Bivalirudin and Heparin Effects on Coronary Flow, Microcirculation and Recovery of Left Ventricular Systolic Function after Primary Coronary Angioplasty

In ST elevation myocardial infarction (STEMI) treated by primary per-coetaneous coronary intervention (PPCI), bivalirudin caused less bleeding and was as effective as combined heparin and IIb IIIa antagonist. Aim: Compare the effects of bivalirudin and heparin on coronary flow, microcirculation and recovery of left ventricular systolic function in patients with STEMI undergoing PPCI. Methods: Forty five patients with anterior STEMI undergoing PPCI, 30 treated with heparin and 15 with bivalirudin were compared. All patients had complete trans-thoracic Doppler echocardiographic studies and sampling of blood velocities in the left anterior descending coronary artery (LAD) early after PPCI and 5 days later. Results: TIMI and myocardial blush grades were similar in both groups before after PPCI. Peak LAD diastolic velocities early after PPCI were higher in the bivalirudin group 42.2±14.4 compared to the heparin group 34.06±8.27 cm/sec, p