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April 7, 2015

Can BRIGHT Restore the Glow of Bivalirudin?

Author Affiliations
  • 1Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA. 2015;313(13):1323-1324. doi:10.1001/jama.2015.2345

Bivalirudin, a direct thrombin inhibitor, has been studied as an alternative to heparin for patients undergoing percutaneous coronary intervention (PCI) with stable coronary artery disease,1,2 non–ST-segment elevation acute coronary syndrome (NSTE-ACS),3,4 and ST-elevation myocardial infarction (STEMI).5,6 These studies found that bivalirudin reduced major bleeding when compared with regimens of heparin plus glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors. However, many of these trials also found small numerical increases in ischemic events with bivalirudin and increases in acute stent thrombosis, particularly in patients with STEMI.5,6

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