Table 11Detailed strength of evidence for bivalirudin versus heparin-based strategy in patients pretreated with clopidogrel

Number of Studies (Patients)DomainsStrength of Evidence and Magnitude of Effect
Effect Estimate (95% CI)
Risk of Bias: Study Design/QualityConsistencyDirectnessPrecision
Composite of All-Cause Mortality, Nonfatal MI, or Revascularization at 30 DaysLow SOE
2 (7104)2 RCTs/Both good qualityConsistentDirectImpreciseBoth studies showed no statistically significant difference in composite event rates ranging from OR 1.11 to 1.25
No difference
Composite of All-Cause Mortality, Nonfatal MI, or Revascularization at 1 YearInsufficient SOE
1 (4570)RCT/Good qualityNADirectImpreciseBivalirudin: 21.5%
Heparin: 20.1%
All-Cause Mortality at 1 YearInsufficient SOE
1 (5126)RCT/Good qualityNADirectImpreciseBivalirudin: 16.0%
Heparin: 16.3%
Major Bleeding at 30 DaysModerate SOE
3 (6322)3 RCTs/2 good quality, 1 fairConsistentDirectPreciseOR 0.64 (0.49 to 0.85)
Favors bivalirudin

CI = confidence interval; MI = myocardial infarction; OR = odds ratio; RCT = randomized controlled trial; SOE = strength of evidence; UA/NSTEMI = unstable angina/non-ST elevation myocardial infarction

From: Results

Cover of Antiplatelet and Anticoagulant Treatments for Unstable Angina/Non–ST Elevation Myocardial Infarction
Antiplatelet and Anticoagulant Treatments for Unstable Angina/Non–ST Elevation Myocardial Infarction [Internet].
Comparative Effectiveness Reviews, No. 129.
Melloni C, Jones WS, Washam JB, et al.

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