PMID- 30032545
OWN - NLM
STAT- MEDLINE
DCOM- 20190211
LR  - 20190215
IS  - 0253-3758 (Print)
IS  - 0253-3758 (Linking)
VI  - 46
IP  - 7
DP  - 2018 Jul 24
TI  - [Efficacy of periprocedural bivalirudin infusion in patients with chronic total 
      occlusion lesion undergoing percutaneous coronary intervention].
PG  - 543-548
LID - 10.3760/cma.j.issn.0253-3758.2018.07.007 [doi]
AB  - Objective: To investigate the efficacy of periprocedural use of bivalirudin for 
      patients with chronic total occlusion(CTO) lesion undergoing percutaneous 
      coronary intervention(PCI) therapy. Methods: In this randomized controlled study, 
      74 patients with CTO lesions confirmed by coronary angiography or CT angiography, 
      hospitalized in the general hospital of Shenyang military region from September 
      2015 to December 2016, were randomly divided into unfractionated heparin(UFH) 
      group (n=38) and bivalirudin group (n=36) by the random number table.Patients in 
      the UFH group were treated with injection of UFH 5 000 U through the artery 
      sheath catheter before coronary angiography,and the UFH was intravenously 
      administered at 100 U/kg before PCI. Patients in the bivalirudin group received 
      intravenous injection of bivalirudin (0.75 mg/kg) before coronary angiography, 
      followed by intravenous infusion of 1.75 mg.kg(-1).h(-1) until at least 2 hours 
      after the PCI. The values of the activated coagulation time (ACT) were 
      measured,and the value was remained at 250 to 350 seconds during the PCI. The 
      incidence rate of adverse events including hemorrhage events, no-reflow/slow 
      flow, and contact thrombus in perioperative period were observed in all patients. 
      In addition, the incidence rate of the major adverse cardiovascular events (MACE) 
      including recurrent angina, heart failure, target vessel revascularization, 
      cardiac death, non-fatal myocardial infarction,and stroke within 1 year follow-up 
      period were also observed in the 2 groups. Results: Baseline clinical and PCI 
      data were similar between the 2 groups (all P>0.05). During the perioperative 
      period, the incidence of the bleeding was significantly lower in the bivalirudin 
      group than in the UFH group(5.6% (2/36) vs. 23.7% (9/38) , P=0.028).The incidence 
      of no-reflow/slow flow was also significantly lower in the bivalirudin group than 
      in the UFH group(0 vs. 15.8% (6/38) , P=0.025). There was no significant 
      difference in the incidence of contact thrombosis between bivalirudin group and 
      UFH group(8.3% (3/36) vs. 0, P=0.110). There was no cardiac death or non-fatal 
      myocardial infarction in the 2 groups within 1 year after PCI, and there was no 
      significant difference in the incidence of MACE in 1 year follow-up after 
      operation between bivalirudin group and UFH group (11.1% (4/36) vs. 21.1% (8/38) 
      , P=0.246). Conclusion: The application of the anticoagulant bivalirudin during 
      PCI in patients with CTO lesion can reduce the incidence of perioperative 
      bleeding and no-reflow/slow flow, and does not increase the risk of MACE within 1 
      year after PCI.
FAU - Kong, L D
AU  - Kong LD
AD  - Department of Cardiology, General Hospital of Shenyang Military Region, Shenyang 
      110016, China.
FAU - Wang, G
AU  - Wang G
FAU - Han, Y L
AU  - Han YL
FAU - Li, G
AU  - Li G
FAU - Li, X Y
AU  - Li XY
FAU - Liu, Z X
AU  - Liu ZX
FAU - Tao, J
AU  - Tao J
FAU - Li, Y
AU  - Li Y
LA  - chi
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - China
TA  - Zhonghua Xin Xue Guan Bing Za Zhi
JT  - Zhonghua xin xue guan bing za zhi
JID - 7910682
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Anticoagulants
MH  - *Antithrombins/administration & dosage
MH  - *Coronary Occlusion/therapy
MH  - Heparin/administration & dosage
MH  - *Hirudins/administration & dosage
MH  - Humans
MH  - *Peptide Fragments/administration & dosage
MH  - *Percutaneous Coronary Intervention
MH  - Recombinant Proteins/administration & dosage
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anticoagulants
OT  - Coronary disease
OT  - Percutaneous coronary intervention
EDAT- 2018/07/24 06:00
MHDA- 2019/02/12 06:00
CRDT- 2018/07/23 06:00
PHST- 2018/07/23 06:00 [entrez]
PHST- 2018/07/24 06:00 [pubmed]
PHST- 2019/02/12 06:00 [medline]
AID - 10.3760/cma.j.issn.0253-3758.2018.07.007 [doi]
PST - ppublish
SO  - Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Jul 24;46(7):543-548. doi: 
      10.3760/cma.j.issn.0253-3758.2018.07.007.