Effects of atorvastatin combined with bivalirudin on coagulation function, cardiac function, and inflammatory factors of percutaneous coronary intervention in elderly patients with acute myocardial infarction

Sheng-hua, Ding; Xu, Song; Chen, Xiaoning; Wu, Shujuan

doi:10.21037/apm-20-925

“…Of note, clotting activation is not lowered by antiplatelet therapy [ 54 ], as shown by previous studies reporting no effect of aspirin and DAPT in reducing D-dimer levels [ 55 ]. Conversely, oral and parenteral anticoagulation, in addition or not to DAPT, has been demonstrated to decrease D-dimer levels in patients with MI [ 41 , 56 , 57 ]. Thus, ATLAS ACS 2-TIMI 51 and COMPASS trials have recently proved the utility of adding low-dose anticoagulation to antiplatelet medications.…”

Section: Discussionmentioning

confidence: 99%

D-dimer for risk stratification and antithrombotic treatment management in acute coronary syndrome patients: a systematic review and metanalysis

Biccirè

¹

,

Farcomeni

²

,

Gaudio

³

et al. 2021

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Background Data on the prognostic role of D-dimer in patients with acute coronary syndrome (ACS) are controversial. Our aim was to summarize current evidence on the association between D-dimer levels and short/long-term poor prognosis of ACS patients. We also investigated the association between D-dimer and no-reflow phenomenon. Methods Systematic review and metanalysis of observational studies including ACS patients and reporting data on D-dimer levels. PubMed and SCOPUS databases were searched. Data were combined with hazard ratio (HR) and metanalysed. The principal endpoint was a composite of cardiovascular events (CVEs) including myocardial infarction, all-cause and cardiovascular mortality. Results Overall, 32 studies included in the systematic review with 28,869 patients. Of them, 6 studies investigated in-hospital and 26 studies long-term outcomes. Overall, 23 studies showed positive association of high D-dimer levels with CVEs. D-dimer levels predicted poor prognosis in all studies reporting in-hospital outcomes. Five studies satisfied inclusion criteria and were included in the metanalysis, with a total of 8616 patients. Median follow-up was 13.2 months with 626 CVEs. The pooled HR for D-dimer levels and CVEs was 1.264 (95% CI 1.134–1.409). Five out of 7 studies (4195 STEMI patients) investigating the association between D-dimer levels and no-reflow showed a positive correlation of D-dimer levels with no-reflow. Conclusions In patients with ACS, D-dimer was associated with higher in-hospital and short/long-term complications. D-dimer was also higher in patients with no-reflow phenomenon. The use of D-dimer may help to identify patients with residual thrombotic risk after ACS. Trial registration The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews: CRD42021267233.

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“…Of note, clotting activation is not lowered by antiplatelet therapy [30], as shown by previous studies reporting no effect of aspirin and DAPT in reducing D-dimer levels [31]. Conversely, oral and parenteral anticoagulation, in addition or not to DAPT, has been demonstrated to decrease D-dimer levels in patients with MI [32][33][34]. Thus, ATLAS ACS 2-TIMI 51 and COMPASS trials have recently proved the utility of adding low-dose anticoagulation to antiplatelet medications.…”

Section: Risk Strati Cation Using D-dimermentioning

confidence: 87%

Role of D-Dimer in the Risk Stratification of Acute Coronary Syndrome Patients: Implications for Antithrombotic Treatment. A Systematic Review and Exploratory Meta-analysis.

Biccirè

¹

,

Farcomeni

²

,

Gaudio

³

et al. 2021

Preprint

0

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Background Data on the prognostic role of D-dimer in patients with acute coronary syndrome (ACS) are controversial. Our aim was to summarize current evidence on the association between D-dimer levels and short/long-term poor prognosis of ACS patients. We also investigated the association between D-Dimer and no-reflow (NR) phenomenon.Methods Systematic review and metanalysis of observational studies including ACS patients and reporting data on D-Dimer levels. PubMed and SCOPUS databases were searched. Data were combined with hazard ratio (HR) and metanalysed. The principal endpoint was a composite of cardiovascular events (CVEs) including myocardial infarction, all-cause and cardiovascular mortality. Results Overall, 32 studies included in the systematic review with 28,869 patients. Of them, 6 studies investigated in-hospital and 26 studies long-term outcomes. Overall, 23 studies showed positive association of high D-Dimer levels with CVEs. D-Dimer levels predicted poor prognosis in all studies reporting in-hospital outcomes. Five studies satisfied inclusion criteria and were included in the metanalysis, with a total of 8,616 patients. Median follow-up was 13.2 months with 626 CVEs. The pooled HR for D-dimer levels and CVEs was 1.264 (95% CI 1.134-1.409). Five out of 7 studies (4,195 STEMI patients) investigating the association between D-Dimer levels and NR showed a positive correlation of D-dimer levels with NR. Conclusions In patients with ACS D-Dimer was associated with higher in-hospital and short/long-term complications. D-Dimer was also higher in patients with NR phenomenon. The use of D-Dimer may help to identify patients with residual thrombotic risk after ACS.Trial registration: the review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews: CRD42021267233.

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“…A large number of studies have demonstrated that coagulation factors play a vital role in the occurrence and development of cardiovascular diseases. Ding et al (2020) [ 20 ] found that the levels of coagulation factors in patients were significantly downregulated after treatment.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Echocardiography and Coagulation Function Detection in the Prognosis Evaluation of Patients with Acute Myocardial Infarction

Zhang

¹

,

Zhao

²

,

Li

³

et al. 2022

Computational and Mathematical Methods in Medicine

1

0

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This research was aimed at discussing the application value of coagulation function detection and three-dimensional echocardiography in the prognosis evaluation of acute myocardial infarction (AMI) patients. 72 patients with AMI were divided into the recovered group (good recovery) and unrecovered group (poor recovery) according to the results of postoperative ultrasonography. The left ventricular parameters of the patients were detected by three-dimensional ultrasound, and the coagulation function was also detected. The results showed that 3 months after surgery, the regional end-systolic volume (rESV) and regional end-diastolic volume (rEDV) of the left ventricle in the patients were smaller than the measured values 1 week after surgery. The left ventricular regional ejection fraction (rEF) was greater than the value measured 1 week after surgery, and all the differences were statistically significant ( P < 0.05 ). For the end-systolic volume (ESV), end-diastolic volume (EDV), and ejection fraction (EF) (%), the two-dimensional ultrasound results were significantly lower than the three-dimensional ultrasound results, and there were significant differences ( P < 0.05 ). Tmsvle6-Dif% of the recovered patients was 14.99 ± 9.88 and 14.37 ± 9.78 3 months and 6 months after surgery, respectively. These were smaller than 30.91 ± 18.63 and 33.51 ± 17.96 of the unrecovered patients; the differences were of statistical significance ( P < 0.05 ). Tmsvl6-SD% of recovered patients was 3.69 ± 2.47 and 3.61 ± 1.83 3 months and 6 months after surgery, respectively, which were also smaller than 7.38 ± 4.06 and 7.96 ± 2.82 of unrecovered patients, showing statistically significant difference ( P < 0.05 ). The postoperative Tmsvle6-Dif% and Tmsvl6-SD% of the recovered group were lower than those of the unrecovered patients, with the statistically significant differences ( P < 0.05 ). The level of coagulation factors in the recovered group was also significantly lower than that in the unrecovered group with the difference statistically significant ( P < 0.05 ). The results suggested that three-dimensional echocardiography played an important role in the evaluation of cardiac conditions in AMI patients. The level of coagulation factors varied with the AMI condition of patients, and there was an obvious relationship between them, which could provide a reference value for the prognosis evaluation of patients.

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Effects of atorvastatin combined with bivalirudin on coagulation function, cardiac function, and inflammatory factors of percutaneous coronary intervention in elderly patients with acute myocardial infarction

Cited by 6 publications

References 6 publications

D-dimer for risk stratification and antithrombotic treatment management in acute coronary syndrome patients: a systematic review and metanalysis

D-dimer for risk stratification and antithrombotic treatment management in acute coronary syndrome patients: a systematic review and metanalysis

Role of D-Dimer in the Risk Stratification of Acute Coronary Syndrome Patients: Implications for Antithrombotic Treatment. A Systematic Review and Exploratory Meta-analysis.

Three-Dimensional Echocardiography and Coagulation Function Detection in the Prognosis Evaluation of Patients with Acute Myocardial Infarction

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