Abstract
ST-segment elevation myocardial infarction is recognized as a life-threatening medical emergency. The goal standard of care is immediate primary percutaneous coronary intervention, restoring blood flow to the myocardium and preserving myocardial pump function. Adjunctive to primary percutaneous coronary intervention is the administration of anti-platelet and anti-coagulation agents to reduce platelet activity and inhibit thrombin-mediated thrombus formation. Bivalirudin is a direct thrombin inhibitor, which inhibits clot-bound and free thrombin. Randomized controlled trials have demonstrated that when compared with heparin plus a glycoprotein IIb/IIIa inhibitor there is a lower incidence of major bleeding, and, as a result, all-cause mortality is reduced. Although bivalirudin has beneficial effects on bleeding, acute stent thrombosis has been identified as a potential risk within the first 24 hours following primary percutaneous coronary intervention.
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