Heparin Binds Plasma Proteins: Angiomax Heparin Binds Plasma Proteins: Angiomax ® (Bivalirudin) Binds (Bivalirudin) Binds Specifically Specifically to Thrombin to Thrombin Heparin (long strand) binds to other plasma proteins (colored molecules) and platelets, reducing heparin’s availability to bind to AT. Heparin-binding proteins are elevated in acute coronary syndrome (ACS). Angiomax (bright blue) binds only to thrombin (orange). Angiomax is not neutralized by other plasma proteins or platelets; it remains fully active near thrombus. Hirsh J et al. Chest. 2001;119(1 suppl):64S-94S. Weitz JI et al. Thromb Res. 2002;106:V275-V284. Wittkowsky AK. Pharmacother. 2002;22(6 Pt 2):97S-104S
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Heparin Binds Plasma Proteins: Angiomax ® (Bivalirudin) Binds Specifically to Thrombin Heparin (long strand) binds to other plasma proteins (colored molecules)
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Heparin Binds Plasma Proteins: AngiomaxHeparin Binds Plasma Proteins: Angiomax®® (Bivalirudin) (Bivalirudin) Binds Binds SpecificallySpecifically to Thrombin to Thrombin
Heparin Binds Plasma Proteins: AngiomaxHeparin Binds Plasma Proteins: Angiomax®® (Bivalirudin) (Bivalirudin) Binds Binds SpecificallySpecifically to Thrombin to Thrombin
Heparin (long strand) binds to other plasma proteins (colored molecules) and platelets, reducing heparin’s availability to bind to AT.
Heparin-binding proteins are elevated in acute coronary syndrome (ACS).
Heparin makes platelets more reactive to activation by other agonists, such as adenosine diphosphate (ADP). Heparin binds to the platelet GP IIb/IIIa receptor.
Given the various ways heparin increases platelet activation, its use may actually increase the need for antiplatelet agents.
Becker R et al. J Invasive Cardiol. 2003;(suppl):1-15. Sobel M et al. J Vasc Surg. 2001;33:587-594.Xiao Z et al. Circulation. 1998;97:251-256.
Heparin Has a Direct Effect on PlateletsHeparin Has a Direct Effect on PlateletsHeparin Has a Direct Effect on PlateletsHeparin Has a Direct Effect on Platelets
• Heparin increases platelet activation in unstable angina patients
Reproduced with permission of Xiao Z et al. Circulation. 1998;97:253.