Risk guided use of the direct thrombin inhibitor bivalirudin: insights from recent trials and analyses

During percutaneous coronary intervention, dual antiplatelet therapy with aspirin and a P2Y12 receptor antagonist are combined with one of three major strategies for antithrombotic therapy: heparins, bivalirudin, or heparin with an intravenous IIb/IIIa platelet receptor antagonist. Economic constraints in the United States are increasingly driving the choice between these therapies.