Current anticoagulation options in percutaneous intervention: designing patient-specific strategies

Anticoagulation during percutaneous coronary intervention is critical to prevent abrupt and subacute closure. Although heparin has been the primary anticoagulant used for this purpose, a number of new drugs are now available. Low molecular weight heparin (LMWH) offers some advantages over unfractionated heparin, and clinical trials have shown its superiority. However, the longer half-life and lack of monitoring of LMWH make its use more difficult. The direct thrombin inhibitors also have been shown to have advantages in the treatment of patients with heparin-induced thrombocytopenia.