[Bivalirudin: a direct thrombin inhibitor in percutaneous coronary interventions].

Bivalirudin is a direct thrombin inhibitor that has biological and pharmacokinetic advantages over heparin, e.g., by inhibiting both fibrin-bound and -unbound thrombin. In patients undergoing subacute or elective percutaneous coronary intervention, bivalirudin + provisional glycoprotein IIb/IIIa inhibition is as effective as unfractionated heparin + glycoprotein IIb/IIIa inhibition and is associated with a reduced risk of bleeding. The results of ongoing trials will further define the promising role of bivalirudin in the treatment of patients with acute coronary syndromes.