| Objective:the patients who were enduring Acute ST-segment elevation myocardial infarction (STEMI) and received emergent primary percutaneous coronary intervention therapy (PCI) were respectively applied bivalirudin and tirofiban plus heparin, and to compare the myocardial reperfusion, recent treatment efficacy and safety between the two groups. Methods:A numberl of 128 patients who suffered from STEMI and received primary PCI were randomly divided into tirofiban plus heparin group andbivalirudin group,respectively 60 and 68 cases in each group, the patients of Bivalirudin group received bivalirudin 0.75mg/kg,followed by an infusion of bivalirudin 1.75mg/(kg·h) continuing 4 hours,while Tirofiban plus heparin group.patients received tirofiban 10ug/kg,followed by tirofiban infusion of 0.075ug/(kg·min)for 36 hours,while taken heparin 100 units/kg during PCI procedure. the patients were requested to observe of TIMI flow grade and TMPG grade; the two group were compared by the safety and effectiveness index of patients, including the total incidence rate of adverse events after 24 hours and 1 month. Result:the two groups of patients after PCI serum P selectin and PTX-3 levels were lower than Before operation, while GMP-140 level was higher than the preoperative (P<0.05), between the two groups of P selectin, GMP-140, PTX-3 concentrations were not statistically significant (P> 0.05).There were not any significant difference between the two groups on TIMI, TMPG flow grade, the major adverse cardiovascular events rate in 24 hours and 1 month (P>0.05); bivalirudin group had a significantly statistically lower rate of bleeding in 1 month follow-up (P<0.05). Conclusion:In patients who were undergoing emergency PCI, bivalirudin and tirofiban plus heparin had the similar incidence of the major adverse cardiovascular events, but bivalirudin can significantly statistically reduce postoperative recent bleeding events, especially in Intermediate and high-risk STEMI patients. |
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