Comparison of benefits and complications of hirudin versus heparin for patients with acute coronary syndromes undergoing early percutaneous coronary intervention

The direct thrombin inhibitor hirudin was associated with a reduced risk of nonfatal (re)infarction, a trend for a reduced risk of death or (re)infarction, and more frequent bleeding complications among 1,410 patients with acute coronary syndromes (ACS) who underwent early PCI in the GUSTO-IIb trial. Hirudin appears to enhance initial medical therapy for patients with ACS who undergo early percutaneous revascularization at the expense of an increased risk of bleeding.