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Bivalirudin for patients with STEMI at high risk of bleeding undergoing PPCI

Nature Reviews Cardiology volume 14, page 626 (2017)Cite this article

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We read the Review by Franchi et al. (Antithrombotic therapy for patients with STEMI undergoing primary PCI. Nat. Rev. Cardiol. 14, 361–379; 2017)1 with great interest. We wish to discuss the role of bivalirudin for patients with ST-segment elevation myocardial infarction (STEMI) who are at high risk of bleeding and undergoing primary percutaneous coronary intervention (PPCI).

Intravenous anticoagulant therapy is mandatory in PPCI and includes heparins and bivalirudin. Currently, bivalirudin has a class I (level of evidence B) recommendation in the ACC/AHA guidelines2 for patients with STEMI undergoing PPCI. Nevertheless, the clinical benefits of bivalirudin use and whether bivalirudin is the optimal regimen have been the subject of debate in patients at high risk of bleeding (criteria defined previously3,4), who need more careful evaluation and attention to anticoagulant management.

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Acknowledgements

The authors are funded by the National Natural Science Foundation of China (No. 81370380), the Major Scientific Research Foundation of colleges and universities of Guangdong province, China (No. 2016KZDXM016), and the Clinical Training Project Foundation of Southern Medical University (No. LC2016PY002).

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Authors and Affiliations

  1. Kai Guo and Zhigang Guo are at the Department of Cardiology, Lu Hu, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Baiyun District, Guangzhou 510515, Guangdong Province, China.,

    Lu Hu, Kai Guo & Zhigang Guo

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  1. Lu Hu
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Correspondence to Zhigang Guo.

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The authors declare no competing financial interests.

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Hu, L., Guo, K. & Guo, Z. Bivalirudin for patients with STEMI at high risk of bleeding undergoing PPCI. Nat Rev Cardiol 14, 626 (2017). https://doi.org/10.1038/nrcardio.2017.141

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