Related Experiment Video

Updated: Jul 16, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Bivalirudin in percutaneous coronary intervention

Sam J Lehman1, Derek P Chew

  • 1Department of Medicine, Flinders University, South Australia, Australia.

Vascular Health and Risk Management
|February 28, 2007
PubMed

Insights

Bivalirudin, a direct thrombin inhibitor, offers a safe and effective alternative to heparin for patients undergoing percutaneous coronary intervention (PCI) and acute coronary syndrome (ACS), reducing bleeding without compromising efficacy.

Area of Science:

  • Cardiovascular Pharmacology
  • Thrombosis and Hemostasis

Background:

  • Bivalirudin is a direct thrombin inhibitor anticoagulant.
  • It is evaluated as an alternative to heparins in percutaneous coronary intervention (PCI) and acute coronary syndrome (ACS).

Purpose of the Study:

  • Review the pharmacology of bivalirudin.
  • Examine clinical trial evidence for its use in PCI and ACS.

Main Methods:

  • Review of pharmacology of bivalirudin.
  • Analysis of clinical trial data and meta-analyses in ACS and PCI settings.
  • Discussion of early results from the ACUITY trial.

Main Results:

  • Bivalirudin is a viable alternative to heparin plus glycoprotein IIb/IIIa inhibitors in PCI and ACS.
  • Consistent reduction in bleeding rates without loss of anti-thrombotic efficacy across trials.
  • Potential economic benefits due to reduced use of glycoprotein IIb/IIIa inhibitors.

Conclusions:

  • Bivalirudin demonstrates pharmacokinetic and pharmacodynamic advantages over indirect anticoagulants.
  • Clinical trials support bivalirudin as an effective and safe anticoagulant option.
  • Further data from trials like ACUITY contribute to understanding its role in cardiovascular interventions.

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...