PMID- 38399411
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240227
IS  - 1424-8247 (Print)
IS  - 1424-8247 (Electronic)
IS  - 1424-8247 (Linking)
VI  - 17
IP  - 2
DP  - 2024 Feb 1
TI  - Impact of Bivalirudin on Ischemia/Reperfusion Injury in Patients with Reperfused 
      STEMI Assessed by Cardiac Magnetic Resonance.
LID - 10.3390/ph17020196 [doi]
LID - 196
AB  - Thrombin is an important ischemia/reperfusion injury (IRI) mediator in patients 
      with ST-elevation myocardial infarction (STEMI). This study examines the use of 
      bivalirudin, a direct thrombin inhibitor, in reducing IRI in STEMI patients. 
      STEMI patients (n = 21) were treated with bivalirudin and compared to 21 patients 
      treated with unfractionated heparin (UFH) from the EARLY Assessment of Myocardial 
      Tissue Characteristics by CMR in STEMI (EARLY-MYO-CMR) registry (NCT03768453). 
      Infarct size (IS) and left ventricular ejection fraction (LVEF) were comparable 
      between the two groups at follow up. During the first cardiac magnetic resonance 
      (CMR) scan within the first week after percutaneous coronary intervention (PCI), 
      all patients in both the bivalirudin and UFH groups exhibited myocardial edema. 
      However, the myocardium edema volume was significantly less in the bivalirudin 
      group (p < 0.05). At the one-month follow-up, a smaller proportion of patients in 
      the bivalirudin group than in the UFH group exhibited myocardial edema (4.7% vs. 
      33.3%, p < 0.05). At the three-month follow-up, myocardial edema had completely 
      resolved in the bivalirudin group, while it persisted in two patients in the UFH 
      group. The incidence and volume of microvascular obstruction (MVO) were 
      significantly lower in the bivalirudin group during the acute phase. 
      Additionally, the incidence of intramyocardial hemorrhage (IMH) was significantly 
      lower in the bivalirudin group during both the acute and follow up (p < 0.05). 
      These findings were corroborated by T2 and T1 mapping results. The study 
      concluded that the use of bivalirudin for anticoagulation is associated with 
      attenuated IRI in STEMI patients who receive primary PCI.
FAU - Zhang, Yizhi
AU  - Zhang Y
AD  - Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
FAU - Zou, Zhiguo
AU  - Zou Z
AUID- ORCID: 0000-0001-9028-9239
AD  - Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
FAU - Xu, Bihe
AU  - Xu B
AD  - Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
FAU - Chen, Binghua
AU  - Chen B
AD  - Department of Radiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
FAU - Ge, Heng
AU  - Ge H
AD  - Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
FAU - Ding, Song
AU  - Ding S
AD  - Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
AD  - Department of Cardiology, Punan Branch of Renji Hospital, Shanghai Jiaotong 
      University School of Medicine, Shanghai 200127, China.
FAU - Pu, Jun
AU  - Pu J
AD  - Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University 
      School of Medicine, Shanghai 200002, China.
LA  - eng
PT  - Journal Article
DEP - 20240201
PL  - Switzerland
TA  - Pharmaceuticals (Basel)
JT  - Pharmaceuticals (Basel, Switzerland)
JID - 101238453
PMC - PMC10893429
OTO - NOTNLM
OT  - STEMI
OT  - bivalirudin
OT  - cardiovascular magnetic resonance
OT  - ischemia/reperfusion injury
COIS- The authors declare no conflicts of interest.
EDAT- 2024/02/24 11:43
MHDA- 2024/02/24 11:44
PMCR- 2024/02/01
CRDT- 2024/02/24 01:19
PHST- 2023/12/16 00:00 [received]
PHST- 2024/01/07 00:00 [revised]
PHST- 2024/01/11 00:00 [accepted]
PHST- 2024/02/24 11:44 [medline]
PHST- 2024/02/24 11:43 [pubmed]
PHST- 2024/02/24 01:19 [entrez]
PHST- 2024/02/01 00:00 [pmc-release]
AID - ph17020196 [pii]
AID - pharmaceuticals-17-00196 [pii]
AID - 10.3390/ph17020196 [doi]
PST - epublish
SO  - Pharmaceuticals (Basel). 2024 Feb 1;17(2):196. doi: 10.3390/ph17020196.