The Therapeutic Effect Of Post-procedural Bivalirudin Infusion Following Primary Percutaneous Coronary Intervention For Elderly Patients With Acute Coronary Syndrome

AIMTo evaluate the efficiency and safety of continuing the bivalirudin infusion after percutaneous coronary intervention in elderly patients with acute coronary syndrome.METHODSMedical records were analyzed in 173 patients(over 65 years old)who underwent percutaneous coronary intervention with acute coronary syndrome,base on the therapy during PCI,heparin was used in 117 patients and bivalirudin without or with post-procedural Infusion was used in 37 patients and 19 patients respectively.The main endpoint events including major adverse cardiac and cerebrovascular events,bleeding complications and stent thrombosis at 30 days.RESULTSThere were no significant differences between three groups at the clinical data.The incidences of MACCE at 30 days(8.5% vs 13.5% vs 5.3%)have no statistical significance(P=0.541).The incidences of bleeding(13.7% vs 2.7% vs 0.0%)were significant different among three arms(P=0.046).The incidences of bleeding for bivalirudin group with post-procedural infusion were significantly lower than bivalirudin group without post-procedural infusion(P=0.047),and were slightly lower without statistical significance compared to heparin group(P=0.086).The incidences of bleeding for bivalirudin group without post-procedural infusion were slightly lower without statistical significance compared to heparin group(P=0.063).No significant difference(P=0.786)was found in stent thrombosis among the three groups(0.9% vs 0%vs 0%)at 30 days.CONCLUSIONIn elderly patients with acute coronary syndrome,The use of bivalirudin with or without post-procedural infusion after percutaneous coronary intervention resulted in a decrease in bleeding events compared to heparin group with comparable and low risks of MACCE and stent thrombosis.