经皮冠状动脉介入术后1年应用低剂量替格瑞洛的可行性及安全性研究  

Feasibility and safety of low-dose ticagrelor in patients with percutaneous coronary intervention after 12 months

作　　者：江小杰[1] 刘丽赟[1] 樊瀛丽 JIANG Xiaojie;LIU Liyun;FAN Yingli(First Department of Cardiology,the First Hospital of Nanchang City,Nanchang 330008,China)

机构地区：[1]南昌市第一医院心内一科,南昌330008

出　　处：《实用医学杂志》2021年第22期2903-2907,共5页The Journal of Practical Medicine

基　　金：江西省卫生健康委科技计划(编号:202040008)。

摘　　要：目的探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后1年应用低剂量替格瑞洛的可行性及安全性。方法连续入选2017年1月至2019年6月在我院PCI术后1年的ACS患者,根据抗血小板策略的不同随机分为三组:阿司匹林组(100 mg、每日1次);替格瑞洛组(90 mg、每日2次)以及低剂量替格瑞洛组(60 mg、每日2次)。随访24月中,比较三组患者的心血管的复合终点事件(MACE)以及所有出血事件,并检测患者的血小板聚集率。结果随访过程中,三组患者MACE的发生率比较,差异均无统计学意义(P>0.05)。和标准剂量替格瑞洛及阿司匹林相比,小剂量替格瑞洛组BARC1型出血有降低趋势,差异有统计学意义(P=0.002);在BARC1型以上出血风险中,三组间无统计学意义(P>0.05)。两组患者血小板聚集率在各个随访时间相比较差异无统计学意义(P>0.05)。结论在PCI术后1年的抗血小板药物选择中,低剂量替格瑞洛可有效降低出血事件发生率,且不影响抗血小板聚集效果。Objective To investigate the feasibility and safety of low-dose ticagrelor in acute coronary syndrome with percutaneous coronary intervention after 12 months. Methods The acute coronary syndrome patients who underwent PCI in our hospital after 1 year from January 2017 to June 2019 were enrolled and randomly divided into three groups according to different antiplatelet strategies:Aspirin group(100 mg,once a day),Ticagrelor group(90 mg twice daily)and Low-dose ticagrelor group(60 mg,twice daily). At a follow-up of 24 months,the Major Adverse Cardiovascular Events(MACCE)and all bleeding events were compared among the three groups,and platelet aggregation rates were measured. Results During the follow-up,there was no statistical significance in the incidence of MACCE among 3 groups(P > 0.05). Compared with the Aspirin group and Ticagrelor group,the Low-dose ticagrelor group had a decreasing trend of BARC1 hemorrhage,and the difference was statistically significant(P = 0.002). There was no statistical significance in the risk of bleeding above BARC1 among the three groups(P > 0.05). There was no statistical significance in platelet aggregation rate between 2 groups at each followup time(P > 0.05). Conclusions After 1 year,in the selection of antiplatelet agents in acute coronary syndrome with PCI,low-dose ticagrelor can effectively reduce the incidence of bleeding events without affecting the antiplatelet aggregation effect.

关 键 词：冠心病 皮冠状动脉介入术 低剂量 替格瑞洛 

分 类 号：R541.4[医药卫生—心血管疾病]