The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

EDITORIAL

Bivalirudin in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: uncertainties almost clarified

EuroIntervention 2017;12:1930-1932. DOI: 10.4244/EIJV12I16A315

1. 3rd Department of Internal Medicine, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, and Sigmund Freud Private University, Medical School, Vienna, Austria; 2. Department of Cardiology, Heartcenter, Onze Lieve Vrouwe Gasthuis (OLVG),


Potent adjunctive parenteral anticoagulants in addition to dual antiplatelet therapy are recommended for the treatment of ST-elevation myocardial infarction (STEMI) with primary PCI (PPCI) in recent guidelines. While unfractionated heparin (UFH) is given to the majority of STEMI patients undergoing PPCI worldwide, the low molecular weight heparin enoxaparin and the direct thrombin inhibitor bivalirudin are less frequently used, which is also based on the current European Society of Cardiology (ESC) revascularisation guidelines that recommend the use of UFH with a class IC, of bivalirudin with a class IIaA, and enoxaparin with a class IIaB recommendation, respectively1. Bivalirudin was even ...

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