Publications by authors named "Yahao Zhang"

3 Publications

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Bivalirudin versus unfractionated heparin during percutaneous coronary intervention in high-bleeding-risk patients with acute coronary syndrome in contemporary practice.

Biomed Pharmacother 2020 Oct 17;130:110758. Epub 2020 Sep 17.

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address:

Background: Bivalirudin, as compared with unfractionated heparin (UFH), has been shown to reduce bleeding complications and supply a better safety profile among low/medium-bleeding-risk patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) in some previous studies. Whether this advantage persists in patients at high risk of bleeding according to contemporary practice characterized by frequent use of radial-artery access and novel P2Y inhibitors, and low use of glycoprotein IIb/IIIa inhibitors (GPIs) is unclear.

Aim Of The Study: This study aimed to assess the efficacy and safety of bivalirudin compared with UFH in high bleeding risk patients with ACS undergoing PCI in current practice.

Materials And Methods: All consecutive high-bleeding-risk patients who underwent PCI for ACS at the First Affiliated Hospital of Zhengzhou University from January to September 2019 were retrospectively analyzed. The 30-day primary outcome was a composite of major bleeding, myocardial infarction, all-cause death, or stroke (net adverse clinical events [NACEs]), and the secondary outcomes at 30 days included a composite of myocardial infarction, stoke, or all-cause death (major adverse cardiovascular events [MACEs]), each component of the primary outcome, target vessel revascularization (TVR) and stent thrombosis (ST). Besides, we assessed angina-related health status at 30 days, the length of hospital stay, and hospitalization costs. A logistic regression model was used to adjust for baseline differences. Consistency of the treatment effect of bivalirudin for NACEs and MACEs compared with UFH was evaluated in 15 prespecified subgroups.

Results: From January to September 2019, 823 patients (361 treated with bivalirudin and 462 treated with UFH) were enrolled in the study. GPIs, novel P2Y inhibitors, and radial approach was used in 5.6 %, 66.1 %, and 89.7 % of the patients, respectively. After adjusting for baseline differences, bivalirudin was associated with significant reduction in NACEs, MACEs, major bleeding, and myocardial infarction at 30 days compared with UFH. The individual endpoints of death, stroke, ST and TVR did not differ significantly between the 2 groups after adjusting for covariates. Furthermore, bivalirudin consistently reduced the rates of NACEs and MACEs in the 15 prespecified subgroups compared with UFH. These benefits of bivalirudin can translate into improved angina-related health status, shorter hospital stays, and lower hospitalization costs.

Conclusions: The treatment of bivalirudin showed better efficacy and safety as compared to UFH among patients with ACS undergoing PCI at high risk of bleeding in contemporary practice.
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http://dx.doi.org/10.1016/j.biopha.2020.110758DOI Listing
October 2020

Efficacy and Safety of Bivalirudin During Percutaneous Coronary Intervention in Chronic Total Occlusion: A Retrospective Study.

Clin Ther 2021 05 31;43(5):844-851. Epub 2021 Mar 31.

Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address:

Purpose: Bivalirudin as a thrombin inhibitor is proven to have a low risk of bleeding during percutaneous coronary intervention (PCI). Some evidence indicates comparable effectiveness and safety between bivalirudin and unfractionated heparin (UFH). Although bivalirudin during PCI offers more clinical and safety benefits to patients with chronic total occlusion (CTO), mostly via radial access, this has not been confirmed. The objective of this study was to examine the efficacy and safety of bivalirudin during percutaneous coronary intervention (PCI) in patients with CTO.

Methods: This trial used a retrospective cohort study design. Medical information from 736 patients with CTO who underwent PCI with bivalirudin or UFH at the First Affiliated Hospital of Zhengzhou University from July 2019 to September 2020 was extracted and analyzed. The primary end point was the 30-day incidence of net adverse clinical events (NACEs), and the secondary end point was the major adverse cardiovascular events (MACEs), which were related to safety and efficacy, respectively. Other end points incorporated each component of the primary outcome, target vessel revascularization, and stent thrombosis. Clinical and procedural characteristics at baseline were adjusted by using a logistic regression model.

Findings: Overall, 71.5% of patients with CTO used the radial approach. Both groups exhibited nonsignificant differences in the majority of baseline characteristics. The bivalirudin group was associated with a significant reduction in NACEs (12.9% vs 21.5%; P = 0.002) and major bleeding (2.5% vs 8.0%; P = 0.001) versus the UFH group at the end of the 30-day follow-up. The incidence of MACEs, myocardial infarction, death, stroke, stent thrombosis, and target vessel revascularization did not differ significantly between the 2 groups. Moreover, the bivalirudin group also reported a lower incidence of NACEs in the prespecified subgroups.

Implications: Bivalirudin exhibited comparative efficacy but superior safety compared with UFH among patients with CTO undergoing PCI. Chinese Clinical Trial Registry: ChiCTR2000034771.
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http://dx.doi.org/10.1016/j.clinthera.2021.03.004DOI Listing
May 2021

Wideband sparse spatial spectrum estimation using matrix filter with nulling in a strong interference environment.

J Acoust Soc Am 2018 Jun;143(6):3891

School of Marine Science and Technology, Northwestern Polytechnical University, Xi'an 710072, China.

Wideband direction of arrival (DOA) estimation using a sensor array plays a fundamental role in passive sonar signal processing. Although sparsity-based DOA estimation methods can attain high resolution in the condition of few snapshots and low signal-to-noise ratio, the localization accuracy is seriously affected by strong interferences. In this paper, a matrix filter with nulling (MFN) is used to pass weak targets in sector-of-interest (passband) while attenuating the out-of-sector (stopband) interferences by forming deep nulls toward the directions of interferences adaptively. Then, a method based on sparse spectrum fitting (SpSF) and MFN is proposed to localize closely spaced wideband signals in a strong interference environment. In comparison with the minimum variance distortionless response and SpSF, the proposed method achieves higher localization accuracy, which is verified by simulation and experimental results.
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http://dx.doi.org/10.1121/1.5042406DOI Listing
June 2018
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