PMID- 37919937
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 1744-8344 (Electronic)
IS  - 1477-9072 (Linking)
VI  - 21
IP  - 12
DP  - 2023 Jul-Dec
TI  - Bivalirudin in acute coronary syndromes.
PG  - 901-911
LID - 10.1080/14779072.2023.2273902 [doi]
AB  - INTRODUCTION: Bivalirudin, a bivalent direct thrombin inhibitor, has been 
      developed to reduce bleeding without any trade-off in thrombotic events in acute 
      coronary syndrome (ACS) patients undergoing percutaneous coronary intervention 
      (PCI). AREAS COVERED: Despite showing a superior safety profile compared with 
      unfractionated heparin (UFH), bivalirudin is not considered the anticoagulant of 
      choice in ACS patients undergoing PCI, mainly because of an increased rate of 
      acute stent thrombosis (ST) shown by several randomized controlled trials (RCTs), 
      in addition to limited availability in certain countries and increased costs. 
      However, RCTs on bivalirudin have been characterized by several confounding 
      factors hindering the interpretation of its safety and efficacy compared with UFH 
      among the spectrum of ACS patients. Furthermore, a significant body of evidence 
      has demonstrated that the risk of acute ST can be mitigated by a full-dose 
      infusion regimen following PCI, without compromising the favorable safety profile 
      compared to UFH. EXPERT OPINION: In light of the increased understanding of the 
      prognostic relevance of bleeding events and the excellent safety profile of 
      bivalirudin, recent trial evidence may allow for this anticoagulant agent to 
      reemerge and have a more prominent role in the management of ACS patients 
      undergoing PCI.
FAU - Galli, Mattia
AU  - Galli M
AD  - Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
FAU - Bernardi, Marco
AU  - Bernardi M
AD  - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University 
      of Rome, Latina, Italy.
FAU - Ortega-Paz, Luis
AU  - Ortega-Paz L
AD  - Division of Cardiology, University of Florida College of Medicine, Jacksonville, 
      FL, USA.
FAU - Nerla, Roberto
AU  - Nerla R
AD  - Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
FAU - D'Amario, Domenico
AU  - D'Amario D
AD  - Dipartimento Universitario di Medicina Traslazionale, Universita Piemonte 
      Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carita di Novara, 
      Novara, Italy.
FAU - Franchi, Francesco
AU  - Franchi F
AD  - Division of Cardiology, University of Florida College of Medicine, Jacksonville, 
      FL, USA.
FAU - Biondi-Zoccai, Giuseppe
AU  - Biondi-Zoccai G
AD  - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University 
      of Rome, Latina, Italy.
AD  - Mediterranea Cardiocentro, Napoli, Italy.
FAU - Angiolillo, Dominick J
AU  - Angiolillo DJ
AUID- ORCID: 0000-0001-8451-2131
AD  - Division of Cardiology, University of Florida College of Medicine, Jacksonville, 
      FL, USA.
LA  - eng
PT  - Journal Article
DEP - 20231213
PL  - England
TA  - Expert Rev Cardiovasc Ther
JT  - Expert review of cardiovascular therapy
JID - 101182328
RN  - TN9BEX005G (bivalirudin)
RN  - 0 (Hirudins)
RN  - 9005-49-6 (Heparin)
RN  - 0 (Antithrombins)
RN  - 0 (Anticoagulants)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
SB  - IM
MH  - Humans
MH  - *Acute Coronary Syndrome/drug therapy
MH  - Treatment Outcome
MH  - Hirudins/adverse effects
MH  - Heparin/adverse effects
MH  - Antithrombins/adverse effects
MH  - Anticoagulants/adverse effects
MH  - Peptide Fragments/adverse effects
MH  - Hemorrhage/chemically induced
MH  - *Percutaneous Coronary Intervention
MH  - Recombinant Proteins/adverse effects
OTO - NOTNLM
OT  - Bivalirudin
OT  - ST-segment myocardial infarction
OT  - acute coronary syndrome
OT  - heparin
OT  - non-ST-segment myocardial infarction
OT  - post-PCI infusion
EDAT- 2023/11/03 06:43
MHDA- 2023/12/17 09:42
CRDT- 2023/11/03 03:40
PHST- 2023/12/17 09:42 [medline]
PHST- 2023/11/03 06:43 [pubmed]
PHST- 2023/11/03 03:40 [entrez]
AID - 10.1080/14779072.2023.2273902 [doi]
PST - ppublish
SO  - Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(12):901-911. doi: 
      10.1080/14779072.2023.2273902. Epub 2023 Dec 13.