Direct Thrombin Inhibitors

The use of direct thrombin inhibitors (DTIs) in the setting of elective PCI has added to the armamentarium of adjunctive therapies in PCI. The potential benefit of use of DTIs such as bivalirudin may lie in their ability to modulate inflammation after PCI. Substudies of the Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events 2 (REPLACE-2) study suggested that the use of bivali-rudin, compared with unfractionated heparin and eptifibatide, may lead to a reduction in markers of inflammation 1 month out from PCI.80 Furthermore, it appears that DTIs may affect platelet surface expression of pro-inflammatory markers such as P-selec-tin.81 Lower rates of platelet-leukocyte aggregation may be just as significant a factor as the effect on platelet aggregation in the setting of inflammation after PCI.

Was this article helpful?

0 0

Post a comment