Value of PCI perioperative application of bivaludin in patients with acute myocardial infarction with high SYNTAX score

YAN Jie-song

doi:10.3969/j.issn.1672-5301.2024.05.010

Abstract：Objective To investigate the value of bivalirudin perioperative PCI use in patients with acute myocardial infarction(AMI)with high SYNTAX score.Methods A total of 141 patients with AMI with high SYNTAX score admitted to our hospital from February 2020 to February 2022 were selected as the study objects.The patients were divided into two groups according to PCI perioperative application of different anticoagulant drugs.68 patients receiving bivalirudin were included in the study group,and 73 patients receiving ordinary heparin were included in the control group.The general data,cardiac function indexes,cardiovascular adverse events and bleeding events were compared between the two groups.A multi-criteria decision analysis model was established for the benefit and risk of perioperative application of bivalirudin in AMI patients with high SYNTAX score.The data were combined by RevMan 5.3 to obtain the effect values of each benefit index and risk index.Hiview 3 was used to analyze the risk value,benefit value and benefit-total risk value of 2 groups,and to analyze the sensitivity of the model.Results There was no significant difference in PLT between the two groups before and after the treatment(P>0.05).LVESD,LVEDD and NT-proBNP of the study group were significantly lower than those of the control group after the treatment(P<0.05).After the treatment,ACT,LVEF,total effective rate,total cardiovascular adverse events and total bleeding events in the study group were significantly higher than those in the control group(P<0.05).The benefit values,the risk values and the benefit-risk total values of 2 groups were 79 and 63,70 and 36 and 75 and 50 respectively.The study group had a higher benefit-risk ratio.No matter how the relative weight of benefit-risk changes,the evaluation results of the model remained unchanged,indicating that the model had a good stability.Conclusion For AMI patients with high SYNTAX score,anticoagulant treatment with bivalirudin during perioperative period of PCI can obtain good clinical efficacy,improve patients'cardiac function and reduce the occurrence of adverse reactions and can be promoted clinically as a substitute for ordinary heparin.