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替格瑞洛用于经皮冠状动脉介入治疗后急性冠状动脉综合征患者的临床疗效。

Clinical effect of ticagrelor administered in acute coronary syndrome patients following percutaneous coronary intervention.

作者信息

Lu Yanjiao, Li Yanshen, Yao Rui, Li Yapeng, Li Ling, Zhao Luosha, Zhang Yanzhou

机构信息

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China.

出版信息

Exp Ther Med. 2016 Jun;11(6):2177-2184. doi: 10.3892/etm.2016.3224. Epub 2016 Apr 4.

Abstract

The aim of the present study was to retrospectively analyze the clinical effect and safety of ticagrelor administration in acute coronary syndrome (ACS) patients following percutaneous coronary intervention (PCI). In total, 203 patients were enrolled, who were confirmed with ACS between March 2013 and May 2013, and had successfully undergone PCI. The patients were randomly divided into two groups, including the clopidogrel (group A, n=108) and ticagrelor groups (group B, n=95). Patients in group A were treated with a 600 mg loading dose of clopidogrel followed by 75 mg/day clopidogrel plus 100 mg/day aspirin. Patients in group B received a 180 mg loading dose of ticagrelor followed by 90 mg ticagrelor twice daily plus 100 mg/day aspirin. Light transmission aggregometry was performed to measure the platelet aggregation rate prior to and following 4 weeks of anti-platelet drug treatment. In addition, the rate of cardiovascular events and the adverse drug reactions were recorded within a 1-year treatment period. Compared with the clopidogrel group, the rate of recurrent angina in the ticagrelor group was significantly lower (P=0.05). However, the rate of dyspnea in the ticagrelor group was significantly higher when compared with that in the clopidogrel group (P=0.03). After 4 weeks of treatment, the reduction in the platelet aggregation rate was significantly different between the two groups (P<0.05). Therefore, ticagrelor, which is a novel antiplatelet aggregation drug, may reduce the rate of the adverse cardiovascular events in ACS patients following PCI, but a higher incidence of side-effects, such as dyspnea, may be observed.

摘要

本研究的目的是回顾性分析替格瑞洛在接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者中的临床疗效及安全性。总共纳入了203例患者,这些患者于2013年3月至2013年5月期间被确诊为ACS,并成功接受了PCI。患者被随机分为两组,包括氯吡格雷组(A组,n = 108)和替格瑞洛组(B组,n = 95)。A组患者接受600 mg负荷剂量的氯吡格雷治疗,随后给予75 mg/天的氯吡格雷加100 mg/天的阿司匹林。B组患者接受180 mg负荷剂量的替格瑞洛治疗,随后给予90 mg替格瑞洛每日两次加100 mg/天的阿司匹林。在抗血小板药物治疗4周前后,采用光透射聚集法测量血小板聚集率。此外,记录1年治疗期内的心血管事件发生率和药物不良反应。与氯吡格雷组相比,替格瑞洛组的复发性心绞痛发生率显著降低(P = 0.05)。然而,与氯吡格雷组相比,替格瑞洛组的呼吸困难发生率显著更高(P = 0.03)。治疗4周后,两组之间血小板聚集率的降低有显著差异(P < 0.05)。因此,替格瑞洛作为一种新型抗血小板聚集药物,可能会降低PCI术后ACS患者的不良心血管事件发生率,但可能会观察到较高的副作用发生率,如呼吸困难。

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