Direct thrombin inhibition in interventional cardiology. The ACUITY trial

The direct thrombin inhibitor bivalirudin was tested in the ACUITY Trial 13 819 patients with acute non-ST-segment elevation coronary syndrome in a prospective and randomized design. Three therapeutic regimens were compared in the context of an early invasive strategy: heparin plus glycoprotein IIb/IIIa inhibitor (GPI), bivalirudin plus GPI, or bivalirudin alone. Concerning the rate of ischaemic events bivalirudin alone was comparable to heparin plus GPI at a significantly lower rate of bleeding complications.