Bivalirudin (Angiomax)
Overview
A synthetic 20-amino acid peptide that acts as a direct thrombin inhibitor by binding both the catalytic active site and anion-binding exosite 1 of thrombin. Bivalirudin inhibits both free and clot-bound thrombin, providing more predictable anticoagulation than heparin without requiring antithrombin III as a cofactor.
Mechanism of Action
It is enzymatically cleaved by thrombin itself, producing a self-limiting anticoagulant effect with a 25-minute half-life.
Research Summary & Key Findings
FDA-approved for use in percutaneous coronary intervention (PCI) and as an anticoagulant in patients with or at risk of heparin-induced thrombocytopenia (HIT). HORIZONS-AMI trial showed reduced major bleeding and 30-day mortality vs. heparin plus GP IIb/IIIa inhibitors in primary PCI for STEMI. Does not cause immune-mediated thrombocytopenia. Widely used as an alternative to heparin in the cardiac catheterization lab.
Clinical Status
Bivalirudin (Angiomax) has received FDA approval and is available for clinical use under appropriate medical supervision. Consult a qualified healthcare provider for prescribing information.
Administration Routes
References
Primary literature
- PubMed — "Bivalirudin"
Peer-reviewed literature indexed by the National Library of Medicine.
- ClinicalTrials.gov — "Bivalirudin"
Registered interventional and observational studies, including status and phase.
- PubChem — "Bivalirudin"
Chemical structure, molecular properties, and bioactivity data.
Study-level citations for this compound are being verified against the primary sources before publication. The database queries above return the current indexed literature in the meantime.
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