Objective To compare the efficacy and safety between Bivalirudin and Heparin during emergency percutaneous coronary intervention(PCI)in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods Retrospective analysis of 80 patients diagnosed with ST-segment elevation myocardial infarction in elderly patients was conducted.The treatment group(n=40) received a bolus intravenous injection of Bivalirudin 0.75 mg/kg before emergency percutaneous coronary intervention,then 1.75 mg · kg 1 · h-1 continuous intravenous drip till the end of the operation from March 2011 to March 2015.Activated clotting time (ACT)was detected at 10 minutes after drug application.If ACT＜225 s,0.3 mg/kg were append.The control group received a bolus intravenous injection of Heparin 100 U/kg during emergency PCI,and after 10 minutes ACT was detected.If ACT＜ 225 s,300 U was appended.When operation extended,1 000 U was appended every 1 hour.Immediate postoperative blood flow,early stent thrombosis,target vessel reconstruction at 30 days after operation,recurrent myocardial infarction,non-fatal cerebrovascular accident,all causes mortality and bleeding conditions at 7 days after operation were compared between two groups.Results The immediate postoperative thrombolysis in myocardial infarction (TIMI)blood flow was significantly improved(P＜0.05) in the treatment group as compared with control group.There was no significant difference in target vessel reconstruction at 30 days after operation,recurrent myocardial infarction,non-fatal cerebrovascular accident,and all-cause mortality between two groups (all P＞ 0.05).The bleeding conditions at 7 days after operation were significant lower in the treatment group [2.5％(1 case)]than in the control group[22.5％ (9 cases)] (x2 =7.31,P＜0.01).Conclusions Bivalirudin treatment does not reduce the major cardiovascular events,but improves the TIMI blood flow after surgery and the incidence of bleeding as compared with control group,which suggests that Bivalirudin is safer in emergency PCI therapy in elderly patients with acute ST-segment elevation myocardial infarction

Objective To investigate the protective effect of meglumine adenosine cyclosphosp (MAC) on the cerebral ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty four healthy rabbits were randomly divided into control group (n =6),I/R group (n =6),MAC pretreated group (n =6),and MAC treated group (n =6).Cerebral ischemia-reperfusion injury model was made by separating and electrocoagulating vertebral arteries and clipping common carotid arteries in the latter 3 groups after anesthesia.The sham-operated group underwent vessel separation without clipping.L/R group was administered with nothing,while MAC pretreated group with MAC before ischemia,and MAC treated group with MAC just after ischemia.Blood was gathered from jugular vein before ischemia,and 30 min,1 h,and 2 h after reperfusion for testing IL-8,superoxide dismutase (SOD) and malondialdehyde (MDA).The brain tissue slice was observed by optical microscope.Results Compared to control group and before ischemia,the levels of IL-8 and SOD in serum were significantly increased and decreased,and the levels of MDA was significantly increased at 30 min after reperfusion in I/R group; the levels of IL-8 and MDA in serum were significantly increased,and the levels of SOD in serum was significantly decreased at 1 h and 2 h after reperfusion in I/R group.The levels of IL-8 in serum was less at 30 min and 1 h and 2 h after reperfusion in MAC pretreated group than in I/R group.At 1 h and 2 h after reperfusion,the levels of MDA in serum was less and the levels of SOD in serum was higher in MAC pretreated group than in I/R group.At 1 h and 2 h after reperfusion,the levels of IL-8 in serum were less and the levels of SOD in serum were higher in MAC treated group than in I/R group.The levels of MDA in serum were less at 2 h after reperfusion in MAC treated group than in I/R group.Compared to I/R group,pathological change was lighter in the MAC pretreated and MAC treated group.Conclusions MAC has a fine cerebral-protective effect and has no side effect.