The Observedvation Of Bivalirudin Effects On The Safety Of High Risk Bleeding Patients Of ACS And Inflammatory Factors

Objective：The experiment comparative observed safety of domestic direct thrombin inhibitorbivalirudin at high risk of bleeding patients with acute coronary syndrome who wereperformed percutaneous coronary artery interventional(PCI), and determined the levelof IL-6,TNF-ɑ, hs-CRP, explore clinical significance of inflammatory factor.Methods:The observation was comparative study.From November,2012to March,2014,the liaoning province people’s hospital of cardiology,a total of70,in high risk ofbleeding patients with ACS who were performed PCI divided into two groups.(1)bivalirudin group:bivalirudin iv0.75mg/kg as loading dose, follow to1.75mg/kg·huntil the end of surgery (ivgtt at least above30min,no more than4hours).(2) heparingroup:heparin iv100u/kg as loading dose, according to the ACT adjust the dosage asfollow. Safety observation:30days after PCI about MACCE (cardiac death、non-fatalacute MI, target vessels reascularization and ischemic stroke)and bleeding events.Bleeding events evaluation ues BARC and REPLACE-2. Lever of inflammatoryfactors:test IL-6,TNF-ɑ,hs-CRP of postoperative about3-7days.Results:At baseline such as age, blood pressure, hypertension, stroke and lab date,therewere no statistical significance between the two groups.The results of CAG: vasculopathy:the success rate of PCI，TIMI3and CTFC were no statistical difference;Bleeding events in30days：under the standard of the REPLACE-2and BARC，themedium dose of bleeding has statistically significant;.Adverse cardiovascular events of30days has no statistical difference; The lever of IL-6, TNF-ɑ,hs-CRP were nosignificant differences, but it is obviousily lower in bivalirudin group.Conclusion:1.In30days after PCI,at the medium of bleeding events,bivalirudin group is lower thanheparin, it tells us bivalirudinis is more suitable for high risk of bleeding patients withsafety.2.The effect of anticoagulant, it is similay between heparin and bivalirudin,incidenceof MACCE after the PCI has no statistical difference.3.Bivalirudin can reduce the level of hs-CRP, IL-6and TNF-ɑ.,but it has no statisticaldifference.