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[Correspondence] Bivalirudin versus heparin use for patients undergoing PPCI

Adeel Shahzad and colleagues1 showed that the use of heparin, compared with bivalirudin, substantially reduces the incidence of major adverse events (principally acute stent thrombosis) in patients, with no differences between the two drugs in bleeding complications. The rates of acute stent thrombosis were 3·4% in the bivalirudin group and 0·9% in the heparin group. These results should urge health-care providers to refrain from using bivalirudin in the setting of primary percutaneous coronary intervention, especially for patients with risk factors of acute stent thrombosis.