Therapy

•  hirudin ^a

Why?

• Patients who are given hirudin compared with heparin are less likely to die, have refractory angina or an MI. ^a
• The risk of major bleeding is increased. ^a

Hirudin reduces MI, but causes more bleeding than heparin

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
unstable angina or non-Q wave MI a	hirudin	heparin	cardiovascular death, new MI or refractory angina at 7 days	6.7%	87% (27% to 100%)	88 (48 to 500)
unstable angina or non-Q wave MI	hirudin	heparin	major bleed at 7 days	0.67%	-73% (-160% to -13%)	-210 (-850 to -120)
unstable angina or non-Q wave MI a	hirudin for	heparin for 3-5 days	MI at 30 days	6.3%	14% (1% to 26%)	110 (58 to 2000)