Heparin and bivalirudin in percutaneous coronary intervention for acute coronary syndrome
Review published in Cardiovasc Ther (2024)
Abstract
Acute coronary syndrome (ACS) is one of the most common leading global causes of mortality, encompassing ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Percutaneous coronary intervention (PCI) has become a pivotal therapeutic approach for ACS, underscoring the importance of anticoagulation strategies. Among the commonly employed anticoagulants in PCI, heparin and bivalirudin take precedence, with heparin serving as the archetypal choice. Nevertheless, the determination of an optimal anticoagulation regimen remains a point of contention in contemporary clinical practice. To address the differences in anticoagulants during PCI, we meticulously conducted a literature review through PubMed and Web of Science, employing search terms such as "heparin," "bivalirudin," "percutaneous coronary intervention," and "acute coronary syndrome." For patients with PIC brought on by STEMI, NSTEMI, and stable or UA pectoris, the review focused on randomized controlled trials to assess and compare the efficacy and safety of heparin and bivalirudin as anticoagulant options. This systematic review is aimed at furnishing valuable insights into the ongoing debate surrounding the choice of anticoagulation regimens in PCI. By scrutinizing clinical evidence derived from relevant trials, we seek to inform and guide healthcare practitioners in making informed decisions based on the unique requirements of patients with various ACS presentations.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Review of heparin and bivalirudin use in PCI for acute coronary syndromes.
Why This Matters for Hirudotherapy
This literature review compared the efficacy and safety of heparin and bivalirudin as anticoagulant options during percutaneous coronary intervention (PCI) for patients with acute coronary syndrome, including STEMI, NSTEMI, and unstable angina, drawing on randomized controlled trials identified via PubMed and Web of Science. The work is directly relevant to hirudotherapy and ASH because bivalirudin is a direct thrombin inhibitor modeled on hirudin, the potent anticoagulant found in medicinal leech saliva; thus, comparative clinical data on this leech-secretome-inspired agent inform how a leech-derived anticoagulant performs in high-stakes interventional cardiology. An honest caveat is that this abstract reports only the review's scope and rationale rather than specific numerical outcomes or definitive conclusions, so actual efficacy and safety comparisons must be drawn from the full article and its underlying trials.
Citation
Heparin and bivalirudin in percutaneous coronary intervention for acute coronary syndrome.
Wang et al. · Cardiovascular therapeutics, 2024
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