Bivalirudin for percutaneous coronary intervention and in acute coronary syndromes.
This review focuses on the use of bivalirudin as a replacement anticoagulant for heparin in patients undergoing percutaneous coronary intervention, or who are being treated for unstable angina pectoris, ST-elevation, or non-ST-elevation myocardial infarction. Potential advantages of bivalirudin include a lack of dependence on antithrombin III for anticoagulant activity, the ability to inactivate both fibrin-bound and soluble thrombin, a lack of aggregatory effects on platelets, a predictable anticoagulant response without monitoring, and a wider therapeutic window. Clinical trial results to date suggest that bivlirudin is at least as effective as heparin with superior safety due to lower bleeding rates.
Bates
E R
ER
University of Michigan Medical Center, B1-F245 UH, Box 0022, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0022, USA. ebates@umich.edu
D000789:Angina, Unstable / Q000188:drug therapy*; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006493:Heparin / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000031:analogs & derivatives; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D010446:Peptide Fragments / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use*
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin