Effects of Bivarudine on Coagulation Function,TIMI Blood Flow Grading and Myocardial Ischemia Markers in Patients with Acute Coronary Syndrome after PCI
Objective:To observe the effects of bivarudine on coagulation function,thrombolysis in myocardial infarction(TIMI)and myocardial ischemia markers in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods:ACS patients were divided into heparin group(treated with heparin for anticoagulation)and bivarudine group(treated with bivarudine for anticoagulation)according to different perioperative anticoagulation medication regimens.Patients with comparable baseline data with balanced data were screened by tendency matching score(callipers value 0.02).Sixty patients were included in each group.The values of activated coagulation time(ACT),TIMI blood grading and postoperative bleeding were compared between the two groups.The indexes of coagulation function[prothrombin time(APTT),thrombin time(TT),prothrombin time(PT)and fibrinogen(FIB)],myocardial ischemia markers[troponin T(cTnT),ischemia modified albumin(IMA)and serum miR-204]of the two groups were compared before and 24 h after surgery.The changes of cardiac function parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV)and left atrial diameter(LA)]before and 4 weeks after surgery and the incidence of major adverse cardiovascular events(MACE)within 1 year of follow-up were compared between the two groups.Results:At 5 min after injection,immediately after operation and 2 h after stopping injection,the ACT of bivarudine group was higher than that of heparin group(P＜0.05).The incidence of postoperative bleeding in the bivarudine group was 3.33％,which was less than that in heparin group(13.33％,P＜0.05).24 h after operation,APTT,TT and PT significantly increased(P＜0.05),FIB significantly decreased(P＜0.05),and APTT,TT and PT in the bivarudine group were more than those in the heparin group(P＜0.05),FIB levels were lower than those in the heparin group(P＜0.05).At surgery and 7 days after surgery,the TIMI blood flow grading of bivarudine group was better than that of heparin group(P＜0.05).Twenty-four hours after operation,cTnT and IMA significantly decreased in both groups(P＜0.05),and miR-204 level significantly increased(P＜0.05),and the improvement degree was significantly better in bivarudine group than that in heparin group(P＜0.05).Four weeks after operation,LVEF was significantly increased in both groups(P＜0.05),LVEDD,LVEDD and LA were significantly decreased(P＜0.05),and the improvement degree of bivarudine group was significantly better than that in heparin group(P＜0.05).One year after operation,the incidence of MACE in the bivarudine group was 11.67％,which was less than that in the heparin group(23.33％),and there was no significant difference between two Groups(P＞0.05).Conclusion:Bivarudine for the treatment of ACS after PCI could significantly reduce the coagulation function of patients,promote coronary artery blood flow,improve myocardial ischemia,and cardiac function,with better prognosis.
万方数据
维普
