American Society of Hirudotherapy

The Use of Bivalirudin in ST-Segment Elevation Myocardial Infarction: Advantages and Limitations

Review published in Interv Cardiol Clin (2012)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentClinical TrialsSergie Z et al. · Interv Cardiol Clin, 2012

Abstract

The incidence of ST-segment elevation myocardial infarction (STEMI) is a common, albeit declining, manifestation of coronary heart disease. Significant improvements in cardiovascular outcomes and mortality in STEMI patients have occurred in recent years, reflecting evolution in the understanding of the pathophysiological mechanisms and therapeutic targets of this disease. Nonetheless, the risks of recurrent ischemia and bleeding complications in this population remain substantial. This review focuses on the adjunctive anticoagulant agents used in the management of STEMI. Major insights from the HORIZONS-AMI trial regarding the impact of bivalirudin on both hemorrhagic and ischemic outcomes in STEMI patients are discussed.

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

Publication typeJournal ArticleReview

Summary

The incidence of ST-segment elevation myocardial infarction (STEMI) is a common, albeit declining, manifestation of coronary heart disease.

Why This Matters for Hirudotherapy

This review article discusses the advantages and limitations of bivalirudin as an adjunctive anticoagulant in STEMI management, focusing on insights from the HORIZONS-AMI trial regarding hemorrhagic and ischemic outcomes. It contextualizes bivalirudin within the broader evolution of anticoagulant therapy for acute coronary syndromes. For ASH's domain, this is relevant because bivalirudin is a synthetic derivative of hirudin, the archetypal anticoagulant from medicinal leech saliva, and its cardiovascular use represents one of the most significant clinical translations of a leech-secretome compound. However, the article is a narrative review of a pharmaceutical agent in interventional cardiology with no direct involvement of leeches, leech therapy, or crude leech extracts. Its relevance to hirudotherapy is strictly pharmacological and historical.

Citation

The Use of Bivalirudin in ST-Segment Elevation Myocardial Infarction: Advantages and Limitations.

Sergie Z et al. · Interv Cardiol Clin, 2012

DOI

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

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