To investigate the clinical efficacy and safety of atorvastatin tablets combined with bivalirudin injection in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).

Patients with acute STEMI were divided into control group and treatment group according to whether combined medication was used. The control group was given an intravenous continuous bolus of bivalirudin for injection at a dose of 0.75 mg·kg^-1 during the operation, and after the operation, intravenous pumping of bivalirudin was continued at a dose of 1.75 mg·(kg·h)^-1 until 6 hours postoperatively. The treatment group was treated with atorvastatin combined with bivalirudin, where the administration method of bivalirudin was the same as that in the control group, and atorvastatin calcium tablets were administered orally at a dose of 20 mg each time, bid. Both groups received a 30-day treatment course, and relevant reexaminations were conducted after the course. The efficacy, myocardial function indicators, blood coagulation indicators, blood lipid indicators, and inflammatory factor indicators were compared between the two groups.

The trial recruited 118 patients, with 54 assigned to the control group and 64 to the treatment group. At 30 days postoperatively, the efficacy rates of the control group and the treatment group were 74.07% and 89.06%, respectively. At 30 days after surgery, the cardiac troponin T levels in the control group and the treatment group were (7.58±1.27) and (7.01±1.38) μg·L^-1, respectively; the global longitudinal strain values were (16.87±1.05)% and (16.34±1.01)%, respectively; the fibrinogen degradation product levels were (4.09±0.80) and (3.82±0.51) μg·mL^-1 , respectively; the D-dimer levels were (0.97±0.42) and (0.82±0.33) mg·L^-1, respectively; the low-density lipoprotein cholesterol levels were (2.26±0.77) and (1.97±0.61) mmol·L^-1, respectively; the β2-microglobulin levels were (2.45±0.12) and (2.36±0.14) mg·L^-1, respectively; and the macrophage inflammatory protein-1α levels were (26.22±3.90) and (24.20±4.33) pg·mL^-1, respectively. The differences in the above indicators between the treatment group and the control group were all statistically significant (all P<0.05). The incidence of adverse reactions was 7.41% (4 cases/54cases) in the control group and 4.69% (3 cases/64cases) in the treatment group, and the incidence of major adverse cardiovascular events was 5.56% (3 cases/54 cases) and 1.56% (1 case/64 cases), respectively, with no statistically significant differences (all P>0.05).

Atorvastatin tablets combined with bivalirudin injection have a significant efficacy in STEMI patients after PCI. It can achieve the goals of improving myocardial function and coagulation function, effectively controlling the patient′s blood lipid level, reducing the inflammatory response, and exhibit good safety.