国产比伐卢定在老年急性冠脉综合征患者介入术中治疗效果

The therapeutic effect of bivalirudin during primary percutaneous coronary intervention in elderly patients with acute coronary syndrome

目的研究老年(年龄>65岁)急性冠脉综合征(ACS)患者在经皮冠脉介入(PCI)治疗术中使用国产比伐卢定的安全和有效性。方法本研究通过回顾性分析我院35例PCI术中应用比伐卢定的老年ACS患者的临床资料,按1∶1匹配选取同期35例PCI治疗过程中常规应用普通肝素的老年ACS患者作为对照组,分析术后30 d内的主要不良心脑血管事件(major adverse cardiac and cerebrovascular events,MACCE)及出血并发症的发生情况。结果两组临床资料对比,差异无统计学意义。术后30 d内MACCE发生率分别为4例(11%)和5例(14%),差异无统计学意义;出血并发症发生率分别为1例(3%)和6例(17%),比伐卢定组优于普通肝素组(P<0.05)。结论老年ACS患者PCI术中使用比伐卢定与普通肝素相比,可减少术后30d内的出血事件发生率,且不增加MACCE的风险。

AIM To evaluate the efficiency and safety of bivalirudin during percutaneous coronary inter- vention （PCI） in elderly patients （ Age 〉 65 ） with acute coronary syndrome （ACS）. METHODS Medical records were analyzed in 35 patients given bivalirudin during PCI. The same type of records were screened in which unfractionated heparin （UFH） was used during PCI at a ratio of 1 ： 1 for a control group of 35 patients. The main endpoint events included major adverse cardiac and cerebrovascular events （MACCE） and severe bleeding complications at 30 days. RESULTS There were no significant differ- ences between the two groups. The incidences of MACCE （11% vs. 14% ）, which was 4 for bivalirudin and 5 for heparin at 30 days, demonstrated no statistical significance. The incidences of bleeding （3% vs. 17% , P 〈0.05） , which was 1 for bivalirudin and 6 for heparin, showed that the bivalirudin group is superior to the heparin group. CONCLUSION The use of bivalirudin resulted in a decrease in bleeding events without significant difference in MACCE compared with heparin alone at 30 days.