Bivalirudin and Provisional Glycoprotein IIb/IIIa Blockade Compared With Heparin and Planned Glycoprotein IIb/IIIa Blockade During Percutaneous Coronary Intervention

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Abstract
Unfractionated heparin has been the standard of adjunctive antithrombin therapy during percutaneous coronary intervention (PCI) for more than 25 years. Yet heparin is subject to important intrinsic limitations, including unpredictable pharmacokinetics, inhibition by plasma proteins, and the potential to activate platelets.1-4 Considerable reductions in periprocedural complications have been achieved with administration of glycoprotein IIb/IIIa (Gp IIb/IIIa) antagonists in addition to heparin.5 These potent platelet inhibitors are not used universally, however, in part because of concerns about cost and increased bleeding risk.

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