论文部分内容阅读
Background Renal insufficiency is associated with an excess risk of vascular complications and bleeding events in patients who undergo PCI. Heparin is still used commonly for PCI, but the bleeding complications is high. However, Bivalirudin is similar to heparin in ischemic complications and superior to the bleeding complications. Methods A total of 181 patients with coronary artery disease and renal insufficiency were randomly assigned two treatment groups: Bivalirudin(n = 90), unfractionated heparin(n = 91). Activated clotting time(ACT)was determined in patients at 5 min after undergoing PCI at the end of operation immediately(stopping drug immediately), and 30 min,1 h, 2 h after stopping drug. Activated partial thromboplastin time(APTT), thrombin time(TT), proth rombin time(PT), fibrinogen(FIB) index were measured before treatment, 6 h, 24 h and 72 h after the treatment through an automated coagulation analyzer. Platelet count was monitored before treatment and24 h after treatment. The end points were the proportion of net adverse clinical events(NACE)and stent thrombosis at 30 days. Results The use of bivalirudin was associated with a statistically significant higher at 5 min after treatment, end of operation immediately(P < 0.05),with statistically significant lower at 1h after stopping drug, 2h after stopping drug(P < 0.05). There were no differences between patients at blood coagulation and platelet after operation(P > 0.05), no differences in the 30-day rates of stent thrombosis(0% vs. 0%, P = 1). Eleven patients(12.22%) treated with bivalirudin vs. 24(26.38%) treated with heparin experienced an adverse clinical events at 30 days(relative risk[RR], 0.46; 95%CI, 0.36-0.56; P < 0.025). There were no differences in the major adverse cardiac or cerebral event at the 30-day end point(1.11% vs. 2.20%, P > 0.05). The bleeding at 30 days was abated by using bivalirudin compared with unfractionated heparin(11.11% vs. 24.18%, P < 0.05). Conclusions Compared with the unfractionated heparin, bivalirudin is more quickly in taking effect and recovering and more efficient for PCI in patients with coronary artery disease and renal insufficiency.
Background Renal insufficiency is associated with an excess risk of vascular complications and bleeding events in patients who undergo PCI. Heparin is still commonly used for PCI, but the bleeding complications is high. However, Bivalirudin is similar to heparin in ischemic complications and superior to the A total of 181 patients with coronary artery disease and renal insufficiency were randomly assigned two treatment groups: Bivalirudin (n = 90), unfractionated heparin (n = 91). Activated clotting time (ACT) was determined in patients at 5 min after undergoing PCI at the end of operation immediately (stopping drug immediately), and 30 min, 1 h, 2 h after stopping drug. Activated partial thromboplastin time (APTT), thrombin time (TT), proth rombin time The fibrinogen (FIB) index was measured before treatment, 6 h, 24 h and 72 h after the treatment through an automated coagulation analyzer. Platelet count was monitored before treatment and 24 h after treatment. The The End points were the proportion of net adverse clinical events (NACE) and stent thrombosis at 30 days. Results The use of bivalirudin was associated with a statistically significant higher at 5 min after treatment, end of operation immediately (P <0.05), with (P <0.05), no significant difference at at least 1h after stopping drug, 2h after stopping drug (P <0.05). There were no differences between patients at blood coagulation and platelet after operation (P> 0.05), no differences in the 30-day rates of stent thrombosis Eleven patients (12.22%) treated with bivalirudin vs. 24 (26.38%) treated with heparin experienced an adverse clinical events at 30 days (relative risk [RR], 0.46; 95% CI was 0.36-0.56; P <0.025). There were no differences in the major adverse cardiac or cerebral event at the 30-day end point (1.11% vs. 2.20%, P> 0.05). The bleeding at 30 days was abated by using bivalirudin compared with unfractionated heparin (11.11% vs. 24.18%, P <0.05). Conclusions Compared with the uunfractionated heparin, bivalirudin is more quickly in taking effect and recovering and more efficient for PCI in patients with coronary artery disease and renal insufficiency.