w. Clinical trial results.org Heparin Binds Plasma Proteins; Angiomax Heparin Binds Plasma Proteins; Angiomax ® (bivalirudin) (bivalirudin) Binds Binds Specifically Specifically to Thrombin to Thrombin Heparin (long strand) binds Heparin (long strand) binds to other plasma proteins to other plasma proteins (colored molecules) and (colored molecules) and platelets, reducing platelets, reducing heparin’s availability to heparin’s availability to bind to AT. bind to AT. Heparin-binding proteins are Heparin-binding proteins are elevated in acute coronary elevated in acute coronary syndromes (ACS). syndromes (ACS). Angiomax (bright blue) binds Angiomax (bright blue) binds only only to thrombin (orange). to thrombin (orange). Angiomax is not neutralized Angiomax is not neutralized by other plasma proteins or by other plasma proteins or platelets; it remains fully platelets; it remains fully active near thrombus. active near thrombus. Hirsh J et al. Hirsh J et al. Chest Chest . 2001;119(1 suppl):64S-94S. . 2001;119(1 suppl):64S-94S. Weitz JI et al. Weitz JI et al. Thromb Res Thromb Res . 2002;106:V275-V284. . 2002;106:V275-V284. Wittkowsky AK. Wittkowsky AK. Pharmacother Pharmacother . 2002;22(6 Pt 2):97S-104S . 2002;22(6 Pt 2):97S-104S CM Gibson 2006 CM Gibson 2006