American Heart Journal
Volume 143, Issue 2 , Pages 229-234 , February 2002

Bivalirudin as a replacement for unfractionated heparin in unstable angina/non-ST-elevation myocardial infarction: Observations from the TIMI 8 trial

  • Elliott M. Antman, MD

      Affiliations

    • TIMI Study Group Boston, Mass
    • Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Carolyn H. McCabe, BS

      Affiliations

    • TIMI Study Group Boston, Mass
    • Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Eugene Braunwald, MD

      Affiliations

    • TIMI Study Group Boston, Mass
    • Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • for the TIMI 8 Investigators

Received 21 December 2000 ,Accepted 2 May 2001.

References 

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  4. Antman EM, for the TIMI 9B Investigators . Hirudin in acute myocardial infarction: thrombolysis and thrombin inhibition in myocardial infarction (TIMI) 9B trial. Circulation. 1996;94:911–921
  5. Global Use of Strategies to Open Occluded Coronary Arteries GUSTO IIb Investigators . A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes. N Engl J Med. 1996;335:775–782
  6. Organisation to Assess Strategies for Ischemic Syndromes OASIS-2 Investigators . Effects of recombinant hirudin (lepirudin) compared with heparin on death, myocardial infarction, refractory angina, and revascularization procedures in patients with acute myocardial ischemia without ST elevation: a randomised trial. Lancet. 1999;353:429–438
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  12. Fuchs J, Cannon CP. Hirulog in the treatment of unstable angina: results of the Thrombin Inhibition in Myocardial Ischemia (TIMI) 7 trial. Circulation. 1995;92:727–733
  13. Kong DF, Topol EJ, Bittl JA, et al.  Clinical outcomes of bivalirudin for ischemic heart disease. Circulation. 1999;100:2049–2053
  14. Telford AM, Wilson C. Trial of heparin versus atenolol in prevention of myocardial infarction in intermediate coronary syndrome. Lancet. 1981;1:1225–1228
  15. Theroux P, Ouimet H, McCans J, et al.  Aspirin, heparin or both to treat unstable angina. N Engl J Med. 1988;319:1105–1111
  16. Oler A, Whooley MA, Oler J, et al.  Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina: a meta-analysis. JAMA. 1996;276:811–815
  17. Thrombin Inhibition in Myocardial Ischaemia TRIM Study Group . A low molecular weight, selective thrombin inhibitor, inogatran, vs heparin, in unstable coronary artery disease in 1209 patients: a double-blind, randomized, dose-finding study. Eur Heart J. 1997;18:1416–1425
  18. Bittl JA, Strony J, Brinker JA, et al.  Treatment with bivalirudin (hirulog) as compared with heparin during coronary angioplasty for unstable or postinfarction angina: Hirulog Angioplasty Study Investigators. N Engl J Med. 1995;333:764–769
  19. White HD. Direct thrombin inhibition and thrombolytic therapy: rationale for the Hirulog and Early Reperfusion/Occlusion (HERO-2) trial. Am J Cardiol. 1998;82:57P–62P
  20. White HD, Aylward PE, Frey MJ, et al.  Randomized, double-blind comparison of hirulog versus heparin in patients receiving streptokinase and aspirin for acute myocardial infarction (HERO): Hirulog Early Reperfusion/Occlusion (HERO) Trial Investigators. Circulation. 1997;96:2155–2161
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☆ Supported by grants from Biogen, Cambridge, Mass, and The Medicines Company, Cambridge, Mass.

☆☆ Reprint requests: Elliott M. Antman, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail: eantman@rics.bwh.harvard.edu

PII: S0002-8703(02)39926-5

doi: 10.1067/mhj.2002.120405

American Heart Journal
Volume 143, Issue 2 , Pages 229-234 , February 2002

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