Efficacy and safety of bivalirudin in elderly patients with ST-segment elevation myocardial infarction
10.3969/j.issn.1009-0126.2023.10.011
- VernacularTitle:比伐芦定在老年ST段抬高型心肌梗死患者中应用的有效性和安全性
- Author:
Baoguo WANG
1
;
Qiang SU
;
Jingwei LIU
;
Chaoqun HUANG
;
Xiang WANG
;
Lin WANG
;
Weihua ZHANG
Author Information
1. 130061 吉林大学第一医院心内科
- Keywords:
myocardial infarction;
hirudins;
heparin;
anticoagulants;
percutaneous coronary inter-vention;
retrospective studies;
logistic models;
bivalirudin
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2023;25(10):1051-1055
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of bivalirudin versus unfractionated heparin during perioperative primary percutaneous coronary intervention(PCI)in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 423 elderly patients with acute STEMI who underwent primary PCI in our hospital were consecutively en-rolled in this study.According to different perioperative anticoagulant regimens,they were divided into bivalirudin group(187 cases)and unfractionated heparin group(236 cases).Baseline data,characteristics of interventional procedures and complications during hospitalization were ana-lyzed.Primary endpoint was major adverse cardiac or cerebral events(MACCE).Secondary end-points were net adverse clinical events.Other observational indicators included stent thrombosis,acquired thrombocytopenia,BARC types 1-2 bleeding and total bleeding events.Results In-hospital MACCE and all-cause mortality were significantly lower in the bivalirudin group than unfractionated heparin group(3.7％vs 9.7％,P=0.021;3.7％vs 8.9％,P=0.039).Univariate logistic regression analysis showed that perioperative application of bivalirudin significantly reduced all-cause mortality in the patients with Killip grade Ⅰ and creatinine clearance ≥60 ml/min when compared with unfractionated heparin(P＜0.05).Conclusion In elderly patients with acute STEMI,perioperative use of bivalirudin significantly reduces the incidences of MACCE and all-cause death during hospitalization,especially in the patients with Killip grade Ⅰ and creatinine clearance ≥60 ml/min.
