Bivarudin Is Used In The Clinical Research Of Coronary Artery Chronic Complete Occlusive Disease (heart-blood Stasis Syndrome)

Purpose: To observe the efficacy and safety of bivalirudin in patients with chronic total coronary occlusion(CTO)(heart blood stasis syndrome)received percutaneous coronary intervention(PCI).Material and method: 60 CTO(heart blood stasis syndrome)patients who were admitted to The General Hospital of Shenyang Military Command were divided into bivalirudin group(n=30)and unfractionated heparin(UFH)group(n=30)by the random number table.The bivalirudin group received intravenous injection of 0.75mg/kg before coronary angiography,followed by intravenous infusion of 1.75mg/(kg·h)until at least 2 hour after the PCI.The UFH group was injected heparin calcium 5000 U through the artery sheath catheter before coronary angiography,and the heparin calcium was supplemented intravenously at 100 U/kg before PCI.Measuring the values of the activated clotting time(ACT)and remaining them above 250 seconds during the surgery.Analyzed the clinical data,compared the bleeding events and adverse events(including the no-reflow or slow flow and acute cardiac tamponade)of two groups of patients in the perioperative period,observed the improvements before and after the treatment on the syndrome of traditional Chinese medicine(TCM),and followed up the patients for one year,collecting and analyzing the major adverse cardiac events(MACE)(including heart failure,recurrent angina,target vessel revascularizition,cardiac death,nonfatal myocardial infarction and stroke).Results: 1.Clinical data of two groups of patients had no statistically significant difference(P> 0.05),The TCM syndrome scores did not differ significantly between the groups before treatment(P>0.05).2.The incidence of bleeding in the perioperative period of the bivalirudin group was lower than the UFH group,with a statistically significant difference(P<0.05).3.The occurrence of no-reflow or slow flow in the PCI of the bivalirudin group was lower than the UFH group,with a statistically significant difference(P<0.05).4.The score of TCM syndrome in each group improved obviously after the treatment(P <0.05),but there was no significant difference between the two groups(P> 0.05).5.There were no cardiac death and nonfatal myocardial infarction in the two groups after the operation for one year,however,one patient with UFH group was apoplexy,which manifested as cerebral hemorrhage.The occurrence of MACE of two groups has no statistically significant difference(P>0.05).Conclusion: 1.Bivalirudin and UFH anticoagulation effect is obviousis clear in CTO(heart blood stasis syndrome)patients,improving the TCM syndrome,reducing the TCM syndrome score,and there was no significant difference between the two groups.2.Compared with UFH group,the bivalirudin group could significantly reduce the incidence of the no-reflow or slow flow after treated with PCI successfully.3.Bivalirudin was able to reduce the incidence of bleeding events in the perioperative period compared with UFH.4.Bivalirudin and UFH for CTO(heart blood stasis syndrome),after one year follow-up,the incidence of MACE was lower in both groups,and no significant difference.