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lüll Percutaneous coronary intervention in patients with acute coronary syndrome: focus on bivalirudin Ramana RK; Lewis BEVasc Health Risk Manag 2008[]; 4 (3): 493-505Previously, indirect thrombin inhibitors such as unfractionated heparin or low-molecular-weight heparin were used as a standard anticoagulation during percutaneous coronary intervention to prevent procedural thrombotic complications but at a risk of hemorrhagic complications. More recently, bivalirudin, a member of the direct thrombin inhibitor class, has been shown to have 1) predictable pharmacokinetics, 2) ability to inhibit free- and clot-bound thrombin, 3) no properties of platelet activation, 4) avoidance of heparin-induced thrombocytopenia, and 5) a significant reduction of bleeding without a reduction in thrombotic or ischemic endpoints compared to heparin and glycoprotein IIbIIIa inhibitors when used in patients presenting with acute coronary syndrome who are planned for an invasive treatment strategy.|*Angioplasty, Balloon, Coronary[MESH]|Acute Coronary Syndrome/epidemiology/physiopathology/*therapy[MESH]|Anemia/epidemiology[MESH]|Angina, Unstable/drug therapy/physiopathology[MESH]|Anticoagulants/adverse effects/pharmacology/therapeutic use[MESH]|Antithrombins/*pharmacology/*therapeutic use[MESH]|Blood Coagulation/physiology[MESH]|Comorbidity[MESH]|Coronary Thrombosis/prevention & control[MESH]|Heparin/adverse effects[MESH]|Hirudins/adverse effects/*pharmacology[MESH]|Humans[MESH]|Myocardial Infarction/prevention & control[MESH]|Peptide Fragments/adverse effects/*pharmacology/*therapeutic use[MESH]|Recombinant Proteins/adverse effects/pharmacology/therapeutic use[MESH]|Thrombocytopenia/chemically induced[MESH] |