替格瑞洛和氯吡格雷在冠状动脉旁路移植术后抗血小板治疗中应用的有效性和安全性比较

doi:10.13481/j.1671-587x.20180422

吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (04): 810-814.doi: 10.13481/j.1671-587x.20180422

替格瑞洛和氯吡格雷在冠状动脉旁路移植术后抗血小板治疗中应用的有效性和安全性比较

赵晨宇, 李博, 朴虎林, 李丹, 续晋宇, 魏士博, 柳克祥

吉林大学第二医院心血管外科, 吉林长春 130041

收稿日期:2017-12-31 出版日期:2018-07-28 发布日期:2018-07-27
通讯作者: 柳克祥,教授,主任医师,博士研究生导师(Tel:0431-81136791,E-mail:kxliu64@hotmail.com) E-mail:kxliu64@hotmail.com
作者简介:赵晨宇(1991-),男,辽宁省辽阳市人,住院医师,在读医学硕士,主要从事冠心病外科治疗方面的研究。
基金资助:
国家科技部科技支撑计划项目资助课题（2013BAI09B01）；吉林大学第二医院横向联合项目资助课题（2017YX007）

Comparison of efficacy and safety between ticagrelor and clopidogrel in antiplatelet therapy after coronary artery bypass grafting

ZHAO Chenyu, LI Bo, PIAO Hulin, LI Dan, XU Jinyu, WEI Shibo, LIU Kexiang

Department of Cardiovascular Surgery, Second Hospital, Jilin University, Changchun 130041, China

Received:2017-12-31 Online:2018-07-28 Published:2018-07-27

摘要/Abstract

摘要： 目的：比较替格瑞洛和氯吡格雷在冠状动脉旁路移植术（CABG）后患者抗血小板治疗中应用的有效性和安全性，以提供更合理的抗血小板治疗策略。方法：选取行CABG术患者260例，随机分为替格瑞洛组（129例）和氯吡格雷组（131例），分别给予替格瑞洛（90 mg·d^-1）+阿司匹林（100 mg·d^-1）、氯吡格雷（75 mg·d^-1）+阿司匹林（100 mg·d^-1）行抗血小板治疗。12个月后随访收集有效性相关不良事件，即主要不良心血管事件（MACE）（心血管死亡、非心血管死亡、再发心肌梗死、因再发不稳定心绞痛入院及因再发心力衰竭入院）和安全性相关不良事件（呼吸困难和出血事件）的发生情况，并进行统计学分析。结果：本研究最终完成随访共241例，其中替格瑞洛组122例，氯吡格雷组119例。替格瑞洛组共发生MACE 10例（8.2%），氯吡格雷组共发生MACE 19例（16.0%），2组间MACE发生率比较差异无统计学意义（P>0.05）；替格瑞洛组发生因心力衰竭再次入院事件1例（0.8%），氯吡格雷组发生6例（5.0%），2组因心力衰竭再次入院事件发生率比较差异有统计学意义（P<0.05）。替格瑞洛组共发生安全性相关不良事件27例（22.1%），氯吡格雷组共发生安全性相关不良事件17例（14.3%），2组间安全性相关不良事件发生率比较差异无统计学意义（P>0.05）。结论：CABG术后患者应用替格瑞洛抗血小板治疗的有效性和安全性与氯吡格雷比较无明显差别，二者均可作为CABG术后抗血小板方案应用。

关键词: 冠状动脉旁路移植术, 有效性, 回顾性研究, 安全性, 替格瑞洛, 氯吡格雷

Abstract: Objective:To compare the clinical efficacy and safety of ticagrelor and clopidogrel that applied in the antiplatelet therapy in the patients after coronary artery bypass grafting(CABG),and to provide a more rational strategy for antiplatelet therapy. Methods:A total of 260 patients underwent CABG were selected randomly and divided into ticagrelor group (n=129) and clopidogrel group (n=131). The patients in ticagrelor group were given ticagrelor 90 mg·d^-1 and aspirin 100 mg·d^-1,and the patients in clopidogrel group were given clopidogrel 75 mg·d^-1 and aspirin 100 mg·d^-1.After 12 months of follow-up,the major adverse cardiovascular events (MACE) and the adverse events related to safety were collected such as cardiovascular death,non-cardiovascular death,recurrent myocardial infarction,re-admission to hospital due to recurrent unstable angina pectoris and heart failure,dyspnea,bleeding,etc.The data was analyzed by statistical method. Results:In this study,241 patients finished the follow-up plan,including 122 patients in ticagrelor group and 119 patients in clopidogrel group.In the aspect of MACE,there were 10 cases (8.2%) in ticagrelor group and 19 cases (16.0%) in clopidogrel group; the difference between two groups was not statistically significant (P>0.05). In ticagrelor group,one patient (0.8%) came back to hospital again because of heart failure,and six cases (5.0%) in clopidogrel group; the difference between two groups was statistically significant (P<0.05). In the safety related adverse events aspect,there were 27 cases (22.1%) in ticagrelor group and 17 cases (14.3%) in clopidogrel group; the difference between two groups was not statistically significant (P>0.05). Conclusion: The efficacy and safety of ticagrelor applicated in the patients after CABG are not different compared with clopidogrel,which can be used as the antiplatelet strategy after CABG.

Key words: saftey, Ticagrelor, Clopidogrel, retrospective study, efficacy, coronary artery bypass graft

中图分类号:

R654.2

赵晨宇, 李博, 朴虎林, 李丹, 续晋宇, 魏士博, 柳克祥. 替格瑞洛和氯吡格雷在冠状动脉旁路移植术后抗血小板治疗中应用的有效性和安全性比较[J]. 吉林大学学报(医学版), 2018, 44(04): 810-814.

ZHAO Chenyu, LI Bo, PIAO Hulin, LI Dan, XU Jinyu, WEI Shibo, LIU Kexiang. Comparison of efficacy and safety between ticagrelor and clopidogrel in antiplatelet therapy after coronary artery bypass grafting[J]. Journal of Jilin University Medicine Edition, 2018, 44(04): 810-814.

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替格瑞洛和氯吡格雷在冠状动脉旁路移植术后抗血小板治疗中应用的有效性和安全性比较

Comparison of efficacy and safety between ticagrelor and clopidogrel in antiplatelet therapy after coronary artery bypass grafting

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