Clinical Observation On The Safety And Therapeutic Effect Of Bivalirudin During PCI To Patients With ACS

Objective:To evaluate the efficacy and safety of domestic bivalirudin during percutaneous coronary intervention(PCI) in treatment of patients with acute coronary syndrome.Methods:The retrospective study included 174 cases of patients with acute coronary syndrome in Shan Dong province hospital from Sep.2014 to Feb.2015. The mean age of the patients was 62.9±10.2 years old and all of them were diagnosed of ACS by clinical symptoms and CAG. According to the different anticoagulant drugs used in PCI, we have 174 patients were divided into two group:GROUP A:intraoperative simple application bivalirudin as anticoagulant drugs (42 cases), GROUP B:intraoperative simply application unfractionated heparin as anticoagulant drugs (132 cases). The incidence of the major adverse cardiac events(MACE) and bleeding events during 24 hours,30 days were compared between the two groups, hemorrhagic complications were evaluated according to TIMI criteria and BARC criteria. The incidence of patients with blood transfusion and thrombocytopenia were also compared between the two groups. The major adverse cardiac events including:cardiac death, myocardial infarction, stroke and revascularization.Results:1. Comparison of the clinical data between the two groups:There were no significant differences between the two groups at the clinical data such as age, sex, coronary heart disease risk factors:hypertension, diabetes, smoking, hyperlipidemia and the approach of PCI. In fasting blood indicators including blood glucose, total cholesterol, low density lipoprotein(LDL), and renal function, there is no statistically significant differences between the two groups. There was no major adverse cardiovascular events occur2. Comparison of the safety between the two groupsThere was no major adverse cardiovascular events occurred in group A. However, group B includes one patient with myocardial infarction after PCI. The incidence of major adverse cardiovascular events had no statistically significant differences between the two groups during 24 hours or 30 days after PCI. According to the TIMI criteria, group A had a significantly lower rate of bleeding (P<0.05) in insignificant bleeding complication. This also occurred in Typel bleeding complication BARC criteria.Conclusions:According to the results of clinical data, compare to UFH, application of bivalirudin in patients with ACS treated by PCI was safe and displayed a low incidence of bleeding complications.