解放军医学院学报2018，Vol.39Issue(2)：106-109,4.DOI:10.3969/j.issn.2095-5227.2018.02.005
血栓弹力图指导氯吡格雷用于经皮冠状动脉介入术后抗血小板治疗的临床预后观察
Tailored clopidogrel maintenance dose according to thromboelastogram for patients undergoing percutaneous coronary intervention
申文彬 1杨霞 2焦云娟 3牛倩 4程庆强 2周思远 2王禹2
作者信息
- 1. 解放军371医院 心内科, 河南新乡 453000
- 2. 解放军总医院 心内科, 北京 100853
- 3. 新乡医学院 基础医学院病理教研室, 河南新乡 453000
- 4. 新乡医学院 药学院, 河南新乡 453000
- 折叠
摘要
Abstract
Objective To investigate the effect of clopidogrel guided by thromboelastogram (TEG) versus ticagrelor for patients undergoing percutaneous coronary intervention (PCI). Methods Two hundred and sixty-three patients who had undergone PCI from August 2015 to August 2016 in Chinese PLA General Hospital were consecutively collected, and they were divided into clopidogrel group (n=123) and ticagrelor group (n=140). The antiplatelet effect of clopidogrel was detected by TEG. When high platelet reactivity [HPR was defined as adenosine diphosphate (ADP) induced platelet inhibition rate ≥50％] was found in clopidogrel group, the maintenance dosage of clopidogrel was adjusted to 150 mg per day. All patients were followed-up for 12 months, and the incidence of MACE in two groups was compared. Results The incidences of stent thrombosis (ST), target vessel revascularization (TVR), angina pectoris recurrence (APAA) and cardiac death in two groups had no statistically significant difference (All P ＞ 0.05). The incidences of readmission for chest pain and MACE in clopidogrel group were higher than those of ticagrelor group (4.9％ vs 0.7％, P=0.042; 13.0％ vs 5.0％, P=0.022). Conclusion The incidence of MACE in clopidogrel group is higher than that of ticagrelor group after PCI, which indicates the effect of tailored clopidogrel therapy is not superior to ticagrelor.关键词
血小板高反应性/氯吡格雷/替格瑞洛/血栓弹力图/冠状动脉粥样硬化性心脏病Key words
high platelet reactivity/clopidogrel/ticagrelor/thrombelastogram/coronary artery disease分类
医药卫生引用本文复制引用
申文彬,杨霞,焦云娟,牛倩,程庆强,周思远,王禹..血栓弹力图指导氯吡格雷用于经皮冠状动脉介入术后抗血小板治疗的临床预后观察[J].解放军医学院学报,2018,39(2):106-109,4.
