不同剂量替格瑞洛在老年急性心肌梗死病人PCI术后抗血小板治疗中的有效性与安全性

doi:10.3969/j.issn.1003-9198.2021.03.009

摘要/Abstract

摘要： 目的比较低剂量替格瑞洛(180 mg负荷量,续贯60 mg每日2次口服)与标准剂量替格瑞洛(180 mg负荷量,续贯90 mg每日2次口服)在老年急性心肌梗死(AMI)病人经皮冠状动脉介入术(PCI)术后抗PLT治疗中的有效性与安全性。方法研究共入选196例成功接受PCI治疗的老年AMI病人,随机分为低剂量替格瑞洛组和标准剂量替格瑞洛组,详细记录病人住院期间及随访1年的主要不良心脑血管事件(MACCE)与出血事件。结果低剂量替格瑞洛组住院期间及随访至1年MACCE发生率与标准剂量替格瑞洛组相比,差异无统计学意义。住院期间2组小出血(8.4% 比18.6%, P=0.061)和大出血发生率(1.1% 比 2.9%,P=0.622)差异无统计学意义;低剂量替格瑞洛组随访1年小出血发生率显著低于标准剂量替格瑞洛组(16.8% 比36.9%,P=0.002),大出血方面2组差异无统计学意义(1.1% 比 3.9%,P=0.371)。Kaplan-Meier生存分析显示,低剂量替格瑞洛组1年无MACCE生存率与标准剂量替格瑞洛组相比,差异无统计学意义(P=0.823)。结论 AMI病人PCI术后接受小剂量替格瑞洛较常规剂量相比,不增加MACCE事件发生率,同时可降低小出血风险。

关键词: 替格瑞洛, 急性心肌梗死, 经皮冠状动脉介入治疗

Abstract: Objective To compare the efficacy and safety of antiplatelet therapy in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) between low-dose ticagrelor (180 mg loading, 60 mg twice daily) and standard-dose ticagrelor (180 mg loading, 90 mg twice daily). Methods A total of 196 patients with AMI who were successfully treated by PCI were randomly divided into low-dose ticagrelor group and standard-dose ticagrelor group. The major adverse cardio-cerebrovascular events (MACCE) and bleeding events during hospitalization and one-year follow-up were recorded in detail. Results There was no significant difference in MACCE between low-dose ticagrelor group and standard-dose ticagrelor group during hospitalization (10. 5% vs 11. 7%, P= 0. 825). The risk of minor bleeding (8. 4% vs 18. 6%, P=0. 061) and major bleeding (1. 1% vs 2. 9%, P=0. 622) were comparable between the two groups. Kaplan-Meier survival analysis showed that there was no significant difference in 1-year MACCE-free survival rate between low-dose ticagrelor group and standard-dose ticagrelor group (P=0. 823). The risk of minor bleeding was significantly lower in low-dose ticagrelor group than that in standard-dose ticagrelor group (16. 8% vs 36. 9%, P=0. 002) 1 year after PCI, and there was no significant difference in major bleeding (1. 1% vs 3. 9%, P=0. 371). Conclusions Compared with the routine dose, low-dose ticagrelor does not increase the incidence of MACCE, while reduce the risk of minor bleeding in the patients with AMI after PCI.

Key words: ticagrelor, acute myocardial infarction, percutaneous coronary intervention

中图分类号:

R 543.31

王宁宁, 张凤梅, 徐新禹, 任国成, 吴迪, 宋爽. 不同剂量替格瑞洛在老年急性心肌梗死病人PCI术后抗血小板治疗中的有效性与安全性[J]. 实用老年医学, 2021, 35(3): 246-249.

WANG Ning-ning, ZHANG Feng-mei, REN Guo-cheng, WU Di, SONG Shuang, XU Xin-yu. Efficacy and safety of different doses of ticagrelor in elderly patients with acute myocardial infarction after percutaneous coronary intervention[J]. Practical Geriatrics, 2021, 35(3): 246-249.

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