Comparison in curative effect and safety between bivalirudin and heparin in elderly patients with STEMI undergone emergency percutaneous coronary intervention
WANG Xue-qin
YANG Chao-rong
SHENG Ming
LI Zhi-zhao
GUO Shuang
WANG Lei
Abstract：Objective To compare the curative effect and safety between bivalirudin and heparin in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergone emergency percutaneous coronary intervention (PCI).Methods The elderly STEMI patients (n=296, male 180 and female 116) undergone emergency PCI were chosen from the Hospital of Beijing Changping District from Jan. 2013 to Dec. 2015. All patients were divided into heparin group (n=169) and bivalirudin group (n=127). The coagulation 4 indexes including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and concentration of fibrinogen (FIB) were detected before and 24 h after PCI. The incidence of major adverse cardiovascular events (MACE) including death, myocardial infarction and re-revascularization were recorded 24 h and 30 d after PCI, and bleeding events were recorded 30 d after PCI.Results The difference in coagulation indexes had no statistical significance between 2 groups before and after PCI (allP>0.05). There were 21 cases (12.43%) of postoperative bleeding and 19 cases of mild bleeding including 13 of hemoptysis and 6 of mucocutaneous hemorrhage, and 2 cases of severe bleeding including 1 of gastrointestinal hemorrhage and 1 of cerebral hemorrhage in heparin group. There were 6 cases (4.72%) of postoperative bleeding and 5 cases of mild bleeding (hemoptysis), and 1 case of severe bleeding (gastrointestinal hemorrhage) in bivalirudin group. The incidence of mild bleeding (3.94%vs. 11.24%) and total incidence of bleeding (4.72%vs. 12.43%) were significantly lower in bivalirudin group than those in heparin group (allP<0.05). The incidence of MACE was lower in bivalirudin group than that in heparin group (2.36%vs. 7.69%) 30 d after PCI (P<0.05). The total incidence of MACE was significantly lower in bivalirudin group than that in heparin group (3.15%vs. 8.88%,P<0.05).Conclusion The incidence of bleeding events and MACE decrease 30 d after PCI in elderly STEMI patients treated with bivalirudin compared with those treated with heparin.
Keywords：Coronary heart diseasePercutaneous coronary interventionBivalirudinHeparinMajor adverse cardiovascular events
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( 1477-1479 )