ACRIPAB- Trial: Anti Coagulation Regimen In High Risk PAtients for Bleeding

Inclusion Criteria: Inclusion criteria (any of the following): * ≥75 years * Creatinin clearance rate \< 60 ml per minute * Anemia (Hb 9-11 mg%) * Hypertension: BP \> 180/95 mmHg but less than 210/110 m Hg * Diabetic Pts * Steroid treated Pts * Recent (within 6 weeks) non major surgery * Pts with hematological disorders associated with tendency for bleeding like Thrombocytopenia (platelets 50000-150000) included TTP; Exclusion Criteria: Exclusion criteria: * Age \< 18 year * Acute STEMI (Primary PCI)\* * Rescue angioplasty \<12h after lytic therapy\* * Active bleeding * S.C LMWH \< 8 hours or UFH \< 4 hours before PCI * Using IIb /IIIa as an upstream therapy before PCI * PCI which will be involved with obligatory IIb /IIIa therapy: (thrombotic complication, occlusive dissection) * INR\>1.5 on day of cathetrization * Bolus of 600mg of Clopidogrel before PCI * Current pregnancy or women in reproductive age without contraceptives * Hypersensitivity to heparin or bivalirudin or its components \*(possible using IIB/IIIA)