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Lack of clopidogrel pretreatment effect on the relative efficacy of bivalirudin with provisional glycoprotein IIb/IIIa blockade compared to heparin with routine glycoprotein IIb/IIIa blockade

A REPLACE-2 substudy

Jacqueline Saw, MD^*, A. Michael Lincoff, MD^*,*, Walter DeSmet, MD, Amadeo Betriu, MD, Wolfgang Rutsch, MD, Robert G. Wilcox, MD^||, Neil S. Kleiman, MD^¶, Kathy Wolski, MPH^*, Eric J. Topol, MD^* REPLACE-2 Investigators^*

^* Department of Cardiovascular Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio, USA
University Hospital Gasthuisberg, Leuven, Belgium
Hospital Clinic, University of Barcelona, Barcelona, Spain
Universitätsmedizin Berlin, Berlin, Germany
^|| University Hospital Nottingham, Nottingham, United Kingdom
^¶ Baylor College of Medicine, Houston, Texas, USA

View larger version (24K): [in a new window]   Figure 1 Comparison of bivalirudin with provisional glycoprotein (GP) IIb/IIIa blockade versus heparin with routine GP IIb/IIIa blockade with respect to the primary composite end point of death, myocardial infarction, urgent revascularization, and in-hospital major bleeding by 30 days in the Randomized Evaluation in Percutaneous coronary intervention Linking Angiomax to reduced Clinical Events (REPLACE-2) trial.

View larger version (15K): [in a new window]   Figure 2 Comparison of clopidogrel pretreatment versus no pretreatment with respect to 30-day primary (death, myocardial infarction, urgent revascularization, and in-hospital major bleeding) and secondary (death, myocardial infarction, and urgent revascularization) end points in patients randomized to bivalirudin plus provisional glycoprotein (GP) IIb/IIIa blockade or heparin plus routine GP IIb/IIIa blockade.

View larger version (24K): [in a new window]   Figure 3 Comparison of bivalirudin with provisional glycoprotein (GP) IIb/IIIa blockade versus heparin with routine GP IIb/IIIa blockade with respect to the secondary composite end point of death, myocardial infarction, and urgent revascularization at 30 days in the Randomized Evaluation in Percutaneous coronary intervention Linking Angiomax to reduced Clinical Events (REPLACE-2) trial.