Clinic value of different antiplatelet therapy policies in preventing and treating cardiovascular events in elderly patients with coronary heart disease
10.3760/cma.j.issn.1008-6315.2016.08.011
- VernacularTitle:不同抗血小板治疗方案在冠心病患者心血管事件防治中的临床价值
- Author:
Yun TANG
;
Bi XIAO
;
Ping LI
;
Houxun MA
- Publication Type:Journal Article
- Keywords:
Coronary heart disease;
Antiplatelet therapy;
Cardiovascular events;
Bleeding events
- From:
Clinical Medicine of China
2016;32(8):708-712
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the use of antiplatelet drugs in patients with coronary heart disease( CHD) ,and to compare the effect of different anti platelet drugs on cardiovascular events in patients with CHD,and to provide clinical evidence for the optimization of anti platelet therapy?Methods One thousand and twenty?three cases patients with CHD who were treated in the First Hospital Affiliated to Chongqing Medical University from April 2010 to June 2014 were chosen?On the basis of conventional treatment,according to the different anti platelet program,the patents were divided into A group(703 cases),B group(211 cases) and C group(109 cases)?Group A was treated with aspirin and clopidogrel,B group was treated with clopidogrel,and C group was given aspirin therapy?Cardiovascular events( MACE) and bleeding events were observed at 1 month,6 months and 1 year after treatment in the 3 groups?Results After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A were 9?1%( 64/703) ,16?6%( 117/703) and 28?4%( 200/703) ,in group B were 14?6%(31/211),25?5%(54/211) and 37?9%(80/211),in group C were 16?5%(18/109),29?4%( 32/109) and 34?0%( 37/109)?After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A was significantly lower than group B and C(P<0?05);after treatment for 1 month,6 months,the incidence rates of MACE in group B were lower than group C,while higher than group C after 1 year,but the differences were not signifiacnt( P>0?05)?There were no significant differences in total incidence of deaths,the recurrence rate of myocardial infarction and stent restenosis rate among the three groups ( P>0?05 )?After treatment for 1 month,6 months,the incidence of angina in group A was lower significantly than that in group B and C( P<0?05) ,but When the treatment time was extended to 1 year,there was no significant difference in the three groups(P>0?05)?At 1 year follow?up,the incidence of gastrointestinal bleeding in group A was slightly higher than that in group B and group C ( 4?3% vs? 2?4% vs?3?7%) , but the difference was not statistically significant ( P>0?05 )?Conclusion In the CHD patients receiving aspirin and clopidogrel dual antiplatelet therapy,the incidence of MACE was lower than that in patients with aspirin or clopidogrel treatment alone, especially a reduction in the incidence of angina,and without increase of the risks in the gastrointestinal bleeding events,but the advantages above waning with treatment time extended to 1 year.
