Study on the efficacy and safety of bivalirudin in PCI for patients with acute coronary syndrome at high risk of bleeding

Wang Zhiyong; Li Gang; Zhang Likun

doi:10.3969/j.issn.1674-4055.2017.09.03

Abstract：Objective To compare efficacy and safety of bivalirudin and tirofiban combined with enoxaparin in percutaneous coronary intervention (PCI) for patients with acute coronary syndrome (ACS) at high risk of bleeding. Methods The ACS patients who received PCI were selected from Oct. 2015 to Sep. 2016. They were divided into experimental group and control group according to CRUSADE bleeding risk classification. The experimental group was given bivalirudin after PCI operation. The control group was given enoxaparin before PCI operation and given tirofiban after PCI operation. Postoperative coronary artery vasospasm blood stream grade and the incidence of adverse cardiac events and bleeding of the two groups of patients undergoing PCI after 30 days are evaluated respectively. Results Gender, the history of diabetes, peripheral vascular and heart failure in experimental group ware significantly higher than those in control group (P<0.05). no significant difference between the two groups with respect to TIMI classification (P>0.05). There was no significant difference in the incidence of adverse cardiac events between the two groups (P>0.05). There were 1 (2.12%) bleeding events in experimental group and 6 (10.34%) bleeding in control group. There was a significant difference in the incidence of bleeding between the two groups (P<0.05). Conclusion Bivalirudin and tirofiban combined with enoxaparin show similar efficacy in prevention of the postoperative incidence of adverse cardiac events after 30 days of PCI. But, bivalirudin can effectively reduce the incidence of postoperative bleeding after PCI.