title: Bivalirudin in stable angina and acute coronary syndromes.
abstract: A parenteral anticoagulant is indicated in patients with acute coronary syndromes. Which anticoagulant should be preferred in each setting is not clearly established. Bivalirudin administration was considered in acute coronary syndromes after several clinical trials showed decreased bleeding risk with its use compared with the association of unfractionated heparin (UFH) with glycoprotein IIb/IIIa inhibitors (GPIs). Most recent data demonstrate that the bleeding benefit identified in the previous studies was not due to bivalirudin's properties but to higher bleeding incidence in the comparator arm due to the disproportional use of GPIs with heparin. This paper reviews clinical evidence on bivalirudin as anticoagulant in stable angina and acute coronary syndromes.
authors: McGill University Health Center, Montreal, Canada; General Internal Medicine Division, Geneva University Hospitals, Geneva, Switzerland.
authors: Thomas A
authors: TA
authors: Mavrakanas
authors: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. Electronic address: ychatzizisis@partners.org.
authors: Yiannis S
authors: YS
authors: Chatzizisis
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D060050:Angina, Stable / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000818:Animals; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006629:Hirudins; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin
keywords: Acute coronary syndrome; Angina; Bivalirudin; Heparin; Non-ST-elevation myocardial infarction; ST-elevation myocardial infarction