中国体外生命支持2025，Vol.23Issue(6)：478-482,5.DOI:10.13498/j.cnki.chin.j.ecls.2025.06.02
冠状动脉旁路移植术后4年两种双联抗血小板强化治疗策略疗效与安全性比较
Comparison of Efficacy and Safety Between Two Dual Antiplatelet Therapy Intensive Treatments 4 Years After Coronary Artery Bypass Grafting
摘要
Abstract
Objective This study aims to compare the effects of aspirin combined with clopidogrel(AC)versus aspirin combined with ticagrelor(AT)on great saphenous veins(GSVs)graft patency and the occurrence of adverse events at 4 years post coronary artery bypass grafting(CABG)on the basis of previous work,and to explore an optimal dual antiplatelet thera-py(DAPT)intensification strategy for Chinese patients after CABG.Methods Patients who successfully underwent elective CABG were randomized into AC group or AT groups.DAPT was initiated within 6 hours postoperatively according to the as-signed group.After one year,both groups were switched to single antiplatelet therapy with aspirin for long-term maintenance treatment.At 4 years post-CABG,GSV graft patency was assessed using 64-slice multidetector computed tomography angiogra-phy.The incidences of major adverse cardiovascular events(MACEs)and bleeding events were also recorded during follow-up.Results Among the 216 patients,3 died,and the remaining 213 patients completed the 4-year follow-up.The GSV graft paten-cy rate was 81.4%in the AC group,which was lower than that in the AT group(87.2%);however,this difference was not statis-tically significant(P>0.05).During the 4-year follow-up,21 MACEs and 55 bleeding events were documented.However,there was no statistically significant difference in the incidence of MACEs and bleeding events between two groups(P>0.05).Con-clusion Integrating the current 4-year follow-up data with our previous findings at 1 and 3 years post-CABG,although there is still no statistically significant difference in the GSV patency rate between the two DAPT intensive treatments,the difference is gradually widening.关键词
冠状动脉旁路移植术/术后/抗血小板治疗/阿司匹林/氯吡格雷/替格瑞洛Key words
coronary artery bypass grafting/postoperation/antiplatelet therapy/aspirin/clopidogrel/ticagrelor引用本文复制引用
ZHONG Keng,LU Jie,ZHANG Boyao,FAN Xingli,ZHANG Guanxin,XUE Qing..冠状动脉旁路移植术后4年两种双联抗血小板强化治疗策略疗效与安全性比较[J].中国体外生命支持,2025,23(6):478-482,5.基金项目
上海市卫健委卫生行业临床研究专项(202240358) （202240358）
海军军医大学基础医学研究课题(2022MS018) （2022MS018）
海军军医大学第一附属医院长风固海计划长剑领军苗子项目(2024CF002) （2024CF002）
海军军医大学第一附属医院基础医学研究专项(2023PY05) （2023PY05）
国家自然科学基金面上项目(82470444) （82470444）
