title: Risk-guided use of the direct thrombin inhibitor bivalirudin.
abstract: Mortality and bleeding risks after percutaneous coronary intervention (PCI) can be predicted with bedside models. Bivalirudin reduces access and non-access bleeding by almost half compared to heparin monotherapy and heparin with IIb/IIIa use. In high (>10%) baseline one-year mortality risk PCI patients, bivalirudin reduces mortality by 4% compared to heparin with IIb/IIIa therapy. Increased acute stent thrombosis may be resolved with a 4-hr post-procedure bivalirudin infusion, eliminating bivalirudin's only major drawback except cost.
authors.affiliation: Heart South Cardiovascular Group, Alabaster, Alabama.|Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: William B
authors.initials: WB
authors.lastname: Hillegass
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use*; D000991:Antithrombins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006470:Hemorrhage; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D006493:Heparin