The application of bivalirudin in elderly patients with chronic total occlusion of coronary artery
Wang Yong
Zhao Hongwei
Wang Chengfu
Fan Chunyu
Zhang Xiaojiao
Luo Defeng
Zhu Yu
Chen Baojun
Yu Guoning
Hou Aijie
Luan Bo
Abstract：investigate the curative effect of bivalirudin in elderly patients with chronic total occlusion of coronary artery (CTO) undergone percutaneous coronary intervention (PCI). Methods CTO patients (n=118) were chosen from People’s Hospital of Liaoning Province from Jan. 2016 to Jan. 2018. All patients were divided randomly into unfractionated heparin group (UFH group, given 2500 U of UFH before coronary angiography, 100 U/kg before PCI, 1000 U every 1 h, n=66), and bivalirudin group (given 0.75 mg/kg of bivalirudin, 1.75 mg/kg/h continuously to 4 h after PCI, n=52). The main efficacy endpoint was defined as the incidence rate major adverse cardiovascular events (MACE) during hospitalization period and after discharged for 6 months. The safety endpoint was any bleeding and postoperative complications around PCI area. Results The incidence rates of slow flow/no-reflow (3.8% vs. 16.7%, P=0.037) and minor bleeding (17.3% vs. 34.8%, P=0.039) were significantly lower in bivalirudin group than those in UFH group after PCI. During hospitalization period, the incidence rate of PCI-related myocardial infarction was significantly lower in bivalirudin group than that in UFH group (9.6% vs. 25.8%, P=0.032). After discharged for 6 months, the incidence rate of MACE had no statistical difference between 2 groups (all P>0.05). Conclusion Bivalirudine as an anticoagulant used during PCI can reduce the incidence rates of slow flow/no-reflow, PCI-related myocardial infarction and bleeding-related complications around PCI area without increasing the risk of MACE for 6 months in elderly patients with CTO.
Keywords：Elderly patientsChronic total occlusion of coronary arteryPercutaneous coronary interventionBivalirudinUnfractionated heparin
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1327-1329,1332 )