Bivalirudin, a bivalent, thrombin specific anticoagulant as an alternative to heparin in interventional procedures

Summary

Among the antithrombotic therapies evaluated to date, the synthetic peptide bivalirudin is unique in its ability to reduce both ischemic and bleeding complications associated with percutaneous coronary intervention (PCI). Bivalirudin is a small peptide consisting of 20 amino acid residues that binds thrombin in a direct, reversible, and bivalent fashion. The agent is approved for use in the United States and New Zealand as an anticoagulant in patients with unstable angina undergoing PCI and may also prove beneficial in patients with acute coronary syndromes (ACS), acute myocardial infarction (AMI) and in patients undergoing coronary artery bypass graft (CABG) procedures. This article examines bivalirudin in more detail.

Zusammenfassung

Unter den bisher untersuchten antithrombotischen Therapien ist das synthetische Peptid Bivalirudin außergewöhnlich, hinsichtlich der Fähigkeit, ischämische Komplikationen und Blutungskomplikationen im Zusammenhang mit einer perkutanen Koronarintervention (PCI) zu reduzieren. Bivalirudin ist ein kleines, aus 20 Aminosäureresten bestehendes Peptid, das Thrombin direkt, reversibel und bivalent bindet. Das Medikament ist in den USA und Neuseeland als Antikoagulans bei Patienten mit instabiler Angina pectoris zugelassen, bei denen eine PCI durchgeführt wird, und kann sich auch bei Patienten mit akutem Koronarsyndrom (ACS), akutem Myokardinfarkt (AMI) sowie bei Patienten, bei denen ein aortokoronarer Venenbypass (ACVB) durchgeführt wird, als günstig erweisen. In dem vorliegenden Artikel wird Bivalirudin ausführlich beschrieben.

Keywords

Bivalirudin - anticoagulant - percutaneous coronary intervention - thrombin inhibitor - unstable angina

Schlüsselwörter

Bivalirudin - Antikoagulans - perkutane Koronarintervention - Thrombininhibitor - instabile Angina pectoris

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