摘要
目的比较急诊高危行经皮冠脉介入术(PCI)治疗患者围手术期应用比伐芦定或肝素抗凝效果、主要心血管不良事件(MACE)发生率及临床疗效。方法选取河北省第七人民医院2018年1月至2019年12月86例行PCI的急性ST段抬高型心肌梗死(STEMI)患者,HAS-BLED评分≥3分,根据随机数字表法分为两组,比伐芦定组(n=43)PCI围手术期接受比伐芦定抗凝治疗,肝素组(n=43)PCI围手术期接受肝素抗凝治疗。比较两组患者ST段回落率、心肌梗死溶栓(TIMI)分级、心肌染色(MBG)分级和PCI术后7 d出血事件发生率以及PCI术后6个月MACE发生率。结果两组患者ST段回落率、TIMI分级、MBC分级和PCI术后6个月MACE发生率比较无统计学差异(P>0.05)。比伐芦定组PCI术后7 d出血事件发生率明显低于肝素组(P<0.05)。结论急诊高危PCI患者围手术期应用比伐芦定,抗凝效果、临床疗效、MACE发生率与肝素相当,且比伐芦定能显著降低出血风险。
Objective To compare the perioperative anticoagulant effects of bivalrudine and heparin,the incidence of major adverse cardiovascular events(MACE)and clinical efficacy in emergency high-risk percutaneous coronary intervention(PCI)patients.Methods A total of 86 ST-segment elevation myocardial infarction(STEMI)patients who underwent PCI in the Seventh People’s Hospital of Hebei Province from January 2018 to December 2019 were selected,with a HAS-BLED score≥3,according to the random number table method,they were divided into two groups,the bivalrudin group(n=43)received bivalrudin anticoagulant therapy during PCI perioperative period,and the heparin group(n=43)received heparin anticoagulant therapy during PCI perioperative period.The ST segment fall rate,myocardial infarction thrombolysis(TIMI)grading,myocardial staining grading(MBG),corrected TIMI frames,the incidence of bleeding events 7 days after PCI,and the incidence of MACE 6 months after PCI were compared between the two groups.Results There was no difference in ST segment fall rate,TIMI grade,MBC grade,and incidence of MACE 6 months after PCI between the two groups(P>0.05).The incidence of bleeding events on the 7th day after PCI in the bivalrudine group was significantly lower than that in the heparin group(P<0.05).Conclusion The perioperative use of bivalarudin in emergency high-risk PCI patients has the same anticoagulant effect,clinical efficacy,and incidence of MACE as heparin.Bivarrudine can significantly reduce the bleeding risk and is worthy of clinical promotion.
作者
刘育慧
李云贺
耿清峰
宋光伟
LIU Yuhui;LI Yunhe;GENG Qingfeng;SONG Guangwei(Department of Internal Medicine-Cardiovascular,The Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine(The Seventh People's Hospital of Hebei Province),Dingzhou 073000,Heibei,China)
出处
《中国分子心脏病学杂志》
CAS
2022年第2期4561-4566,共6页
Molecular Cardiology of China
基金
河北省卫生厅科研基金项目(20160054)。
关键词
经皮冠脉介入术
比伐芦定
肝素
抗凝
出血
主要心血管不良事件
Percutaneous coronary intervention
Bivarrudine
Heparin
Anticoagulation
Hemorrhage
Major cardiovascular adverse events
