替格瑞洛在老年冠脉病变介入治疗中的疗效及安全性分析  

Clinical efficacy and safety of ticagrelor in elderly patients with complex coronary disease undergoing primary percutaneous coronary intervention

作　　者：柳杨[1] 李运田[1] 王小冬[1] 武效宏[1] 李巍[1] 杜大勇[1] 

机构地区：[1]解放军第305医院心脏中心,北京100017

出　　处：《解放军医学院学报》2017年第5期423-425,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的分析替格瑞洛在老年复杂冠脉疾病介入治疗中的疗效与安全性。方法连续纳入2013年1月-2014年12月在我院行复杂冠脉病变介入治疗的老年患者(>65岁)82例,随机分为氯吡格雷组(对照组,n=40)和替格瑞洛组(观察组,n=42),分别给予负荷量阿司匹林300 mg+氯吡格雷600 mg或阿司匹林300 mg+替格瑞洛180 mg,次日起改为维持剂量阿司匹林100 mg/d+氯吡格雷75 mg/d或阿司匹林100 mg/d+替格瑞洛180 mg/d,术后随访12个月,比较两组心血管缺血事件和主要出血事件的发生率。结果替格瑞洛组12个月主要不良心血管事件和再发心绞痛发生率明显低于氯吡格雷组(0 vs10%,4.8%vs 20.0%;P均<0.05),呼吸困难发生率明显高于氯吡格雷组(14.3%vs 0,P<0.05),而支架内血栓、主要出血事件两组差异无统计学意义。结论与氯吡格雷相比,替格瑞洛可以降低老年介入治疗心血管缺血事件发生率,尽管存在呼吸困难不良反应,但未增加出血事件,安全性良好。Objective To analyze the clinical efficacy and safety of ticagrelor in aged patients with complex coronary disease undergoing primary percutaneous coronary intervention（PCI）.Methods Eighty-two elderly patients（〉65 years old） with complex coronary disease undergoing primary PCI in our hospital from Jan.2013 to Dec.2014 were included.The patients were randomly divided into clopidogrel group（n=40） and ticagrelor group（n=42）.A loading dose of aspirin 300 mg ＋ clopidogrel 600 mg versus aspirin 300 mg ＋ ticagrelor 180 mg were prescribed respectively for the two groups,followed by aspirin 100 mg/d ＋ clopidogre 175 mg/d versus aspirin 100 mg/d ＋ ticagrelor 180 mg/d for maintenance dose from the next day.All the patients were followed up for 12 months.The incidences of cardiovascular ischemic events and major bleeding events were recorded and compared.Results after a 12-month follow-up,incidences of the major adverse cardiovascular events and recurrent angina in ticagrelor group were lower than those of clopidogrel group（0 vs 10%,P〈0.05; 4.8% vs 20.0%.P〈0.05）.Dyspnea were more commonly seen in ticagrelor group compared with clopidogrel group（14.3% vs 0,P〈0.05）,while no significant difference were shown in severe hemorrhage and stent thrombosis between the two groups.Conclusion In elderly patients with complex coronary disease treated by PCI,ticagrelor can reduce major adverse cardiovascular events compared with clopidogrel.Though a common adverse reaction as dyspnea occurs in ticagrelor group,risk of bleeding doen＇t increase showing its safety.

关 键 词：替格瑞洛 老年人 冠心病 介入治疗 

分 类 号：R543.31[医药卫生—心血管疾病]