The thrombin inhibitor bivalirudin failed to reduce major bleeding in patients who underwent transradial primary PCI, according to an analysis of 1,009 consecutive STEMI patients who received either bivalirudin or heparin plus provisional glycoprotein IIb/IIIa inhibitors. SCAI fellow Dr. Sunil V. Rao agreed with the study authors that the low number of patients enrolled, particularly in the bivalirudin group, may have affected outcomes. "There may be an effect of radial access that decreases bleeding enough to blunt the effect of other bleeding avoidance strategies. Only a randomized trial will resolve this," Rao said, adding that "we need to wait for the MATRIX trial before making any practice changes."

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