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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
 
 
 

Can bivalirudin and provisional GP IIb/IIIa blockade REPLACE heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention?

The combined use of low dose heparin and glycoprotein (GP) IIb/IIIa blockers is standard treatment during percutaneous coronary interventions (PCIs). Bivalirudin has a different mechanism of anticoagulant action than heparin. In REPLACE-2, patients undergoing PCI were randomised to bivalirudin with provisional GP IIb/IIIa blockade or heparin and planned GP IIb/IIIa blockade. The primary quadruple composite end point was death, myocardial infarction, urgent repeat revascularisation or in-hospital major bleeding by 30 days, and statistical analysis showed that bivalirudin was not inferior to heparin plus GP IIb/IIIa blockade. There were fewer major and minor bleeding events with bivalirudin than with heparin plus GP IIb/IIIa blockade. Bivalirudin and provisional GP IIb/IIIa blockade should now be considered as an alternative to heparin plus planned GP IIb/IIIa blockade in patients undergoing urgent or elective revascularisation.[1]

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