Bivalirudin in acute coronary syndromes
Research article published in Expert review of cardiovascular therapy (2023)
Abstract
INTRODUCTION: Bivalirudin, a bivalent direct thrombin inhibitor, has been developed to reduce bleeding without any trade-off in thrombotic events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). AREAS COVERED: Despite showing a superior safety profile compared with unfractionated heparin (UFH), bivalirudin is not considered the anticoagulant of choice in ACS patients undergoing PCI, mainly because of an increased rate of acute stent thrombosis (ST) shown by several randomized controlled trials (RCTs), in addition to limited availability in certain countries and increased costs. However, RCTs on bivalirudin have been characterized by several confounding factors hindering the interpretation of its safety and efficacy compared with UFH among the spectrum of ACS patients. Furthermore, a significant body of evidence has demonstrated that the risk of acute ST can be mitigated by a full-dose infusion regimen following PCI, without compromising the favorable safety profile compared to UFH. EXPERT OPINION: In light of the increased understanding of the prognostic relevance of bleeding events and the excellent safety profile of bivalirudin, recent trial evidence may allow for this anticoagulant agent to reemerge and have a more prominent role in the management of ACS patients undergoing PCI.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Bivalirudin, a bivalent direct thrombin inhibitor, has been developed to reduce bleeding without any trade-off in thrombotic events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).
Why This Matters for Hirudotherapy
This article reviews the role of bivalirudin, a bivalent direct thrombin inhibitor, in acute coronary syndrome patients undergoing percutaneous coronary intervention, discussing its safety profile relative to unfractionated heparin, the issue of acute stent thrombosis, and how infusion regimens may mitigate that risk. It suggests bivalirudin may reemerge as a relevant anticoagulant in ACS management. The abstract contains no mention of leeches, hirudotherapy, hirudin as a leech-derived substance, or the leech secretome. The only potential link to ASH's domain is the shared MeSH indexing term 'Hirudins'; the article itself provides no substantive relevance to hirudotherapy or the leech secretome.
Citation
Bivalirudin in acute coronary syndromes
Galli M et al. · Expert review of cardiovascular therapy, 2023
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