| Management of patients with acute coronary syndromes: what is the clinical role of direct thrombin inhibitors? | |
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MedLine Citation:
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PMID: 12215055 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Despite important pharmacokinetic and biological advantages of direct thrombin inhibitors over heparin, early randomised trials failed to demonstrate a clear net clinical benefit of these agents compared with heparin because of a higher bleeding risk, particularly with hirudin, and only modest efficacy gains. More recently, however, a systematic review of the direct thrombin inhibitor trials based on individual patient data as well as the results of the 17 000-patient Hirulog Early Reperfusion or Occlusion (HERO)-2 trial have confirmed the superiority of both hirudin and bivalirudin over unfractionated heparin in patients with acute coronary syndromes and undergoing percutaneous coronary intervention. Ongoing trials should further clarify the role of bivalirudin in patients undergoing percutaneous coronary intervention in the context of glycoprotein IIb/IIIa inhibitor use, while additional studies are required to define the role of direct thrombin inhibitors used in conjunction with other newer antithrombotic and/or thrombolytic strategies in patients with acute coronary syndromes. |
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Authors:
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John W Eikelboom; John French |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Drugs Volume: 62 ISSN: 0012-6667 ISO Abbreviation: Drugs Publication Date: 2002 |
Date Detail:
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Created Date: 2002-09-06 Completed Date: 2002-10-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7600076 Medline TA: Drugs Country: New Zealand |
Other Details:
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Languages: eng Pagination: 1839-52 Citation Subset: IM |
Affiliation:
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Department of Medicine, Thrombosis and Haemophilia Unit, University of Western Australia, Royal Perth Hospital, Australia. john.eikelboom@heath.wa.gov.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Angioplasty, Transluminal, Percutaneous Coronary* Antithrombins / pharmacology, therapeutic use* Clinical Trials, Phase II as Topic Clinical Trials, Phase III as Topic Coronary Disease / drug therapy*, therapy Humans Randomized Controlled Trials as Topic Thrombin / antagonists & inhibitors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antithrombins; EC 3.4.21.5/Thrombin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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