Argatroban: a synthetic thrombin inhibitor of low relative molecular mass

This narrative review summarizes argatroban, a small-molecule arginine-derivative direct thrombin inhibitor, noting it was experimentally more effective than heparin but that whether this held in humans was not yet established and that trials to date had been too small to define efficacy or safety, with large-scale studies then underway in unstable angina, angioplasty, and acute myocardial infarction. Its relevance to hirudotherapy is contextual rather than direct: argatroban is a synthetic thrombin inhibitor, not a leech-derived molecule, but it belongs to the same direct-thrombin-inhibitor class that hirudin (the medicinal-leech secretome's flagship anticoagulant) helped define, so it helps map where leech-inspired and synthetic antithrombotics sit relative to one another. Honest caveat: this is a 1996 narrative review, not original or systematic evidence, and it explicitly describes the human efficacy and safety data as still undetermined at the time of writing, so it should be read as historical orientation about the drug class, with no leech-secretome content of its own.