AI Article Synopsis
- The limitations of unfractionated heparin (UFH) in treating coronary artery disease (CAD) have led to the consideration of bivalirudin, a direct thrombin inhibitor endorsed for its advantages, especially during percutaneous coronary interventions (PCI).
- Bivalirudin's safety and efficacy in CAD patients are supported by extensive evidence from clinical trials and reviews, emphasizing its important pharmacological properties.
- It is particularly recommended for patients with heparin-induced thrombocytopenia and those experiencing ST elevation myocardial infarction undergoing PCI, advocating for its use alongside early antiplatelet therapy.
Article Abstract
Introduction: Various limitations of unfractionated heparin (UFH) have triggered a search for new antithrombotic therapies for patients with coronary artery disease (CAD). Bivalirudin is a direct thrombin inhibitor with several pharmacological advantages over UFH and is currently endorsed by practice guidelines, particularly in patients with acute coronary syndromes undergoing percutaneous coronary intervention (PCI). To maximize effectiveness of an antithrombotic regimen and reduce complications, both ischemic and bleeding risks should be known when an antithrombotic strategy is chosen.
Areas Covered: This review focuses on the safety and tolerability of bivalirudin in patients with CAD in the setting of currently approved indications. Synthesis of evidence has been made from clinical trials, systematic reviews, meta-analyses and registries (1992 - 2011). The reader is provided with an overview of pharmacological properties of bivalirudin and its efficacy, with special emphasis on its safety in patients with CAD.
Expert Opinion: Bivalirudin has an impressive safety profile in CAD patients treated with PCI. Bivalirudin is the antithrombotic of choice in suspected or verified heparin-induced thrombocytopenia. For ST elevation myocardial infarction patients undergoing primary PCI, bivalirudin should become the preferred antithrombotic agent together with early institution of antiplatelet therapy.
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| http://dx.doi.org/10.1517/14740338.2012.628312 | DOI Listing |
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