Pharmacotherapy of acute coronary syndrome: the ACUITY trial

Abstract

Background: Bivalirudin, a direct thrombin inhibitor, has unique attributes including predictable pharmacokinetics, a reduction in bleeding complications and avoidance of heparin induced thrombocytopenia. Objective: We critically review the role of bivalirudin in the management of patients with acute coronary syndrome in light of the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial. Methods: Data from the ACUITY trial was critically reviewed along with other contemporary data. Results/conclusion: In the ACUITY trial, bivalirudin monotherapy was associated with rates of ischemic events that were noninferior to those associated with heparin plus glycoprotein IIb/IIIa inhibition, but was associated with a significantly reduced incidence of major bleeding. Bivalirudin seems to be an attractive antithrombotic agent in patients with acute coronary syndrome undergoing early invasive management.

Keywords::

• acute coronary syndrome
• bivalirudin
• bleeding
• direct thrombin inhibitor
• percutaneous coronary intervention

Notes