中国医科大学学报2025，Vol.54Issue(7)：626-630,637,6.DOI:10.12007/j.issn.0258-4646.2025.07.009
经导管主动脉瓣置换术后单联抗血小板和双联抗血小板疗效比较
Comparative outcomes of single versus dual antiplatelet therapy following transcatheter aortic valve replacement
摘要
Abstract
Objective To compare the effects of single antiplatelet therapy(SAPT)versus dual antiplatelet therapy(DAPT)on bleeding and ischemic events in patients undergoing transcatheter aortic valve replacement(TAVR)without long-term anticoagulation indications.Methods This randomized controlled trial included 90 post-TAVR patients without anticoagulation indications,who were allocated to the SAPT group(n=46,aspirin 100 mg/d)or DAPT group(n=44,aspirin 100 mg/d+clopidogrel 75 mg/d for 3 months,followed by aspirin monotherapy).Maximum aggregation rates of platelets induced by arachidonic acid(MARAA)and adenosine diphosphate(MARADP)were measured 1,3,6,and 12 months postoperatively.Bleeding and ischemic events were recorded during the follow-up visits.Results The SAPT group exhibited significantly higher MARAA and MARADP scores at 1 and 3 months,and higher MARAA scores at 6 months compared to the DAPT group(P<0.05).At the 12-month follow-up,the SAPT group had a significantly lower inci-dence of bleeding events compared to the DAPT group(13.0%vs.31.8%,P=0.043).No statistically significant difference was observed in ischemic events between the groups(15.2%vs.11.4%,P=0.759).Conclusion For TAVR patients without anticoagulation indica-tions,SAPT significantly reduced the 1-year bleeding risk compared to DAPT,without increasing ischemic events.These findings support the safety and efficacy of SAPT after TAVR.关键词
经导管主动脉瓣置换术/抗血小板治疗/出血事件Key words
transcatheter aortic valve replacement/antiplatelet therapy/bleeding events分类
医药卫生引用本文复制引用
马伊珊,李柳,王宇,周洁,王乐,杨志瑜..经导管主动脉瓣置换术后单联抗血小板和双联抗血小板疗效比较[J].中国医科大学学报,2025,54(7):626-630,637,6.基金项目
河北省医学科学研究课题计划(20242228) （20242228）
