中国药业2025，Vol.34Issue(7)：117-121,5.DOI:10.3969/j.issn.1006-4931.2025.07.026
冠状动脉粥样硬化性心脏病患者经皮冠状动脉介入术后不同双联抗血小板方案的经济性评价
Economic Evaluation of Different Dual Antiplatelet Regimens in Patients with Coronary Heart Disease After Percutaneous Coronary Intervention
摘要
Abstract
Objective To evaluate the economics of different dual antiplatelet therapy regimens in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI)based on CYP2C19 gene polymorphism.Methods A retrospective analysis was conducted on the clinical data of 84 patients diagnosed with CHD and underwent CYP2C19 gene testing who visited the hospital from January to December 2022.According to the CYP2C19 gene testing results,they were divided into rapid metabolism genome group(37 cases)and loss-of-function genome group(47 cases).The patients in the rapid metabolism genome group received aspirin combined with clopidogrel,while the patients in the loss-of-function genome group received aspirin combined with ticagrelor.The readmission rate of major adverse cardiovascular events(MACE)and cost-effectiveness ratio between the two groups were compared,and sensitivity analysis and scenario analysis were conducted.Results The readmission rate of MACE within one year after discharge in the loss-of-function genome group was 2.13%,which was significantly lower than 10.81%in the rapid metabolism genome group(P=0.025).The cost-effectiveness ratio in the loss-of-function genome group was 249.87±45.76,which was significantly higher than 204.04±48.76 in the rapid metabolism genome group(P<0.05).The sensitivity analysis results indicated that the economic evaluation results were robust.Scenario analysis assumed that patients in the loss-of-function genome group received domestic ticagrelor,and there was no significant difference in cost-effectiveness between the two groups(P>0.05).Conclusion Under the guidance of CYP2C19 gene testing,the dual antiplatelet regimen of aspirin combined with clopidogrel is more economical compared to aspirin combined with imported ticagrelor.However,if domestically produced ticagrelor is used,the cost-effectiveness of the two regimens is comparable.关键词
氯吡格雷/替格瑞洛/CYP2C19基因多态性/冠状动脉粥样硬化性心脏病/经皮冠状动脉介入术/急性冠状动脉综合征/经济性评价Key words
clopidogrel/ticagrelor/CYP2C19 gene polymorphism/coronary heart disease/percutaneous coronary intervention/acute coronary syndrome/economic evaluation分类
药学引用本文复制引用
王培培,吴义来..冠状动脉粥样硬化性心脏病患者经皮冠状动脉介入术后不同双联抗血小板方案的经济性评价[J].中国药业,2025,34(7):117-121,5.基金项目
安徽省教育厅高等学校省级质量工程项目[2023sx090] （）
校企融合发展-"恒瑞科研基金"横向课题项目[XQHR202426]. （）
