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Updated: Mar 1, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

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Controversies in the Management of ST Elevation Myocardial Infarction: Thrombin Inhibition

Neeraj Shah1, David Cox1

  • 1Department of Cardiology, Lehigh Valley Heath Network, 1250 S Cedar Crest Boulevard, Allentown, PA 18103, USA.

Interventional Cardiology Clinics
|June 6, 2017
PubMed

Anticoagulation is essential in patients with ST elevation myocardial infarction (STEMI) to prevent further thrombosis and to maintain patency of the infarct-related artery after reperfusion. The various anticoagulant medications available for use in patients with STEMI include unfractionated heparin (UFH), low-molecular-weight heparin, fondaparinux, and bivalirudin, a direct thrombin inhibitor. The authors review the current anticoagulation strategies for patients with STEMI undergoing primary percutaneous coronary intervention (PCI), fibrinolysis, or no reperfusion. The authors present the latest evidence and controversies on this topic, with a focus on bivalirudin versus UFH in the setting of primary PCI for STEMI.

Keywords:
BivalirudinDirect thrombin inhibitorsFibrinolysisPrimary percutaneous coronary intervention (primary PCI)ST elevation myocardial infarction (STEMI)Unfractionated heparin (UFH)

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