AIM To investigate the efficacy and safety of the low dose Bivalirudin (80% of the recommended dose) without post-procedure intravenous infusion in patients ≥65 years of age with acute coronary syndrome (ACS) during elective percutaneous coronary intervention (PCI).
METHODS 854 consecutive patients≥65 years of age with ACS who underwent elective PCI and received Bivalirudin from January 2019 to February 2021 were enrolled, 485 patients were included in the recommended dose group and 369 patients were included in the low dose group. Using propensity score matching (PSM) to reduce confounding factors. The incidence of net adverse clinical events (NACE), major adverse cardiac events (MACE) and bleeding events at 30 days were observed.
RESULTS The incidence of ST-segment elevation myocardial infarction, hypertension and anemia in the low dose group was lower than that in the recommended dose group, and the difference was statistically significant (P<0.05). After PSM, there were no statistically significant differences in clinical data between the two groups. Before or after PSM, the activated clotting time (ACT) after 5 min and the proportion of ACT≥250 s in two groups without statistical significance, the incidence of NACE, MACE and bleeding 30 days after PCI in two groups without statistical significance.
CONCLUSION The 80% recommended dose of bivalirudin used for anticoagulation in patients over 65 years of age with ACS during elective PCI does not increase the risk of thrombosis or bleeding.
DownLoad: