Effects of Bivalirudin and Unfractionated Heparin on Liver and Renal Function in Chinese Patients with Coronary Artery Disease Undergoing Coronary Angiography with/without Percutaneous Coronary Intervention  

作　　者：Qiaowei Jia Jia Hu Wenfeng Ji Liansheng Wang Enzhi Jia 

机构地区：[1]Department of Cardiovascular Medicine,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,China [2]Department of Cardiovascular Medicine,Liyang People’s Hospital,Liyang,Jiangsu,China

出　　处：《Journal of Clinical and Translational Hepatology》2021年第4期477-483,共7页临床与转化肝病杂志（英文版）

基　　金：This study received support from the National Natural Science Foundations of China(No.81970302).

摘　　要：Background and Aims:Unfractionated heparin(UFH)and bivalirudin are widely used as anticoagulants in cardiovascular medicine,including for thrombosis prevention during coronary angiography(CAG)and percutaneous coronary intervention(PCI).Little is known of the effects of UFH and bivalirudin on liver and kidney function in patients subjected to these procedures.This study compared the effects of bivalirudin and UFH on liver/renal function in patients with coronary artery disease who underwent CAG,with or without PCI.Methods:The study comprised 134 consecutive patients(40–89 years-old),who underwent CAG(or CAG and PCI);among them,66 and 68 patients were subject to,respectively,bivalirudin or UFH.The following indicators of liver/renal function were measured before and after the procedures:plasma alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen,estimated glomerular filtration rate(eGFR),creatinine clearance,and serum creatinine.Patients were further stratified by severity of chronic kidney disease(CKD),based on original eGFR.Results:Relative to baseline,in the bivalirudin group,ALT and AST were higher after CAG(p=0.005,0.025),while blood urea nitrogen and serum creatinine were lower(p=0.049,<0.001).In the UFH group,ALT,AST,eGFR,and creatinine clearance were lower after CAG(p≤0.001,all).Patients given bivalirudin with moderate or severe CKD,but not those with mild CKD,gained significant improvement in kidney function.Conclusions:Relative to UFH,bivalirudin may better safeguard the renal function of patients with coronary artery disease who undergo CAG,especially patients with moderate-to-severe renal insufficiency.UFH may cause less liver damage than bivalirudin.

关 键 词：BIVALIRUDIN Unfractionated heparin Coronary artery disease Coro-nary angiography Percutaneous coronary intervention Liver function 

分 类 号：R54[医药卫生—心血管疾病]