延长双联抗血小板治疗时程对急性冠状动脉综合征行经皮冠状动脉介入治疗患者预后的作用OACSTPCD

Objective To investigate the effect of extending dual antiplatelet therapy(DAPT)duration on the prognosis of patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 1 175 patients with ACS who underwent PCI at Langfang People's Hospital from June 2017 to August 2022 were selected.All patients received standard DAPT treatment for 12 months without experiencing major adverse cardiovascular and cerebrovascular events(MACCE)or bleeding events.Patients were divided into the standard treatment group(545 cases)and the prolonged dual antiplatelet group(630 cases)according to whether they extended DAPT duration.The standard treatment group received a 12-month DAPT regimen,while the prolonged dual antiplatelet group extended DAPT duration to 18-24 months postoperatively,followed up for 24 months.The primary endpoint of the study was the occurrence of MACCE during follow-up,including a composite end point of cardic death,myocardial infarction,stroke,and ischemia-driven revascularization.The primary safety endpoint was bleeding events,including major and minor bleeding events.Results Compared with the standard treatment group,the prolonged dual antiplatelet group showed a reduction in the incidence of MACCE,with a ststistically significant difference(χ2=3.892,P<0.05).In terms of safety,the prolonged dual antiplatelet group exhibited a significant increase in bleeding events(χ2=7.475,P<0.01),mainly attributed to the increase in minor bleeding events(χ2=6.061,P<0.05).Cox regression analysis showed that the number of diseased vessels was an independent predictor for MACCE occurrence(HR=0.389,P<0.01).Conclusion For ACS patients undergoing PCI,compared to the standard 12-month DAPT regimen,extending DAPT duration to 18-24 months can reduce the occurrence of MACCE,but increases the risk of minor bleeding in patients.