bivalirudin significantly reduced major bleeding compared to heparin. Shown here, bivalirudin (blue) deactivating thrombin. (Source: The Medicines Company) Sanofi-Aventis) before PCI was not advised and treatment was at the discretion of the referring cardiologist. Clopidogrel pretreatment completely abolishes the increase of plasminogen activator inhibitor 1 (PAI-1) active antigens after coronary stent implantation, which Katsaros and colleagues said “may explain in part the beneficial effects of this treatment regimen.” In another study, Herbert D. Aronow, MD, from Michigan Heart & Vascular Institute in Ann Arbor, and colleagues found that clopidogrel pretreatment was administered in about 20 percent of 1,200 patients enrolled in the NHLBI Dynamic PCI registry. They determined that clopidogrel pretreatment was more common in Asians (vs. Whites), those with a history of prior PCI, those presenting with MI, and those who received unfractionated or low molecular weight heparin or bivalrudin before the procedure and later in the study year. In contrast, clopidogrel initiation was less common before PCI among African Americans (vs. Whites), those in cardiogenic shock, ad hoc procedures and among patients who received beta blockers beforehand. They concluded that strategies are needed to improve utilization of clopidogrel treatment before PCI. centers in 11 countries with STEMI undergoing primary PCI were randomized to bivalirudin or heparin plus GPI and followed for 30 days. The researchers found that the bivalirudin monotherapy significantly reduced major bleeding and net adverse clinical events, including cardiac mortality. In another study, researchers from Massachusetts General Hospital found that the use of bivalirudin in patients undergoing PCI had better outcomes regarding vascular access site complications, as well as earlier ambulation. Leave the Counting to Us ACC: Studies make case for choosing bivalirudin over heparin Research presented at the ACC conference has shown that the antithrombin agent bivalirudin has certain advantages over the blood-thinner heparin in various situations and patient populations. A prospective economic analysis enrolled nearly 8,000 U.S. patients in the ACUITY trial who were randomized to receive heparin plus glycoprotein IIb/IIIa inhibitor (GPI), bivalirudin plus GPI or bivalirudin alone. Although anticoagulant costs were lowest for heparin plus cath lab GPI, initial hospital costs were lowest with bivalirudin alone compared to either heparin plus upstream GPI or heparin plus cath lab GPI. Similar results were found at 30 days. Regression modeling demonstrated that savings with bivalirudin (Angiomax, The Medicines Company) were primarily due to less major and minor bleeding. In the HORIZONS AMI trial, a total of 3,602 patients at 123 With WaveMark CIMS you’ll always have what you need WaveMark CIMS captures inventory and usage information in real-time with RFID-enabled cabinets and bins. Information is available via a web browser empowering hospitals to intelligently set target inventory levels, manage expiring products, track lot and serial #s, identify usage patterns, provide accurate charge capture, optimize bulk buys, and more. A web-based solution with a low monthly service fee, means no capital expense or up-front fees. Call 877-4WAVEMARK, or visit us at “With WaveMark we are now able to reduce the manual work of inventory tracking.” —Halsey Bagg, Director, Cardiac Services www.wavemark.net CardiovascularBusiness.com Cardiovascular Business 17 http://www.wavemark.net http://www.wavemark.net http://CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - May/June 2008

Cardiovascular Business - May/June 2008 Contents First Word Cover Story - Coronary CTA: Drafting the Strategic Plan Financing New Technologies: Early Adopters, Lease vs. Purchase, and Joint Ventures Clinical Study Digest: ACE or ARB: It's Your Choice Can Off-Hour D2B Times Be Reduced Without Breaking the Bank? Digital Image Management Primer: Integrating Echo SPECT/CT for Cardiac Disease Detection: An Economic Conundrum Integrating the Healthcare Enterprise Connects IT Systems News & Views Calendar Reader's Resources The Back Page

Cardiovascular Business - May/June 2008

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