Clinical observation of anticoagulant effect and safety of bivalirudin and heparin in elderly patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention
10.3760/cma.j.cn114015-20220408-00297
- VernacularTitle:比伐芦定和肝素在老年ST段抬高型心肌梗死经皮冠状动脉介入术中的抗凝疗效及安全性临床观察
- Author:
Chao XU
1
;
Lixia YUE
;
Jichun HAO
;
Dong MA
;
Lei WANG
Author Information
1. 河北省沧州市中心医院导管室，沧州 061001
- Publication Type:Journal Article
- Keywords:
ST elevation myocardial infarction;
Percutaneous coronary intervention;
Heparin;
Bivalirudin;
Efficiency;
Safety
- From:
Adverse Drug Reactions Journal
2023;25(2):101-106
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the efficacy and safety of bivalirudin for perioperative use in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).Methods:Clinical data of elderly patients with STEMI who were anticoagulated with bivalirudin (observation group) and the same number of consecutive cases who were anticoagulated with heparin (control group) during the perioperative period of PCI in Cangzhou Central Hospital from May 2018 to June 2020 were collected according to the catheterization room record. The information included patients′ demographic information, previous disease history, preoperative examination and intraoperative findings, thrombolysis in myocardial infarction (TIMI) flow grade before and after operation, as well as all-cause death, major adverse cardiac and cerebrovascular event (MACCE), bleeding events, and stent thrombosis events within 30 days after operation. The improvement of TIMI blood flow grade after PCI and the incidence of all-cause death, MACCE, bleeding events, and stent thrombosis within 30 days after PCI were compared between the 2 groups.Results:A total of 85 patients who were treated with bivalirudin during PCI were entered in the observation group, including 51 males and 34 females, and 85 patients who were treated with heparin during PCI were entered in the control group in the same period, including 50 males and 35 females. The differences in age, gender, previous history of cardiovascular-related diseases, smoking history, heart rate before PCI, estimated glomerular filtration rate, left ventricular ejection fraction, Killip grading, TIMI blood flow grading before the PCI, infarct-related artery, use of intra-aortic balloon pump during operation, PCI procedure route, vascular lesions, and stent implantation between the 2 groups were not statistically significant (all P>0.05). The TIMI blood flow grade in the observation group and the control group after PCI treatment was significantly improved compared with that before treatment, and the difference was statistically significant (all P<0.001). But the difference in TIMI blood flow grade after treatment between the 2 groups was not statistically significant ( P=0.278). The incidence of MACCE within 30 days after PCI in the observation group was lower than that in the control group ( P=0.026), but the differences in all-cause death, cardiogenic death, myocardial infarction, stroke, and target vessel revascularization events, and stent thrombosis within 30 days after PCI were not statistically significant (all P>0.05). Conclusions:The efficacy of anticoagulation with bivalirudin during PCI in elderly patients with STEMI is similar to that of heparin. Compared with heparin, bivalirudin can reduce the overall incidence of MACCE within 30 days after PCI, and does not increase the occurrence risk of stent thrombosis.
