Mahmoud Ahmed, Saad Marwan, Elgendy Akram Y, Abuzaid Ahmed, Elgendy Islam Y
Department of Medicine, University of Florida, Gainesville, FL, USA.
Department of Medicine, Seton Hall University School of Health and Medical Sciences, Trinitas Regional Medical Center, Elizabeth, NJ, USA.
Cardiovasc Ther. 2015 Aug;33(4):227-35. doi: 10.1111/1755-5922.12124.
For decades, unfractionated heparin (UFH) has been widely used in catheterization laboratories for anticoagulation for percutaneous coronary intervention (PCI). The direct thrombin inhibitors, bivalirudin, has emerged as an alternative to UFH for PCI procedures, due to its lower bleeding risk. More recently, randomized trials and meta-analyses questioned the efficacy of bivalirudin, and demonstrated that bivalirudin might be associated with a higher incidence of ischemic events and in particular stent thrombosis. In this review, we discuss the pharmacology of bivalirudin along with the clinical evidence comparing bivalirudin versus UFH in patients undergoing PCI for various indications.
几十年来，普通肝素（UFH）在导管实验室中被广泛用于经皮冠状动脉介入治疗（PCI）的抗凝。直接凝血酶抑制剂比伐卢定已成为PCI手术中UFH的替代品，因为其出血风险较低。最近，随机试验和荟萃分析对比伐卢定的疗效提出质疑，并表明比伐卢定可能与更高的缺血事件发生率相关，尤其是支架血栓形成。在本综述中，我们讨论了比伐卢定的药理学，以及比较比伐卢定与UFH用于各种适应症的PCI患者的临床证据。
