Study Of Bivalirudin In Patients With Acute Myocardial Infarction In Percutaneous Coronary Intervention

Objective: To evaluate efficacy and safety of bivalirudin in patients with acutemyocardial infarction in percutaneous coronary intervention.Methods: The study was prospective, randomized, control study. From May,2012to Feb,2013, a total of200patients with acute myocardial infarction(including STEMIand NSTEMI)) were enrolled. Patients were randomized into two groups. Bivalirudingroup (n=100): Bivalirudin0.75mg/kg, iv as loading dose, and then1.75mg/kg/h tilloperation endless. Heparin plus tirofiban group (n=100): patients used tirofiban iv,initial dose was10μg/kg (iv should be done within3mins). When in the CatheterRoom, heparin was injected by vein. Main evaluation indicators: in hospital and30daysafter PCI MACCEs (cardic death, non-fatal acute myocardial infarction, emergentrevascularization target vessel, ischemic stroke), and bleeding events.Results: There were no differences between the two groups in the baselinecharacters: gender, ages, active smoking, history of stroke and MI.(P>0.05). After30days follow up, the MACCEs in two groups were2patients vs4patients respectively(2.0%vs4.0%, P=0.683); For the incidence rate of all bleeding events, Bivalirudingroup was lower than heparin+tirofiban group (2.0%vs10.0%, P=0.033). For theincidence rate of bleeding in BARC1~2grade，Bivalirudin group was2.0%, andheparin+tirofiban group was8.0%(P=0.101).Conclusion: Compared to heparin combined with tirofiban, bivalirudin could achievegood anticoagulant effect and has a lower incidence of bleeding for AMI patients in thePCI perioperative.