the direct thrombin inhibitor bivalirudin,when used instead of heparin plus glycoprotein IIb/IIIa inhibitors, has been shown in large-scale, randomized trials to reduce major and minor bleeding and thrombocytopenia while resulting in similar rates of ischemia after PCI in patients with stable angina, those with unstable angina, and those with non–ST-segment elevation myocardial infarction
study evidence reveals that In patients with ST-segment elevation myocardial infarction who are undergoing primary PCI, anticoagulation with bivalirudin alone, as compared with heparin plus glycoprotein IIb/IIIa inhibitors, results in significantly reduced 30-day rates of major bleeding and net adverse clinical events (1)
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