Department of Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Xiamen Cardiovascular Hospital, Xiamen University, Fujian, China.
Cardiovasc Drugs Ther. 2020 Oct;34(5):677-684. doi: 10.1007/s10557-020-07021-w. Epub 2020 Jun 22.
To compare the effect of ticagrelor with clopidogrel in reducing the risk of ischemic cardiovascular events in patients with late or very late stent thrombosis (LST/VLST) after primary percutaneous coronary intervention (PCI).
A total of 4538 patients with acute coronary syndrome were screened for angiographically determined LST/VLST. Two hundred and forty-one patients were included in the analysis and grouped according to ticagrelor (n = 81) or clopidogrel (n = 160) at discharge. The clinical outcome was major adverse cardiovascular events (MACE) defined as death, myocardial infarction (MI), ischemic stroke, and revascularization during the 1-yr follow-up period.
After propensity score matching, 65 pairs were generated. The incidence of MACE was significantly lower in the ticagrelor group compared with the clopidogrel group (9.3% vs. 21.5%, log-rank p = 0.048). However, no difference was observed in event rates of death, MI, ischemic stroke, and revascularization between the ticagrelor group and the clopidogrel group.
Following successful primary PCI, patients with LST/VLST who received ticagrelor had fewer ischemic cardiovascular events at 1-yr follow-up, compared with those who received clopidogrel.
比较替格瑞洛与氯吡格雷在降低经皮冠状动脉介入治疗（PCI）后迟发或极晚期支架血栓形成（LST/VLST）患者缺血性心血管事件风险方面的效果。
共筛选出 4538 例急性冠脉综合征患者，进行血管造影确定的 LST/VLST。241 例患者纳入分析，并根据出院时替格瑞洛（n=81）或氯吡格雷（n=160）分组。主要不良心血管事件（MACE）定义为 1 年随访期间的死亡、心肌梗死（MI）、缺血性卒中和血运重建。
经倾向评分匹配后，生成 65 对。与氯吡格雷组相比，替格瑞洛组的 MACE 发生率显著降低（9.3% vs. 21.5%，对数秩检验 p=0.048）。然而，替格瑞洛组与氯吡格雷组之间的死亡率、MI、缺血性卒中和血运重建的事件发生率无差异。
在成功进行经皮冠状动脉介入治疗后，与接受氯吡格雷治疗的患者相比，接受替格瑞洛治疗的 LST/VLST 患者在 1 年随访时发生缺血性心血管事件的风险更低。
Zotero 插件