Curative effect and safety of bivalirudin combining different antiplatelet drugs for patients with acute ST-segment elevation myocardial infarction undergone percutaneous coronary intervention
SUN Jin-liang
Abstract：Objective To review the curative effect and safety of bivalirudin combining different antiplatelet drugs for patients with acute ST-segment elevation myocardial infarction (STEMI) undergone emergency percutaneous coronary intervention (PCI). Methods STEMI patients with planed emergency PCI (n=159, male 96, female 63 and aged from 28 to 87) were chosen from Jun. 2013 to Oct. 2015. The patients were randomly divided into group A (treated with bivalirudin and clopidogrel, n=48), group B (treated with bivalirudin and ticagrelor, n=42) and group C (treated with heparin and clopidogrel, n=69). During PCI, the patients in 3 groups were given routine intracoronary injection of tirofiban. Group A and group B were orally given aspirin (300 mg) and clopidogrel (600 mg), and group B was orally given aspirin (300 mg) and ticagrelor (180 mg) in emergency department. Group A and group B were given intravenous injection of bivalirudin in loading dose (0.75 mg/kg) before PCI, intravenous pumping of bivalirudin 1.75 mg/(kg·h)continuously during PCI and reduced to 0.2 mg/(kg·h)at the end of PCI until a tube finished. After stopping injection of bivalirudin for 1 h, group A and group B were given hypodermic injection of Enoxaparin (100 U/kg, bid) for 7 d. Group C was given intravenous injection of Enoxaparin (100 U/kg) before PCI, 4 h after PCI and was given hypodermic injection of Enoxaparin (100 U/kg, 1/12 h) for 7 d. The blood flow grades of coronary culprit vessel after stenting, and incidence of cardiac events and bleeding within 30 d after PCI was recorded in 3 groups. Results The comparison in TIMI flow grades showed no statistical difference among 3 groups after stenting (all P>0.05). The total incidence of cardiac events increased significantly in group C compared with group A (24.64% vs. 8.33%) and group B (24.64% vs. 4.67%, all P<0.05). The difference in bleeding incidence had no statistical significance among 3 groups (all P>0.05). Conclusion In case of routine use of tirofiban, bivalirudin combining clopidogrel or ticagrelor has superior curative effect and higher safety than heparin combining clopidogrel in STEMI patients undergone emergency PCI.
Keywords：Acute myocardial infarctionBivalirudinTirofibanClopidogrelTicagrelor
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 550-552 )