Introduction
microvascular obstruction, bleeding, chronic coronary syndrome
INFLAMMATION, BLEEDING, CHRONIC CORONARY SYNDROME
ePCI is considered as a safe approach to treating chronic coronary syndrome (CCS), with a very low incidence of major procedural complicationsBivalirudin is a naturally occurring oligopeptide analog of hirudin that reversibly binds to the active site and the external site I of thrombin. Bivalirudin effectively inhibits free fibrin-bound thrombin, is not inactivated by platelet factor 4, does not require antithrombin to exert its activity, does not bind to proteins and matrices other than thrombin, has low immunogenicity, and does not cause liver-induced thrombocytopeniaThe pathophysiological mechanisms of PMI during ePCI are not fully understood, and activation of platelets and inflammation, along with distal embolization and microvascular obstruction, seem to play an important roleIn the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT) 3 trial, 30-day outcomes in 4,570 biomarker-negative patients undergoing PCI after clopidogrel loading revealed less bleeding with bivalirudin compared with UN, but no difference in the 30-day net clinical benefit was observed