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Heparin Binds Plasma Proteins; AngiomaxHeparin Binds Plasma Proteins; Angiomax®® (bivalirudin) Binds (bivalirudin) Binds SpecificallySpecifically to Thrombin to Thrombin

Heparin (long strand) binds to other Heparin (long strand) binds to other plasma proteins (colored molecules) plasma proteins (colored molecules) and platelets, reducing heparin’s and platelets, reducing heparin’s availability to bind to AT.availability to bind to AT.

Heparin-binding proteins are elevated Heparin-binding proteins are elevated in acute coronary syndromes (ACS). in acute coronary syndromes (ACS).

Angiomax (bright blue) binds onlyAngiomax (bright blue) binds onlyto thrombin (orange).to thrombin (orange).

Angiomax is not neutralized by other Angiomax is not neutralized by other plasma proteins or platelets; it plasma proteins or platelets; it remains fully active near thrombus. remains fully active near thrombus.

Hirsh J et al. Hirsh J et al. ChestChest. 2001;119(1 suppl):64S-94S.. 2001;119(1 suppl):64S-94S.Weitz JI et al. Weitz JI et al. Thromb ResThromb Res. 2002;106:V275-V284.. 2002;106:V275-V284.Wittkowsky AK. Wittkowsky AK. PharmacotherPharmacother. 2002;22(6 Pt 2):97S-104S. . 2002;22(6 Pt 2):97S-104S.

CM Gibson 2006CM Gibson 2006