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替格瑞洛联合奥美拉唑对行直接经皮冠状动脉介入治疗的急性心肌梗死患者的影响(MACE 和出血事件)。

Effects (MACE and bleeding events) of ticagrelor combined with omeprazole on patients with acute myocardial infarction undergoing primary PCI.

机构信息

Department of Cardiology, Xinxiang Central Hospital, Xinxiang, Henan 45300 China.

Department of Cardiology, Xinxiang Central Hospital, Xinxiang, Henan 45300 China.

出版信息

Hellenic J Cardiol. 2020 Sep-Oct;61(5):306-310. doi: 10.1016/j.hjc.2019.06.001. Epub 2019 Jul 3.

Abstract

BACKGROUND

This study aimed to investigate the effect of ticagrelor combined with omeprazole on patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI).

METHODS

Eighty-six patients with AMI who underwent primary PCI in Xinxiang Central Hospital between July 2015 and December 2016 were included and divided randomly into the observation group and the control group by the draw, with 43 patients in each group. All patients were routinely treated with dual antiplatelet therapy with aspirin plus ticagrelor. Omeprazole was used in the observation group and placebo was used in the control group. Data of baseline patient characteristics, platelet response index (PRI), ADP-induced platelet aggregation (ADP-Ag), major adverse cardiac events (MACE), and incidence of bleeding events were recorded and compared between both groups.

RESULTS

PRI and ADP-Ag at 7 days, 1 month, and 6 months after operation in both groups were significantly lower than those in the same group before administration (p < 0.017). Incidence of bleeding events in the observation group was significantly lower than that in the control group (p < 0.05).

CONCLUSION

For patients with AMI undergoing primary PCI, omeprazole was found to reduce the incidence of gastrointestinal bleeding without reducing the antiplatelet aggregation effect of ticagrelor or increasing the risk of MACE, which is worthy of clinical promotion.

摘要

背景

本研究旨在探讨替格瑞洛联合奥美拉唑对行经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者的影响。

方法

选取 2015 年 7 月至 2016 年 12 月在新乡市中心医院行经皮冠状动脉介入治疗的 86 例 AMI 患者,采用抽签法随机分为观察组和对照组,每组 43 例。所有患者均常规给予双联抗血小板治疗,即阿司匹林联合替格瑞洛。观察组加用奥美拉唑,对照组加用安慰剂。记录并比较两组患者的基线特征、血小板反应指数(PRI)、ADP 诱导的血小板聚集(ADP-Ag)、主要不良心脏事件(MACE)和出血事件发生率。

结果

两组患者术后 7d、1 个月和 6 个月的 PRI 和 ADP-Ag 均明显低于同组治疗前(p<0.017)。观察组出血事件发生率明显低于对照组(p<0.05)。

结论

对于行经皮冠状动脉介入治疗的 AMI 患者,奥美拉唑可降低胃肠道出血的发生率,而不降低替格瑞洛的抗血小板聚集作用,也不增加 MACE 风险,值得临床推广。

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