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

Ke Zhu, Wen Lu, Yi-jie Huang, Lin-guang Wang, Qiang Wu, Chun-guang Feng and Qiang Fu

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 the intervention, post- PCI 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 a lower risk of bleeding compared with heparin plus Tirofiban in elderly patients with acute myocardial infarction undergoing primary PCI.