中国临床药学杂志2017，Vol.26Issue(6)：364-368,5.
替格瑞洛对氯吡格雷不同反应性患者的有效性与安全性
Clinical efficacy and safety of ticagrelor in patients with different reactivity of clopidogrel
张岩 1黄艳艳 2魏荣荣 1赵庆春 1任天舒1
作者信息
- 1. 沈阳军区总医院药学部,沈阳110016
- 2. 北部战区空军参谋部门诊部,沈阳110015
- 折叠
摘要
Abstract
AIM To analyze the efficacy and safety of ticagrelor compared with clopidogrel for acute coro nary syndrome(ACS) patients with different platelet reactivity so as to provide evidence for clinical antiplatelet treatment.METHODS A retrospective analysis was done on patients with ACS from January 2015 to March 2015.Totally 301 patients were included in the present study.The baseline data and clinical treatment were collected and telephone follow-up of 12 months was conducted by telephone.Adenosine diphosphate(ADP) induced platelet aggregation ratio test was run to identify patients with clopidogrel resistance by light transmission aggregometry.They were divided into CR-ticagrelor group,CR-clopidogrel group,CS-ticagrelor group and CS-clopidogrel group.Laboratory indexes were tested again within one week.Major adverse cardiovascular and cerebral events (MACCE) and adverse drug reactions were observed within 12 months.RESULTS In 301 patients there were 65 cases of CR-ticagrelor,59 cases of CR-clopidogrel group,89 cases of CS-ticagrelor group and 88 patients of CS-clo pidogrel group.Compared with multiple groups,ST segment elevation myocardial infarction (STEMI) proportion of CR-ticagrelor group was higher than that of CR-clopidogrel group (P ＜ 0.05),suggesting that the former group patients were more urgent.In PCI surgery situation the 2 vessel lesions of CS-ticagrelor group were higher than those of CS-clopidogrel group (P ＜ 0.05).Comparing multiple groups' data between preoperative and postoperative within a week there were no statistical significances (P ＞ 0.05).CR-clopidogrel group had more MACCE incidence than that in CR-ticagrelor group (P ＜ 0.05);MACCE incidence between CS-clopidogrel group and CS-ticagrelor group had no statistical significance.For adverse drug reaction,patients using ticagrelor had higher rate of bleeding incidence than that of clopidogrel group(P ＜ 0.05),and the incidence of dyspnea was also significantly higher than that of clopidogrel group (P ＜ 0.05).CONCLUSION For CR patients,ticagrelor can significantly reduce the rate of MACCE.But for CS patients,both of ticagrelor and clopidogrel are effective.Ticagrelor compared with clopidogrel can reduce the rate of MACCE with more significant effect in CR patients,but may increase the incidence of bleeding and respiratory difficulties.关键词
急性冠脉综合征/经皮冠状动脉介入术/氯吡格雷抵抗/替格瑞洛/氯吡格雷Key words
acute coronary syndrome/percutaneous coronary intervention/clopidogrel resistance/ticagrelor/clopidogrel引用本文复制引用
张岩,黄艳艳,魏荣荣,赵庆春,任天舒..替格瑞洛对氯吡格雷不同反应性患者的有效性与安全性[J].中国临床药学杂志,2017,26(6):364-368,5.
