不同的MA_(ADP)对抗栓治疗有效性和安全性的影响  

Effect of Different MA_(ADP) on Efficacy and Safety of Antithrombotic Therapy

作　　者：谭晓燕 宋莹[1] 许连军[1] 王欢欢[1] 许晶晶[1] 陈纪林[1] 杨跃进[1] 高润霖[1] 徐波[1] 袁晋青[1] 陈珏[1] TAN Xiao-yan;SONG Ying;XU Lian-jun;WANG Huan-huan;XU Jing-jing;CHEN Ji-lin;YANG Yue-jin;GAO Run-lin;XU Bo;YUAN Jin-qing;Chen Jue(Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院心内科,北京市100037

出　　处：《中国分子心脏病学杂志》2021年第3期3939-3944,共6页Molecular Cardiology of China

摘　　要：目的对于行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)、服用双联抗血小板药物的冠状动脉性心脏病(简称"冠心病")患者,评估不同的二磷酸腺苷诱导的血小板纤维蛋白凝块强度(adenosine diphosphate-induced platelet-fibrin clot strength,MA_(ADP))对抗栓治疗有效性和安全性的影响。方法本研究纳入2013年1月至2013年12月于阜外医院行PCI且有术后12~72 h血栓弹力图检测结果的冠心病患者4606例,分为MA_(ADP)<31mm(n=1871)、31mm≤MA_(ADP)≤47mm(n=1407)、MA_(ADP)>47mm(n=1328)三组。主要研究终点为2年主要不良心脑血管事件(major adverse cardiovascular and cerebrovascular events,MACCE:包括死亡、心肌梗死、靶血管或靶病变血运重建、脑卒中)及支架内血栓、大出血事件(BARC 3型和5型)。结果通过2年的随访,三组的MACCE及各单一主要终点事件包括死亡、心肌梗死、靶血管或靶病变血运重建、脑卒中和支架内血栓、大出血等差异均无显著性(P>0.05),Cox分析包括亚组结果显示,MA_(ADP)并非是MACCE及各单一主要终点事件的独立预测因素。结论对于行PCI治疗的冠心病患者,通过2年的随访,不同MA_(ADP)对抗栓治疗的有效性和安全性的影响均无显著性差异。Objective To evaluate the efficacy and safety of different adenosine diphosphate induced platelet fibrin clot strength(MA_(ADP))in patients with coronary heart disease undergoing percutaneous coronary intervention(PCI)and taking dual antiplatelet drugs.Methods Atotal of 4606 patients with coronary heart disease who underwent PCI in Fuwai Hospital from January 2013 to December 2013 and had the results of thromboelastography 12-72 h after PCI were included in this study.They were divided into three groups:MA_(ADP)<31 mm,31 mm≤MA_(ADP)≤47 mm,MA_(ADP)>47 mm.The main endpoint was major adverse cardiovascular and cerebrovascular events(MACCE:death,myocardial infarction,target vessel or target lesion revascularization,stroke)and stent thrombosis and massive hemorrhage(BARC 3 and 5).Results After 2-year follow-up,there were no significant differences in MACCE and single primary end-point events including death,myocardial infarction,target vessel or target lesion revascularization,stroke and stent thrombosis,and massive hemorrhage among the three groups(P>0.05).COX regression model analysis including subgroup results shows that MA_(ADP) is not an independent predictor of MACCE and single major endpoint events.Conclusion There is no significant difference in the efficacy and safety of different MA_(ADP) in the treatment of coronary heart disease after 2 years of follow-up.

关 键 词：经皮冠状动脉介入术 二磷酸腺苷诱导的血小板纤维蛋白凝块强度 主要不良心脑血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]