Angiomax on Its Own Shows Success

A year-long U.S. trial shows that bivalirudin — sold as Angiomax — can be used alone in some heart procedures that now rely on at least two drugs.

The drugs are used to prevent unwanted clotting around devices used in angioplasty and stenting.

The procedures usually require the use of other agents known as glycoprotein IIb/IIIa inhibitors, but Stone’s study indicated that use of bivalirudin by itself is safe and effective.

In patients with high-risk acute coronary syndromes undergoing an early invasive strategy, bivalirudin is an acceptable substitute for either unfractionated heparin or enoxaparin, said Gregg Stone, director of Cardiovascular Research and Education at the Cardiovascular Research Foundation at Lenox Hill Hospital, New York.

The goal of the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) Trial was to prevent composite of death, myocardial infarction or unplanned revascularization at least as well as the other strategies.

In almost all the endpoints checked, the three strategies were similar. For example, in the primary endpoint, cardiovascular events occurred in 16.4 percent of patients taking the heparins; 16.5 percent for bivalirudin and the glycoprotein IIb/IIIa inhibitors; and 16.4 percent for bivalirudin alone.