Comparison of the effects on coagulation function and safety of bivalirudin and heparin
Comparative study published in Medicine (2024)
Abstract
BACKGROUND: To analyze the effects on coagulation function and safety of bivalirudin and heparin in patients undergoing percutaneous coronary intervention (PCI) and provide clinical evidence for their application. METHODS: A total of 42 patients with coronary heart disease undergoing PCI treatment from July 2019 to January 2022 at Datong Third People's Hospital in China were divided into 2 groups: the bivalirudin group and the heparin group. The former received perioperative administration of bivalirudin, while the latter received heparin. After 24 hours of treatment, blood indicators, coagulation functions, as well as cardiac, hepatic, and renal markers were evaluated. Additionally, Thrombolysis In Myocardial Infarction (TIMI) flow graded infarct-related vessel blood flow was assessed in both groups. Adverse cardiovascular and cerebrovascular events were monitored for a duration of 12 months. RESULTS: The Activated clotting time (ACT), D-dimer (D-D), and prothrombin time (PT) levels in the bivalirudin group were significantly lower than those in the heparin group (P < .05). Both the bivalirudin and heparin groups showed significant improvement in TIMI flow grade after PCI (P < .05). The levels of Creatine Kinase-MB (CK-MB), N-terminal Pro-B-type Natriuretic Peptide (NT-proBNP) in the bivalirudin group were significantly lower than those in the heparin group (P < .05). There were no serious adverse cardiovascular and cerebrovascular events in either group. CONCLUSION: Bivalirudin has a slightly superior impact on coagulation function and safety profile in patients undergoing PCI compared to heparin, and the preventive effect of both on postoperative cardiovascular events is similar.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Comparative analysis of coagulation function and safety endpoints between bivalirudin and heparin.
Why This Matters for Hirudotherapy
This study compared bivalirudin versus heparin for perioperative anticoagulation during percutaneous coronary intervention (PCI) in 42 patients with coronary heart disease, evaluating coagulation markers, cardiac biomarkers, TIMI flow grade, and adverse cardiovascular/cerebrovascular events over 12 months. Bivalirudin is a direct thrombin inhibitor structurally derived from hirudin, the anticoagulant in medicinal leech saliva, so clinical studies of its performance are directly relevant to understanding how leech-secretome-inspired anticoagulants function in practice. The bivalirudin group showed significantly lower activated clotting time, D-dimer, prothrombin time, CK-MB, and NT-proBNP levels compared to heparin, with both groups showing improved TIMI flow and no serious adverse events. However, this is a single-center study with a small sample of 42 patients and no long-term follow-up beyond 12 months, so its findings are exploratory rather than definitive evidence of superiority.
Citation
Comparison of the effects on coagulation function and safety of bivalirudin and heparin.
Wang et al. · Medicine, 2024
Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026