American Society of Hirudotherapy

Antithrombotic drugs in cardiovascular medicine: a year in review

Review published in Current opinion in cardiology (2018)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsIbrahim H et al. · Current opinion in cardiology, 2018

Abstract

PURPOSE OF REVIEW: To provide an up to date review of the most recent randomized clinical trials in the field of antithrombotic drugs for cardiovascular diseases. RECENT FINDINGS: In 2017, low-dose anti-Xa treatment added to aspirin proved to be more efficacious than either treatment alone in patients with stable atherosclerotic disease despite the increase in nonfatal bleeding events. Furthermore, anticoagulation strategy during coronary interventions was again tested in a registry-based trial and showed comparable efficacy and safety between heparin alone and bivalirudin. Data from safety trials demonstrated lower risk of bleeding with dual antithrombotic therapy compared with triple antithrombotic therapy following coronary intervention, albeit these trials were underpowered for efficacy. Although still in its infancy, the role of antithrombotic treatment following transcatheter aortic valve replacement (TAVR) has been investigated in small trials with evidence that a single antiplatelet drug may be noninferior to dual antiplatelet therapy with a better safety profile. SUMMARY: In this review, we discuss the most recent clinical trials investigating antithrombotic drugs for cardiovascular diseases published in 2017.

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

Publication typeJournal ArticleReview
Indexed MeSH termsAspirinCardiovascular DiseasesDrug Therapy, CombinationFactor Xa InhibitorsFibrinolytic AgentsHumansPercutaneous Coronary InterventionRandomized Controlled Trials as TopicTranscatheter Aortic Valve Replacement

Summary

To provide an up to date review of the most recent randomized clinical trials in the field of antithrombotic drugs for cardiovascular diseases.

Why This Matters for Hirudotherapy

This review synthesized major 2017 randomized clinical trials of antithrombotic drugs in cardiovascular disease, including a registry-based trial reporting comparable efficacy and safety between heparin alone and bivalirudin during coronary interventions. For ASH and hirudotherapy, this is relevant because bivalirudin is a direct thrombin inhibitor structurally modeled on hirudin, the potent anticoagulant from medicinal leech saliva; thus clinical cardiovascular outcome data for bivalirudin inform how a leech-secretome-derived anticoagulant strategy performs relative to conventional heparin in practice. The review also covers low-dose anti-Xa plus aspirin in stable atherosclerotic disease, dual versus triple antithrombotic therapy post-intervention, and antiplatelet strategies after TAVR. An honest caveat: this is a broad narrative review of multiple drug classes, only one of which has leech-secretome origin, and the bivalirudin finding demonstrated comparable—not superior—performance, so it does not establish an advantage for hirudin-based agents.

Citation

Antithrombotic drugs in cardiovascular medicine: a year in review

Ibrahim H et al. · Current opinion in cardiology, 2018

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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