替格瑞洛用于冠状动脉慢性完全闭塞病变经皮冠状动脉介入治疗术后的有效性和安全性研究  

Clinical efficacy and safty of ticagrelor in patients with chronic total coronary artery occlusion received percutaneous coronary intervention

作　　者：徐承义[1] 苏晞[1] 宋丹[1] 彭剑[1] 何蕾[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,湖北武汉430022

出　　处：《中国介入心脏病学杂志》2015年第2期105-108,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的观察冠状动脉慢性完全闭塞病变(CTO)经皮冠状动脉介入治疗(PCI)术后应用替格瑞洛治疗的有效性和安全性。方法回顾性分析武汉亚洲心脏病医院2012年10月至2013年9月216例行PCI成功的CTO患者的临床资料,术后给予替格瑞洛治疗作为研究组(82例),继续氯吡格雷治疗的患者为对照组(134例)。研究主要终点为两组患者随访1年的主要不良心血管事件(MACE,包括支架内急性或亚急性血栓形成、非致死性心肌梗死、靶血管再次血运重建、心原性死亡)的发生率;次要终点为一般不良事件(包括出血、呼吸困难)的发生率。结果随访12个月,两组患者总体MACE发生率比较,差异无统计学意义(15.6%比21.3%,P=0.318),但非致死性心肌梗死发生率在研究组显著降低(3.9%比12.6%,P=0.038)。两组患者出血事件发生率比较,差异无统计学意义(13.0%比9.4%,P=0.430),但研究组呼吸困难更为多见(9.1%比1.6%,P=0.011)。结论与氯吡格雷比较,替格瑞洛用于CTO-PCI术后临床疗效确切,且不增加出血风险,但呼吸困难症状较多见。Objective To observe the efficacy and safty of ticagrelor in patients with chronic total coronary artery occlusion（ CTO） received percutaneous coronary intervention（ PCI）. Methods We retrospectively reviewed 216 consecutive patients enrolled in Wuhan Asia Heart Hospital from October 2012 to September 2013,who diagnosed with CTO and treated with PCI successfully. They were divided into two groups after PCI,the study group（ switching to ticagrelor,n = 82） and the control group（ continued with clopidogrel,n = 134）. The primary endpoints for the study were the incidence of major adverse cardiovascular events（ MACE, including acute or subacute stent thrombosis, nonfatal myocardial infarction,target vessel revascularization,cardiac death） in 1-year follow up. The secondry endpoints were the rate of adverse drug reaction（ including bleeding and dyspnea）. Results The overall incidence of MACE had no significant difference between the two groups（ 15. 6% vs. 21. 3%,P = 0. 318）,but the incidence of nonfatal myocardial infarction were reduced in the study group（ 3. 9% vs. 12. 6%,P = 0. 038）.There was no difference about the incidence of hemorrhagic events（ 13. 0% vs. 9. 4%,P = 0. 430） between the two groups,but the study group had higher incidence of dyspnea（ 9. 1% vs. 1. 6%, P = 0. 011）.Conclusions Compared with clopidogrel, using ticagrelor for antiplatelet therapy in patients with CTO treated with PCI successfully is effective without increased risk of bleeding despite more episodes of dyspnea.

关 键 词：慢性完全闭塞病变 经皮冠状动脉介入治疗 氯吡格雷 替格瑞洛 

分 类 号：R541.4[医药卫生—心血管疾病]