bivalirudin
Pronunciation: bye-val-ih-ROO-din
Direct thrombin inhibitor anticoagulant used during percutaneous coronary interventions as an alternative to heparin plus glycoprotein inhibitors.
Full Definition
Bivalirudin is a synthetic direct thrombin inhibitor that provides anticoagulation during percutaneous coronary interventions and acute coronary syndromes. Unlike heparin, which requires antithrombin III as a cofactor, bivalirudin directly and reversibly binds to thrombin, providing predictable anticoagulation without the need for activated clotting time monitoring. The drug has been shown to reduce bleeding complications compared to heparin plus glycoprotein IIb/IIIa inhibitor combinations while maintaining equivalent ischemic protection in many clinical scenarios.
Usage
Usage note: Brand name Angiomax; particularly useful in patients with heparin-induced thrombocytopenia or high bleeding risk.
In Context
- "Bivalirudin was chosen for anticoagulation during primary PCI to minimize bleeding risk in this elderly patient." — Interventional procedure note
- "The patient developed thrombocytopenia on heparin, so bivalirudin was substituted for subsequent catheterization." — Cardiology consultation