He also said that he found the result surprising, especially because until recently bivalirudin had been his anticoagulant of choice. Now that he has switched to more routinely using heparin, he has channeled the money he saves on each case into more liberal use of drug-eluting coronary stents in these patients. “Our drug-eluting stent use has risen from about 30% of patients to about 80%,” Dr. Angerås said in an interview. He also acknowledged that bleeding is not a benign complication, but added that bleeding is a surrogate endpoint with less clinical importance if it doesn’t produce increased mortality, and that in the data he reported bleeding rates were roughly equal between the bivalirudin and heparin subgroups.
Dr. Angerås said that he had no disclosures. Dr. Baumbach said that he has received research support from the Medicines Company, which markets bivalirudin (Angiomax).