Abstract:

Objective To observe the difference of bleeding risk in coronary heart disease（CHD）patients using different anticoagulants during percutaneous coronary intervention （PCI）and its influence on the CMBs. Methods Seventy⁃eight patients with PCI admitted to the emergency department of Hebei Petro China Central Hos⁃ pital from September 2019 to October 2020 were selected and they were divided into heparin group and bivalirudin group according to the anticoagulants used. Susceptibility weighted imaging（SWI）was performed 72 hours after operation. The bleeding site and volume of patients within 2 weeks after operation were collected，and the differences of CMBs，and bleeding events were compared between the two groups；The CMBs of PCI patients before and after the second operation were compared. The patients in heparin group were divided into two sub⁃groups of bleeding group and non⁃bleeding group，and the changes of CMBs in bleeding group were analyzed. Logistic regression analysis was used to analyze the risk factors of bleeding in PCI patients and the impact on the number changes of CMBs. Results （1）The number of CMBs and bleeding rate in heparin group were significantly higher than those in bivalirudin group （P < 0.05）.（2）The CMBs after the second operation were higher than those before the second operation，and the difference was statistically significant（P < 0.05）.（3）Cr，Glu，AA，heparin and CMBs of the bleeding group were higher than those of the non⁃bleeding group（P < 0.05）.（4）Heparin volume and CMBs were independent risk factors for bleeding in PCI patients. Conclusion The stronger the anticoagulant effect and the more action targets， the greater the impact on CMBs. The number of CMBs is significant for predicting the bleeding after PCI.

Key words:

percutaneous coronary intervention, susceptibility weighted imaging, CMBs, crusade