Document Detail


Bivalirudin: a new approach to anticoagulation.
MedLine Citation:
PMID:  11975781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bivalirudin is one of the first of a new class of anticoagulants known as direct thrombin inhibitors. These drugs are able to overcome many of the shortcomings of traditional heparin anticoagulation by virtue of this unique mechanism of action. Bivalirudin is a semisynthetic derivative of hirudin, a modified component of leech saliva. Hirudin has been plagued by bleeding complications, likely due to its high affinity for thrombin. Bivalirudin has lower thrombin affinity than hirudin and therefore is believed to be a much safer compound. Bivalirudin has been shown to be a very effective anticoagulant in laboratory models, though its clinical efficacy remains to be fully proven. Bivalirudin has been studied in the setting of coronary angioplasty, unstable angina, and acute myocardial infarction and has shown some promise in many of these settings, particularly in preventing complications of percutaneous coronary interventions. Bivalirudin has consistently shown less major bleeding compared with standard heparin, although limitations in study methodologies somewhat hinder an accurate interpretation of this finding. Larger-scale studies are indicated and are currently being performed, the results of which will more definitively define the role of bivalirudin for the treatment of cardiovascular disease.
Authors:
J J Nawarskas; J R Anderson
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Heart disease (Hagerstown, Md.)     Volume:  3     ISSN:  1521-737X     ISO Abbreviation:  Heart Dis     Publication Date:    2001 Mar-Apr
Date Detail:
Created Date:  2002-04-26     Completed Date:  2002-05-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100887299     Medline TA:  Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  IM    
Affiliation:
College of Pharmacy, University of New Mexico, Albuquerque 87131-5691, USA. nawarska@unm.edu
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / complications,  drug therapy
Anticoagulants / pharmacology*,  therapeutic use*
Antithrombins / pharmacology*,  therapeutic use*
Clinical Trials as Topic
Heparin / pharmacology,  therapeutic use
Hirudin Therapy*
Hirudins / analogs & derivatives*,  pharmacology*
Humans
Myocardial Infarction / complications,  drug therapy
Peptide Fragments / pharmacology*,  therapeutic use*
Recombinant Proteins / pharmacology*,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Antithrombins; 0/Hirudins; 0/Peptide Fragments; 0/Recombinant Proteins; 128270-60-0/bivalirudin; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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