Efficacy and safety of bivalirudin in elderly patients with ST-segment elevation myocardial infarction
Wang Baoguo
Su Qiang
Liu Jingwei
Huang Chaoqun
Wang Xiang
Wang Lin
Zhang Weihua
Abstract：Objective To investigate the efficacy and safety of bivalirudin versus unfractionated heparin during perioperative primary percutaneous coronary intervention(PCI)in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 423 elderly patients with acute STEMI who underwent primary PCI in our hospital were consecutively en-rolled in this study.According to different perioperative anticoagulant regimens,they were divided into bivalirudin group(187 cases)and unfractionated heparin group(236 cases).Baseline data,characteristics of interventional procedures and complications during hospitalization were ana-lyzed.Primary endpoint was major adverse cardiac or cerebral events(MACCE).Secondary end-points were net adverse clinical events.Other observational indicators included stent thrombosis,acquired thrombocytopenia,BARC types 1-2 bleeding and total bleeding events.Results In-hospital MACCE and all-cause mortality were significantly lower in the bivalirudin group than unfractionated heparin group(3.7％vs 9.7％,P=0.021;3.7％vs 8.9％,P=0.039).Univariate logistic regression analysis showed that perioperative application of bivalirudin significantly reduced all-cause mortality in the patients with Killip grade Ⅰ and creatinine clearance ≥60 ml/min when compared with unfractionated heparin(P＜0.05).Conclusion In elderly patients with acute STEMI,perioperative use of bivalirudin significantly reduces the incidences of MACCE and all-cause death during hospitalization,especially in the patients with Killip grade Ⅰ and creatinine clearance ≥60 ml/min.
Keywords：myocardial infarctionhirudinsheparinanticoagulantspercutaneous coronary inter-ventionretrospective studieslogistic modelsbivalirudin
Publication Date：2023-10-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1051-1055 )