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Updated: Feb 19, 2026

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Published on: October 12, 2012
Safety, efficiency and cost effectiveness of Bivalirudin: A systematic review
Melorin Mehrzad1, Rasikh Tuktamyshov1, Raman Mehrzad2
1Department of Internal Medicine, Yale New Haven Hospital, Yale School of medicine, New Haven, CT 06510, United States.
Aim:
To review the early and more recent studies of Bivalirudin, to assess the safety, effectiveness, and cost benefits of this drug.
Methods:
Literature search of MEDLINE and PubMed databases from 1990 to 2017 using keywords as "bivalirubin" and "angiomax", combined with the words "safety", "effectiveness", "efficiency", "side effects", "toxicity", "adverse effect", and "adverse drug reaction".
Results:
A total of 66 publications were reviewed. The changes in clinical practice and differences in clinical protocols make it difficult to do direct comparisons of studies among each other. However, most trials showed decreased bleeding complications with bivalirudin, although ischemic complications and mortality were mostly comparable, with some favor towards bivalirudin.
Conclusion:
Bivalirudin and heparin are both acceptable options according to current ACA/AHA guidelines. Authors conclude however, that that due to bivalirudin safer bleeding profile, it should be the preferred medication for anticoagulation.
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