Heparin, bivalirudin, or the best of both for STEMI interventions

Research output: Contribution to journalEditorial

Abstract

Whether heparin, bivalirudin, or bivalirudin delivered on the background of prior heparin therapy, during primary PCI therapy is associated with a better outcome is difficult to ascertain from any one study. Meta-analysis of available trials suggests that the use of bivalirudin on top of prior heparin therapy may be associated with the lowest all-cause mortality and major adverse cardiovascular events while preserving much of the access site bleeding reduction of bivalirudin alone. There may be a role for initial therapy of STEMI with a broad-spectrum anticoagulant such as heparin that is then focused to a more specific direct-thrombin inhibitor (bivalirudin) in primary PCI.

Original languageEnglish (US)
Pages (from-to)248-249
Number of pages2
JournalCatheterization and Cardiovascular Interventions
Volume93
Issue number2
DOIs
StatePublished - Feb 1 2019

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Heparin
Antithrombins
Therapeutics
Anticoagulants
Meta-Analysis
ST Elevation Myocardial Infarction
bivalirudin
Hemorrhage
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Heparin, bivalirudin, or the best of both for STEMI interventions",
abstract = "Whether heparin, bivalirudin, or bivalirudin delivered on the background of prior heparin therapy, during primary PCI therapy is associated with a better outcome is difficult to ascertain from any one study. Meta-analysis of available trials suggests that the use of bivalirudin on top of prior heparin therapy may be associated with the lowest all-cause mortality and major adverse cardiovascular events while preserving much of the access site bleeding reduction of bivalirudin alone. There may be a role for initial therapy of STEMI with a broad-spectrum anticoagulant such as heparin that is then focused to a more specific direct-thrombin inhibitor (bivalirudin) in primary PCI.",
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Heparin, bivalirudin, or the best of both for STEMI interventions. / Gilchrist, Ian C.

In: Catheterization and Cardiovascular Interventions, Vol. 93, No. 2, 01.02.2019, p. 248-249.

Research output: Contribution to journalEditorial

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