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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...
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...
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...
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

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

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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

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Related Experiment Video

Updated: Jul 5, 2026

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
16:19

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Published on: September 13, 2014

Bivalirudin.

Theodore E Warkentin1, Andreas Greinacher, Andreas Koster

  • 1Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster Unniversity, Hamilton, Ontario, L8L 2X2 Canada. twarken@mcmaster.ca

Thrombosis and Haemostasis
|May 2, 2008
PubMed
Summary
This summary is machine-generated.

Bivalirudin, a direct thrombin inhibitor, is a key anticoagulant for percutaneous coronary intervention (PCI). Its unique properties and short half-life offer advantages in managing anticoagulation, particularly in patients with heparin-induced thrombocytopenia (HIT).

Related Experiment Videos

Last Updated: Jul 5, 2026

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
16:19

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Published on: September 13, 2014

Area of Science:

  • Cardiology
  • Pharmacology
  • Hematology

Background:

  • Bivalirudin is a direct thrombin inhibitor (DTI) widely used in invasive cardiology, especially for percutaneous coronary intervention (PCI).
  • It possesses a unique pharmacokinetic profile, characterized by non-organ elimination (proteolysis) and a short half-life of approximately 25 minutes.
  • Its intermediate affinity for thrombin influences clotting assays, impacting interpretations of anticoagulation status.

Purpose of the Study:

  • To review key clinical trials evaluating bivalirudin for acute coronary syndrome (ACS) treated with PCI.
  • To examine studies on bivalirudin's use as an anticoagulant in cardiac surgery (on- and off-pump).
  • To highlight bivalirudin's role in patients with or at risk of heparin-induced thrombocytopenia (HIT) and HIT with thrombosis syndrome (HITTS).

Main Methods:

  • Review of pivotal clinical trials assessing bivalirudin efficacy and safety in ACS and PCI.
  • Analysis of studies investigating bivalirudin in various cardiac surgical procedures.
  • Evaluation of bivalirudin's performance in specific patient populations, including those with HIT/HITTS.

Main Results:

  • Bivalirudin is effective for anticoagulation during PCI, with a development program focusing on a quadruple endpoint (efficacy plus major bleeding).
  • Its intermediate thrombin affinity leads to a distinct pattern of interference with clotting assays like PT (INR) and APTT.
  • Studies support its use in PCI, including cases requiring provisional glycoprotein IIb/IIIa inhibitor therapy, and in HIT/HITTS patients.

Conclusions:

  • Bivalirudin offers a valuable anticoagulation option in interventional cardiology and cardiac surgery.
  • Its pharmacokinetic and pharmacodynamic properties make it suitable for specific patient groups, including those with HIT.
  • The focus on bleeding reduction in bivalirudin trials aligns with modern strategies for improving clinical outcomes.