Impact of perioperative extracorporeal anticoagulation assisted PCI on treatment and prognosis of acute coronary syndrome
[Objective]To observe the impact of perioperative PACT assisted PCI on the treatment and prognosis of ACS.[Methods]This article is a prospective study,with cases included from June 2021 to December 2022.The study subjects were 120 patients with ACS.The enrolled patients were randomly divided into a combination group(60 cases)and a conventional group(60 cases)using a random number table method.The conventional group received preoperative treatment with ordinary heparin as an adjuvant PCI,while the combination group received preoperative treatment with ordinary heparin and intraoperative anticoagulant therapy with bivalirudin as an adjuvant PCI.Both groups were followed up for a short period of 1 month after surgery.The treatment and prognosis of two groups of patients were compared.[Results]At admission,the coagulation function of the two groups of patients was similar(P＞0.05).The APTT,PT,and TT within 8 hours after surgery in the combination group were 33.25±5.32 s,13.49±3.27 s,and 27.11±5.26 s,respectively,which were higher than those in the conventional group(30.42±5.24 s,11.25±3.16 s,and 24.12±5.31 s)(P＜0.05).At admission,the levels of myocardial injury markers in both groups of patients were similar(P＞0.05).Within 8 hours after surgery,the CK-MB,cTnI,and LDH levels in the combination group were 7.25±1.33 U/L,0.45±0.21 ng/mL,and 122.45±20.75 U/L,respectively,lower than those in the conventional group(8.33±2.01 U/L,0.82±0.31 ng/mL,and 140.74±20.18 U/L)(P＜0.05).At admission,the cardiac function indicators of the two groups of patients were similar(P＞0.05).The LVEF within 8 hours after surgery in the combination group were 56.33％±10.27％,higher than that in the conventional group(50.45％±10.32％).The LVDD was 37.25±5.44 mm,lower than the conventional group(40.18±5.26 mm)(P＜0.05).During the follow-up period,the incidence of MACE in the combination group was 8.33％(5/60),lower than 21.67％(13/60)in the conventional group(P＜0.05).The incidence of drug-related side effects in the combination group was 11.67％(7/60),slightly higher than that in the conventional group[10.00％(6/60)](P＞0.05).[Conclusion]Perioperative PACT can prolong the clotting time of ACS patients to a certain extent,reduce myocardial damage,promote the recovery of patients'cardiac function,enhance the effectiveness of emergency treatment,and reduce the risk of postoperative MACE.Perioperative PACT did not significantly increase the risk of drug side effects and has certain promotional value.
万方数据
维普
