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Bivalirudin is a synthetic 20-amino acid peptide anticoagulant that acts as a direct and reversible inhibitor of thrombin. It binds specifically to both the catalytic site and the anion-binding exosite of circulating and clot-bound thrombin, thereby preventing thrombin from converting fibrinogen into fibrin—a critical step in blood clot formation. Bivalirudin is primarily used to prevent thrombosis during percutaneous coronary intervention (PCI), such as angioplasty, especially in patients with heparin-induced thrombocytopenia or at high risk for adverse reactions to other anticoagulants. Its short half-life allows for rapid reversibility of its effects after cessation, reducing bleeding risks compared to some traditional anticoagulants[1][2][3][5][8].
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