title: Bivalirudin in contemporary percutaneous coronary intervention for non-ST-segment elevation acute coronary syndromes: what is the current role of platelet glycoprotein IIb/IIIa receptor inhibitor agents?
abstract: Currently, the wide variety of antithrombotic agents as adjunctive pharmacological therapy for non-ST-segment elevation acute coronary syndromes (ACS) in the setting of contemporary percutaneous coronary intervention (PCI) available for clinical use has made choosing the optimal drug therapy a complex and difficult task. In the stent era, bivalirudin, a semisynthetic direct thrombin inhibitor, has recently been shown to provide similar efficacy with less bleeding compared with unfractionated heparin plus platelet glycoprotein IIb/IIIa inhibitors in ACS patients treated with PCI. Although there are some controversial results and limitations in the studies with bivalirudin, this drug certainly is a plausible option in the treatment of ACS. With current findings in contemporary PCI, there may be a steady increase in the utilization of bivalirudin. On the other hand, in the real world, there may be reinforcement in the sole use of unfractionated heparin confining glycoprotein IIb/IIIa inhibitors and other intravenous antithrombotics to bailout therapy for periprocedural PCI complications in ACS patients.
authors: Cardiovascular Institute, Sanatorio Migone-Battilana, Asunción, Paraguay. osmarcenturion@hotmail.com
authors: Osmar Antonio
authors: OA
authors: Centurión
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D001777:Blood Coagulation / Q000187:drug effects*; D003131:Combined Modality Therapy; D004562:Electrocardiography; D006470:Hemorrhage / Q000139:chemically induced / Q000378:metabolism / Q000517:prevention & control*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D006629:Hirudins / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D006801:Humans; D010446:Peptide Fragments / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D013810:Therapeutic Equivalency
chemical_list: D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin