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Direct thrombin inhibitors for non-ST-segment elevation acute coronary syndromes: what, when, and where?

A Michael Lincoff1

  • 1Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.

American Heart Journal
|October 18, 2003
PubMed

Insights

Direct thrombin inhibitors show promise for treating acute coronary syndromes. Clinical trials suggest these agents may offer advantages over unfractionated heparin in specific patient populations.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis Research

Background:

  • Unfractionated heparin is the standard antithrombin therapy for non-ST-segment elevation acute coronary syndromes.
  • New anticoagulants are being investigated for unstable coronary syndromes and percutaneous coronary intervention.
  • Direct thrombin inhibitors present potential advantages over unfractionated heparin.

Purpose of the Study:

  • To review clinical trials of direct thrombin inhibitors.
  • To evaluate their use in non-ST-segment elevation acute coronary syndromes and coronary angioplasty.

Main Methods:

  • Review of clinical trials involving direct thrombin inhibitors.
  • Focus on hirudin and bivalirudin.
  • Comparison with unfractionated heparin.

Main Results:

  • Bivalirudin demonstrated a promising efficacy and safety profile in percutaneous coronary revascularization compared to unfractionated heparin.
  • Hirudin has been studied in various acute coronary syndromes and angioplasty settings.

Conclusions:

  • Direct thrombin inhibitors are a developing class of anticoagulants.
  • Further research supports their potential role in managing acute coronary syndromes and during percutaneous coronary intervention.
Abstract

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