Draft guidance recommends the drug for ST-segment-elevation MI in combination with aspirin and clopidogrel, in patients undergoing surgery to reopen their coronary artery.
A NICE appraisal showed treatment with bivalirudin was both more effective and less expensive than with a glycoprotein inhibitor plus heparin.
NICE fast-tracked the appraisal of the drug due to the 'strength of the evidence' for its benefit to patients.
Dr Carole Longson of NICE said: 'Although deaths from heart attacks and other cardiovascular causes are declining, unfortunately the incidence of heart attacks is not.'
Each year, around 180,000 people in the UK are admitted with an MI and nearly 30,000 people subsequently die.