Efficacy and Safety of Bivalirudin versus Heparin Plus Tirofiban in Elderly Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Objective: The aim of this study was to investigate the antithrombotic effect and safety of Bivalirudin compared with heparin plus Tirofiban in elderly patients with acute myocardial infarction undergoing primary Percutaneous Coronary Intervention (PCI). Methods: One hundred and twenty elderly patients were randomly assigned to receive two different antithrombotic therapies (Group A: Bivalirudin alone or Group B: Heparin plus Tirofiban) in a 1:1 ratio according to the treatment sequence and a table of random numbers. The clinical information, routine examination results, infarct-related sites of the enrolled patients were recorded, and the Thrombolysis in Myocardial Infarction (TIMI) flow grade and other safety indexes after PCI were analyzed. Results: No statistically significant differences existed in ST-segment depression at 2 h after intervention, postPCI TIMI flow grade and reduction of N-terminal pro-B type natriuretic peptide (NT-proBNP) serum concentrations in patients on day 7 versus day 1 after PCI between the two groups (P>0.05). However, the adverse clinical events of bleeding showed significant differences in the two groups (P<0.05). Conclusion: Bivalirudin exerts confirmed anticoagulant effect and indicates lower risk of bleeding compared with heparin plus Tirofiban in elderly patients with acute myocardial infarction undergoing primary PCI. *Corresponding author: Qiang Fu, Department of Cardiology, Xuzhou Hospital Affiliated East South University School of Medicine, Xuzhou Cardiovascular Disease Institute, 199 Jiefang Road, Xuzhou 221009, PR China, Tel: +86 18952170277; E-mail: [email protected] Received January 21, 2016; Accepted February 01, 2016; Published February 08, 2016 Citation: Zhu K, Lu W, Huang Y, Wang L, Wu Q, et al. (2016) Efficacy and Safety of Bivalirudin versus Heparin Plus Tirofiban in Elderly Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Cardiovasc Pharm Open Access 5: 172. doi:10.4172/2329-6607.1000172 Copyright: © 2016 Zhu K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. University School of Medicine from February 2013 to August 2015 because of STEMI undergoing primary PCI, were enrolled. Patients were randomly assigned to receive two different antithrombotic therapies (Group A: bivalirudin alone or Group B: heparin plus tirofiban) in a 1:1 ratio according to the treatment sequence and a table of random numbers. The enrolled patients were eligible for STEMI diagnostic criteria of American College of Cardiology (ACC) and European Society of Cardiology (ESC). Exclusion criteria included previous or current serious heart, liver, renal or other critical organ failures, neurological or psychiatric diseases, major surgery or trauma history, systemic infection, patients in the menstrual period, pregnancy, lactation and other special populations. All patients provided written informed consent before randomization. Treatment Patients in the two groups were treated with the same routine support therapy. All patients were pretreated before intervention with aspirin (300 mg) and clopidogrel (600 mg). For Group A, bivalirudin was given as an intravenous bolus of 0.75 mg/kg before intervention,