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.
Resumen
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).
Por qué esto importa para la hirudoterapia
Este artículo revisa el papel de la bivalirudina, un inhibidor bivalente directo de la trombina, en pacientes con síndrome coronario agudo sometidos a intervención coronaria percutánea, analizando su perfil de seguridad en relación con la heparina no fraccionada, el problema de la trombosis aguda del stent y cómo los regímenes de infusión pueden mitigar dicho riesgo. Sugiere que la bivalirudina podría resurgir como un anticoagulante relevante en el manejo del SCA. El resumen no contiene ninguna mención a sanguijuelas, hirudoterapia, la hirudina como sustancia derivada de la sanguijuela ni el secretoma de la sanguijuela. El único vínculo potencial con el ámbito de ASH es el término compartido de indexación MeSH 'Hirudins'; el artículo en sí mismo no aporta relevancia sustantiva a la hirudoterapia o al secretoma de la sanguijuela.
Citación
Bivalirudin in acute coronary syndromes
Galli M et al. · Expert review of cardiovascular therapy, 2023
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026