Efficacy Of Intracoronary Bivalirudin On No-reflow Patients Undergoing PCI In Acute ST-segment Elevation Myocardial Infarction

Objective: To explore the safety and efficacy of intracoronary infusion of bivalirudin in patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing primary percutaneous coronary intervention(PPCI).Methods:This is a retrospective study.A total of 32 patients who were undergoing PPCI from May 2017 to August 2018 in Yongchuan Hospital of Chongqing Medical University,with STEMI and no-reflow or slow flow during PPCI,were enrolled into this study(All patients were treated with bivalirudin anticoagulant during PCI).According to the choice of drugs to treat no-reflow in coronary artery,the patients were divided into two groups: the bivalirudin group(n=16)and the control group(n=16).The TIMI blood flow grade of target vessel after treatment,the incidence of postoperative hemorrhage,adverse cardiovascular events and 30 major adverse cardiac events(MACE)were observed and compared between the two groups.Results: Compared with the control group,the proportion of TIMI grade 3 patients [12 cases(75%)/ 6 cases(37.5%)] in the bivalirudin group was significantly higher than that in the control group(P<0.05),and therewas no difference between the two groups in postoperative adverse cardiovascular events(P > 0.05).There were no postoperative bleeding events and 30 days MACE events in both groups.Conclusions: Intracoronary injection of bivalirdine can improve the no-reflow or slow blood flow in the PPCI of patients with STEMI,and increase the TIMI grade of the target vessel.