Effect of bivalirudin on coagulation function and prognosis in women with coronary artery disease undergoing PCI

AIM To determine the effects of bivalirudin on coagulation function and prognosis in women with coronary artery disease undergoing percutaneous coronary intervention (PCI). METHODS A total of 71 women with coronary artery disease were assigned to two groups: Bivalirudin group (n=32) and heparin group (n=39). Activated clotting time (ACT) was determined at preoperative, 5 min after medication, immediately after operation, and 30 min, 1 h and 2 h after stopping medication. Before operation, and 6 h, 24 h and 72 h after stopping medication, thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen (FIB) index were detected using automated coagulation analyzer. Before operation and 24 h after operation, a platelet count was performed. Net adverse clinical events (NACE) and stent thrombosis at 30-day were compared. RESULTS At 5 min after medication and immediately after operation, ACT in the bivalirudin group was significantly higher (P<0.01) and no significant difference was found at 30 min after stopping medication and preoperatively between the two groups. At 1 h and 2 h after stopping medication, ACT was significantly lower in the bivalirudin group (P<0.01). No significant difference was found in blood coagulation and platelet count after operation between the two groups and the 30-day follow-up revealed no difference in stent thrombosis and in major adverse cardiac or cerebral event between the two groups. All bleeding at 30 days and BARC types 2 through 5 were significantly reduced by using bivalirudin compared with using heparin (P<0.05). CONCLUSION Compared with heparin, bivalirudin produces better effects and quicker recovery and bivalirudin is thus safer and more efficient for women with coronary artery disease undergoing PCI.