Assessing the Impact of Using Heparin and Bivalirudin on Clinical Outcome of Subjects Undergoing Percutaneous Coronary Intervention: A Meta-Analysis

Background: Bivalirudin is increasingly used as an alternative to heparin in patients undergoing percutaneous coronary intervention (PCI) due to its potential for reducing adverse clinical outcomes. This meta-analysis aimed to compare the effectiveness and safety of bivalirudin versus heparin across various clinical outcomes. Method: A total of 27 studies were included, comprising 63,624 patients: 30,492 received Bivalirudin, and 33,132 received Heparin. Key endpoints analyzed include net adverse clinical events (NACE), major adverse clinical events, major bleeding, mortality, stroke, and stent thrombosis. Data were pooled using a random-effects model, and heterogeneity was assessed using the I² statistic. Publication bias was evaluated using Begg’s and Egger’s tests. Results: Bivalirudin significantly reduced the risk of major bleeding (MD=-0.4445, 95% CI [-0.6276, -0.2615], P