TY - JOUR
T1 - Bivalirudin in ST-segment-elevation myocardial infarction
T2 - For better or worse?
AU - Mavrakanas, Thomas A.
AU - Chatzizisis, Yiannis S.
N1 - Funding Information:
TA Mavrakanas has received a grant from the Swiss National Science Foundation. YS Chatzizisis has received a grant from the Behrakis Foundation, Boston, MA, USA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Publisher Copyright:
© 2015 Informa UK Ltd.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Bivalirudin and heparin are the major available parenteral anticoagulants for percutaneous coronary intervention (PCI) in ST-segment-elevation myocardial infarction. Even though hard clinical outcomes are comparable with both drugs, bivalirudin appears to be safer (less bleeding events) at the expense of lower short-term efficacy (more acute stent thrombosis events). The selection of anticoagulation during PCI in ST-segment-elevation myocardial infarction should be individualized, taking into account the patient's ischemic and bleeding risk. In patients with increased bleeding risk, bivalirudin might be preferable to heparin, whereas in complex PCI with increased risk for stent thrombosis, heparin is preferable. Further clinical studies are needed to elucidate the role of these drugs in PCI for ST-segment-elevation myocardial infarction in the era of radial approaches, new potent antiplatelet agents and the use of glycoprotein IIb/IIIa inhibitors.
AB - Bivalirudin and heparin are the major available parenteral anticoagulants for percutaneous coronary intervention (PCI) in ST-segment-elevation myocardial infarction. Even though hard clinical outcomes are comparable with both drugs, bivalirudin appears to be safer (less bleeding events) at the expense of lower short-term efficacy (more acute stent thrombosis events). The selection of anticoagulation during PCI in ST-segment-elevation myocardial infarction should be individualized, taking into account the patient's ischemic and bleeding risk. In patients with increased bleeding risk, bivalirudin might be preferable to heparin, whereas in complex PCI with increased risk for stent thrombosis, heparin is preferable. Further clinical studies are needed to elucidate the role of these drugs in PCI for ST-segment-elevation myocardial infarction in the era of radial approaches, new potent antiplatelet agents and the use of glycoprotein IIb/IIIa inhibitors.
KW - ST-segment elevation myocardial infarction
KW - bivalirudin
KW - bleeding
KW - heparin
KW - stent thrombosis
UR - http://www.scopus.com/inward/record.url?scp=84937574114&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84937574114&partnerID=8YFLogxK
U2 - 10.1586/14779072.2015.1064311
DO - 10.1586/14779072.2015.1064311
M3 - Article
C2 - 26138859
AN - SCOPUS:84937574114
SN - 1477-9072
VL - 13
SP - 893
EP - 895
JO - Expert review of cardiovascular therapy
JF - Expert review of cardiovascular therapy
IS - 8
ER -