The arranged marriage of cangrelor and bivalirudin.

B ivalirudin and cangrelor are 2 intravenous drugs, 1 for anticoagulation and the other for antiplatelet therapy, with a rapid onset of action, thus in theory perfectly adapted to percutaneous coronary intervention (PCI) that requires simultaneous thrombin and platelet inhibition. These effects are especially needed for mechanical coronary reperfusion of acute patients such as those presenting with ST-segment elevation myocardial infarction (STEMI). The short half-lives and good tolerance of these 2 drugs add to the attractiveness of their profile in the contemporary era of expeditious and safetyoriented care. Bivalirudin anticoagulation has been associated with a reduction of major bleeding complications, the magnitude of which varies based on whether glycoprotein IIb/IIIa inhibitors are used in the control arm with unfractionated heparin (1). There is no significant reduction of major bleeding when glycoprotein IIb/IIIa inhibitors are used provisionally with both anticoagulant strategies of unfractionated heparin and bivalirudin. Currently, glycoprotein