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Risk‐guided use of the direct thrombin inhibitor bivalirudin
Author(s) -
Hillegass William B.
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26441
Subject(s) - bivalirudin , medicine , conventional pci , percutaneous coronary intervention , heparin , direct thrombin inhibitor , cardiology , myocardial infarction , warfarin , atrial fibrillation , dabigatran
Key Points Mortality and bleeding risks after percutaneous coronary intervention (PCI) can be predicted with bedside models. Bivalirudin reduces access and non‐access bleeding by almost half compared to heparin monotherapy and heparin with IIb/IIIa use. In high (>10%) baseline one‐year mortality risk PCI patients, bivalirudin reduces mortality by 4% compared to heparin with IIb/IIIa therapy. Increased acute stent thrombosis may be resolved with a 4‐hr post‐procedure bivalirudin infusion, eliminating bivalirudin's only major drawback except cost.