In-hospital outcomes after switching from a bivalirudin- first strategy to an unfractionated heparin-first strategy for percutaneous coronary interventions

Since the initial days of balloon angioplasty, anticoagulants agents such as unfractionated heparin (UFH) or bivalirudin, either alone or in combination with a glycoprotein IIb/IIIa inhibitor (GPI), have been used during percutaneous coronary intervention (PCI) (1). Major adverse bleeding complications from PCI have been shown to have a strong association with poor prognosis including higher 30-day mortality rates (2,3). Other studies have shown a strong, dose-dependent relationship between major bleeding and mortality at 1 year (4)