To compare the effects of bivalirudin and combination of tirofiban and heparin on perioperative anticoagulation of coronary heart disease in percutaneous coronary intervention (PCI).

The clinical data of 56 emergency PCI patients admitted in Huxi Hospital Affiliated to Jining Medical College from January 2016 to December 2017 were analyzed retrospectively. According to different treatment methods, the patients were divided into observation group (29 cases) and control group (27 cases). The patients in the observation group were given bivalirudin for anticogulation, and the patients in the control group were given heparin and tirofiban for anticogulation. The percentage of ST segment regression, acquisition rate of thrombolysis in myocardial infarction (TIMI) grade 3 blood flow, acquisition rate of myocardial blush grade (MBG) grade 3, corrected TIMI fram count (CTFC), major cardiovascular events (MACE) and no-reflow, and bleeding events were counted in the two groups.

There was no significant difference in the distribution of percentage of ST segment regression between the two groups after PCI (P>0.05). In the observation group, the postoperative TIMI grade 3 blood flow acquisition rate was 82.74% and MBG grade 3 blood flow acquisition rate was 72.41%; in the control group, the postoperative TIMI grade 3 blood flow rate was 85.18% and MBG grade 3 blood flow rate was 74.09%. The distribution of TIMI and MBG ratings between the two groups was compared, and the differences were not significant (P>0.05). The CTFC in the two groups after treatment was significantly lower than that before treatment, and the decrease of CTFC in the observation group was more obvious than that in the control group (P<0.05). The bleeding rate after PCI in observation group(6.89%) was significantly lower than that in control group (33.33%, P<0.05), and there was no significant difference in the occurrence of no-reflow or incidence of MACE after PCI between the two groups (P>0.05).

In the course of PCI treatment for ST-elevation myocardial infarction patients, bivalirudine alone is used as anticoagulant. The efficacy and incidence of MACE are consistent with that of tirofiban combined with heparin as anticoagulant. At the same time, it can significantly reduce the risk of bleeding after operation, and help patients recover better, with high safety. It is worthy of clinical promotion.

Coronary heart disease; Percutaneous coronary intervention; Bivalirudin; Tirofiban; Heparin