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N-3 多不饱和脂肪酸不会影响经皮冠状动脉介入治疗后稳定型心绞痛患者双联抗血小板治疗的疗效。

N-3 polyunsaturated fatty acids do not influence the efficacy of dual antiplatelet therapy in stable angina pectoris patients after percutaneous coronary intervention.

机构信息

1st Department of Cardiology, Medical University of Silesia, Katowice, P oland.

出版信息

Cardiol J. 2013;20(5):478-85. doi: 10.5603/CJ.2013.0132.

Abstract

BACKGROUND

We aimed to prospectively assess the influence of the recommended dose, 1.0 g of polyunsaturated fatty acids (N-3 PUFA) daily, on platelet reactivity in patients with stable angina pectoris (SAP) after elective percutaneous coronary intervention (PCI).

METHODS

Forty consecutive patients with SAP and successful PCI were randomized to the study group (group PUFA: n = 20; age 65 ± 8; standard therapy + 75 mg acetylsalicylic acid + 75 mgclopidogrel + N-3 PUFA/Omacor 1 g daily) and the control group (group C: n = 20; age 65 ± 9; standard therapy + 75 mg acetylsalicylic acid + 75 mg clopidogrel). Platelet reactivity tests (COL, TRAP, ASPI, ADP) were performed using whole blood aggregometry (multiplate platelet [PLT] function analysis) on the 2,nd and 30th day after PCI.

RESULTS

Baseline patients' characteristics and clinical outcomes were comparable between the groups. There were no differences between both groups in the mean values of the PTL tests measured 30 days after PCI (PUFA vs.

C ASPI

18.5 ± 17 vs. 27 ± 29 U, COL: 30.4 ± 14.3 vs. 30.3 ± 13.4 U, ADP: 25.4 ± 16.1 vs. 20 ± 10.7 U, TRAP: 65.8 ± 25.6 vs. 57.1 ± 20.4 U, p = NS). The mean delta values of the PTL tests (18-24 h post-PCI/30 days post-PCI) were also comparable between the groups. The PTL aggregometry results were related to time - the baseline values of the ADP (p = 0.003), COL (p = 0.037) and TRAP (p < 0.001) tests were smaller and the ASPI (p = 0.027) test was higher than those measured after 1-month.

CONCLUSIONS

N-3 PUFA supplementation does not affect the efficacy of dual antiplatelettherapy in patients with SAP after PCI.

摘要

背景

我们旨在前瞻性评估推荐剂量(每日 1.0 克多不饱和脂肪酸(N-3 PUFA))对择期经皮冠状动脉介入治疗(PCI)后稳定型心绞痛(SAP)患者血小板反应的影响。

方法

连续 40 例 SAP 患者成功行 PCI,随机分为研究组(PUFA 组:n=20;年龄 65±8;标准治疗+75mg 乙酰水杨酸+75mg 氯吡格雷+N-3 PUFA/Omacor 1g 每日)和对照组(C 组:n=20;年龄 65±9;标准治疗+75mg 乙酰水杨酸+75mg 氯吡格雷)。在 PCI 后第 2 天和第 30 天使用全血聚集仪(多血小板 [PLT] 功能分析)进行血小板反应测试(COL、TRAP、ASPI、ADP)。

结果

两组患者 PCI 后第 30 天的血小板检测(PUFA 与 C 组 ASPI:18.5±17 与 27±29 U,COL:30.4±14.3 与 30.3±13.4 U,ADP:25.4±16.1 与 20±10.7 U,TRAP:65.8±25.6 与 57.1±20.4 U,p=NS)的平均值之间无差异。两组间血小板检测的平均差值(PCI 后 18-24 小时/PCI 后 30 天)也相似。血小板聚集仪的结果与时间有关-ADP(p=0.003)、COL(p=0.037)和 TRAP(p<0.001)基线值较小,ASPI(p=0.027)值较高,高于 1 个月后测量的值。

结论

N-3 PUFA 补充剂不影响 SAP 患者 PCI 后双联抗血小板治疗的疗效。

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