The benefit from bivalirudin came mainly from reduced bleeding, not reduced mortality. The risk of major bleeding not associated with CABG was 2.7% in the bivalirudin group and 6.1% in the control group, a significant 57% reduction.
Rates of cardiac or noncardiac death at 30 days did not differ significantly between groups. Cardiac death occurred in 2.4% in the bivalirudin group and in 3% in the control group; noncardiac death occurred in 0.5% and 0.1%, respectively.
The EUROMAX findings were consistent across subgroups of patients, including subgroups defined by PCI access site or by the choice of P2Y12 inhibitor, Dr Steg reported at the meeting, cosponsored by the American College of Cardiology.
Dr Steg received fees from The Medicines Company, which sponsored the study and markets bivalirudin, and he reported financial associations with 16 other companies. Four of his colleagues in the study were employees of The Medicines Company, and 12 other colleagues reported financial associations with that company and/or multiple other companies. Dr Stone reported financial associations with Boston Scientific, Eli Lilly, and other companies.