Du YK, Cui LJ, Gao HB. Effect of bivalirudin on myocardial microcirculation and adverse events after interventional therapy in older patients with acute coronary syndrome. World J Clin Cases 2024; 12(22): 4890-4896 [PMID: 39109044 DOI: 10.12998/wjcc.v12.i22.4890]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2024; 12(22): 4890-4896 Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4890
Effect of bivalirudin on myocardial microcirculation and adverse events after interventional therapy in older patients with acute coronary syndrome
Hong-Bo Gao, Li-Jun Cui, Ya-Kun Du
Ya-Kun Du, Li-Jun Cui, Hong-Bo Gao, Cardiovascular Department, Hanzhong People’s Hospital, Hanzhong 723000, Shaanxi Province, China
Author contributions: Du YK, Cui LJ, and Gao HB designed the research study; Du YK, Cui LJ, and Gao HB performed the primary literature review and data extraction; Du YK and Cui LJ analyzed the data and wrote the manuscript; Du YK, Cui LJ, and Gao HB were responsible for revising the manuscript for intellectual content; All authors have read and approved the final version.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Hanzhong People’s Hospital.
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before study enrolment.
Conflict-of-interest statement: The authors declare they have nothing to disclose.
Data sharing statement: No other data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: April 10, 2024 Revised: May 6, 2024 Accepted: June 5, 2024 Published online: August 6, 2024 Processing time: 82 Days and 20.9 Hours
Abstract
BACKGROUND
Bivalirudin, a direct thrombin inhibitor, is used in anticoagulation therapies as a substitute for heparin, especially during cardiovascular procedures such as percutaneous coronary intervention.
AIM
To explore the effect of bivalirudin on myocardial microcirculation following an intervention and its influence on adverse cardiac events in elderly patients with acute coronary syndrome (ACS).
METHODS
In total, 165 patients diagnosed with acute myocardial at our hospital between June 2020 and June 2022 were enrolled in this study. From June 2020 to June 2022, elderly patients with ACS with complete data were selected and treated with interventional therapy. The study cohort was randomly divided into a study group (n = 80, administered bivalirudin) and a control group (n = 85, administered unfractionated heparin). Over a 6-mo follow-up period, differences in emergency processing times, including coronary intervention, cardiac function indicators, occurrence of cardiovascular events, and recurrence rates, were analyzed.
RESULTS
Significant differences were observed between the study cohorts, with the observation group showing shorter emergency process times across all stages: Emergency classification; diagnostic testing; implementation of coronary intervention; and conclusion of emergency treatment (P < 0.05). Furthermore, the left ventricular ejection fraction in the observation group was significantly higher (P < 0.05), and the creatine kinase-MB and New York Heart Association scores were notably lower than those in the control group (P < 0.05).
CONCLUSION
In elderly patients receiving interventional therapy for ACS, bivalirudin administration led to increased activated clotting time achievement rates, enhanced myocardial reperfusion, and reduced incidence of bleeding complications and adverse cardiac events.
Core Tip: Effective anticoagulation management is essential for older patients with acute coronary syndrome, especially in those with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. Bivalirudin may be an innovative drug for achieving this goal.
