Bivalirudin in percutaneous coronary intervention
Review published in Vascular health and risk management (2006)
Abstract
Bivalirudin is a member of the direct thrombin inhibitor group of anticoagulants. It has been evaluated as an alternative to unfractionated and low-molecular-weight heparins in the settings of percutaneous coronary intervention (PCI) and acute coronary syndrome (ACS). Results of clinical trials to date suggest bivalirudin is a viable alternative to the use of a heparin combined with a glycoprotein (GP) IIb/IIIa inhibitor in these settings. Thrombin has a central role in coagulation and platelet activation in ACS and during PCI. Its direct inhibition is an attractive target for therapy in these settings. Bivalirudin is a 20 amino acid polypeptide hirudin analog. It displays bivalent and reversible binding to the thrombin molecule, inhibiting its action. Direct inhibition of thrombin with bivalirudin has theoretical pharmacokinetic and pharmacodynamic advantages over the indirect anticoagulants. A reduction in rates of bleeding without loss of anti-thrombotic efficacy has been a consistent finding across multiple clinical trials. There may be economic benefits to the use ofbivalirudin if it permits a lower rate of use of the GP IIb/IIIa inhibitors. This article reviews the pharmacology of bivalirudin and clinical trial evidence to date. There are now data from multiple clinical trials and meta-analyses in the setting of ACS and PCI. Early results from the acute catheterization and urgent intervention strategy (ACUITY) trial are discussed.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Bivalirudin is a member of the direct thrombin inhibitor group of anticoagulants.
Por qué esto importa para la hirudoterapia
Esta revisión examina la farmacología y la evidencia de ensayos clínicos de la bivalirudina, que el resumen identifica explícitamente como un polipéptido análogo de la hirudina de 20 aminoácidos que presenta unión bivalente y reversible a la trombina. Evalúa la bivalirudina como alternativa a la heparina con inhibidores de la glucoproteína IIb/IIIa en la intervención coronaria percutánea y el síndrome coronario agudo, con ensayos clínicos que muestran una reducción del sangrado sin pérdida de eficacia antitrombótica. Dado que el resumen nombra directamente a la bivalirudina como un análogo de la hirudina, el artículo posee una relevancia defendible, aunque indirecta, para el ámbito de la ASH, al documentar la traslación farmacológica de un compuesto relacionado con la hirudina. Sin embargo, el resumen no menciona sanguijuelas, saliva de sanguijuela, descubrimiento de sanguijuelas ni la hirudoterapia en sí, por lo que la conexión se limita estrictamente a la relación señalada de 'análogo de la hirudina' y no a la terapia con sanguijuelas vivas ni al conjunto más amplio del secretoma de la sanguijuela.
Citación
Bivalirudin in percutaneous coronary intervention
Lehman SJ et al. · Vascular health and risk management, 2006
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026