Liu Zijing, Wang Guozhong, Niu Dan, Wu Yongxia, Li Zixuan, Zhang Libin, Zhu Guohua, Hua Qi, Guo Jincheng
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 10000, China.
Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing 100000, China.
J Interv Cardiol. 2020 Sep 26;2020:7905021. doi: 10.1155/2020/7905021. eCollection 2020.
This study aimed to evaluate the antithrombotic efficacy between bivalirudin and unfractionated heparin (UFH) on radial artery thrombosis (RAT) during transradial coronary intervention (TRI) by optical coherence tomography (OCT).
We consecutively reviewed a total of 307 patients who underwent radial artery OCT inspection after TRI in our centre from October 2017 to January 2019; afterwards, 211 screened patients were divided into the UFH group ( = 144) and the bivalirudin group ( = 67) according to their anticoagulation strategy during TRI. The thrombosis in the radial artery was observed in 51 cases (24.17%) with a median thrombus volume of 0.054 mm (0.024, 0.334) and median thrombus score of 7 (4, 15). Thrombus occurred in 28 cases in the bivalirudin group with an incidence of 41.8%, which was significantly higher than that in the UFH group ( = 23, 16.0%, < 0.001). This difference was even more remarkable after propensity score matching (bivalirudin group = 22, 42.3% vs. UHF group = 11, 13.9%, < 0.001). Multivariate logistic analysis revealed that bivalirudin increased the RAT risk by 3.872 times (95% CI 2.006-8.354, < 0.001) after adjustment for the other predictors.
In this present study, the use of bivalirudin was associated with a higher risk of RAT than UFH. It highlighted UFH should be a more considerable choice to prevent radial artery access thrombosis in TRI.
本研究旨在通过光学相干断层扫描（OCT）评估比伐卢定与普通肝素（UFH）在经桡动脉冠状动脉介入治疗（TRI）期间对桡动脉血栓形成（RAT）的抗血栓疗效。
我们连续回顾了2017年10月至2019年1月在本中心接受TRI后进行桡动脉OCT检查的307例患者；之后，根据他们在TRI期间的抗凝策略，将211例筛选出的患者分为UFH组（n = 144）和比伐卢定组（n = 67）。在51例（24.17%）患者中观察到桡动脉血栓形成，中位血栓体积为0.054 mm（0.024，0.334），中位血栓评分7分（4，15）。比伐卢定组有28例发生血栓，发生率为41.8%，显著高于UFH组（n = 23，16.0%，P < 0.001）。倾向评分匹配后，这种差异更为显著（比伐卢定组n = 22，42.3% vs. UHF组n = 11，13.9%，P < 0.001）。多因素逻辑分析显示，在对其他预测因素进行调整后，比伐卢定使RAT风险增加3.872倍（95%CI 2.006 - 8.354，P < 0.001）。
在本研究中，与UFH相比，使用比伐卢定与RAT风险较高相关。这突出表明UFH应是预防TRI中桡动脉穿刺部位血栓形成更值得考虑的选择。
