Du Ya-Kun, Cui Li-Jun, Gao Hong-Bo
Cardiovascular Department, Hanzhong People's Hospital, Hanzhong 723000, Shaanxi Province, China.
World J Clin Cases. 2024 Aug 6;12(22):4890-4896. doi: 10.12998/wjcc.v12.i22.4890.
Bivalirudin, a direct thrombin inhibitor, is used in anticoagulation therapies as a substitute for heparin, especially during cardiovascular procedures such as percutaneous coronary intervention.
To explore the effect of bivalirudin on myocardial microcirculation following an intervention and its influence on adverse cardiac events in elderly patients with acute coronary syndrome (ACS).
In total, 165 patients diagnosed with acute myocardial at our hospital between June 2020 and June 2022 were enrolled in this study. From June 2020 to June 2022, elderly patients with ACS with complete data were selected and treated with interventional therapy. The study cohort was randomly divided into a study group ( = 80, administered bivalirudin) and a control group ( = 85, administered unfractionated heparin). Over a 6-mo follow-up period, differences in emergency processing times, including coronary intervention, cardiac function indicators, occurrence of cardiovascular events, and recurrence rates, were analyzed.
Significant differences were observed between the study cohorts, with the observation group showing shorter emergency process times across all stages: Emergency classification; diagnostic testing; implementation of coronary intervention; and conclusion of emergency treatment ( < 0.05). Furthermore, the left ventricular ejection fraction in the observation group was significantly higher ( < 0.05), and the creatine kinase-MB and New York Heart Association scores were notably lower than those in the control group ( < 0.05).
In elderly patients receiving interventional therapy for ACS, bivalirudin administration led to increased activated clotting time achievement rates, enhanced myocardial reperfusion, and reduced incidence of bleeding complications and adverse cardiac events.
比伐芦定是一种直接凝血酶抑制剂，在抗凝治疗中用作肝素的替代品，尤其是在经皮冠状动脉介入治疗等心血管手术期间。
探讨比伐芦定对老年急性冠状动脉综合征（ACS）患者介入治疗后心肌微循环的影响及其对不良心脏事件的影响。
选取2020年6月至2022年6月在我院诊断为急性心肌梗死的165例患者纳入本研究。2020年6月至2022年6月，选取资料完整的老年ACS患者并给予介入治疗。将研究队列随机分为研究组（n = 80，给予比伐芦定）和对照组（n = 85，给予普通肝素）。在6个月的随访期内，分析急诊处理时间的差异，包括冠状动脉介入治疗、心功能指标、心血管事件的发生情况和复发率。
研究队列之间观察到显著差异，观察组在所有阶段的急诊处理时间均较短：急诊分类；诊断检查；冠状动脉介入治疗的实施；以及急诊治疗的结束（P < 0.05）。此外，观察组的左心室射血分数显著更高（P < 0.05），肌酸激酶同工酶和纽约心脏协会评分明显低于对照组（P < 0.05）。
在接受ACS介入治疗的老年患者中，给予比伐芦定可提高活化凝血时间达标率，增强心肌再灌注，并降低出血并发症和不良心脏事件的发生率。
