Hollywood Hospital, Cardiology, Nedlands, WA 6009, Australia.
Heart Lung Circ. 2013 Oct;22(10):793-800. doi: 10.1016/j.hlc.2013.05.636. Epub 2013 Jul 31.
Major bleeding remains a major risk factor for percutaneous coronary intervention of acute coronary syndromes and is associated with higher morbidity, mortality, prolonged hospital stay and costs. With the recognition that bleeding is an important factor in patient outcomes, the prevention of bleeding has become as important a goal as the prevention of ischaemia. The direct thrombin inhibitor bivalirudin has been shown to reduce ischaemia and importantly, is associated with less bleeding. In this article we review the evidence base that supports the use of bivalirudin across all spectrums of coronary syndromes and percutaneous coronary intervention. An algorithm for the use of bivalirudin in high risk subgroups and coronary syndromes is suggested.
主要出血仍然是急性冠状动脉综合征经皮冠状动脉介入治疗的一个主要危险因素，与更高的发病率、死亡率、住院时间延长和费用增加相关。随着人们认识到出血是患者预后的一个重要因素，预防出血已经变得与预防缺血同样重要。直接凝血酶抑制剂比伐卢定已被证明可减少缺血，重要的是，与出血减少相关。在本文中，我们回顾了支持比伐卢定在所有冠状动脉综合征和经皮冠状动脉介入治疗范围内使用的证据基础。建议了一种用于高危亚组和冠状动脉综合征的比伐卢定使用算法。
