The effects of bivalirudin and ordinary heparin on the incidence of bleeding events and the level of inflammation after interventional therapy

OBJECTIVE: To evaluate and compare the efficacy, bleeding events, and inflammation levels of optimized bivalirudin versus ordinary heparin in the context of percutaneous coronary intervention (PCI) for patients with acute myocardial infarction. This approach will underscore the comprehensive scope of the study, addressing multiple dimensions of clinical outcomes. METHODS: This study involved 120 acute myocardial infarction patients treated from January 2022 to January 2023, randomly allocated into two groups: the control group received ordinary heparin, and the observation group received bivalirudin. Both groups underwent percutaneous coronary intervention (PCI). The study specifically measured coagulation indexes such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), and inflammatory markers including C-reactive protein (CRP) and interleukin-6 (IL-6). Additionally, the incidence of bleeding events and major adverse cardiovascular events (MACE) within 30 days post-PCI were recorded, with bleeding events categorized according to the Bleeding Academic Research Consortium (BARC) criteria and MACE defined by the occurrence of death, non-fatal myocardial infarction, or stroke. RESULTS: No significant differences were observed in coagulation indexes and pre-operation inflammation levels between the two groups (P > .05). However, at 7 days post-operation, despite both groups showing reduced inflammation-NLR decreased by 25%, hs-CRP by 30%, and IL-10 increased by 20%-the bivalirudin group exhibited notably lower incidence rates of various bleeding events (mucosal 2% vs 6%, gingival 1% vs 4%, puncture site 3% vs 8%, and hematuria 1% vs 5%) within 30 days post-PCI compared to the heparin group. TIMI blood flow grades 3 (indicating normal flow) were achieved in 85% of the bivalirudin group compared to 70% in the heparin group. The incidence of MACE was comparable between groups with both reporting a 5% occurrence rate (P > .05). CONCLUSION: The study reveals that while both bivalirudin and ordinary heparin effectively prevent MACE post-acute myocardial infarction intervention, bivalirudin significantly reduces postoperative bleeding events and maintains comparable anti-inflammatory effects. This suggests its preferable use in clinical settings, particularly in patient populations at high risk for bleeding. Future research could further explore the specific patient characteristics that optimize bivalirudin's benefits over heparin, enhancing tailored therapeutic approaches. This could potentially include randomized trials focusing on patients with different baseline bleeding risks.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Comparison study of bivalirudin vs UFH following PCI showing reduced bleeding events and lower hs-CRP inflammatory markers in the bivalirudin group.

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