Opinion statement
In ST-segment elevation myocardial infarction (STEMI), interventional cardiologists must move quickly to safely re-establish blood flow while choosing an antithrombotic to preclude wire thrombosis, aid in the restoration of flow, minimize thrombus propagation, and reduce the risk of stent thrombosis. Currently, operators have a choice between heparin and bivalirudin with the possible addition of glycoprotein IIb/IIIa inhibitors (GPIs). Prior studies have shown that bivalirudin use lowers rates of bleeding, but with a clear risk of acute stent thrombosis. Recent studies have examined this question in the modern era of radial access and newer antiplatelet agents. Despite these studies, there remains a question regarding which antithrombotic agent is to be selected in STEMI.
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Jad Raffoul, Ammar Nasir, and Andrew J. P. Klein each declare that they have no conflict of interest.
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Raffoul, J., Nasir, A. & Klein, A.J.P. Antithrombotic Selection in ST-Segment Elevation Myocardial Infarction: a Year in Review. Curr Treat Options Cardio Med 18, 53 (2016). https://doi.org/10.1007/s11936-016-0473-7
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DOI: https://doi.org/10.1007/s11936-016-0473-7