a Department of Cardiology , Patras University Hospital , Patras , Greece.
b Department of Cardiology , Attikon University Hospital, Athens, Greece , Athens , Greece.
Platelets. 2017 Nov;28(7):691-697. doi: 10.1080/09537104.2016.1265919. Epub 2017 Feb 2.
In 'real life' acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and receiving contemporary antiplatelet treatment, data on dyspnea occurrence and impact on persistence with treatment are scarce. In a prospective, multicenter, cohort study, ACS patients undergoing PCI were recruited into the GReekAntiPlatElet (GRAPE) registry. During 1-year follow up, overall, 249/1989 (12.5%) patients reported dyspnea, more frequently at 1-month and decreasing thereafter. Multivariate analysis showed that ticagrelor administration (n = 738) at discharge was associated with the occurrence of dyspnea: Odds ratio 2.46 (95% confidence interval, CI, 1.87-3.25), p < 0.001. Older age, lower hematocrit, and prior bleeding event were also associated with dyspnea reports. Persistence, switching, and cessation rates were 68.3%, 20.9%, and 10.8% vs 76.7%, 12.5%, and 10.9% among patients reporting dyspnea compared with those who did not, p for trend = 0.002. In conclusion, in ACS patients undergoing PCI and treated with a P2Y receptor antagonist, dyspnea occurs commonly, particularly when ticagrelor is administered. Non-persistence with antiplatelet agents at discharge is more frequently observed among dyspnea-reporters.
在接受经皮冠状动脉介入治疗（PCI）并接受当代抗血小板治疗的急性冠状动脉综合征（ACS）患者的“真实生活”中，关于呼吸困难发生及其对治疗持续的影响的数据很少。在一项前瞻性、多中心队列研究中，将接受 PCI 的 ACS 患者招募到希腊抗血小板（GRAPE）登记处。在 1 年的随访期间，共有 249/1989（12.5%）名患者报告出现呼吸困难，在 1 个月时更为常见，此后逐渐减少。多变量分析显示，出院时使用替格瑞洛（n = 738）与呼吸困难的发生相关：比值比 2.46（95%置信区间，CI，1.87-3.25），p < 0.001。年龄较大、较低的红细胞压积和先前的出血事件也与呼吸困难报告相关。报告呼吸困难的患者的持续、转换和停药率分别为 68.3%、20.9%和 10.8%，而未报告呼吸困难的患者分别为 76.7%、12.5%和 10.9%，p 趋势=0.002。总之，在接受 PCI 治疗并使用 P2Y 受体拮抗剂治疗的 ACS 患者中，呼吸困难很常见，尤其是当使用替格瑞洛时。在呼吸困难报告者中，出院时抗血小板药物的持续不达标更为常见。
