Chen H, Yu X, Kong X, Li L, Wu J, Ma L. Efficacy and safety of bivalirudin application during primary percutaneous coronary intervention in older patients with acute ST-segment elevation myocardial infarction.
J Int Med Res 2020;
48:300060520947942. [PMID:
32985292 PMCID:
PMC7536496 DOI:
10.1177/0300060520947942]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective
ST-segment elevation myocardial infarction (STEMI) is the most serious type
of acute coronary syndrome. This study aimed to investigate the efficacy and
safety of bivalirudin application during primary percutaneous coronary
intervention (PPCI) in older patients with acute STEMI.
Methods
A total of 672 older patients with STEMI (>75 years) who underwent PPCI
were studied. The primary endpoints were 30-day net adverse clinical events
(NACEs) post-emergency percutaneous coronary intervention, including major
adverse cardiac and cerebrovascular events (MACCEs) and Bleeding Academic
Research Consortium grades 2 to 5 (BARC 2–5) bleeding events.
Results
The incidence of NACEs and BARC 2–5 bleeding events in the bivalirudin group
was significantly lower than that in the unfractionated heparin group.
Multivariate Cox regression analysis showed that bivalirudin significantly
reduced 30-day NACEs (odds ratio: 0.700, 95% confidence interval:
0.492–0.995) and BARC 2–5 bleeding events (odds ratio: 0.561, 95% confidence
interval: 0.343–0.918). At 1-year follow-up, these results were similar.
Conclusions
Bivalirudin can be safely and effectively used during PPCI in older patients
with STEMI. Bivalirudin reduces the risks of NACEs and bleeding within 30
days after PPCI, without increasing the risks of MACCEs and stent thrombosis
compared with heparin.
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