Randomized Comparison of Abciximab Plus Heparin With Bivalirudin in Acute Coronary Syndrome

Inclusion Criteria: * Episode of unstable angina * Elevated cardiac markers * Angiographic lesions requiring PCI * Informed, written consent Exclusion Criteria: * Age \< 18 years and \> 80 years * ST-segment elevation acute myocardial infarction within 48 hours * Cardiogenic shock * Pericarditis * Malignancies or other comorbid conditions with life expectancy less than one year or that may result in protocol non-compliance * Active bleeding; bleeding diathesis; history of gastrointestinal or genitourinary bleeding, recent trauma or major surgery in the last month; history of intracranial bleeding or structural abnormalities; suspected aortic dissection; pericarditis; and patient's refusal to blood transfusion * Oral anticoagulation therapy with coumarin derivative within the last 7 days * Recent use of GPIIb/IIIa inhibitors within 14 days * Treatment with unfractionated heparin within 4 hours unless ACT \> 150sec; or low-molecular weight heparin within 8 hours before randomization * Treatment with bivalirudin within 24 hours before randomization * Severe uncontrolled hypertension \> 180/110 mm Hg unresponsive to therapy * Planned staged PCI procedure within 30 days from index procedure or prior PCI within the last 30 days * Relevant hematologic deviations * Glomerular filtration rate (GFR) \< 30 ml/min or serum creatinine \> 30 mg/L or dependence on renal dialysis * Known allergy or intolerance to the study medications, stainless steel or true anaphylaxis after prior exposure to contrast media * Previous enrollment in this trial * Women who are known to be pregnant, who are of childbearing potential and test positive for pregnancy, who have given birth within the last 90 days, who are breastfeeding * Patient's inability to fully cooperate with the study protocol