Bivalirudin in patients with coronary artery disease.
Bivalirudin, a DTI, has evolved from relative obscurity as an anticoagulation option in patients resistant to or allergic to either LMWH or UFH to a commonly used, safe alternative. Most of the early studies comparing bivalirudin to UFH with or without a GP IIb/IIIa agent had composite endpoints (death, MI, bleeding) whose statistical significance were driven exclusively by a significant reduction in bleeding. Newer studies now demonstrate reductions in mortality, which has led to a paradigm shift in anticoagulant choice both in elective and emergent coronary procedures. We present the major studies that have brought bivalirudin to the forefront of coronary artery disease, specifically coronary interventional procedures.
Linden
Julie A
JA
Department of Cardiology, INTEGRIS Baptist Medical Center, University of Oklahoma, Oklahoma City, Oklahoma 73112, USA.
Chrysant
George S
GS
D000925:Anticoagulants / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000188:drug therapy*; D006629:Hirudins; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin