Effect observation and safety evaluation of Bivalrudine on slow blood flow/no-reflow treatment in elderly patients with coronary heart disease after PCI
FAN Linglong ZHANG Yilin▲
Department of Cardiovascular Medicine, Hangzhou Ninth People’s Hospital, Zhejiang Province, Hangzhou 311225, China
Abstract:Objective To investigate the effect of Bivalrudin on the treatment of slow blood flow/no-reflow in elderly patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods A total of 146 elderly patients with coronary heart disease with slow blood flow/no-reflow during emergency PCI who were admitted to Hangzhou Ninth People’s Hospital from August 2019 to October 2021 were collected, and theye were divided into the study group (treated with Bivalrudine, 73 cases) and control group (treated with unfractionated heparin, 73 cases) by digital parity method. Coronary artery TIMI blood flow classification and coagulation function (prothrombin time [PT], activated partial thromboplastin time [APTT], thrombin time [TT], the maximum platelet aggregation rate (MPAR) and related indicators of microcirculation function (coronary artery blood flow reserve [CFR], microcirculation resistance index [IMR]) in two groups after PCI were compared. Major adverse cardiac events (MACE) and bleeding events within 30 days after PCI were compared between the two groups. Results Blood flow grading in the study group was better than that in the control group (P < 0.05). After treatment, PT, APTT, and TT increased in both groups, while MPAR decreased. PT, APTT, and TT in the study group were higher than those in the control group, while MPAR was lower than that in the control group (P < 0.05). After treatment, CFR and IMR in the two groups were increased, and CFR in the study group were higher than those in the control group, and IMR was lower than the control group (P < 0.05). The total incidence and bleeding rate of MACE in the study group were lower than those in the control group (P < 0.05). Conclusion The application of Bivalrudin during PCI in elderly patients with coronary heart disease can improve patients’ slow blood flow/no-reflow, coagulation function and microcirculation function, regulate MPAR, and reduce the incidence of MACE and bleeding after surgery.