Effect Of Bivalirudin On Interventional Treatment Of Coronary Bifurcation Lesions

Objective: This study aimed to investigate the efficacy and safety of bivalirudin in the interventional treatment of coronary bifurcation lesions.METHODS: This study was a retrospective cohort study and was included in the interventional treatment of coronary artery bifurcation lesions in the Department of Cardiology,Second Affiliated Hospital of the Army Military Medical University from January 2016 to December 2016.According to the different methods of anticoagulation,it was divided into heparin group and bivalirudin group.RESULTS: There were no MACE in both heparin and bivalirudin groups within 24 h or within 7d after PCI,heparin group had 3 bleeding cases,and no cases in major bleeding events;5 cases of bleeding occurred,1 case in major bleeding events in the bivalirudin group;the difference between the two groups was not significant(P=0.477,P=0.459).After 12 months of follow-up,there were 20 patients with MACE in the heparin group and 15 patients with bivalirudin.Multivariate analysis showed that bivalirudin had no significant difference in MACE after PCI for bifurcation lesions compared with heparin.(HR=0.839,95% CI 0.420–1.676,P=0.619).After 12 months of follow-up,49 patients in the heparin group had bleeding events,6 major bleeding events;27 patients in the bivalirudin group had bleeding events,3 major bleeding events;multivariate analysis further showed bivalirudin Heparin significantly reduced the risk of bleeding events in patients with bifurcation lesions(HR=0.557,95% CI 0.355–0.937,P=0.026);there was no significant difference in the risk of major bleeding events(HR= 0.535,95% CI 0.130–2.206,P=0.387).CONCLUSIONS: In patients undergoing interventional therapy for coronary bifurcation lesions,the anticoagulant effect of bivalirudin was not inferior to unfractionated heparin within 24 h or within 7d after PCI,and did not increase the incidence of MACE events and the risk of bleeding;bivalirudin significantly reduced bleeding risk compared with unfractionated heparin at 12 months of follow-up,without increasing the incidence of MACE events.