American Society of Hirudotherapy

Bivalirudin for primary percutaneous coronary intervention in acute myocardial infarction: the HORIZONS-AMI trial

Review published in Expert Rev Cardiovasc Ther (2012)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentClinical TrialsCapranzano P et al. · Expert Rev Cardiovasc Ther, 2012

Abstract

The combination of unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPIs) has been a frequently used anti-thrombotic treatment strategy for acute coronary syndrome patients, including those with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. However, the ischemic benefit of the UFH plus GPI combination came at the expense of high rates of bleeding complications and thrombocytopenia, both of which have been independently associated with increased mortality. By contrast, bivalirudin monotherapy compared with the combination of UFH plus GPI resulted in improved net clinical outcomes, based on similar ischemic protection with significant reductions in bleeding complications in randomized trials including patients with stable angina, those with unstable angina and those with non-ST-segment elevation myocardial infarction. More recently, the HORIZONS-AMI randomized, open-label, multicenter trial has compared the efficacy and safety of bivalirudin alone versus UFH plus a GPI in 3602 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Clinical results derived from this large study, including the final 3-year follow-up data, will be reviewed in the present clinical trial report.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAngioplasty, Balloon, CoronaryAntithrombinsCombined Modality TherapyDrug Therapy, CombinationHeparinHirudinsHumansMyocardial InfarctionPeptide FragmentsPlatelet Glycoprotein GPIIb-IIIa ComplexRandomized Controlled Trials as TopicRecombinant Proteins

Summary

The combination of unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPIs) has been a frequently used anti-thrombotic treatment strategy for acute coronary syndrome patients, including those with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Why This Matters for Hirudotherapy

This review article describes the HORIZONS-AMI randomized, open-label, multicenter trial comparing bivalirudin monotherapy versus unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor in 3,602 STEMI patients undergoing primary PCI, stating that final 3-year follow-up results will be reviewed. The abstract notes that bivalirudin monotherapy showed improved net clinical outcomes with significant bleeding reductions compared with heparin plus GPI in prior randomized trials of stable and acute coronary syndrome patients. The abstract does not mention leeches, hirudin, hirudotherapy, or any leech-derived connection, so the article's relevance to ASH's domain is not established.

Citation

Bivalirudin for primary percutaneous coronary intervention in acute myocardial infarction: the HORIZONS-AMI trial.

Capranzano P et al. · Expert Rev Cardiovasc Ther, 2012

DOI

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