title: Advantages of direct thrombin inhibition in high- and low-risk patients.
abstract: For an anticoagulant to replace heparin (and possibly glycoprotein IIb/IIIa inhibitors) for the interventional cardiologist, it must be proven to be useful in preventing ischemic complications and minimize bleeding risk in low- and high-risk patients in the settings of percutaneous coronary interventions (PCI), acute coronary syndromes (ACS) and acute myocardial infarction (AMI). The optimal agent will also streamline care and be cost effective. Bivalirudin has desirable pharmacokinetic properties and has been shown to improve outcomes as an alternative to heparin and glycoprotein IIb/IIIa inhibitors in both high- and low-risk patients undergoing urgent and elective PCI. Ongoing studies are investigating the utility of this agent in patients with ACS and AMI.
authors.affiliation: Center for Interventional Vascular Therapy at Columbia University Medical Center, New York, New York, USA.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000991:Antithrombins / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D017046:Cost Savings; D006629:Hirudins / Q000191:economics / Q000494:pharmacology; D006801:Humans; D015999:Multivariate Analysis; D010446:Peptide Fragments / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D062645:Percutaneous Coronary Intervention; D011994:Recombinant Proteins / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin