Heparin, bivalirudin, or the best of both for STEMI interventions

Ian C. Gilchrist

Research output: Contribution to journalEditorialpeer-review


Whether heparin, bivalirudin, or bivalirudin delivered on the background of prior heparin therapy, during primary PCI therapy is associated with a better outcome is difficult to ascertain from any one study. Meta-analysis of available trials suggests that the use of bivalirudin on top of prior heparin therapy may be associated with the lowest all-cause mortality and major adverse cardiovascular events while preserving much of the access site bleeding reduction of bivalirudin alone. There may be a role for initial therapy of STEMI with a broad-spectrum anticoagulant such as heparin that is then focused to a more specific direct-thrombin inhibitor (bivalirudin) in primary PCI.

Original languageEnglish (US)
Pages (from-to)248-249
Number of pages2
JournalCatheterization and Cardiovascular Interventions
Issue number2
StatePublished - Feb 1 2019

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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