Why the study?
Does bivalirudin compared to unfractionated heparin improve outcomes in patients undergoing percutaneous coronary intervention?
Does bivalirudin compared to unfractionated heparin improve outcomes in patients undergoing percutaneous coronary intervention?
This review discusses the pharmacology and clinical evidence comparing bivalirudin to unfractionated heparin in patients undergoing PCI, highlighting the trade-offs between bleeding and ischemic risks.
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Trade-offs in bleeding versus ischemic risk persist for bivalirudin in PCI; leaves open optimal agent selection without new RCTs.
For decades, unfractionated heparin (UFH) has been widely used in catheterization laboratories for anticoagulation for percutaneous coronary intervention (PCI). The direct thrombin inhibitors, bivalirudin, has emerged as an alternative to UFH for PCI procedures, due to its lower bleeding risk. More recently, randomized trials and meta-analyses questioned the efficacy of bivalirudin, and demonstrated that bivalirudin might be associated with a higher incidence of ischemic events and in particular stent thrombosis. In this review, we discuss the pharmacology of bivalirudin along with the clinical evidence comparing bivalirudin versus UFH in patients undergoing PCI for various indications.
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Ahmed et al. (2015) studied this question.
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