Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2017; 9(9): 761-772
Published online Sep 26, 2017. doi: 10.4330/wjc.v9.i9.761
Safety, efficiency and cost effectiveness of Bivalirudin: A systematic review
Melorin Mehrzad, Rasikh Tuktamyshov, Raman Mehrzad
Melorin Mehrzad, Rasikh Tuktamyshov, Raman Mehrzad, Department of Internal Medicine, Yale New Haven Hospital, Yale School of medicine, New Haven, CT 06510, United States
Author contributions: All authors contributed equally to the manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: All data supporting this study are provided in the reference section accompanying this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Raman Mehrzad, MD, MHL, Clinical Instructor, Department of Internal Medicine, Yale New Haven Hospital, Yale School of Medicine, 20 York St., New Haven, CT 06510, United States. Raman.Mehrzad@ynhh.org
Telephone: +1-475-3554932 Fax: +1-203-789322
Received: May 5, 2017
Peer-review started: May 10, 2017
First decision: June 12, 2017
Revised: July 31, 2017
Accepted: August 15, 2017
Article in press: August 16, 2017
Published online: September 26, 2017
Processing time: 142 Days and 8.2 Hours
Core Tip

Core tip: Bivalirudin is a direct thrombin inhibitor used in clinical practice since 1990’s. It was initially introduced as an alternative medication to heparin during percutaneous coronary intervention. Early studies showed advantages of bivalirudin over heparin. We did a systematic review of the literature since 1990 and summarized all relevant trials. The majority showed better outcomes with bivalirudin. However, some trials are difficult to compare directly as protocols and patient populations differ. Bivalirudin and heparin are both acceptable options according to current ACA/AHA guidelines. Authors conclude however, that that due to bivalirudin safer bleeding profile, it should be the preferred medication for anticoagulation.