ArticleJournal of the Society for Cardiovascular Angiography & Interventions2025
Impact of Pre-PCI Activated Clotting Time on Outcomes of Bivalirudin Versus Heparin During Primary PCI.
Article in Journal of the Society for Cardiovascular Angiography & Interventions, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Mechanical Thrombectomy for Pediatric Acute Ischemic Stroke With Large Vessel Occlusion: Technical Guide and Case Series.Stroke (Hoboken, N.J.) · 2026Article
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The BRIGHT-4 trial demonstrated that procedural anticoagulation with bivalirudin followed by a median 3-hour high-dose infusion reduced the 30-day composite of all-cause mortality or Bleeding Academic Research Consortium (BARC) types 3 to 5 bleeding compared with heparin alone among patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Whether the pre-PCI activated clotting time (ACT) influences this benefit is unknown. In the study, we aim to investigate whether the pre-PCI ACT levels affected the outcomes with each anticoagulant. Methods: The BRIGHT-4 protocol required a pre-PCI ACT to be assessed 5 minutes after study medications were administered with additional anticoagulant boluses given to achieve an ACT ≥225 seconds. In the present prespecified analysis, 30-day outcomes were analyzed according to the initial pre-PCI ACT level. Results: The initial pre-PCI ACT was <225 seconds in 971 of 5461 (17.8%) patients, including 123 of 2776 (4.4%) after bivalirudin and 848 of 2685 (31.6%) after heparin ( Conclusions: Among patients with ST-segment elevation myocardial infarction undergoing PCI with radial artery access, procedural anticoagulation with bivalirudin was associated with lower 30-day rates of mortality, BARC types 3 to 5 bleeding, and stent thrombosis compared with heparin, findings that were consistent regardless of the pre-PCI ACT level.
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