title: Pharmacokinetic evaluation of  argatroban  for the treatment of acute coronary syndrome.
abstract: BACKGROUND
  Limitations and contraindications of heparins and oral vitamin K antagonists have led to the development of new anticoagulant drugs over the last few years. Argatroban is an intravenous direct thrombin inhibitor currently indicated for the prophylaxis and treatment of thrombosis associated with heparin-induced thrombocytopenia (HIT) and for patients at risk of HIT undergoing percutaneous coronary intervention (PCI). The role of argatroban for the treatment of acute coronary syndrome (ACS) is under evaluation.
  
  
  METHODS
  This article reviews the potential use of argatroban for the treatment of ACS and presents the pharmacokinetic data currently available. The authors also present the pharmacodynamic literature of agratroban in addition to highlighting the safety and tolerability of the drug.
  
  
  CONCLUSIONS
  Theoretically, argatroban's pharmacokinetics makes it an attractive alternative to heparin. Pharmacological advantages of argatroban over heparin include a more-predictable anticoagulant response and the absence of a risk of HIT. Furthermore, argatroban has a fast and predictable dose-dependent anticoagulant effect with low inter-individual variability. It is non-immugenic, not susceptible to degradation by proteases and it is cleared via the liver. These characteristics confer argotroban a different profile from other anticoagulants. Agatroban is an effective alternative for patients when heparin, lepirudin and bivalirudin cannot be used. Its utility in ACS and PCI in non-HIT patients has been evaluated but further studies are warranted to define its role in this context.
authors.affiliation: University Hospital of Salamanca, Cardiology Division, Paseo San Vicente 58-182, 37007, Salamanca, Spain. cruzgonzalez.ignacio@gmail.com
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cruz-González
authors.forename: Rosana
authors.initials: R
authors.lastname: López-Jiménez
authors.forename: Angel
authors.initials: A
authors.lastname: Perez-Rivera
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Yan
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D000818:Animals; D000991:Antithrombins / Q000493:pharmacokinetics* / Q000494:pharmacology*; D001120:Arginine / Q000031:analogs & derivatives; D004195:Disease Models, Animal; D004341:Drug Evaluation; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010875:Pipecolic Acids / Q000493:pharmacokinetics* / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D010875:Pipecolic Acids; D011994:Recombinant Proteins; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban; C074619:bivalirudin; C083544:lepirudin